Managing the risk of a COVID-19 outbreak from border arrivals
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Abstract
In an attempt to maintain the elimination of COVID-19 in New Zealand, all international arrivals are required to spend 14 days in government-managed quarantine and to return a negative test result before being released. We model the testing, isolation and transmission of COVID-19 within quarantine facilities to estimate the risk of community outbreaks being seeded at the border. We use a simple branching process model for COVID-19 transmission that includes a time-dependent probability of a false-negative test result. We show that the combination of 14-day quarantine with two tests is highly effective in preventing an infectious case entering the community, provided there is no transmission within quarantine facilities. Shorter quarantine periods, or reliance on testing only with no quarantine, substantially increases the risk of an infectious case being released. We calculate the fraction of cases detected in the second week of their two-week stay and show that this may be a useful indicator of the likelihood of transmission occurring within quarantine facilities. Frontline staff working at the border risk exposure to infected individuals and this has the potential to lead to a community outbreak. We use the model to test surveillance strategies and evaluate the likely size of the outbreak at the time it is first detected. We conclude with some recommendations for managing the risk of potential future outbreaks originating from the border.
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SciScore for 10.1101/2020.07.15.20154955: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Another caveat is that this method estimates the probability that an infected individual has travelled to a given region, not the probability they have passed the virus on to someone else there. The latter will depend on the time since the traveller was infected, the length of stay and contact rates in the destination region, and …
SciScore for 10.1101/2020.07.15.20154955: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Another caveat is that this method estimates the probability that an infected individual has travelled to a given region, not the probability they have passed the virus on to someone else there. The latter will depend on the time since the traveller was infected, the length of stay and contact rates in the destination region, and potential correlations among these variables. We do not attempt to quantify this, but we note the probability of onward transmission in the destination region will necessarily be less than the probability of travel, so our results provide a conservative upper bound for the risk of inter-regional spread. This method may be useful in determining the geographical scale of any response measures in response to the outbreak detection. These findings apply to all workers who have contact with international arrivals, whether direct or indirect. Workers who experience only indirect or environmental contact with quarantined individuals have a lower overall risk of being infected, but if they are infected the consequences are the same. Maintaining elimination of COVID-19 depends on the ability to contain all cases at the border. While the controls investigated here may seem onerous, in the long run they are likely to be a preferable alternative to regional or national lockdowns. We did not model superspreaders or superspreading events inside quarantine facilities, as these are unlikely to occur in this environment. It is possible that communal spaces and surfac...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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