Travel-related control measures to contain the COVID-19 pandemic: an evidence map

Abstract

Objectives: To comprehensively map the existing evidence assessing the impact of travel-related control measures for containment of the SARS-CoV-2/COVID-19 pandemic.

Design: Rapid evidence map.

Data sources: MEDLINE, Embase and Web of Science, and COVID-19 specific databases offered by the US Centers for Disease Control and Prevention and the WHO.

Eligibility criteria: We included studies in human populations susceptible to SARS-CoV-2/COVID-19, SARS-CoV-1/severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus/Middle East respiratory syndrome or influenza. Interventions of interest were travel-related control measures affecting travel across national or subnational borders. Outcomes of interest included infectious disease, screening, other health, economic and social outcomes. We considered all empirical studies that quantitatively evaluate impact available in Armenian, English, French, German, Italian and Russian based on the team's language capacities.

Data extraction and synthesis: We extracted data from included studies in a standardised manner and mapped them to a priori and (one) post hoc defined categories.

Results: We included 122 studies assessing travel-related control measures. These studies were undertaken across the globe, most in the Western Pacific region (n=71). A large proportion of studies focused on COVID-19 (n=59), but a number of studies also examined SARS, MERS and influenza. We identified studies on border closures (n=3), entry/exit screening (n=31), travel-related quarantine (n=6), travel bans (n=8) and travel restrictions (n=25). Many addressed a bundle of travel-related control measures (n=49). Most studies assessed infectious disease (n=98) and/or screening-related (n=25) outcomes; we found only limited evidence on economic and social outcomes. Studies applied numerous methods, both inferential and descriptive in nature, ranging from simple observational methods to complex modelling techniques.

Conclusions: We identified a heterogeneous and complex evidence base on travel-related control measures. While this map is not sufficient to assess the effectiveness of different measures, it outlines aspects regarding interventions and outcomes, as well as study methodology and reporting that could inform future research and evidence synthesis.

Keywords: diabetic foot; infectious diseases; public health.

Figure 1

Flow chart of studies identified and included during different stages of searching and screening.

Figure 2

Illustration of the number of studies published over time; the top panel (2002–2020) shows studies focused on SARS, MERS, influenza and hypothetical disease with COVID-19 relevant properties, while the bottom panel (2020) shows studies focused on COVID-19. The specific disease is indicated by the single letter within the circle. Additionally, the colour represents the WHO world region. MERS, Middle East respiratory syndrome; SARS, severe acute respiratory syndrome.

Figure 3

Overview of the body of evidence showing the frequency of studies investigating the specific diseases (left column), interventions (middle column) and the WHO world regions (right column). MERS, Middle East respiratory syndrome; SARS, severe acute respiratory syndrome.

Figure 4

Bubble plots illustrating in included studies (A) during which phase of an epidemic or pandemic different types of interventions were implemented and (B) which intervention categories were assessed against different types of outcomes.