Border health measures and controls

Border health measures exist to protect human health and safety on an international scale. There is a variety of core protection measures and controls which may be applied individually or together to prevent the spread of infectious disease and other public health risks.

COVID-19

Information on the border controls in place for COVID-19 is available at COVID-19: Border controls. The following information is more generic in nature and not specific to the COVID-19 response.

Border health measures

The health measures considered most viable for implementing at New Zealand points of entry in response to public health threats include:

  • providing proactive public health advisories and alerts for travelers
  • enabling traveler self-reporting
  • providing passenger locator information to manage symptomatic and exposed travelers
  • having a visible public health presence at points of entry
  • screening travelers from high-risk countries or with high-risk exposures to provide them with targeted advice
  • using a range of communication platforms to get information to people (electronic message boards, forms and handouts, targeting ‘meeters and greeters’, etc.)
  • providing landside monitoring and support to travelers (not airside)
  • isolating symptomatic travelers
  • offering treatment for symptomatic travelers
  • tracing contacts
  • conducting regular point-of-entry workforce briefs (eg, personal protective equipment training).

These measures are summarised below and more information provided in the Ministry’s guidance document: Responding to Public Health Threats of International Concern.

A number of other regulatory controls are also routinely used at the border in the aviation and maritime contexts. For example, pratique (health clearance for incoming aircraft or ships) and the global ship sanitation certification system (which helps prevent and manage potential public health risks on international vessels). Information on such controls is available here:

Quarantine and isolation

The word ‘quarantine’ is often used in the border health context. Human quarantine procedures seek to prevent an event that may adversely affect human health. They can help identify and control the spread of diseases, including those that are airborne, foodborne, and waterborne, or spread by vectors such as rats and mosquitoes.

Quarantine rules can restrict the activities of well persons or animals that have been exposed to an infectious disease during the period when the disease was contagious.

While the public may use the terms ‘quarantine’ and ‘isolation’ interchangeably, in public health terms:

  • quarantine: refers to the restriction of activities and/or separation from others of suspect persons (who are not ill) or of suspect baggage, containers, conveyances or goods in such a manner as to prevent the possible spread of infection or contamination.
  • isolation is the separation of ill or contaminated persons or affected baggage, containers, conveyances, goods or postal parcels from others in such a manner as to prevent the spread of infection or contamination.

Quarantine procedures also deal with matters such as:

  • the provision of potable water at airports and ports
  • passenger surveillance
  • ship and aircraft arrivals
  • sanitation controls
  • general and contingency planning for quarantinable and other communicable diseases.

Selecting the most appropriate health measure(s)

Measures such as ‘quarantine’ or ‘isolation’ are only two of a range of border health protection measures or controls that might be applied – and are generally at the more extreme end of the spectrum.

In deciding whether to implement border health measures, or deciding which measure to rollout, it is important to:

  • assess the nature and extent of the public health risk. Could it have a significant impact on the current and future health status of the total population or priority groups in terms of morbidity, mortality, and/or quality of life?
  • consider if pre-border or post-border action may be a more appropriate and effective response (or used in combination with border measures)
  • balance the potential benefits of any border health measures against their potential social and economic impacts (eg, interfering with travel and trade), and the likely effectiveness of the measure(s). Public health measures at the border can be costly and resource intensive to implement.
  • consider if the World Health Organization has issued any recommendations under the International Health Regulations (2005) that include specific border health measures at air and sea ports.

Further guidance on decision-making is provided the Ministry’s guidance: Responding to Public Health Threats of International Concern.

A range of different measures is described below.

Travel measures at international points of entry

Health advisories or alerts for travellers

Authorities can publicise information to raise the awareness of the public and incoming/outgoing travellers, and to promote personal hygiene and appropriate behaviours.

Entry screening for travellers

Screening aims to identify ill or potentially ill travellers at the border before they enter the country. There are a number of ways of doing such screening, including:

  • inspections on board aircraft/ships to identify ill travellers prior to arrival/departure
  • requiring Health Declarations from some or all travellers
  • visual screening to identify travellers who are visibly ill
  • temperature screening to detect travellers with a fever
  • rapid laboratory investigations, which can increase the specificity of screening and help determine the likelihood of infection in symptomatic travellers
  • screening of at-risk goods, cargo, or conveyances such as aircrafts and ships.

International travel advisories

In order to prevent or delay the introduction of the disease into a non-affected country, authorities can issue advisories aimed at reducing travel to and from certain countries or areas. Advisories can come in a number of forms, such as discouraging ill people from travelling or discouraging non-essential travel to affected areas.

Travel restrictions

Restrictions can be placed on travel to and from selected countries or areas, in order to prevent or delay the introduction of a disease into a non-affected country or area.

Diversion of conveyances to another airport or seaport

Diversion aims to delay or prevent introduction of public health threats and ensure the most appropriate venue and facility can be used to provide a public health response.

Border closures

Travel to and from countries or areas can be prohibited (eg, by refusing international flights), in order to prevent or delay the introduction of a disease into a non-affected country. This is a measure that has historically been very rarely used (if at all) internationally – the recent exception has been the closing of borders in the COVID-19 pandemic response.

Measures focused on managing symptomatic travellers

Passenger locator information

Contact information can be collected from travellers for future follow-up if necessary.

Medical assessment

Arriving or departing travellers with symptoms can be assessed in order to determine the likelihood of infection in symptomatic travellers.

Rapid laboratory investigations

Investigations can be launched to increase the specificity of screening and help determine the likelihood of infection in symptomatic travellers.

Isolation

Depending on the circumstances, ill or contaminated people can be separated from others, as can affected baggage and cargo. Isolation could occur at home, in a facility such as a hospital, hotel or marae, or at the airport/seaport of entry/exit.

Treatment

Authorities can treat infected individuals in order to reduce the severity of the illness and minimise complications.

Contact tracing and/or prophylaxis

Authorities can identify other people who have been in close contact with the symptomatic traveller and provide prophylaxis (eg, preventative medication or a vaccination).

Measures focused on managing exposed travellers

Some people may have been exposed to a disease, but it is uncertain whether they have actually contracted it. The following measures are options that may be applied to such people.

Passenger locator information

Contact information can be collected from travellers for future follow-up if necessary.

Measures on board aircraft to manage suspected cases and contacts

Implementing measures on board aircraft can reduce the severity of illness and minimise complications in infected individuals.

Self-health monitoring and illness reporting

People can be asked to monitor their own health status, and report illness. This may help identify infected individuals amongst exposed crew/passengers.

Quarantine

Authorities can restrict the activities of suspect persons who are not ill or separate them from others. They may also separate suspect baggage or other cargo in order prevent the possible spread of infection or contamination. There are different types of quarantine measure available.

  • Voluntary quarantine, where potentially infected people are encouraged to quarantine themselves until their state of health is confirmed.
  • Home quarantine, which requires people to stay at their places of residence and is intended to identify individuals and break the transmission cycle.
  • Institutional quarantine, which requires people to stay at an institution or facility (eg, hospital or hotel) and is intended to identify individuals and break the transmission cycle.

Exit measures

  • Many of the measures mentioned above can also be applied to aircraft, ships, and travellers wanting to depart New Zealand.
  • To be effective, exit measures need to be applied from the time potential travellers are considering decisions about whether and where to travel rather than solely at the point of departure.
  • Exit measures would likely only be used at the recommendation of the World Health Organization and/or at the request of the country of destination.
  • Implications for business, trade, and tourism in the countries of destination may be significant, so the public health risk would need to be greater than the impacts of the measures (eg, effects on income, food security, etc.).
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