The differential importation risks of COVID-19 from inbound travellers and the feasibility of targeted travel controls: A case study in Hong Kong

Background: Many countries/regions implemented strict border measures (e.g., 14-day quarantines) as a blanket policy to prevent COVID-19 importations, while proposed “travel bubbles” as an alternative to reduce the impact of border controls. We aim to examine the differential importation risks with...

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Bibliographic Details
Main Authors: Bingyi Yang, Tim K. Tsang, Jessica Y. Wong, Yinan He, Huizhi Gao, Faith Ho, Eric H.Y. Lau, Peng Wu, Sheena G. Sullivan, Benjamin J. Cowling
Format: Article
Language:English
Published: Elsevier 2021-08-01
Series:The Lancet Regional Health. Western Pacific
Online Access:http://www.sciencedirect.com/science/article/pii/S2666606521000936
Description
Summary:Background: Many countries/regions implemented strict border measures (e.g., 14-day quarantines) as a blanket policy to prevent COVID-19 importations, while proposed “travel bubbles” as an alternative to reduce the impact of border controls. We aim to examine the differential importation risks with departure origins and post-arrival controls. Methods: We developed a Bayesian framework to model disease progress of COVID-19 and the effectiveness of travel measures and inferred the origin-specific disease prevalence among inbound travellers, using data on passengers arriving in Hong Kong and laboratory-confirmed imported cases. We estimated the origin-specific risks of releasing infectious travellers under different control strategies and traveller volumes. We also estimated the risk of having released infectious travellers when a resurgence occurs in departure locations with no imported cases during a certain period. Findings: Under the then strict controls of 14-day quarantine and testing on day 12, the Philippines imposed the greatest importation risk among the studied countries/regions (95.8% of releasing at least one infectious traveller, 95% credible interval (CrI), 94.8-96.6%). This was higher than that from low prevalence countries/regions (e.g., 23.4%, 95% CrI, 21.6-25.3% for Taiwan) if controls relaxed (i.e., 7-day quarantine and test on day 5). Increased traveller volumes and resurgence in departure locations with low prevalence under relaxed controls did not impose a greater importation risk than high prevalence locations under stricter controls. Interpretation: Moderate relaxation of control measures for travellers arriving from low prevalence locations did not impose higher risks of community outbreaks than strict controls on travellers from high prevalence locations. Funding: Health and Medical Research Fund, Hong Kong.
ISSN:2666-6065