Wednesday, March 25, 2020

Why quarantine works better than airport screening

On Monday, the Indian Council of Medical Research (ICMR) published research from February 27 that attempts to “identify rational intervention strategies that might work towards control of the outbreak in India” of COVID-19. The research compares the effectiveness and feasibility of two approaches — attempting to contain an outbreak at the border, and quarantining symptomatic cases within the country.

The research makes a case for post-travel tracking rather than border containment. It uses mathematical modelling to show that spending resources on quarantining symptomatic cases can achieve a meaningful impact on the disease burden (assuming an “optimistic” scenario), rather than attempting to achieve infeasible levels of containment at the borders.

At the same time, it also accounts for the inevitability that an outburst of cases would make lab confirmations impractical. Therefore, the paper proposes “symptomatic surveillance” to be included with quarantine measures.
The government has focused on random sampling of patients with severe symptoms and quarantining positive cases. In the initial weeks of rising cases in India, asymptomatic travellers were not tested.
The researchers found that if India screened all symptomatic airport arrivals from China, the epidemic would occur in 45 to 47.7 days. If all asymptomatic arrivals from China were screened, India would need to identify at least 75% of asymptomatic infected arrivals in order to achieve an “appreciable” delay in the outbreak. If 90% were identified, the delay would be 20 days.
25/03/20 Karishma Mehrotra/Indian Express
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