Abstract
BackgroundCountries are well advised to prepare for future pandemic risks (e.g., pandemic influenza, novel emerging agents or synthetic bioweapons). These preparations do not typically include planning for complete border closure. Even though border closure may not be instituted in time, and can fail, there might still plausible chances of success for well organized island nations.ObjectiveTo estimate costs and benefits of complete border closure in response to new pandemic threats, at an initial proof-of-concept level. New Zealand was used as a case-study for an island country.MethodsAn Excel spreadsheet model was developed to estimate costs and benefits. Case-study specific epidemiological data was sourced from past influenza pandemics. Country-specific healthcare cost data, valuation of life, and lost tourism revenue were imputed (with lost trade also in scenario analyses).ResultsFor a new pandemic equivalent to the 1918 influenza pandemic (albeit with half the mortality rate, “Scenario A”), it was estimated that successful border closure for 26 weeks provided a net societal benefit (e.g., of NZ$11.0 billion, USD$7.3 billion). Even in the face of a complete end to trade, a net benefit was estimated for scenarios where the mortality rate was high (e.g., at 10 times the mortality impact of “Scenario A”, or 2.75% of the country’s population dying) giving a net benefit of NZ$54 billion (USD$36 billion). But for some other pandemic scenarios where trade ceased, border closure resulted in a net negative societal value (e.g., for “Scenario A” times three for 26 weeks of border closure–but not for only 12 weeks of closure when it would still be beneficial).ConclusionsThis “proof-of-concept” work indicates that more detailed cost-benefit analysis of border closure in very severe pandemic situations for some island nations is probably warranted, as this course of action might sometimes be worthwhile from a societal perspective.
Highlights
A widespread view is that country border closures have a limited, if any, role in preventing the spread of infectious diseases [1]
For a new pandemic equivalent to the 1918 influenza pandemic, it was estimated that successful border closure for 26 weeks provided a net societal benefit
For some other pandemic scenarios where trade ceased, border closure resulted in a net negative societal value
Summary
A widespread view is that country border closures have a limited, if any, role in preventing the spread of infectious diseases [1]. The World Health Organization (WHO) advice is that even though unaffected countries may be able to delay the introduction of the infectious agent by imposing severe limits on international travel, border closure is unlikely to be able to prevent importation, and can have huge economic and personal costs. Such border closures can potentially damage trade and economies with one US study estimating the GDP halving from one year’s closure that suspended 95% of imports and exports [2]. Even though border closure may not be instituted in time, and can fail, there might still plausible chances of success for well organized island nations
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