Travel Restrictions Research Articles

Family caregivers’ administration of medications at the end-of-life in China: a qualitative study

BackgroundEffective medication management is crucial for ensuring timely pain and symptom control at the end of life. Dying in pain is a major concern for patients, yet some find less effective pain control at home. Family caregivers (FCGs) play a vital role in managing pain and symptom control for dying patients. However, the experience of administering medications at home for terminal-stage patients has not been widely recognized or understood. Our study aimed to explore the experiences of FCGs in administering medications to adult dying patients.MethodsWe conducted a directed content analysis of data from 73 semi-structured interviews with FCGs across 19 Chinese provinces from 2021 to 2023. FCGs were recruited through the Voluntary Cooperative Network Research. We asked, “Could you recall the end-of-life care process for the patients?” We aligned the themes with the five issues identified by Wilson et al. (2018): administration, organizational skills, empowerment, relationships, and support.ResultsFCGs in China exhibit concerns about over-engagement and empowerment in medication administration, concealing medication information from the patient, and medication accessibility. FCGs faced significant challenges in accurately identifying and addressing pain and symptoms, determining appropriate dosages, accessing effective medications, and managing the emotional stress associated with potential medication errors. Financial burden, medication regulatory restrictions, geographical inequality, and travel restrictions during COVID impeded patients and FCGs from accessing medication. A culturally specific finding is the use of alternative medicine at the end of life.ConclusionOur findings build upon Wilson et al.‘s framework and extend their insights on empowerment, highlighting the need for policies to support home-based palliative care professionals in training FCGs for effective medication administration.

‘I am afraid to fly there’: informal care in Polish migrants’ families immobilised by COVID-19

ABSTRACT This paper discusses the COVID-19 pandemic as a new external challenge to transnational family life that can undermine the care arrangements and intentions developed by the families of Polish migrants following the 2004 EU enlargement. The pandemic, associated lockdowns and travel restrictions raise questions about assumed transnationalism, building upon earlier concerns about taking for granted migrants’ cross-national mobility. Based on focus group discussions with Polish grandparents conducted in July 2020 and March 2021, we analyse the pandemic’s impact on intergenerational relations with both geographically close and distant kin. We point to perceptions of risks of COVID-19 associated with ethnicised stereotypes and evolving with time. While the pandemic caused temporary restrictions to mobility, it shows the immobilising side of “unsettling events”], the consequences of which, for privileged EU migrants, will unfold in time as their parents’ age and require personal care.

Multi-Cell Discrete-Time SIRI Epidemic Model with Travel Restrictions and Vaccination Controls

Multi-Cell Discrete-Time SIRI Epidemic Model with Travel Restrictions and Vaccination Controls

The Extent of Performance Loss of the Adelante Dance Troupe during the Modification of Cultural Implementation

This study aims to investigate the factors that contribute to the decline in performance of the Adelante Dance Troupe of the University of San Jose-Recoletos during cultural modification, focusing on (1) human motivation, (2) human personality, and (3) psychological needs: Relatedness, competence, and autonomy. Through the firsthand experiences of 30 members affected by COVID-19-induced changes, the research identifies essential factors. The study reveals the impact of collecting limitations, travel restrictions, and safety procedures on cultural performance organizations. Modifications, such as social distancing and virtual platforms, contribute to the observed performance decrease. This study assesses ADT performance; there is a corresponding 89.8% improvement in personality. When dancers lose performance, their level of competence declines during cultural implementation adjustments, too. This ties in with personal issues and personality-driven decision-making, highlighting that dancers' difficulties adjusting to changing cultural implementation are more closely related to their situations and decisions than to dance group policies or programs. The prevalent factors influencing performance can be enhanced through various initiatives, programs, and skims. The study highlights the importance of addressing motivation in dance troupes undergoing cultural adaptations to minimize performance issues. This suggests that the psychological aspects of individuals play a more critical role in influencing performance outcomes than the technical skills and proficiency in dance.

