背景:尽管全球国际机场对COVID-19感染旅客的机场筛查措施已大大放松,仅在机场评估发烧筛查的观察性研究仍然很少。这项研究的目的是回顾性评估机场发烧筛查在预防COVID-19感染者涌入方面的有效性。
方法:我们对2020年5月至2022年3月在冲绳县9个机场实施的发热筛查进行了回顾性流行病学分析。同期,抵达冲绳县9个机场的旅客人数为9,003,616人,那霸机场的旅客人数为5,712,983人。捕获率定义为报告的通过机场筛查的COVID-19病例与通过机场发烧筛查的疑似病例数的比例,该计算使用了冲绳县在2020年5月至2021年3月之间到达那霸机场的乘客和收集的监视数据。
结果:从2020年5月到2021年3月,据报道有409万人通过冲绳机场。在同一时期,至少122名感染COVID-19的人抵达冲绳机场,但只发现了10起疑似病例;因此,捕获率估计高达8.2%(95%CI:4.00-14.56%)。我们的发烧筛查率为0.0002%(95CI:0.0003-0.0006%)(10例疑似病例/2,971,198名到达乘客)。通过热成像检测到的对温度测量没有响应的乘客的拒绝率为0.70%(95%CI:0.19-1.78%)(4名乘客/572名乘客)。
结论:这项研究表明,仅基于热成像的机场筛查就错过了90%以上的COVID-19感染病例,表明热成像筛查作为边境控制措施可能无效。在筛查大约300万乘客后,仅发现10例发热病例,这表明有必要采取针对无症状感染的措施,尤其是潜伏期长。因此,其他对策,例如,登机前RT-PCR测试,强烈建议在符合世界卫生组织(WHO)国际关注的突发公共卫生事件(PHEIC)标准的流行病中,病原体特征类似或超过SARS-CoV-2,尤其是在前往医疗资源有限的农村城市旅行时。
BACKGROUND: While
airport screening measures for COVID-19 infected passengers at international airports worldwide have been greatly relaxed, observational studies evaluating fever screening alone at airports remain scarce. The purpose of this study is to retrospectively assess the effectiveness of fever screening at airports in preventing the influx of COVID-19 infected persons.
METHODS: We conducted a retrospective epidemiological analysis of fever screening implemented at 9 airports in Okinawa Prefecture from May 2020 to March 2022. The number of passengers covered during the same period was 9,003,616 arriving at 9 airports in Okinawa Prefecture and 5,712,983 departing passengers at Naha Airport. The capture rate was defined as the proportion of reported COVID-19 cases who would have passed through
airport screening to the number of suspected cases through fever screening at the
airport, and this calculation used passengers arriving at Naha
Airport and surveillance data collected by Okinawa Prefecture between May 2020 and March 2021.
RESULTS: From May 2020 to March 2021, 4.09 million people were reported to pass through airports in Okinawa. During the same period, at least 122 people with COVID-19 infection arrived at the airports in Okinawa, but only a 10 suspected cases were detected; therefore, the capture rate is estimated to be up to 8.2% (95% CI: 4.00-14.56%). Our result of a fever screening rate is 0.0002% (95%CI: 0.0003-0.0006%) (10 suspected cases /2,971,198 arriving passengers). The refusal rate of passengers detected by thermography who did not respond to temperature measurements was 0.70% (95% CI: 0.19-1.78%) (4 passengers/572 passengers).
CONCLUSIONS: This study revealed that
airport screening based on thermography alone missed over 90% of COVID-19 infected cases, indicating that thermography screening may be ineffective as a border control measure. The fact that only 10 febrile cases were detected after screening approximately 3 million passengers suggests the need to introduce measures targeting asymptomatic infections, especially with long incubation periods. Therefore, other countermeasures, e.g. preboarding RT-PCR testing, are highly recommended during an epidemic satisfying World Health Organization (WHO) Public Health Emergency of International Concern (PHEIC) criteria with pathogen characteristics similar or exceeding SARS-CoV-2, especially when traveling to rural cities with limited medical resources.