The ethics of the Omicron travel ban

12 December 2021

6:00 PM

12 December 2021

6:00 PM

The Omicron variant had not even been named when the government’s reflexes sprung into almost involuntary reaction last month, and it introduced yet more Covid restrictions. The ‘red list’ was immediately revived and South Africa was placed on it. All travellers from there and several other African countries were soon forced into expensive quarantine hotels to live on microwaved mush for ten days. Some European countries even banned flights from southern Africa, while, in turn, Switzerland responded to the first cases of Omicron in Britain by banning flights from here.

Whenever Covid rebounds, the first thing to happen is that international borders are closed. Governments seem to entertain the fantasy that life within their borders can carry on as long as certain outsiders are prevented from entering. This is in spite of obvious evidence to the contrary. Omicron was already present and spreading fast in Britain and in several other European countries. We now know that the Netherlands had a case a week before South Africa identified the variant and reported it. Which country first detects a variant depends largely on how good that country is at sequencing the virus. South Africa has been very good at this, and so it has been punished with travel bans. Shutting off the country is not only pointless and unfair, it is counter-productive in that its experience will deter other countries from making the effort to detect, or to report, new variants.

Even assuming the government’s argument that border closures can slow down the spread of Omicron – the UK government’s explanation for them – it is far from clear why we would want to take this action now. There was a case for border closures at the beginning of the pandemic, when known cases of Covid were mainly restricted to China and when people in Europe had no immunity to it and no vaccine or treatment available. At that point, arguably, border restrictions were introduced too little, too late. Angela Merkel at first declared that in the name of solidarity, EU countries should not isolate themselves from one another. A week later, she was sealing off Germany’s borders. Britain even kept open its border with China. Countries which did close down early, such as Australia and New Zealand, fared much better in terms of keeping the virus at bay.

But we are at a very different stage of the pandemic now. The disease is endemic. We have mass vaccination with the booster dose and treatments available. Why do we think that measures which would have been appropriate in March 2020 are the best response in this very different context?

From the point of view of public health ethics, governments should set four conditions before restricting liberty with coercive measures. Firstly, there must be a grave threat to the public interest, such as imminent collapse of the healthcare system. Secondly, the proposed intervention must be safe and effective. Thirdly, it must be more effective than less-coercive alternatives. Fourthly, the extent to which we restrict liberty must be proportionate to the benefits we can expect from it.

Does closing the borders in response to Omicron conform to these conditions? We doubt it. The response is not proportionate, considering its costs and the benefits that we can realistically expect. Given the situation, the strongest argument in favour of travel restrictions is one based on buying time to decide the most effective response. But the proportionality issue rears its head: is buying time worth the costs to people? You can call travel restrictions ‘precautionary’ only if you disregard all the costs to the economy, mental health, physical health, social inequality, and so on that restrictions typically entail (and the list is very long). These include not only border closures, but also the same old restrictions now introduced as part of the so-called ‘plan B’, and the looming prospect of a ‘plan C’ and lockdown. Take all these costs into account and arguably the precautionary and proportionate thing to do is to avoid restrictions until we know more about the virus. Many people, especially the young, could be said to require protection from the harmful impacts of restrictions more than from Omicron.

There is a lot we don’t know about Omicron yet, but on what we know so far it seems unlikely that everyone will be vulnerable. It is more transmissible than earlier variants, yet it also appears to be associated with milder illness. The latest evidence suggests that while two doses of the vaccine don’t offer good protection, the booster dose is 70 to 75 per cent effective at preventing symptomatic infection. The UK has now vaccinated 40 per cent of its eligible population with the booster.

A more proportionate approach to border restrictions would be to push on with the booster immunisation campaign and, if some level of restriction is necessary, mandate the vaccine for those at risk of serious illness, such as the elderly. This could be combined with, in the extreme, selective lockdown for those most at risk. Fairness and proportionality demand targeted policies, not indiscriminate mandates across the whole population, including younger groups that are unlikely to require hospital health care.

Proportionality is an ethical issue, not a scientific one. It seems throughout this pandemic we have lost our sense of proportion. We have stopped giving due consideration to costs and benefits of coercive measures. Governments now appear to treat everything as an emergency. Panic prevails and we tend to be reactive rather than proactive. We adopt a ‘better safe than sorry’ approach without pausing to consider what ‘safety’ means, to what extent it is achievable, and if it is worth the costs. The costs of indiscriminate restrictions are a matter of safety as well, when we consider their harms. A prolonged state of emergency is not sustainable economically, psychologically, and socially.

It seems we are incapable of regaining that sense of proportion. On the one hand, we have become so desensitised to the infringement of individual freedoms that we now consider it normal to prevent people from travelling and to force isolation upon them. That is not normal: it is an exceptional and rarely justifiable infringement of a basic right. On the other hand, we obsessively focus on only one, largely unattainable, good: the containment of Covid-19 spread. In the name of it, we are prepared to introduce one more restriction, and then another, and then another one, every time convincing ourselves that this will be the last sacrifice.

Restricting everyone’s freedom in order to protect a public good threatened by a small proportion of the population is an emergency response. But we need to stop treating every new variant as an emergency. We need a more systematic, calm, and ethical approach. We need to put individual freedoms back to where they belong, among the values that liberal societies have a duty to guarantee. Infringing upon individual freedoms, including freedom of movement, should be a measure of last resort, not our default reaction.

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