Strategies at points of entry to reduce importation risk of COVID-19 cases and reopen travel
Strategies at points of entry to reduce importation risk of COVID-19 cases and reopen travel
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DOI：
10.1093/jtm/taaa141
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发表时间：
2020-12-01
影响因子：
25.7
通讯作者：
Cook, Alex R.
中科院分区：
文献类型：
--
作者：
Dickens, Borame L.;Koo, Joel R.;Cook, Alex R.
背景资料：随着越来越多的国家解除封锁，公共卫生安全需要在国际旅行入境点采取筛查措施，以防止与严重急性呼吸道综合征相关的冠状病毒2的重新引入或输入。在这里，我们估计了捕获的病例数、避免的筛查天数和预计通过筛查干预发生的继发病例数。估计来自153个有记录的冠状病毒病国家的活跃病例输出风险-2019例和死亡，我们创建了一个简单的数据-驱动框架，以计算来自每个国家的1亿潜在旅行者中的传染性和即将发生的传染性个体数量，并评估了六项减少进口风险战略;策略1（S1）在入境时没有筛查，S2对所有旅行者进行检测，并分离检测阳性的人，其中7天内检测阴性的人被允许入境，S3相当于14天，S4对所有旅行者进行7天的检查，随后所有人都被允许入境，S5相当于14天，S6是对所有旅行者进行检测，并防止检测结果呈阳性的人入境。结果：相对于S1，各国病例输入的平均减少率为S2的90.2%，S3的91.7%，S4的55.4%，S5的91.2%和S6的77.2%。平均79.6%的受感染旅客在抵达时具有传染性。对于前100个出口国，通过S2对检测阳性者进行7天隔离，预计继发病例平均减少88.2%，通过S3对14天隔离，增加到92.1%。预计7天的所有旅行者rectitining的30.0%的大幅减少，增加到84.3%，为14天的所有旅行者rectitining.Conclusions：测试和隔离测试阳性应实施提供良好的测试实践。如果测试不可行，建议至少进行14天的检查，并采取严格的遵守措施。
Background: With more countries exiting lockdown, public health safety requires screening measures at international travel entry points that can prevent the reintroduction or importation of the severe acute respiratory syndrome-related coronavirus-2. Here, we estimate the number of cases captured, quarantining days averted and secondary cases expected to occur with screening interventions.Methods: To estimate active case exportation risk from 153 countries with recorded coronavirus disease-2019 cases and deaths, we created a simple data-driven framework to calculate the number of infectious and upcoming infectious individuals out of 100 000 000 potential travellers from each country, and assessed six importation risk reduction strategies; Strategy 1 (S1) has no screening on entry, S2 tests all travellers and isolates test-positives where those who test negative at 7 days are permitted entry, S3 the equivalent but for a 14 day period, S4 quarantines all travellers for 7 days where all are subsequently permitted entry, S5 the equivalent for 14 days and S6 the testing of all travellers and prevention of entry for those who test positive.Results: The average reduction in case importation across countries relative to S1 is 90.2% for S2, 91.7% for S3, 55.4% for S4, 91.2% for S5 and 77.2% for S6. An average of 79.6% of infected travellers are infectious upon arrival. For the top 100 exporting countries, an 88.2% average reduction in secondary cases is expected through S2 with the 7-day isolation of test-positives, increasing to 92.1% for S3 for 14-day isolation. A substantially smaller reduction of 30.0% is expected for 7-day all traveller quarantining, increasing to 84.3% for 14-day all traveller quarantining.Conclusions: The testing and isolation of test-positives should be implemented provided good testing practices are in place. If testing is not feasible, quarantining for a minimum of 14 days is recommended with strict adherence measures in place.