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 international air- and seaports in response to public health threats include:

  • providing proactive public health advice and issuing advisories and alerts for travellers
  • enabling traveller self-reporting (eg, symptoms and travel history)
  • taking pre-departure measures (eg, declaration of vaccination and health status related to the public health threat or any other appropriate measures)
  • providing passenger locator information to manage/monitor symptomatic and exposed travellers
  • having a visible public health presence at international air- and seaports
  • screening travellers from high-risk countries or with high-risk exposures to provide them with targeted advice and to implement other public health actions (eg, self-isolation)
  • testing travellers, conveyances, and goods
  • using a range of platforms to communicate information effectively (electronic message boards, forms and handouts, targeting ‘meeters and greeters’, etc)
  • providing landside monitoring and support to travellers (not airside)
  • isolating symptomatic travellers
  • quarantining high-risk but non-symptomatic travellers
  • offering treatment for symptomatic travellers
  • tracing contacts
  • conducting regular air- and seaport workforce briefs (eg, personal protective equipment training)
  • during significant public health events, and only when justified, restricting the people and craft permitted to travel to and from New Zealand.

A mix of measures, or a layering approach, at the border (together with community measures) may be needed, depending on the public health threat in question. Likewise, other border measures may be appropriate in specific situations. In response to any threats, appropriate infection prevention and control measures will need to be identified and implemented.

These measures are summarised below and more information provided in the Ministry’s guidance document: Responding to Public Health Threats at New Zealand Air- and Seaports.

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 at New Zealand Air- and Seaports.

A range of different measures is described below.

Travel measures at international points of entry

Health advice or alerts for travellers and the border and travel sectors

Such communications can be used to raise awareness, provide information, and to promote personal hygiene and appropriate health seeking behaviour.

Screening travellers (entry and/or exit)

Entry screening aims to identify ill or potentially ill travellers before they get into the country. There are a number of ways of doing such screening, including:

  • screening on board aircraft/ships, or once people have disembarked
  • using health declarations forms
  • using observational methods, such as visual or temperature screening of travellers.

Exit screening is probably best considered in situations where New Zealand may be experiencing community-level outbreaks, for example, screening (including self-reporting) and/or pre-departure testing for people flying from New Zealand to countries in the Pacific (such as the Cook Islands) where the overseas government requests New Zealand undertake exit measures.

Managing contaminated goods, cargo, aircraft, vessels and/or the air- or sea port environments

Such measures can identify contaminated or infectious baggage, goods, containers, postal items, aircraft or vessels, and/or environment in order to cleanse, decontaminate, disinsect, disinfect, fumigate or otherwise treat them. Vector control (eg, mosquitoes, rodents) is one of the more common environmental measures, but other threats where goods, craft and environment require management include chemical or radiological hazards.

Medical and other testing

Medical and other testing aims to increase screening specificity and help determine the likelihood of infected or contaminated travellers, goods, cargo, craft or airport/port environments. A range of different types of tests may be carried out on people, aircraft/vessels, cargo and the airport/port environments (eg, testing of drinking water, etc). For each threat, there may be existing test methods (eg, measles testing, chemical analyses, radiological testing, mosquito identification, etc), or testing options may need be developed during the response (eg, the COVID‑19 polymerase chain reaction, PCR, testing).

Testing may:

  • give immediate results (eg, a rapid antigen test, Geiger counter testing, testing chlorine levels in drinking water or swimming pool water, or mosquito identification)
  • require samples to be sent for laboratory analysis, with the time required for laboratory analyses dependent on the test undertaken.

International travel advisories

Such advisories provide information for people and can also seek to deter people from travelling to/from countries or regions if there are serious risks in doing so (such as war, extreme civil unrest or significant health threats). The New Zealand government publishes travel advisories on the Ministry of Foreign Affairs and Trade’s SafeTravel website.

Diversion of conveyances to another air- or seaport

Aircraft or vessels may sometimes need to be diverted from their original destination to other air- or seaports for a range of reasons. This could include bad weather, mechanical issues with the craft, problems with port facilities or because of ill travellers or public health reasons. In addition to diverting craft, international travel could be limited to specific designated air- or seaports.

