Sundhedsudvalget 2021-22
SUU Alm.del Bilag 283
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www.oxera.com
www.edgehealth.co.uk
Impact of travel restrictions on
Omicron in the UK
Prepared for Manchester Airports Group
5 January 2021
1
Introduction and executive summary
Oxera and Edge Health have been commissioned by Manchester Airports
Group (‘MAG’) to consider the impact of travel restrictions on the spread of
variants in the UK, and to compare this to the impact of domestic restrictions.
1
The Omicron variant is now highly prevalent in the UK and the government is
considering what, if any, further measures should be taken to mitigate the
variant’s impact. Our analysis indicates that when a variant is already highly
prevalent in the domestic environment, travel restrictions are likely to have a
very limited impact on the growth and the peak of cases and hospitalisations.
This must be considered alongside analysis undertaken by Oxera in December
2021, which indicated that Omicron travel restrictions could lead to an
additional £3.1bn loss in GVA and £1.5bn loss in tax revenue over the next
year.
2
This note sets out the high-level findings from our analysis. The key
conclusions are as follows.
•
Although it is now known that Omicron was circulating internationally
throughout November, testing and sequencing of tests for air passengers
arriving in the UK over the course of November did not identify Omicron as
a Variant of Concern (VOC) in the UK before it was reported by South Africa
towards the end of November.
•
Additional testing requirements—i.e. pre-departure tests and Day 2 PCR
tests—were put in place by the UK government quickly in late
November/early December after Omicron was identified as a VOC.
1
This work is an extension of previous analysis undertaken by Oxera and Edge Health for MAG in April
2021. Assumptions have been updated to take account of recent developments and evidence.
2
Oxera (2021), ‘Assessing the impact of recent international travel restrictions on the UK aviation sector
and the wider economy’, 15 December.
Oxera Consulting LLP is a limited liability partnership registered in England no. OC392464, registered office: Park Central, 40/41
Park End Street, Oxford OX1 1JD, UK; in Belgium, no. 0651 990 151, branch office: Avenue Louise 81, 1050 Brussels, Belgium;
and in Italy, REA no. RM - 1530473, branch office: Via delle Quattro Fontane 15, 00184 Rome, Italy. Oxera Consulting (France)
LLP, a French branch, registered office: 60 Avenue Charles de Gaulle, CS 60016, 92573 Neuilly-sur-Seine, France and
registered in Nanterre, RCS no. 844 900 407 00025. Oxera Consulting (Netherlands) LLP, a Dutch branch, registered office:
Strawinskylaan 3051, 1077 ZX Amsterdam, The Netherlands and registered in Amsterdam, KvK no. 72446218. Oxera
Consulting GmbH is registered in Germany, no. HRB 148781 B (Local Court of Charlottenburg), registered office: Rahel-Hirsch-
Straße 10, Berlin 10557, Germany.
Although every effort has been made to ensure the accuracy of the material and the integrity of the analysis presented herein,
Oxera accepts no liability for any actions taken on the basis of its contents.
No Oxera entity is either authorised or regulated by any Financial Authority or Regulation within any of the countries within which
it operates or provides services. Anyone considering a specific investment should consult their own broker or other investment
adviser. Oxera accepts no liability for any specific investment decision, which must be at the investor’s own risk.
© Oxera 2022. All rights reserved. Except for the quotation of short passages for the purposes of criticism or review, no part may
be used or reproduced without permission.
 SUU, Alm.del - 2021-22 - Bilag 283: Rapporter om effekter af rejserestriktioner om omicron in Italien, Finland og UK
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Impact of travel restrictions on Omicron in the UK
Oxera and Edge Health
2
However, these restrictions were ineffective at preventing the spread of
Omicron in the UK.
•
Even if these, or other, travel testing requirements had been in place from
the beginning of November, they would not have had a significant impact on
the spread of Omicron in the UK. Compared to a Day 2 antigen test, a Day
2 PCR and pre-departure testing regime would have delayed the peak of
cases by just five days and reduced the peak by only 3%. If no travel
restrictions had been in place at all in November/December, cases would
have peaked seven days earlier and the peak would have been 8% higher
than without any travel testing.
•
Now that Omicron is highly prevalent in the UK, if all travel testing
requirements are removed in January, there would be no impact on
Omicron case numbers or hospitalisations in the UK, and there would be
much lower costs imposed on the UK economy than if the current
restrictions are kept in place.
3
2
2.1
Overview of analysis
Background
There have been significant changes in travel policy in the UK over the course
of the pandemic. By 1 November 2021, there were no remaining countries on
the red list and the only restriction in place was a requirement to take an
antigen test on or before Day 2 of a passenger’s arrival in the UK.