An Impact Assessment of Cordon Pricing Relaxation on Modal Shift During the COVID-19 Pandemic

ABSTRACT The COVID-19 pandemic brought significant disruptions to transportation patterns worldwide, with a notable increase in Private Vehicle (PV) usage. Many studies have focused on travel restrictions, while neglecting to consider potential changes in transportation-related policies implemented during COVID-19 that may have improved public health. The present study explores the motivations for modal shifts to PVs and tries to analyze which of the risks of exposure and modifications in transportation policies has caused these modifications. Focusing on the case study of Tehran, Iran, where cordon pricing was relaxed during the pandemic, the study collected data through online and paper-based surveys from 1475 respondents. Binary logit models were employed to analyze the data and understand the impact of destination location, residency area, trip purpose, trip frequency, and vehicle characteristics on modal shift behavior. In addition to COVID-19 exposure as a primary reason for the modal shift, respondents also identified the relaxation of cordon pricing restrictions as a factor that increased the utility of PVs. The study's findings contribute to better understanding the dynamics of travel behavior during pandemics, guiding policymakers in devising effective strategies to address both public health concerns and traffic conditions.

Quantifying the impact of COVID-19 restrictions on air pollution in Ahvaz: a comparative dual-approach assessment of observed against baseline and forecasted criteria air pollutants.

In response to the COVID-19 pandemic, the Iranian government swiftly implemented immediate and decisive measures to control the spread of the infection. This study aims to demonstrate the impact of restriction measure on air pollution, also to highlight the potential variability in results that can arias from different methodological approach. A comprehensive dual-approach assessment was conducted to evaluate the effect of the lockdown measures on criteria air pollutants. Firstly, a traditional approach compared air quality during the pandemic period with baseline conditions from 2013 to 2019. Secondly, observed air pollution values during different periods with varying restrictions in 2020 were compared with expected values. This comprehensive analysis allows for a robust comparison and quantification of the impact of different lockdown measures in Ahvaz. The study revealed significant changes in air pollutant concentrations in Ahvaz during 2020, with variations observed across different pollutants. Notable reductions were observed in O3 levels, particularly in November (-54.44% compared to the baseline) and December (-63.58% compared to expected values). Decreases in CO levels were observed in multiple months, while substantial reductions in PM10 and PM2.5 were observed during various periods. Inconsistencies in the magnitudes and directions of changes were found when comparing baseline and forecasted values. The overall stringency index showed an inverse association with changes in O3, NO2, and CO, with international travel controls and restrictions on internal movement having significant impacts. This study provides valuable insights into the impact of COVID-19 lockdown measures on air pollution in Ahvaz, Iran, using a comprehensive dual-approach assessment. The findings highlight the effectiveness of these measures in reducing specific criteria air pollutants and emphasize the importance of implementing appropriate strategies for air quality management during similar public health emergencies.

Overtourism perception among residents in a rural proximity destination during the COVID-19-pandemic – The writing on the wall for a sustainability transition of tourism?

Abstract This contribution investigates overtourism perceptions among residents in a rural German destination during the COVID-19 pandemic. Using a qualitative approach, it examines the impact of these perceptions on residents’ quality of life and subjective well-being in the Allgäu. As international travel declined due to pandemic-induced travel restrictions, domestic tourism surged, potentially foreshadowing effects of a net-zero transformation in global tourism on rural proximity destinations. Semi-structured interviews with 12 residents reveal that most respondents perceived tourism levels as excessive, negatively impacting their subjective well-being. Changed spatio-temporal visitor behavior patterns, with tourists venturing into previously less frequented areas, often felt intrusive to locals. This shift in tourism dynamics from urban hotspots to rural destinations challenges the notion that overtourism disappeared during the pandemic. Notably, the contribution introduces subjective well-being as a reliable indicator for overtourism and explores a novel notion of overtourism resulting from the interrelationship between perception, subjective well-being, and attitudes. The findings suggest that increased proximity tourism, while reducing carbon footprints, may lead to perceived overtourism and declining tourism acceptance in substitute destinations. The study underscores the necessity for participatory destination management approaches that balance sustainability goals with resident well-being to facilitate a broader sustainability transition in tourism.

Criminal liability for human trafficking in the context of the war in Ukraine: Challenges and impact

Martial law and travel restrictions for citizens aged 18 to 60 were introduced after Russia's actions against Ukraine, but exceptions to this rule quickly emerged due to the potential negative consequences for the economy, politics and humanitarian situation. Despite this, society still faces difficulties related to the restriction of fundamental human rights. The study is important because of the increase in criminal behaviour associated with illegal crossing of the Ukrainian border during the conflict. The effectiveness of measures to counter this phenomenon and the socio-economic consequences for Europe can be determined by comparing them to European standards. This comparative analysis will also help to develop recommendations for improving legislation and international cooperation in this area. The research methods used in this study include systemic and structural, formal legal, comparative legal, logical and semantic, dialectical, sociological, statistical, empirical, and analytical. The purpose of this study is to analyse criminal liability for illegal crossing of the State border of Ukraine in the context of the military situation and to identify ways to improve legislation and international cooperation to effectively counter this phenomenon.

