Background: On 11 June the World Health Organization officially raised the phase of pandemic alert (with regard to the new H1N1 influenza strain) to level 6. As of 19 July, 137,232 cases of the H1N1 influenza strain have been officially confirmed in 142 different countries, and the pandemic unfolding in the Southern hemisphere is now under scrutiny to gain insights about the next winter wave in the Northern hemisphere. A major challenge is pre-empted by the need to estimate the transmission potential of the virus and to assess its dependence on seasonality aspects in order to be able to use numerical models capable of projecting the spatiotemporal pattern of the pandemic.
After the emergence of the H1N1 influenza in 2009, some countries responded with
travel-related controls during the early stage of the outbreak in an attempt to
contain or slow down its international spread. These controls along with
self-imposed travel limitations contributed to a decline of about 40% in
international air traffic to/from Mexico following the international alert.
However, no containment was achieved by such restrictions and the virus was able
to reach pandemic proportions in a short time. When gauging the value and
efficacy of mobility and travel restrictions it is crucial to rely on epidemic
models that integrate the wide range of features characterizing human mobility
and the many options available to public health organizations for responding to
a pandemic. Here we present a comprehensive computational and theoretical study
of the role of travel restrictions in halting and delaying pandemics by using a
model that explicitly integrates air travel and short-range mobility data with
high-resolution demographic data across the world and that is validated by the
accumulation of data from the 2009 H1N1 pandemic. We explore alternative
scenarios for the 2009 H1N1 pandemic by assessing the potential impact of
mobility restrictions that vary with respect to their magnitude and their
position in the pandemic timeline. We provide a quantitative discussion of the
delay obtained by different mobility restrictions and the likelihood of
containing outbreaks of infectious diseases at their source, confirming the
limited value and feasibility of international travel restrictions. These
results are rationalized in the theoretical framework characterizing the
invasion dynamics of the epidemics at the metapopulation level.
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