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By Selam Gebrekidan, Katrin Bennhold, Matt Apuzzo and David D. Kirkpatrick
The World Health Organization said opening borders would help fight the disease. Experts and a global treaty categorically agreed, but clinical evidence never did.
ISCHGL, Austria – They have come from all over the world to ski in the best known ski resorts of the Austrian Alps.
Jacob Homiller and his schoolmates flew from the United States; Jane Witt, a retired teacher, came from London for a circle of relatives; Annette Garten, the youth director of a Hamburg tennis club, celebrating her birthday with her husband and two adult children.
They knew in February and early March that the coronavirus was spreading near northern Italy and across the border with Germany, but no one was alarmed. Austrian officials minimized considerations when tourists crowded cable cars during the day and bars approved-ski at night.
“The overall total comes combined in Ischgl,” Garten said.
Then they all went home, accidentally taking the virus with them. Infected in Ischgl (pronounced “ISH-gul”) or surrounding villages, thousands of skiers have transported coronavirus to more than 40 countries on five continents. Many of the earliest known cases in Iceland have been attributed to Ischgl. In March, almost part of the cases in Norway were similar to the ski holiday in Austria.
Nine months after the onset of an epidemic that has killed one million people worldwide, Ischgl is where the era of global tourism, imaginable through reasonable airfares and open borders, has clashed with a pandemic. The treaty’s nearest global public conditioning policy has encouraged global mass tourism by asking for open borders, even during epidemics.
When the coronavirus gave the impression in China in January, the World Health Organization did not become unmoved in its council: do not limit travel.
But what is now transparent is that politics focuses more on politics and the economy than on public health.
Public physical fitness records, dozens of clinical studies, and interviews with more than two dozen experts show that the policy of not blogging has never been based on strong science. It was a political decision, reshaped on a physical fitness council, that arose after a plague epidemic in India. In the 1990s, when Covid-19 appeared, he had an article of faith.
“This is a component of the global fitness faith: restrictions and industry are bad,” Lawrence O said. Gostin, professor of global aptitude law at Georgetown University, who helped draft global regulations known as International Health Regulations. I am one of the faithful. “
Covid-19 broke that faith. Prior to the pandemic, some studies had shown that restrictions delayed, but did not stop, the spread of SARS, pandemic influenza and Ebola. However, most were based on mathematical models and no one had collected genuine data. The effect of restrictions on the spread of the last coronavirus is not yet understood.
“Anyone who is fair will tell you that he is a great ‘We don’t know,’ said Professor Keiji Fukuda, a former senior official at the World Health Organization who teaches at the University of Hong Kong.
Not knowing is provocative because the global is looking for a way back to normal. For months, national leaders have invoked travel restrictions that vary in rigor and are occasionally contradictory. Some closed their borders and simultaneously imposed national closures, others demanded evidence and quarantine. Many reviewed their lists of high-risk destinations, responding infrequently to tat when their citizens were denied entry.
Restrictions have humiliated harsh nations like the United States, whose citizens are no longer welcome in most countries around the world. Despite this, President Trump called his restrictions “the greatest resolution we’ve ever made” and called WHO advice, ‘deastrous’ edges.
However, it is too early to know, based on knowledge and clinical knowledge, how many restrictions help and, if they do, which restrictions help the most. Experts who advocated the opening of borders at the beginning of the pandemic now say that countries deserve to use practical measures. WHO is now calling for a slow reopening in which each country weighs its own risks.
“In fact, there is a radical replacement in the way it is discussed,” said Kelley Lee, a professor at Simon Fraser University in Canada who studies the effect of travel restrictions on this pandemic. “But the evidence has not replaced. We still have bad evidence.
What is very transparent is that global public fitness policies are inadequate, i. e. with respect to ArrayCheap airlines have created a wave from all over the world. The number of other people traveling abroad at least once a year has increased by 80% since regulation was formulated in 2005.
The ease and spread around the world explains why occasions of “super spread” have helped fuel the pandemic: just as skiers from Ischgl have carried the virus around the world, the faithful of a French mega-church have carried the disease to Africa, Latin America. America and Europe.
After their trip to Austria, Homiller and at least 4 friends tested positive for coronavirus. Witt escaped tiredness in his kitchen and ended up fighting for his life. Garten’s family circle has also fallen ill and in Germany her husband was hospitalized.
Today, at least another 1,000 people from dozens of countries intend to sue the Austrian government. A lawyer in Vienna filed the first verification instances on Wednesday on behalf of 4 visitors, two of whom have since died as a result of Covid-19. The lawsuit says the government closed the station earlier and told tourists to stay away.