While the first known Omicron sequence in South Africa was on 8 November
2021, Omicron was only identified as a VOC by the WHO on 26 November
2021. Therefore, for a month before it was identified as a concern, Omicron
was in circulation internationally and being seeded in the UK, despite the travel
testing regime in place.
Once Omicron was identified as a VOC, the UK government reacted quickly
and introduced a number of new travel restrictions, including red listing six
countries on 26 November
4
and requiring a Day 2 PCR test as of 27
November. On 7 December, the restrictions were further amended such that a
pre-departure test was also required to enter the UK. The first domestic
restriction, a mask mandate, was imposed on 10 December.
While red-listed countries had a higher proportion of Omicron cases than other
countries, by 15 December Omicron was already highly prevalent in the UK.
For this reason, the UK government removed all countries from the red list.
However, the additional travel restrictions introduced over the course of
November/December remain in place.
2.2
Impact of travel restrictions on Omicron in the UK
Our analysis indicates that the new travel restrictions introduced in late
November/early December after Omicron was identified as a VOC were
ineffective at preventing the spread of Omicron. In Figure 2.1 below we model
the UK’s actual travel restrictions over the course of November/December (the
red line)
5
and compare this to what would have happened if the government
Oxera (2021), ‘Assessing the impact of recent international travel restrictions on the UK aviation sector and
the wider economy’, 15 December.
4
More countries were later added to the red list.
5
The actual policy modelled is a Day 2 antigen test until 27 November, a Day 2 PCR test from 27 November,
and then a Day 2 PCR and a pre-departure test from 7 December.
3
 SUU, Alm.del - 2021-22 - Bilag 283: Rapporter om effekter af rejserestriktioner om omicron in Italien, Finland og UK
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Impact of travel restrictions on Omicron in the UK
Oxera and Edge Health
3
had not made changes to the travel testing policy—i.e. requiring only Day 2
antigen testing (the blue line).
The figure illustrates that the modelled trajectories of Omicron cases in the UK
between the two scenarios are indistinguishable. This suggests that at the
point that Omicron was identified, putting further travel restrictions in place was
ineffective.
Figure 2.1
Trajectory of Omicron cases in the UK, comparing a
continuation of Day 2 antigen testing to the travel policies
introduced in November/December
Source: Edge Health and Oxera.
While the figure above compares the effect of travel policies once Omicron was
identified as a VOC, it is also important to consider whether the spread of
Omicron could have been prevented if more stringent travel restrictions had
been in place earlier—i.e. already from the beginning of November. Figure 2.2
below presents the results of our analysis, and shows that if more stringent
testing requirements had been in place from the beginning of November, there
would not have been a significant impact on the spread of Omicron in the UK.
 SUU, Alm.del - 2021-22 - Bilag 283: Rapporter om effekter af rejserestriktioner om omicron in Italien, Finland og UK
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Impact of travel restrictions on Omicron in the UK
Oxera and Edge Health
4
Figure 2.2
Trajectory of Omicron cases in the UK, based on different
testing policies in November/December
Source: Edge Health and Oxera.
For example, if the government had introduced Day 2 PCR tests and pre-
departure tests (i.e. the current policy) in early November rather than
continuing with Day 2 antigen tests, the peak of cases would have only been
3% lower and would have been delayed by five days. If no travel restrictions
had been in place at all in November/December, cases would have peaked
seven days sooner and the peak would have been 8% higher than without any
travel testing.
2.3
Impact of travel restrictions compared to domestic restrictions
As demonstrated above, now that Omicron is highly prevalent in the UK,
removing all travel testing in January would not affect domestic Omicron
spread. Domestic measures are currently the best approach to reducing
potential pressure on the healthcare system. Figure 2.3 below plots the
trajectory of future Omicron hospitalisations in the UK, based on three different
domestic policies:
•
Scenario 1: mandatory masks, work-from-home orders and further roll-out of
booster doses (i.e. the current policy with no further restrictions);
•
Scenario 2: intermediate interventions (i.e. with gathering sizes limited to ten
people);
•
Scenario 3: stay at home order (i.e. national lockdown, with schools and
businesses closed).
 SUU, Alm.del - 2021-22 - Bilag 283: Rapporter om effekter af rejserestriktioner om omicron in Italien, Finland og UK
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Impact of travel restrictions on Omicron in the UK
Oxera and Edge Health
5
Figure 2.3
Trajectory of future Omicron hospitalisations in the UK,
based on different domestic policies
Source: Edge Health and Oxera.
The figure above demonstrates that across all domestic restriction scenarios,
there is no benefit to maintaining the current travel policy indefinitely compared
to removing travel restrictions in January.