key: cord-0868485-y0ovthgs
authors: Baddal, Buket; Sanlidag, Tamer; Uzun, Berna; Uzun Ozsahin, Dilber
title: The use of double border-screening strategy in the surveillance and prevention of COVID-19
date: 2021-03-29
journal: J Infect Public Health
DOI: 10.1016/j.jiph.2021.03.012
sha: bd0e0fe545fa17281d9dad8c4bbb277c5906704e
doc_id: 868485
cord_uid: y0ovthgs

nan

As a global health problem, COVID-19 has led to a worldwide effort and an immense response aimed at tackling the pandemic. Effective control measures including nonpharmaceutical interventions such as temporary lockdowns, social distancing and enhanced personal hygiene were implemented to limit the spread of the disease. As hyperconnectivity in the modern world has been considered to facilitate the exponential global spread of COVID-19 [1] , reduced travel both domestically and internationally was an additional control measure universally adopted. In a recent study, early and sustained implementation of containment through internal and external border controls was identified as a key strategy in curbing the spread of the disease [2] . Accordingly, distinct travel restrictions in addition to entry/exit screening and isolation methods have been applied at international land borders in different countries.

Secondary cases of COVID-19, transmitted from imported cases, pose a significant risk of community spread in a country [3] . The requirement of a negative reverse transcriptase polymerase chain reaction (RT-PCR) test result performed within 72 hours of boarding for air and sea travel, in addition to a second RT-PCR screening upon arrival at the country border, was among the measures imposed by the local government in Northern Cyprus. This was later followed by the implementation of a one-week quarantine procedure for all passengers arriving from high risk countries [4] . In this study, we aimed to evaluate the effectiveness of a double RT-PCR screening procedure for border surveillance. In order to determine the effectiveness of double RT-PCR testing, the results of two independently administered tests were evaluated in terms of chances of obtaining two false-negative or -positive results, two accurate results or either a false-negative or -positive result in one of the administered tests [5] . The conditional probability has been defined as the probability of event A, when it is known that an event such as B has occurred either by assumption or evidence [6] and has been denoted by P (A | B) or P (A/B). In order to determine the effect of the COVID-19 RT-PCR test on the probability of giving correct results, all scenarios, applied with a second RT-PCR test are discussed with conditional probabilities (Table 1) . If the first test has a false-negative or -positive rate of 40%, the chances of obtaining two false-negative or two false-positive results declines to 16%. On the contrary, if the first test has a false-negative or -positive result, the chances of obtaining a second accurate test result would be 24%. These The results show that the probability of deriving at least one true test is

The second test increased the probability of reaching at least one true test by 24%, indicating that the second test had a significant effect on reaching the correct test.

Double border-screening measures have also been implemented by Iceland during the pandemic. The use of a first test upon arrival and a second test after 5-6 days in a quarantine facility in Iceland was shown to minimize the risk of a false negative result which may lead to the spread of infection [7] . Several countries have established temporary travel arrangements between neighboring countries with similar COVID-19 incidence termed as 'travel bubbles' or 'travel corridors' and allow travel within their respective borders without on-arrival quarantine. Travel bubbles require strict surveillance and control measures to limit the importation of COVID-19 [8] .

As an additonal international border surveillance measure against COVID-19, the use of trained biodetection dogs has been suggested as a preliminary screening method at country borders.

Biodetection dogs may aid in the early identification and isolation of potential asymptomatic SARS-CoV-2-infected passengers, however this strategy has an average sensitivity of 82.63% and should be confirmed by RT-PCR testing [9, 10] .

J o u r n a l P r e -p r o o f

Introducing the 21st Century's New Four Horsemen of the Coronapocalypse

Superposition of COVID-19 waves, anticipating a sustained wave, and lessons for the future

The effects of border control and quarantine measures on the spread of COVID-19

Current situation of covid-19 in northern cyprus

Test, re-test, re-test': using inaccurate tests to greatly increase the accuracy of COVID-19 testing

Probability: A Graduate Course

Double border screening for all arriving passengers

International travel during the COVID-19 pandemic: implications and risks associated with "travel bubbles

Scent dog identification of samples from COVID-19 patients -A pilot study

Bio-detection dogs for COVID-19: an