Brexit was about 'taking back control' - so why not of our borders during a pandemic?

It is one of the pandemic’s cruellest ironies that in the very time when public health would have benefitted most from this pull-up-the-drawbridge mentality that Westminster opted not to do so.

Yet they have had no qualms with signing off on an immigration policy that, from January, will make it difficult for foreigners to enter the country for work unless they have a job lined up that pays at least £25,600 - ruling out many social care workers that our care sector so desperately needs.

A joint report this week by the Care Inspectorate and Scottish Social Services Council, for example, showed that 68 per cent of care-at-home services and 60% of care homes for older people were reporting vacancies that were hard to fill at the end of 2019 - months before the pandemic struck.

READ MORE: What Scotland should learn from the disastrous unravelling of Wales' firebreak 'success'

Meanwhile, two other studies illustrated the fatal error of failing to lockdown our borders.

One, by epidemiologists at the London School of Hygiene of Tropical Medicine, set out to investigate the impact imported cases on coronavirus outbreaks.

In other words, what role does international travel play?

The paper, in the Lancet journal Public Health, estimated that the UK would have to reduce international arrivals by around 95% to bring imported cases down to less than 1% of the total Covid incidence, compared to 70% for France.

Travel restrictions “have clear benefits when there are zero or few cases in the destination country”, noted the researchers, but “once case numbers within a country are sufficiently large that local outbreaks have been established and are self-sustaining, travel restrictions become less effective”.

Time is of the essence. Taiwan began inspecting plane passengers coming from Wuhan for signs of fever from December 31 - the same day that the World Health Organisation was first notified of a mysterious ‘Wuhan pneumonia’.

The island nation, which has had just seven Covid deaths in a population of nearly 24 million, banned travellers coming from Wuhan as of January 23 - two days after recording its own first Covid case. By February 6, all travellers from China were prohibited, with strict quarantines imposed on everyone else.

By contrast, the US decision to ban travellers from Europe as of March 12 “came too late to prevent a large epidemic in New York already seeded mainly by European travellers”.

The UK’s problem was is that we only half shut the door after the horse had long bolted: international travel was strongly discouraged (but not actually controlled) during lockdown, with quarantine rules not introduced until June.

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Even then, people were “told” to self-isolate for 14 days on arrival, with promises of spot checks and £480 fines, but monitoring was slow to get started and enforcement slight.

Since June 8, nearly 500,000 people have entered Scotland from outside the UK, of whom 166,261 (arriving from Covid hotspot zones) have been required to quarantine.

Of these, only 31,500 were earmarked to be followed up by contact tracers, but more than 4000 could not be reached.

Figures reported in October showed that 124 people were referred to the police by Public Health Scotland for potential breaches of quarantine by the end of August, but only one fine issued.

Compare this to Australia, where borders have been closed since March except (but for a few rare exceptions) to Australian citizens and permanent residents.

Even then, all international arrivals are escorted by police from the airport to a hotel where they must remain in their room for 14 days at a cost to themselves of AU$10,000(£5,700). Meals are ordered online and delivered to guests’ doors, and there are fines for anyone caught breaching quarantine.

To date, Australia has had 908 confirmed Covid deaths in a population of 25 million. Ironically, 820 were in the state of Victoria alone, where a second wave in August was linked to travellers in a quarantine hotel infecting staff due to lapses in infection control procedures.

Scotland has had 4,070 Covid deaths in population of 5.5 million.

We might not have control over UK borders, but the Scottish Government could have adopted more stringent quarantine controls if it chose.

It might even have been wise to restrict cross-border travel with England.

A genomic analysis led by Edinburgh’s Roslin Institute for the UK's Scientific Advisory Group for Emergencies makes clear that “travel-associated imports (mostly from Europe or other parts of the UK) following the easing of lockdown are responsible for seeding the current epidemic population”.

READ MORE: How did we end up back in lockdown? Just follow the numbers

By mid-July, the effects of lockdown had “eliminated the majority of community transmissions in Scotland”.

Illustration showing strains of the Covid-causing coronavirus in circulation in Scotland during 2020

This would have been the moment to ramp up travel restrictions and quarantine; instead summer holidays reignited a second wave.

Between July 17 and August 30, there were 46 “import events” from elsewhere into Scotland (that is, 46 very slightly genetically distinct variants of Covid introduced into Scotland by travel).

Of these, 28 came from England, 13 from Europe, and four from Asia, with an “apparent peak of imports in August”.

These were subsequently responsible for 26% of the viral strains circulating in the population from summer onwards - though European imports seemed to spread faster and accounted for twice as many infections as those brought from England.

The hard lesson is that it is not enough to bring the virus under control through lockdown - you need strict curbs on movement afterwards to safeguard areas of very low prevalence.

By doing so, we might have prevented many of the other restrictions we have faced on hospitality, retail and leisure - as Taiwan has.

Instead, and ironically, the UK has paid the price for granting its citizens free movement.