Many countries across Europe including Ireland are concluding that the only way to curb Covid-19 "is to bring this virus sharply under control" with tighter measures on isolation and mandatory quarantine, according to public health specialist Prof Anthony Staines.

Speaking at a webinar on the case for an international travel quarantine, the Dublin City University academic predicted that if Ireland was not the first country in the European Union to pursue this course, Germany would be.

"Each country has to decide for itself what it wants to do. I have a sense across Europe that many are facing the same challenge that we're facing and moving to the same conclusions. We need to bring this virus sharply under control. But they're looking for someone to go first," Prof Staines said at the event hosted by the Independent Scientific Advocacy Group (ISAG) for Covid in Ireland.

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“If this is not done,” he added, “the consequences will be on all of our heads.” While the current scenario might appear to be overwhelming when it comes to cases, deaths, pressure on intensive care units and new variants, it should be stressed that “things are difficult but there are ways out”.

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The response in all instances, he said, had to be intense public health measures including isolation and quarantine for those travelling between countries.

Dr Tomás Ryan, a neuroscientist at Trinity College Dublin, said international travel quarantines were shown to work in South Korea, Australia and New Zealand. "There is no question. We can do this and we have the hotel capacity," he said.

There was “a false narrative” featuring in media coverage, he said, which suggested it could not be done in Ireland because of the importance of international travel to the economy. Research, however, indicated swift implementation minimised impacts and costs, while the ultimate benefits outweighed these, he added.

Random cases

Mathematical scientist Paul Dempsey said a fourth Covid wave could be avoided by an effective quarantine within a range of properly-implemented restrictions over a four to six-week period. This would protect health services and quickly confine cases to households and hospitals, while eliminating random cases arising from foreign travel, he said.

Pandemic researcher at the New England Complex Systems Institute in Boston, Prof Yaneer Bar-Yam, said the recent rapid decline in Irish cases "shows it can be done and will control new variants". People were at the point of thinking Covid-19 cannot change, he said, but looking at life in countries which had successfully negotiated a mandatory travel quarantine and comparing them to those struggling at present was "the difference between night and day".

The choices were obvious, he added, and could be implemented in a matter of weeks. “We should just do it.”

Epidemiologist Dr Gabriel Scally said all eggs could not be put in the vaccination basket and three rules should apply: "Get it down, keep it down and keep it out." Current travel restrictions were not operating effectively, he said, sharing concern that more cases increased the likelihood of new variants occurring that might not only be more infectious but could also "dodge some of the effects of vaccines".

It was the right time to introduce strict border controls including the ending of self-isolation and replacing it with “a system of managed self-isolation, perhaps with tests along the way”, he said. In trying “to ensure no importation of cases and of new variants in particular”, associated costs should be met by travellers.

ISAG member Prof Aoife McLysaght of Trinity College Dublin, who hosted the webinar, said it would be negligent to think vaccines will solve everything. “Vaccination is not a sure thing” in the sense that it could be sabotaged by allowing the virus to evolve, she said.

Public opinion

Public opinion polls expert Kevin Cunningham of Technological University Dublin said 90 per cent of Irish people from across a broad range of demographics and political persuasion were found to favour an international travel quarantine. This position had hardened from 76 per cent in favour last November.

Mathematician at University College Cork Dr Philipp Hoevel, who examined the effectiveness of county-wide restrictions, said they work if they are fully adopted, but even a 1 per cent rate of non-compliance had a large impact, which was compounded when restrictions were eased.

“The virus does not stop at borders. It stops with every single one of us. Every measure counts: vaccination, quarantine, movement restrictions, hand hygiene, home office, ventilation and masks,” he said.

He added every contact should be regarded as “a flying spark” that could quickly lead to the next Covid-19 hotspot.