Travel restrictions and border closures

Travel to and from countries or areas can be restricted 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. There are wide reaching consequences to implementing such measures, and countries should not rush into them without fully considering their implications. Options for implementing travel restrictions and border closure include:

  • restricting travel to selected areas
  • restricting travel from selected areas, including imposing further administrative requirements or a total ban
  • closing international borders (eg, refusing international maritime and aviation arrivals).

Measures to manage symptomatic or exposed international travellers

Pre-departure measures

There are several potential measures that could be applied before people leave their country of origin and journey to New Zealand:

  • pre-departure testing – for example, returning a negative test in the required time before travel and having proof of this
  • getting vaccinated with an acceptable/approved vaccine and being able to demonstrate proof of this
  • demonstrating immunisation – that is, getting vaccinated with an approved vaccine, within acceptable timeframes and with the required doses and having the requisite proof (eg, yellow fever vaccination certificates that have been used internationally for many years)
  • designating high-risk countries where travellers cannot travel directly to New Zealand and must stay in a lower-risk country for a given time before departing for New Zealand and being able to confirm this – for example, in the COVID‑19 response, some countries were designated as high risk.

Passenger locator information

Passenger locator information is collected from travellers for contact tracing purposes.

Medical assessment of arriving travellers

This measure involves assessing symptomatic or exposed travellers to determine the likelihood of infection or contamination. Such a measure could also be applied to other potentially exposed people at the border, such as border workers (eg, crew, port and airport workers, border officials, etc).

Medical and other testing

As noted above, testing aims to make screening more specific and help determine the symptomatic travellers’ likelihood of contamination or infection. Options for implementing testing include:

  • symptomatic or exposed travellers fulfilling the definition for a suspected case after medical assessment
  • symptomatic or exposed travellers from selected areas/countries/aircraft/vessels detected through previous screening
  • all symptomatic or exposed travellers detected through previous screening
  • all travellers from selected areas/countries/aircraft/vessels.

Isolation

Isolation involves separating ill or contaminated travellers or affected baggage, containers, parcels, other goods or aircraft or vessels in a way that prevents the spread of infection or contamination. Isolation can be implemented at a person’s home, in a facility such as a hospital, hotel, community building or other temporary facility, or at the air- or seaport. In the maritime sector, isolation can occur (and often does) on the vessel. Such as approach is not usually viable with aviation arrivals where space is much more limited and aircraft are quickly turned around for onwards flights or moved to another location in the airport.

Treatment

The aim of offering treatment to symptomatic travellers is to reduce the severity of the illness, minimise complications in individuals infected with the disease, and reduce the potential spread of the disease.

Contact tracing and/or prophylaxis

Contact tracing can identify people who might have been in close contact with a case (eg, a symptomatic or contaminated traveller). Contacts can be made aware of their risk of exposure, can be offered medical treatment (eg, prophylaxis), testing and support if needed, and may be required to undergo isolation or quarantine or take other steps to prevent further transmission. Prophylaxis is medical treatment used to prevent a disease from occurring in an exposed person.

Home or institutional quarantine

In public health terms, ‘quarantine’ involves restricting activities and/or separating travellers who are not ill but are suspected cases or contacts of a suspected case in a way that prevents the possible spread of infection or contamination (as opposed to ‘isolation’ (discussed above), which in public health terms, relates to people who are symptomatic). The intent of quarantine is to identify infected individuals and break the transmission cycle of a disease.

Quarantine could be implemented at the traveller’s home or in a facility (eg, a hospital, hotel, community building, or other facility). In the maritime sector, quarantine (as with isolation) can occur on the vessel. Quarantine may also include separating goods, aircraft or vessels for further examination or decontamination.

Exit measures

Many of the border health measures mentioned above could also potentially be applied to aircraft, vessels, and travellers leaving 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 if public health threat originates within New Zealand,  and/or 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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