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Routine asymptomatic testing strategies for airline travel during the COVID-19 pandemic: a simulation study.
Mathew V Kiang1, Elizabeth T Chin2, Benjamin Q Huynh2
1Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
The Lancet. Infectious Diseases
|March 25, 2021
Summary
Pre-travel testing for SARS-CoV-2 (COVID-19) reduces infectious traveler numbers. Combining pre-travel tests with post-travel quarantine and testing significantly lowers population-level transmission risk during air travel.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Modeling
Background:
- Assessing the effectiveness of viral testing strategies for safe air travel during the COVID-19 pandemic.
- Evaluating the impact of test-and-travel protocols on reducing SARS-CoV-2 transmission among airline passengers.
Purpose of the Study:
- To simulate the effectiveness of various SARS-CoV-2 testing strategies for airline travelers.
- To quantify the reduction in passenger risk and population-level transmission associated with different testing and quarantine protocols.
Main Methods:
- Developed a microsimulation model for SARS-CoV-2 transmission in 100,000 US domestic airline travelers.
- Assessed five testing strategies: pre-travel PCR, pre- and post-travel PCR, same-day antigen, same-day antigen with post-travel PCR, and post-travel PCR alone.
- Included quarantine periods for strategies involving post-travel testing.
Main Results:
- A pre-travel PCR test reduced infectious days by 36% and identified 88% of infectious travelers.
- Adding post-travel quarantine and PCR reduced infectious days by 70% compared to no testing.
- Same-day antigen testing reduced infectious days by 32%, with a 63% reduction when combined with post-travel measures.
Conclusions:
- Routine pre-travel SARS-CoV-2 testing effectively reduces passenger infection risk during air travel.
- Abbreviated quarantine combined with post-travel testing is crucial for minimizing population-level transmission from imported infections.
