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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/429| Interventions targeting air travellers early in the pandemic may delay local outbreaks of SARS-CoV-2 | |
| Petra Klepac CMMID COVID-19 working group Rosalind M Eggo Samuel J Clifford Stefan Flasche Kevin Van Zandvoort Billy J Quilty Carl A B Pearson | |
| Novel Coronavirus | |
| Acceso Abierto | |
| Atribución | |
| 10.1101/2020.02.12.20022426 | |
| Background: We evaluated if interventions aimed at air travellers can delay establishment of a SARS-CoV-2 outbreak in a previously unaffected country. Methods: For countries with no sustained SARS-CoV-2 transmission and with no shared border with affected regions we simulated arriving infected air travellers. We assessed the effectiveness of syndromic screening at departure and/or arrival & traveller sensitisation to the COVID-2019-like symptoms with the aim to trigger rapid self-isolation and reporting on symptom onset to enable contact tracing. We assumed that syndromic screening would reduce the number of infected arrivals and that traveller sensitisation reduce the average number of secondary cases. We report the minimal expected delay achievable in 50% (75% & 97.5%) of simulations. In the simulations we account for uncertainty in the number of secondary cases in the absence of air traveller targeted interventions and the arrival times of infected cases and also present sensitivity analyses on arrival rates of infected travellers and the effectiveness of traveller sensitisation. Results: Under baseline assumptions exit and entry screening combined with traveller sensitisation can delay a local SARS-CoV-2 outbreak by at least 83 (75% of simulations: at least 36, 97.5% 8) days while there is no more than 1 infected traveller per week. The benefit of entry screening is small if exit screening is effective: the combination of only exit screening and traveller sensitisation can delay an outbreak by at least 76 (75%: 33, 97.5%: 7) days. With increasing rates of infected travellers, less effective sensitisation or without screening these delays shrink rapidly to a week or less. Conclusion: Syndromic screening and traveller sensitisation in combination could delay outbreaks in yet unaffected countries and support local containment efforts, but only if infected traveller numbers are very low. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement SF and SC are supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (Grant number 208812/Z/17/Z). RME acknowledges an HDR UK Innovation Fellowship (Grant number MR/S003975/1). BQ was funded by the National Institute for Health Research (NIHR) (16/137/109) using UK aid from the UK Government to support global health research. PK was funded by the Bill & Melinda Gates Foundation (INV-003174). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the UK Department of Health and Social Care. The following authors were part of the Centre for Mathematical Modelling of Infectious Disease SARS-CoV-2 working group and contributed equally and appear in random order: Christopher I Jarvis, Yang Liu, Nikos I Bosse, Kiesha Prem, Adam J Kucharski, W John Edmunds, Timothy W Russell, Sebastian Funk, Mark Jit, Hamish Gibbs, Sam Abbott, James D Munday, Amy Gimma, Nicholas Davies, Carl AB Pearson, Charlie Diamond, Joel Hellewell. Each contributed in processing, cleaning and interpretation of data, interpreted findings, contributed to the manuscript, and approved the work for publication. We also like to thank John Edmunds, Graham Medley and Annelies Wilder-Smith for their helpful comments during the conception of this work. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The study contains no primary data [https://github.com/samclifford/screening_outbreak_delay/][1] [1]: https://github.com/samclifford/screening_outbreak_delay/ | |
| Cold Spring Harbor Laboratory Press | |
| 2020 | |
| Preimpreso | |
| https://www.medrxiv.org/content/10.1101/2020.02.12.20022426v2 | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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