Id |
Subject |
Object |
Predicate |
Lexical cue |
T60 |
0-26 |
Sentence |
denotes |
Discussion and conclusions |
T61 |
27-197 |
Sentence |
denotes |
As a response to the ongoing outbreak of the 2019-nCoV originating in Wuhan, exit screening has been implemented for international flights leaving China’s major airports. |
T62 |
198-395 |
Sentence |
denotes |
Thermal scanning, which can identify passengers with fever (high external body temperature), allows for passengers exhibiting symptoms of 2019-nCoV infection to be tested before they board a plane. |
T63 |
396-547 |
Sentence |
denotes |
Similarly, entry screening for flights originating in the most affected regions may be under consideration at airports in regions in and outside China. |
T64 |
548-894 |
Sentence |
denotes |
We estimate that the key goal of syndromic screening at airports - to prevent infected travellers from entering countries or regions with little or no ongoing transmission - is only achievable if the rate of asymptomatic infections that are transmissible is negligible, screening sensitivity is almost perfect, and the incubation period is short. |
T65 |
895-1086 |
Sentence |
denotes |
Based on early data from Li et al. [8], 2019-nCoV appears to have a shorter incubation period than severe acute respiratory syndrome (SARS), and a higher rate of asymptomatic infections [11]. |
T66 |
1087-1209 |
Sentence |
denotes |
Under generally conservative assumptions on sensitivity, we find that 46 of 100 infected travellers will enter undetected. |
T67 |
1210-1317 |
Sentence |
denotes |
Entry screening is an intuitive barrier for the prevention of infected people entering a country or region. |
T68 |
1318-1502 |
Sentence |
denotes |
However, evidence on its effectiveness remains limited and given its lack of specificity, it generates a high overhead of screened travellers uninfected with the targeted pathogen [5]. |
T69 |
1503-1695 |
Sentence |
denotes |
For example, when entry screening was implemented in Australia in response to the 2003 SARS outbreak, 1.84 million people were screened, 794 were quarantined, and no cases were confirmed [12]. |
T70 |
1696-1904 |
Sentence |
denotes |
While some cases of 2019-nCoV infection have been identified through airport screening in the current outbreak, our estimates indicate that likely more infected travellers have not been detected by screening. |
T71 |
1905-2074 |
Sentence |
denotes |
It is important to note that our estimates are based on a number of key assumptions that cannot yet be informed directly by evidence from the ongoing 2019-nCoV outbreak. |
T72 |
2075-2204 |
Sentence |
denotes |
The current outbreak has spread rapidly and early evidence suggests that the average disease severity is lower than that of SARS. |
T73 |
2205-2274 |
Sentence |
denotes |
This may also suggest a substantial proportion of asymptomatic cases. |
T74 |
2275-2479 |
Sentence |
denotes |
A recent analysis of a family transmission cluster is based on a small sample size but one in six infections was asymptomatic [11]; this is a major impediment for the effectiveness of syndromic screening. |
T75 |
2480-2598 |
Sentence |
denotes |
However, if asymptomatic cases were not infectious they would not pose a risk for seeding infection chains on arrival. |
T76 |
2599-2805 |
Sentence |
denotes |
To allow easy adaptation of our results as new insight becomes available in the coming weeks, we developed a free interactive online tool, available at https://cmmid-lshtm.shinyapps.io/traveller_screening/. |
T77 |
2806-3022 |
Sentence |
denotes |
While the most up-to-date data on the incubation period or the time until recovery from 2019-nCoV infection have been used in this analysis, these figures are likely to change over time as more data become available. |
T78 |
3023-3286 |
Sentence |
denotes |
Unless the incubation period is only a small fraction of the duration of infection in relation to that of symptomatic disease, and fever in particular, syndromic screening is likely to detect an insufficient fraction of infected cases to prevent local infections. |
T79 |
3287-3391 |
Sentence |
denotes |
In addition, the sensitivity of airport screening for the detection of 2019-nCoV has not been evaluated. |
T80 |
3392-3536 |
Sentence |
denotes |
However, we chose conservative estimates and show that with reduced sensitivity, the effectiveness of syndromic screening would further decline. |
T81 |
3537-3702 |
Sentence |
denotes |
In many international airports, information is provided to travellers from affected regions recommending action if they develop symptoms on or after arrival [13-16]. |
T82 |
3703-3857 |
Sentence |
denotes |
Some countries, for example Japan, also require incoming passengers to complete forms detailing their past and future travel in order to aid tracing [17]. |
T83 |
3858-4154 |
Sentence |
denotes |
Due to the duration of the incubation period of 2019-nCoV infection, we find that exit or entry screening at airports for initial symptoms, via thermal scanners or similar, is unlikely to prevent passage of infected travellers into new countries or regions where they may seed local transmission. |