Unintended health and societal consequences of international travel measures during the COVID-19 pandemic: a scoping review

Abstract

Rationale for Review International travel measures to contain the COVID-19 pandemic represent a relatively intrusive form of non-pharmaceutical intervention. To inform decision-making on the (re)implementation, adaptation, relaxation or suspension of such measures, it is essential to not only assess their effectiveness but also their unintended effects. This scoping review maps existing empirical studies on the unintended consequences, both predicted and unforeseen, and beneficial or harmful, of international travel measures. We searched multiple health, non-health and COVID-19-specific databases. The evidence was charted in a map in relation to the study design, intervention and outcome categories identified and discussed narratively. Key findings Twenty-three studies met our inclusion criteria—nine quasi-experimental, two observational, two mathematical modelling, six qualitative, and four mixed-methods studies. Studies addressed different population groups across various countries worldwide. Seven studies provided information on unintended consequences of the closure of national borders, six looked at international travel restrictions, and three investigated mandatory quarantine of international travelers. No studies looked at entry and/or exit screening at national borders exclusively, however six studies considered this intervention in combination with other international travel measures. In total, eleven studies assessed various combinations of the aforementioned interventions. The outcomes were mostly referred to by the authors as harmful. Fifteen studies identified a variety of economic consequences, six reported on aspects related to quality of life, well-being, and mental health, and five on social consequences. One study each provided information on equity, equality, and the fair distribution of benefits and burdens, environmental consequences and health system consequences. Conclusions/recommendations This scoping review represents the first step towards a systematic assessment of the unintended benefits and harms of international travel measures during COVID-19. The key research gaps identified might be filled with targeted primary research, as well as the additional consideration of gray literature and non-empirical studies.

A cross-sectional investigation of the mental health and wellbeing among individuals who have been negatively impacted by the COVID-19 international border closure in Australia

“…Reported levels of perceived distress were also substantially higher than those found in previous studies in Australia [26] while results for wellbeing followed a similar pattern. These results are in line with findings from a recent scoping review demonstrating the unintended harmful negative consequences on the wellbeing and mental health of those affected by border restrictions [11].…”

“…COVID-19 mental health consequences are often linked to direct and indirect implications from community restrictions and lockdowns, and their flow-on effects such as financial distress, social and/or work impairment [5][6][7], and decreased social connections and feelings of loneliness [8,9]. While the mental health impact of common restrictions such as lockdowns is increasingly being studied around the globe (e.g., [10]), less attention has been paid to the specific impact or consequences of strict border closures [11].…”

“…Given that almost 30% of Australians were born overseas, up to 50% were either born overseas or have at least one parent born overseas [17], and the fact that many Australians currently overseas are attempting to return home, the international border closure policy has the potential to impact significantly on the mental health of a sizeable proportion of the population. In fact, a recent scoping review has identified a variety of harmful unintended outcomes, including wellbeing and mental health, of international travel measures during the COVID-19 pandemic [11]. However, empirical data on important characteristics, for example, the mental health and wellbeing of those directly impacted by the current Australian border restrictions, has not yet been established.…”

Factors associated with the opposition to COVID-19 vaccination certificates: A multi-country observational study from Asia

“…For example, those in agriculture, IT, or unemployed may not be direct beneficiaries of CVCs compared to those in industry, trade and services, and therefore, more likely to oppose CVCs. However, CVCs can provide indirect financial benefits through multiplier effect from across sectors and countries [ 22 ] and non-financial personal benefits by allowing social activities to resume and improve mental and physical well-being [ 40 ]. Communicating these wider personal benefits (which have proven effective in addressing vaccine hesitancy) of CVCs may improve acceptance.…”

“…Foreign travel may have been considered as non-essential and optional, therefore purposing CVCs for such would not impact daily lives. However, employment, education, events, hospitality, and domestic travel are tied to domestic socioeconomic activities which can have profound impact on people's lives [ 40 ]. Hence, requiring CVCs to participate in these activities may be seen as discriminatory and an infringement on their rights.…”