PMC:7060038 / 34507-35788 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7060038","sourcedb":"PMC","sourceid":"7060038","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7060038","text":"The international expansion of COVID-19 cases has led to widespread adoption of symptom and risk screening measures, in travel-associated and other contexts, and programs may still be adopted or expanded as source epidemics of COVID-19 emerge in new geographic areas. Using a mathematical model of screening effectiveness, with preliminary estimates of COVID-19 epidemiology and natural history, we estimate that screening will detect less than half of infected travellers in a growing epidemic, and that screening effectiveness will increase marginally as growth of the source epidemic decelerates. We found that two main factors influenced the effectiveness of screening. First, symptom screening depends on the natural history of an infection: individuals are increasingly likely to show detectable symptoms with increasing time since exposure. A fundamental shortcoming of screening is the difficulty of detecting infected individuals during their incubation period, or early after the onset of symptoms, at which point they still feel healthy enough to undertake normal activities or travel. This difficulty is amplified when the incubation period is longer; infected individuals have a longer window in which they may mix socially or travel with low probability of 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