“They knew, they didn’t tell anyone, ” said Witt, who is part of the trial.
“Health of wealth, ” she says.
Annette Garten grew up in Hamburg and was 16 when her family circle first visited the quiet beach hotel of Ischgl in the 1980s, aimed at passionate, basically German skiers. Cow manure covered the streets.
“It’s an Austrian people in general,” he says.
The village became a beach hotel in the 1960s, after an enterprising resident went door-to-door to raise cash for a cable car. During her visit, Ms. Garten appeared slightly on the map of world tourism.
This will replace in the 1990s, when Garten began seeing Britons on the slopes and Russians dressed in giant furry hats. New hotels have emerged along the narrow streets. Stars like Elton John and Bob Dylan made headlines.
The same forces of globalization that Arechgl are reshaping are the world. Multinational companies have adopted outsourcing and chains from foreign sources. Global industry makes countries interdependent, which also carries risks.
In the fall of 1994, a plague epidemic hit the Indian port city of Surat. Hysteria erupted and countries temporarily banned entry to India. Tourists have left their holidays. Airlines have cancelled flights. The United Arab Emirates banned Indian cargo, while Russia demanded quarantines on shipments.
Plague is not uncommon, with small outbreaks every year, even in the United States, and the Surat epidemic has been benign, with just over 50 deaths, but global panic devastated the city and charged the Indian economy for about $3 billion.
The reaction to the outbreak alarmed David Heymann, an American epidemiologist who was then a senior WHO official concerned about the agency’s reaction to Surat. The Indian government reported on the outbreak and temporarily controlled it. However, India was punished, a reaction he thought. as “irrational. “
“This has nothing to do with the epidemic,” said Dr Heymann, who trained at the U. S. Centers for Disease Control and Prevention. But it’s not the first time
At that time, the International Health Regulations were designed to prevent disruptions in industry, but applied to only 3 diseases: plague, cholera and yellow fever. The application is highly unlikely and countries impose arbitrary travel bans for other diseases.
Surat exposed the ultimate atrocious blind spot. The precautionary formula for a global pandemic depended on political leaders sounding the alarm. If the cost were monetary ruin, no country would report an epidemic.
“It made us realize that it was necessary to change the regulations,” said Dr. Heymann.
Who. Soon, a broad reassessment of regulations began, but revisions progressed slowly until the SARS outbreak occurred in 2003. Fearing a pandemic, W. H. O. no is advised by affected countries, the strictest recommendations of its 55-year history.
Most of the affected countries were in Asia, however, Canada felt more aggrieved after the W. H. O. he didn’t advise Toronto. and told the firm to complete the reviews.
This time, the procedure was quick. In 2005, diplomats reached a commitment to balance public aptitude desires with the economic consequences of “unnecessary interference” in and trade. While the new regulations did not explicitly prohibit countries from defining their borders or restricting trade, they made it clear that this deserves to be just a last resort.
But the regulations were never based on a set of clinical evidence. There were moderate assumptions: closing borders can delay the arrival of doctors and humanitarian workers, for example. However, no one has studied whether restricting travel can delay a trip. spread of diseases, in component because there was no culture of gathering knowledge about such interventions.
“We didn’t think we had to measure them because we thought we knew,” said Professor Gostin, a Georgetown expert who was involved in the review process. “Obviously, we didn’t. “
The new regulations came into force in 2007, even when the world was making them obsolete. Focused heavily on trade, they did not take into account “a tourism industry that is breaking the boundaries,” said Professor Ilona Kickbusch of the Graduate Institute for International Studies and Development in Geneva.
In the 2000s, Ischgl’s nightlife earned it the nickname “Ibiza of the Alps”. Huge car parks had been built for a bus flow across Europe. Most significantly, however, was the effect on reasonable air travel.
Today, tourists can succeed in Ischgl from 8 nearby airports in Austria, Germany, Switzerland and Italy, one of them, Memmingen Airport in Germany, once an army airfield, whose immediate transformation began when Ryanair, the cheap Irish airline, started flying there in 2009. The airport now serves several cheap airlines and had more than 1. 7 million passengers last year.
Over the past decade, flights through Munich and Zurich have taken tourists as far away as the United States and China, and Ischgl now receives 300,000 tourists from 36 countries a year.
This winter, Ischgl hotels filled, even when disturbing reports emerged from Italy.
Ms. Garten said she had never cared and laughed when her boss warned her to bring the virus.
“I think we were going to the mountains, being in a new air,” Ms. Garten said. “What can happen?”
