Letter to the Editor: Mandatory isolation is an absolute requirement

Letter to the Editor: Mandatory isolation is an absolute requirement

The purpose of my letter is to raise public awareness that travel restrictions and mandatory isolation measures are consistent with World Health Guidelines and that we should implement such measures as a matter of urgency, as other countries are now beginning to do.

I am writing to call for an urgent rethink on policy regarding the arrival of the Covid-19 virus into Ireland. 

Mathematical and statistical models point to the absolute necessity of travel restrictions and mandatory self-isolation to reduce the number of Covid-19 cases coming into Ireland.

The most recent World Health Organisation (WHO) recommendations state that travellers returning from affected areas should follow “national protocols of receiving countries”. 

Moreover, the WHO specifically states that “some countries may require returning travellers to enter quarantine”. 

In addition, the recommendations explicitly make provision for countries to implement “additional health measures which significantly interfere with international traffic”.

Furthermore, the most recent European Centre for Disease Control (ECDC) risk assessment accepts that travel restrictions have had “the apparent effect of delaying the spread of this disease in China”. 

Therefore, the ECDC Risk Assessment implicitly points towards travel restrictions and/or mandatory isolation as being critical measures to delay the spread of Covid-19 in Ireland.

Perhaps the most salient finding in relation to the effectiveness of travel restrictions on the spread of Covid-19 is to be found in the report of the WHO-China Joint Mission on Covid-19. 

This report unambiguously states that “the cordon sanitaire around Wuhan and neighboring [sic] municipalities imposed since 23 January 2020 has effectively prevented further exportation of infected individuals to the rest of the country”. 

Thus, the success of China in limiting the spread of Covid-199 virus outside Hubei province is the result of the imposition of effective travel restrictions.

In light of this evidence, merely requesting that people coming back from Spain and Italy restrict their movements for two weeks does not go far enough to prevent imported Covid-19 cases in Ireland and the seeding of new clusters of the disease.

The levels of infection are equally high in France, with those in Germany, Belgium, the Netherlands, and Austria not far behind. 

Indeed, the levels of Covid-19 cases in Switzerland, Denmark, Norway and Sweden far exceed those in Spain. In fact, outside of Iran, the countries at present experiencing the highest levels of new infection are all in the EU.

Therefore, the list must be expanded to include all affected countries, while the two-week period of self-isolation must be made fully mandatory, not optional guidance.

The implementation of such measures would be consistent with the most recent WHO guidance and are critical to limit the spread of Covid-19. 

The absence of a specific recommendation in the ECDC Risk Assessment is not a compelling reason for our government not to implement them.

The social distancing measures introduced by our Government are very welcome and must be implemented rigorously.

However, these measures may well be made redundant if we do not simultaneously do everything within our power to limit the arrival of new Covid-19 cases into Ireland from affected regions abroad.

To give Ireland the best possible chance of reducing the impact of Covid-19 we must act immediately to implement at a minimum the essential measure of a mandatory period of self-isolation of at least two weeks for all individuals arriving into Ireland from affected regions.

In response to my previous calls for such measures, the Department of Health informed me that Ireland’s current approach is “in line with guidance from the WHO and European Centre for Disease Control”.

However the WHO recommendations allow for a very wide range of interpretations. It is therefore critical everyone understands that travel restrictions and mandatory self-isolation are not excluded by the guidance provided by the WHO or any other expert group.

Otherwise I fear that the Department may continue with an ineffective policy that could put many vulnerable lives needlessly at risk.

Dr Brendan McCann

Lecturer in Mathematics

Waterford Institute of Technology

This readers' opinion will be published in the letters page of the Irish Examiner print edition on March 18, 2020

    Useful information
  • The HSE have developed an information pack on how to protect yourself and others from coronavirus. Read it here
  • Anyone with symptoms of coronavirus who has been in close contact with a confirmed case in the last 14 days should isolate themselves from other people - this means going into a different, well-ventilated room alone, with a phone; phone their GP, or emergency department - if this is not possible, phone 112 or 999 and in a medical emergency (if you have severe symptoms) phone 112 or 999

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