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Border health measures
We have a variety of core protection measures and controls to prevent the spread of infectious diseases and other public health risks. These can be applied individually or together.
Border health measures
Border health measures
The most practical health measures to implement at New Zealand's international airports and seaports in response to public health threats are:
- providing proactive public health advice and issuing advisories and alerts for travellers
- enabling traveller self-reporting (e.g., symptoms and travel history)
- taking pre-departure measures (e.g., declaration of vaccination and health status related to a public health threat or any other appropriate measures)
- providing passenger locator information to manage and monitor symptomatic and exposed travellers
- having a visible public health presence at international airports 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 (e.g., self-isolation)
- testing travellers, conveyances, and goods
- using various 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 (e.g., 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.
Choosing different measures
Choosing different measures
Quarantine and isolation
Quarantine and isolation
The word ‘quarantine’ is often used in the border health context. Human quarantine procedures are used to prevent the spread of diseases. These procedures aid in detecting and controlling risks associated with airborne, foodborne, waterborne, and vector-borne diseases (such as rats and mosquitoes).
Quarantine rules can restrict the activities of healthy persons or animals exposed to an infectious disease during the period when the disease is 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 response
Selecting the most appropriate health response
Various border health protection measures can be implemented, with quarantine and isolation being among the more extreme options.
When implementing border health measures, it is important to consider the following:
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Assess the nature and extent of the public health risk. Could it significantly affect the general health status or priority groups regarding morbidity, mortality, and/or quality of life, both now and in the future
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Assess whether pre-border or post-border measures, or a combination of both, would be more suitable and efficient.
- Consider the effectiveness and benefits of any border health measures (these are costly and resource intensive) against their potential social and economic impacts (eg, interference with travel and trade).
- Check if the World Health Organisation (WHO) has recommended border health measures for air and sea ports under the International Health Regulations (2005).
Further decision-making guidance can be found in Responding to Public Health Threats at New Zealand Air- and Seaports.
Travel measures at international points of entry
A range of different measures are described below.
Health advice/alerts for travellers and the border/travel sectors
Health advice/alerts for travellers and the border/travel sectors
This type of communication helps raise awareness, provide information, and promote personal hygiene and appropriate health-seeking behaviour.
Screening travellers at entry/exit
Screening travellers at entry/exit
Entry screening aims to identify ill or potentially ill travellers before entering the country. There are several ways of doing such screening, such as:
- screening onboard 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 best considered in situations where New Zealand may be experiencing community-level outbreaks, for example, screening (including self-reporting) and pre-departure testing for people flying from New Zealand to countries in the Pacific, where the overseas government requests New Zealand undertake exit measures.
Managing contaminated goods, cargo, aircraft, vessels and/or the air- or sea port environments
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 to cleanse, decontaminate, disinfect, disinfect, fumigate or otherwise treat them.
Vector control (eg, mosquitoes, rodents) is one of the more common environmental measures.
Chemical or radiological hazards are also threats, where goods, craft, and the environment require management.
Medical and other testing
Medical and other testing
Testing is done to help make sure that travellers, goods, cargo, aircraft, and airports/ports are safe and not contaminated. It helps to find out how likely it is that there is an infection or contamination.
Various tests may be conducted on people, aircraft/vessels, cargo and the airport/port environments (eg, drinking water testing). For a threat, there may be existing test methods (eg, measles testing, chemical analyses, radiological testing, mosquito identification), or testing options may need to 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 needed for laboratory analyses dependent on the test undertaken.
International travel advisories
International travel advisories
Advisories offer valuable information to people and may discourage travel to or from countries or regions with high risks, such as war, civil unrest, or 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
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 various reasons. This could include bad weather, mechanical issues with the craft, problems with port facilities, 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 restrictions and border closures
Travel to and from countries or areas can be restricted or prohibited (e.g., by refusing international flights) to prevent or delay the introduction of a disease into a non-affected country. This measure has historically been 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 (e.g., refusing international maritime and aviation arrivals).
Measures to manage symptomatic or exposed international travellers
These measures can be applied to travellers either arriving or leaving New Zealand.
Pre-departure measures
Pre-departure measures
Before travelling to New Zealand, several measures could be taken in the country of origin:
- pre-departure testing – eg, 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 – 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 – eg, in the COVID‑19 response, some countries were designated as high-risk.
Passenger locator information
Passenger locator information
Passenger locator information is collected from travellers for contact tracing purposes.
Medical assessment of arriving travellers
Medical assessment of arriving travellers
This measure involves assessing symptomatic or exposed travellers to determine the likelihood of infection or contamination. It can 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
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
Isolation involves separating ill or contaminated travellers or affected baggage, containers, parcels, other goods, aircraft or vessels to prevent 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 on the vessel.
This approach is not usually viable with aviation arrivals where space is much more limited, and aircraft are quickly turned around for onward flights or moved to another location in the airport.
Treatment
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 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 a medical treatment used to prevent a disease from occurring in an exposed person.
Home or institutional quarantine
Home or institutional quarantine
Quarantine involves restricting activities and/or separating travellers who are not ill but are suspected cases or contacts of a suspected case to prevent the possible spread of infection or contamination (as opposed to isolation which relates to symptomatic people). The intent of quarantine is to identify infected individuals and break the transmission cycle of 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
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).