Ms Garten comes to Ischgl to ski and rarely goes out, however she made an exception the day before her 50th birthday. When she arrived at the Kitzloch bar with her husband and friends, the grounds were packed with people and music was playing. ski clothing. The waiters whistled twice in Mrs. Garten’s face to separate the noisy crowd.
“I just delight in being very wet,” she recalls.
That night, March 5, Iceland issued a warning against Ischgl after more than a dozen returning lers tested positive. Two days later, a German bartender from Kitzloch became covid-19’s first known case in Ischgl, but the local government reassured. visitors that everything was fine.
“From a medical point of view, the transmission of coronavirus to visitors to the bar is quite unlikely,” said a provincial medical director the next day. The Kitzloch was disinfected and reopened to the public.
The next day, all his wait came back positive. Bernhard Zangerl, the 25-year-old manager, blamed the “bad luck” and was irritated by accusations of negligence.
“The virus is not From Ischgl, ” said Zangerl, also infected. “He brought here.
At that time, however, the European formula of the impeccable was collapsing. An overworked Italy had closed its borders. In Vienne, Austrian leaders struggled to respond to global turmoil.
“A few weeks earlier, we looked at China and the idea that such quarantine was only imaginable in China,” said Rudolf Anschober, Austria’s minister of health. That month, he said, his government had to make decisions that he had once discovered “unimaginable to imagine. “
The Kitzloch closed, but other bars remained open during the day, even when warnings from the rest of Europe arrived.
Finally, the province’s governor, Gonther Platter, announced that the winter season would end early throughout the province, threatening to allow another 150,000 visitors to arrive next Saturday.
“That 1. 5 billion euros had disappeared,” Platter said.
Platter said his province was aimless because organizations like the W. H. O. and the German Institute Robert Koch took time to react. At the time, Platter said he felt he was going “too far, too fast. “
Peter Kolba, the Viennese lawyer leading the case opposed to the Austrian government, argued that the valley had been closed a week earlier, after the first instances were similar to Ischgl and remained open only because officials were interested in tourism, he said. .
“Every day is valuable during the winter season, especially in Ischgl, where other people spend a lot of money,” Mr. Kolba.
Once Platter made the decision to close the stations, local officials temporarily drafted an evacuation plan: foreign tourists would leave, while Austrians and seasonal staff would be quarantined. But before it became public, the Austrian chancellor announced the closure of television. .
All quick to go.
Witt, the retired instructor from London, saw the merchants hurriedly lock themselves up in the nearby town of San Antonio. A girl, still skiing, saw that elevator operators were leaving their posts.
“In less than an hour, there’s no one on the street, ” said Witt. “It’s scary.
The main road of the valley is obstructed by the cars that make the horns sound. According to Kolba, police were unable to gather the search bureaucracy for the contacts of many tourists at first, leaving their country of origin blind to the risks involved. introduced themselves to them.
At least 27 tourists died after contracting the virus in Ischgl, St. Anton and nearby towns, Kolba said. More than 11,000 Europeans have become inflamed in Austria, many in Ischgl and nearby spas, according to an Austrian public broadcaster. Orf.
Researchers at the University of Innsbruck evaluated 1,500 ischgl citizens in April and 42% had antibodies to the virus.
Andreas Steibl, the jovial and eccentric director of the Ischgl tourist office, has no doubt that the hotel will recover.
Some tourists, such as Mr Homiller, are determined to return. “We deserve to go home, ” he said. Even though many of us were sick, it was a wonderful week. “
However, infections are on the rise and no one can tell what the world will look like when the ski season begins in November. Returning to an unrestricted world is hard to imagine, at least for now.
As scientists around the global rush to make a vaccine, understanding the role of a pandemic and what kind of restrictions might be effective is also essential, even if it is most likely to take much longer. This month, the W. H. O. began another review of foreign fitness regulations.
Dr Heymann, who contributed to the progression of the most recent review, recognizes that existing regulations “are not suitable for trade. “
“Increasingly,” Dr Heymann said, “we perceive that it is mandatory to limit travel and trade. “
However, experts such as Georgetown University Professor Gostin are concerned that, in the absence of data, the world is over-correcting to locate in the next pandemic that new restrictions have slowed medicines, the first to respond in arrears, and fragile unnecessarily broken economies.
“If we want to make possible options that the global so deeply, we want to perceive if it works,” he said. “Otherwise, we just fly blindly. “
Selam Gebrekidan and Katrin Bennhold reported from Ischgl, Matt Apuzzo of Brussels and David D. Kirkpatrick of London, Julia Echikson contributed to the investigation.
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