Beyond Dialysis: Reshaping CKD Paradigms in Developing Nations

Dear Sir / Madam, Respected Editor, I am writing to bring attention to the critical need for increased research on conservative kidney management (CKM) in the context of patients with advanced chronic kidney disease (CKD). The recent advancements in developed nations have demonstrated that CKM is a novel and effective approach to caring for CKD patients, particularly those who choose not to pursue maintenance dialysis. Historically, medical care for individuals with CKD has adhered to a paternalistic model, where clinicians make treatment decisions independent of patient preferences. JS Scherer et al observed that a provider's assessment of a patient's frailty and response exerted a more substantial influence on the treatment provided than the patient’s comorbidities, functional status, and stated preferences. 2 Furthermore, another study showed that some individuals exhibited a preference for conservative care after shared-decision making, irrespective of the potential survival benefits offered by dialysis if it entailed frequent hospital visits or travel restrictions. 3 This underscores the significance of patient autonomy, where the pursuit of freedom can sometimes outweigh the emphasis on clinical outcomes. However, contemporary CKD management in the 21st century emphasizes shared decision-making and patient empowerment. While research suggests CKM can improve quality of life, reduce hospitalizations, and minimize invasive procedures, offering a valuable alternative to dialysis, its impact on survival becomes less clear for patients over 80 or those with multiple comorbidities.4 Additionally, the inclusion of patients and their families in collaborative decision-making processes has proven advantageous, supported by specialized decision aids that promote well-informed discussions regarding CKM with healthcare providers.5 Nephrologists face significant challenges in implementing effective conservative kidney management (CKM) due to a lack of clinical guidelines, training, evidence, and system-level infrastructure. This has resulted in limited awareness and discussion of CKM among patients and healthcare providers, hindering its adoption. With the global burden of chronic kidney disease (CKD) increasing significantly over the past three decades, particularly affecting low- and middle-income countries, there is a pressing need for innovative, cost-effective solutions. CKM emerges as a viable alternative where dialysis is often inaccessible or unaffordable, with the potential to significantly impact CKD management, especially in resource-limited settings such as Pakistan. I urge the scientific community and policymakers to recognize the importance of supporting and conducting research on conservative kidney management. ---Continue

Bordering: Australia’s Policy to Border During COVID-19

Why did Australia border earlier than most other states in response to the outbreak of COVID-19? Between mid-January and March 2020, the Australian government adopted increasingly restrictive travel bans that led to the country closing its borders to all non-residents, adopting mandatory hotel quarantines for 14 days and a travel ban on Australians travelling overseas. These actions were in contravention of the World Health Organization advice to states on travel restrictions. Australia’s border closure was one of the strictest and, ultimately, longest in the world. In this article, we complement existing explanations on bordering that include critical border studies, securitization and bio/necropolitics with theoretical approaches from public policy literature to examine the domestic conditions that inform border closure policies and practices. We demonstrate that the decision to border, in this case, was not a rejection of World Health Organization advice but a turn towards the domestic pull factors – including domestic expert advice – to border.

High Adherence to COVID-19 Public Health Preventive Measures in Indigenous Communities in the Canadian Northwest Territories.

The aim of this project is to explore perceptions towards and adherence to COVID-19 public health preventive measures in Indigenous communities within Northwest Territories, Canada. Utilizing a cross-sectional study design the project took place within ten Northwest Territories communities between 1st April and 30th November 2021. Convenience sampling methods were utilized and adhered to public health restrictions. Self-identifying Indigenous adults (≥ 18 years old) were invited to complete a semi-structured interviewer-administered questionnaire. Participants (n = 287; 33.1% men, 66.6% women) had a mean age of 41.6 years (SD ± 13.5). Preventive measures were practiced by 98.6% of participants. Most participants reported often or always practicing three measures: avoiding gatherings (67.2%), avoiding usual greetings (63.3%), and limiting contact with high-risk individuals (71.4%). Most participants reported rarely/never practicing self-isolation (67.5%) and self-quarantining (76.5%) measures. Significant associations existed between the August 2021 COVID-19 outbreak and self-quarantining (p = 0.0023), self-isolating (p = 0.0023), and going onto the land (p = 0.0001). Participants found masking and travel restrictions challenging. Sadness and loneliness resulted from limited access to Elders. Kinship and community safety were important to Indigenous community members and influenced COVID-19 preventive measure utilization. The findings can inform culturally specific COVID-19 public health policy development.

