As the world battles with localised CoVID-19 outbreaks, it is now clear that a major source of transmission of infection is no longer from the influx of expatriates nor travellers. CoVID-19 is now a community problem. The politicizing of the pandemic has obfuscated the fact that, in most countries, communities and family groups have been battling the epidemic for several months.
Employing locally based providers to COVID-19 is an effective public health policy.
It is clear that border restrictions are a convenient distraction and pander to the already-heightened xenophobia. As a deterrent, they are only as effective as policing can ensure. As we have known for decades about policing, there will never be enough policers nor deterrents to prevent spread – and if there were, the community upheaval due to CoVID-19 fatigue would be just as unmanageable.
It is time for a community-led recovery. As a Professor of General Practice, I know that provider-led community action can be a winner. Countries with strong primary medical care systems, are well-positioned with clinical services to utilise their established community ties in areas such as prevention, to effect real control of the CoVID-19 spread that extends beyond travel.
Just as primary care providers have embraced and enhanced telehealth and made it work more efficiently in these times, so can they embrace monitoring COVID-19 in communities and also in their expatriate returnees, who are seeking return or relocate safely.
GP could validate community-based quarantine and assess CoVID-19 safety, just as we monitor fitness for licenses for elderly drivers. Families could apply to their local GP to certify they are suitable to monitor a CoVID-19 return and/or quarantiner. GPs could regularly receive contact from family members, confirming the terms of adherence. Clinics could be the sites for rapid testing and rapid reassessment of fitness-for-work.
Until something sensible is done, countries like Australia will keep the double standard flying high, wringing their hands over foreign nationals in refugee camps and yet relegating their own expatriate citizens to those same camps. Employing locally based providers to allow expatriates and their families to safely come home is not only humane, it is good public health policy.