Global trends in air travel: implications for connectivity and resilience to infectious disease threats

Ashleigh R Tuite; Deepit Bhatia; Rahim Moineddin; Isaac Bogoch; Alexander G Watts; Kamran Khan

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.03.29.20046904 doi: medRxiv preprint important feature of travel trends -connectivity between countries with differential capacities to detect and respond to infectious disease threats. Increased travel between two countries with strong health care and public health systems will likely have very different implications for global health security than increased travel between countries with less developed infrastructure or countries with disparities in their capacities to respond to public health threats. For instance, an increase in travelers to more vulnerable countries may increase the likelihood of exportation of cases to other countries, thereby increasing the rapidity of global transmission. However, if the countries to which the disease is exported have suitable health capacity, the risk of establishment and ongoing transmission may be less of a concern, 9 albeit nonnegligible. 10 Increased connectivity also increases the likelihood of introduction of pathogens via infected tourists to less resilient countries, where disease establishment is a risk. 11 To better understand the impact of globalization on our ability to mitigate infectious disease threats, we sought to describe trends in air passenger numbers over a 10-year period (2007-2016) and investigate if connectivity between countries with different levels of resilience has changed over this time period.