What happens when tourism is turned off: Exploring the outcomes of the COVID-19 pandemic travel restrictions for Indigenous people in Rarotonga, The Cook Islands

The sea, sand, and sun allure of the Cook Islands has seen tourism become the most significant driver of the country's economic development. However, the increasing reliance on the tourism sector since the 1980's has created a mono-economy at the expense of diversification and alternative economic models. The COVID-19 pandemic emphasized the risks and consequences associated with an over- reliance on international tourism as the lockdown measures and international travel restrictions caused the sudden shutdown of international tourism, resulting in serious negative economic consequences for tourism-dependent communities. However, the pandemic also offered an opportunity for small island societies to reflect on pre-existing challenges associated with the tourism industry. Through qualitative semi-structured interviews with Indigenous Cook Islanders in Rarotonga, this study aimed to develop a deeper understanding of how the lived experiences of participants responding to the sudden collapse of tourism may have influenced how Indigenous Cook Islands peoples perceive the role of tourism in supporting the wellbeing of their small island nation. The presented study is the result of a collaborative research partnership between an Indigenous Pacific scholar and non-Indigenous European scholar. While the research adopted a western methodology, the relationships developed between the researchers and participants were guided by the cultural values of reciprocity and respect, which are key principles underpinning Indigenous research in the Pacific. The findings revealed that participants adapted to the adverse impacts of COVID-19 through the revitalization of their traditional socio-economies, the resurgence of customary practices, a strengthened connection to nature, and a renewed sense of community spirit and pride in cultural identity—all of which were perceived to positively impact their spiritual, social, cultural, environmental, physical, and mental wellbeing. By demonstrating the positive adaptive responses of participants, this article aims to emphasize the non-economic dimensions of wellbeing that are critical to supporting the cultural values, social priorities, and the Indigenous ways of life that preceded the development of tourism. These findings can be used to inform and guide international development policy makers and tourism stakeholders who seek to reduce the adverse impacts of tourism on the wellbeing of Indigenous communities in the Pacific.

The adoption of international travel measures during the first year of the COVID-19 pandemic: a descriptive analysis

ObjectiveTo describe the adoption of international travel measures during the first year of the COVID-19 pandemic.MethodsTo comprehensively analyze the measures adopted, we constructed a dataset based on the WHO’s Public Health and Social Measures (PHSM) database, which covered 252 countries, territories, or other areas (CTAs), including all 194 WHO Member States, from December 31, 2019, to December 31, 2020. We examined the adoption of measures by type, over time, and by the implementing and targeted CTA, including their levels of income.FindingsWe identified 11,431 international travel measures implemented during the first year of the pandemic. The adoption of measures was rapid and widespread: over 60% of Member States had adopted a travel measure before the WHO declared COVID-19 a Public Health Emergency of International Concern on January 30, 2020. Initially, health screening and travel restrictions were the most adopted measures; however, quarantine and testing became more widely adopted over time. Although only a small portion of the total measures adopted constituted full border closure, approximately half of all Member States implemented this measure. Many travel measures targeted all CTAs but were unlikely to have been adopted universally enough to provide public health benefits. Low-income countries relied more on more universal measures, including full border closure, and were slower in scaling up testing compared to higher-income countries.ConclusionThe adoption of international travel measures during the first year of the COVID-19 pandemic varied across jurisdictions and over time. Lower-income countries used a different mix and scaled-up measures slower than higher-income countries. Understanding what measures were used is crucial for assessing their effectiveness in controlling the spread of COVID-19, reviewing the usefulness of the International Health Regulations, and informing future pandemic preparedness and response activities.

Trends in shigellosis notifications in England, January 2016 to March 2023.

