Comparing US and UK Covid case numbers suggests Australia’s India flight ban based on ‘fear factor’

Epidemiologists are questioning why Australia has banned all flights from India, with a Guardian analysis revealing India has fewer coronavirus cases per capita than either the United States or the United Kingdom during their respective Covid peaks.

The Australian government did not suspend flights from those countries as it did this week with India.

Experts say cases in India could be underreported but they believe the numbers are still lower than the spikes seen in other countries in recent months. They also note one variant of interest in India has not yet been deemed as concerning as the UK strain that dominated Britain’s December wave.

Peter Collignon, a professor of infectious diseases at the Australian National University, believes Australia “needs to rethink blanket bans”. He says Canberra is ethically obliged to allow Australians to return from India because they risk contracting the virus in a country where hospital access isn’t guaranteed.

A comparison of infection data has led Mary-Louise McLaws, a professor of epidemiology at the University of New South Wales and a World Health Organization advisor, to argue the government’s ban on flights from India is likely “an act out of fear”.

She says the Morrison government must offer a route home for citizens “to ensure there is no misconception the ban is in any way racist”.

Arrival bans for specific countries, including China, were introduced before a public health order barring all non-citizens and permanent residents entry to Australia was made at the beginning of the pandemic in early 2020.

But the suspension of direct flights from India – until at least 15 May – is the first time Australian citizens have essentially been banned from entering their own country.

Almost 100 countries have had days with more cases per capita than India, according to Our World in Data statistics analysed by Guardian Australia.

The UK and US were also responsible for a greater share of overseas acquired cases in Australia at the height of their outbreaks, according to data released by the New South Wales health department.

In NSW, 41% of Covid-19 cases acquired overseas in December were from the United States.

While India is the largest source of overseas acquired cases in the latest data, from 17 April, the country accounted for just 21% of overseas infections in the preceding four weeks.

At the beginning of January, the height of their most recent outbreaks, the United Kingdom and the United States recorded 1,004 and 907 new cases per million people per day.

India hit a high watermark of 225 new cases per million last week. India does have one of the largest case totals in raw numbers, however, with over 17m cases as of 26 April.

NSW Health has released data on overseas acquired infections by source country since November. Examining the past five months, it can be seen that India, the UK and the US all had similar numbers of resident returns in the past year – 11,760 then 12,510 and 10,990 respectively.

But significantly more residents returned from the United Kingdom and the United States over the three months to January than from India.

Responding to the figures, Collignon said “the fear factor has now come into this”.

“I look at the numbers and I’m not sure the rates are higher in India, that the risk is all that different. We need to rethink blanket bans because I’m not sure it’s being done on a consistent basis,” he said.

“There are Australians there and I don’t think it’s reasonable to stop them coming to Australia.”

Collignon urged the federal government to resume arrivals from India and use a single quarantine site for them similar to a medical hotel used by some states for infected arrivals.

He said even if the government was afraid travellers will have Covid or could catch it in Australian quarantine, it was ethically obliged to allow them to return, because they may not be able to access a hospital in India.

“Australians are going to be much better off if they develop Covid here where they can access hospitals. We should look at accepting that risk.”

McLaws agreed that even though there was an ethical responsibility to ensure returning travellers would be safe in quarantine and not contract Covid, there was also a responsibility to ensure Australians in India had access to health care – something it could only guarantee by repatriating them.

She also questioned why a flight ban was not put in place when larger spikes were recorded in other countries. In response to the UK wave in December, the Australian government introduced a requirement for arrivals to have a negative PCR test 72 hours before departure to Australia, something still in place for all arrivals.

“As a multicultural country that loves their multicultural community, it is beholden to the authorities to care for that multicultural community that needs to come home and for them to come home safely,” McLaws said.

She said the government’s ban meant some vulnerable Australians could contract Covid in India and die. It ignored the fact many people had been trying to return before the current wave but couldn’t due to flight caps.

To increase the safety of hotel quarantine, McLaws believes Indian arrivals should be tested far more regularly and positive cases diverted to separate facilities sooner in their infectious period.

“This [flight ban] is a knee jerk reaction,” she said. “I can understand the government is worried about India but it’s still a knee jerk reaction.”