What effect might border screening have on preventing the importation of COVID-19 compared with other infections? A modelling study

Declan Bays*, Emma Bennett, Thomas Finnie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
24 Downloads (Pure)

Abstract

The effectiveness of screening travellers during times of international disease outbreak is contentious, especially as the reduction in the risk of disease importation can be very small. Border screening typically consists of travellers being thermally scanned for signs of fever and/or completing a survey declaring any possible symptoms prior to admission to their destination country; while more thorough testing typically exists, these would generally prove more disruptive to deploy. In this paper, we describe a simple Monte Carlo based model that incorporates the epidemiology of coronavirus disease-2019 (COVID-19) to investigate the potential decrease in risk of disease importation that might be achieved by requiring travellers to undergo screening upon arrival during the current pandemic. This is a purely theoretical study to investigate the maximum impact that might be attained by deploying a test or testing programme simply at the point of entry, through which we may assess such action in the real world as a method of decreasing the risk of importation. We, therefore, assume ideal conditions such as 100% compliance among travellers and the use of a 'perfect' test. In addition to COVID-19, we also apply the presented model to simulated outbreaks of influenza, severe acute respiratory syndrome (SARS) and Ebola for comparison. Our model only considers screening implemented at airports, being the predominant method of international travel. Primary results showed that in the best-case scenario, screening at the point of entry may detect a maximum of 8.8% of travellers infected with COVID-19, compared to 34.8.%, 9.7% and 3.0% for travellers infected with influenza, SARS and Ebola respectively. While results appear to indicate that screening is more effective at preventing disease ingress when the disease in question has a shorter average incubation period, our results suggest that screening at the point of entry alone does not represent a sufficient method to adequately protect a nation from the importation of COVID-19 cases.

Original languageEnglish
Article numbere238
Number of pages5
JournalEpidemiology and Infection
Volume149
DOIs
Publication statusPublished - 4 Nov 2021

Bibliographical note

Funding Information: No funding information.

Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

Publisher Copyright: © 2021 Crown Copyright-UK Health Security Agency. Published by Cambridge University Press.

Citation: Bays D, Bennett E, Finnie T (2021). What effect might border screening
have on preventing the importation of COVID-19 compared with other infections? A modelling study. Epidemiology and Infection 149, e238, 1–5.

DOI: https://doi.org/10.1017/S0950268821002387

Keywords

  • COVID-19
  • Ebola virus
  • SARS
  • public health
  • screening programme

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