We reviewed all diagnoses of Shigella species notified to the UK Health Security Agency from January 2016 to March 2023. An overall increase in notifications of shigellosis was seen between 2016 (n = 415/quarter) and 2023 (n = 1029/quarter). However, notifications dramatically declined between March 2020 and September 2021 during the COVID-19 pandemic (n = 208/quarter) highlighting the impact of travel and social distancing restrictions on transmission. S. sonnei diagnoses were more affected by lockdown restrictions than S. flexneri, most likely due to a combination of species-specific characteristics and host attributes. Azithromycin resistance continued to be associated with epidemics of sexually transmissible S. flexneri (adult males = 45.6% vs. adult females = 8.7%) and S. sonnei (adult males = 59.5% vs. adult females = 14.6%). We detected resistance to ciprofloxacin in S. sonnei from adult male cases not reporting travel at a higher frequency (79.4%) than in travel-associated cases (61.7%). Extensively drug-resistant Shigella species associated with sexual transmission among men almost exclusively had ESBL encoded by blaCTX-M-27, whereas those associated with returning travellers had blaCTX-M-15. Given the increasing incidence of infections and AMR, we recommend that enhanced surveillance is used to better understand the impact of travel and sexual transmission on the acquisition and spread of MDR and XDR Shigella species.

Re-surging airport noise: understanding aircraft noise dynamics during and after the COVID-19 pandemic at Dublin airport

This paper explores the dynamics of aircraft noise patterns, examining the transformative impact of the COVID-19 pandemic on flight numbers and noise contours during the years 2021, 2022, and 2023 at a European airport. Focused on both peak and low flight months, the study explores how the aviation landscape experienced shifts during the pandemic and post-pandemic scenarios. As a transport hub for an island nation Dublin Airport is a key piece of national infrastructure but as the global travel restrictions took effect, the airport witnessed a substantial reduction in flight numbers, resulting in a notable decrease in airport noise and subsequent lower population exposure to environmental noise. This paper analyzes the trends in noise contours and flight frequencies during this period, shedding light on the immediate effects of the pandemic on aviation-related noise. Furthermore, as the restrictions gradually lifted, the study investigates the extent to which flight numbers and associated noise contours rebounded in the post-pandemic era. This comprehensive examination provides insights into the evolving environmental soundscape, capturing not only the changes during the pandemic but also the subsequent rise in flight numbers. The potential impact on societal expectations of aircraft noise is discussed.

Rooms versus F&B: How changes in operations contribute to hotel productivity

This study investigates how different operational responses impact hotel productivity change, specifically investigating the importance of F&B operations in comparison to room operations and applying the case of the Taiwanese hotel industry, conducting 93 international tourist hotels from April 2012 to March 2021. Using regression discontinuity design analysis, first, the study finds a significant causal impact of COVID-19 travel restrictions on hotel operations. Second, using the control function methods, findings show that F&B operation is a more efficient strategy compared to rooms to recover hotel productivity from crises. This research provides insights into how hotels can reallocate their operational resources in response to crises and offers an alternative measure of productivity for the hotel industry.

Resilience in Healthcare: A Hospital-based Investigation of Breast Cancer Diagnostics Amid the Pandemic in Indonesia

Background: Widespread disruptions in healthcare services have occurred due to ongoing challenges during the pandemic. The tremendous impacts have struck countries with limited resources, greater distances of geographical access to healthcare services, and a shortage of healthcare personnel. Long delay of diagnosis and disruption in patient care affects the long-term prognosis of breast cancer. This study was conducted to investigate the effects of the COVID-19 pandemic and government-mandated social restrictions on the provision of diagnostic services for breast cancer patients in a tertiary referral hospital. The study aimed to explore how travel restrictions and patients' apprehension about COVID-19 exposure have contributed to notable declines in diagnostic and treatment procedures for breast cancer within this healthcare setting. Methods: This study was retrospective design and used a hospital registry to collect information on demographics, imaging, and pathology from January 2018 to September 2021. Breast ultrasound (US) and mammography data were collected from the Picture Archiving and Communication System (PACS), while pathology data were collected from e-medical records. The descriptive statistics of the annual total volume of imaging and pathological examinations were interpreted and statistics were only calculated for diagnostics mammography. Results: Between 2018 and 2021, the volume of monthly breast sonograms drastically decreased by 65% in 2020 and 2021 during the pandemic, while mammography significantly reduced by more than 40% from the 2019 levels. Breast US and mammography procedures were significantly lower during the first and second waves of the pandemic in March until May 2020 and June until September 2021, respectively. Although the proportion of breast ultrasound-guided fine-needle aspiration biopsy (FNAB) increased year by year, the number of FNAB for primary breast lesions significantly decreased by 84% in 2020 and 2021. Conclusions: We observed significant decreases in diagnostic procedures for breast cancer. Reconfiguration of breast cancer care scheduling is required to accommodate the potential for increased hospital visits after the travel restrictions.

U.S. Airline Customer Complaint Trends: A Decade-Long Analysis (2013-2022) Including COVID-19 Impacts

The Airline Deregulation Act of 1978 significantly reshaped the U.S. aviation industry, transitioning from government-controlled pricing and service standards to market-driven dynamics. This shift led to the rise of low-cost carriers, reduced service quality, and increased customer complaints. In response to fluctuating service standards, the Air Travel Consumer Report (ATCR) was introduced in 1987 to provide transparency in airline service quality. This study leverages ATCR data from 2013 to 2022 to analyze trends in customer complaints across major U.S. airlines. The primary objectives are identifying the major customer complaints and determining which airlines received the most complaints during the studied period including the COVID-19 pandemic era. Results indicate that flight problems, refunds, baggage issues, customer service, and reservations/ticketing/boarding are the top complaints, with refunds peaking during the COVID-19 pandemic due to travel restrictions. Airlines such as Frontier, Spirit, and United consistently received higher complaints, while Alaska, Delta, and SkyWest had fewer complaints. The study underscores the importance of service quality in fostering customer satisfaction and loyalty, suggesting that airlines should focus on reducing complaints in key areas to enhance service quality. The findings provide valuable insights for both airlines and consumers, highlighting areas for improvement and aiding consumers in making informed choices. This study also emphasizes the need for comprehensive service quality measures beyond consumer complaints to assess airline performance accurately.

Challenges of patients with intrathecal baclofen pump therapy during COVID-19 pandemic in Saudi Arabia

Background: This study was carried out to analyze the effects of the COVID-19 pandemic on patients with intrathecal baclofen (ITB) therapy. Methods: Patients who came for ITB refill during the COVID-19 pandemic between March 2020 and August 2020 were contacted, and a survey was conducted regarding challenges faced during the COVID-19 pandemic. Data obtained from the chart review included demographics, diagnoses, pump information, baclofen dose, and COVID triage. Information was collected regarding travel arrangements, appointments, and problems related to ITB therapy or travel. The survey included 12 multiple-choice questions related to travel, appointment scheduling, and difficulties faced during the travel restrictions. Results: The study included 19 patients with ITB (mean age: 38.1±14.4) from outside Riyadh city who came for ITB refill during the COVID-19 pandemic. The majority of the patients were males. Spinal cord injury with paraplegia was the most common diagnosis (52.6%). In total, 7 patients had either clinical (31.6%) or travel-related difficulties (15.8%). No patient had ITB withdrawal at the time of the clinic visit. Nearly half (47.4%) of the patients had to change their appointment for refill. The percentage of patients who used a car as a mode of travel pre-COVID was 42.1%, which increased to 78.9% during the pandemic. They traveled 747.4±356.6 km (7.4±3.7 h) to reach the hospital for refill. Patients needed 1–4 accompanied persons for assistance during travel, with the majority (68.4%) requiring 2 accompanied persons. Statistical analysis did not reveal any significant associations between clinical or travel difficulties and appointment changes. Conclusions: A pandemic or similar disaster can pose challenges to patients on ITB therapy living in areas with limited access to specialized care. In this study, none of the patients had serious complications or adverse outcomes; however, the main difficulties were attributed to travel. It is crucial to establish strategies at institutional, regional, or national levels to formulate guidelines for managing patients with ITB therapy during a pandemic.

Externality and policy intervention in interregional travel with infectious diseases.

This paper theoretically investigates externalities and policy interventions in travel during a pandemic. We develop a tractable static model of two regions from a short-run perspective. The model shows that the externalities can be both negative and positive, depending on regional asymmetry. Thus, even when infectious diseases are widespread, travel restrictions do not necessarily reduce infections and do not necessarily improve social welfare. A formula for the optimal policy intervention is derived and shown to be the weighted average of four types of externalities defined by the direction of travel and the epidemiological status of a traveler.