COVID-19

Concerns for Well being Screening for COVID-19 at Factors of Entry

purpose

Support ministries of health and their POE (point-of-entry) partners in determining whether and how travel screening should be carried out at POE for coronavirus (COVID-19).

introduction

This document is intended to help ministries of health and their POE (point-of-entry) partners determine whether and how to conduct travel screening of POE for coronavirus (COVID-19).

The aim of screening is to reduce the international spread of communicable diseases by detecting departing travelers who are sick or exposed to the disease and preventing them from leaving the country in which they are (exit screening), or by discovering them on arrival and instructing them for appropriate care and follow-up care as required (entry check)

Public health screening occurs in two phases:

(1) Primary screeningThis includes watching travelers for obvious signs of illness, taking temperature measurements, and gathering information about travel and exposure history. and

(2) secondary screeningThis will include having a healthcare professional (whenever possible) conduct an additional public health assessment of sick or potentially exposed travelers identified as part of the primary screening process.

In addition to detecting sick travelers, public health screening at POE provides an excellent opportunity for countries to educate travelers about the signs and symptoms of COVID-19, protect themselves and their families from infection, and do what they can when they get sick.

Public health screening for POE can be resource intensive, but it is a flexible measure that can be scaled up or down depending on the needs of the country and the status of the outbreak. It is important that countries continuously monitor the development of the pandemic globally, nationally and locally and adapt the screening processes to current needs. For example, screening at the onset of an outbreak can be most important and effective when it provides an opportunity to slow the geographic spread of a disease of public health concern so that unaffected areas have more time to prepare their health systems, citizens and social institutions (e.g. schools, companies) for a possible import of diseases.

Countries may want to use different screening strategies after a communicable disease has been introduced and transmission is sustained in local communities. At this stage, access screening may no longer be the best use of limited human and other resources. Strategies to educate travelers and contain the community (e.g. social distancing, school closings, cancellation or postponement of mass gatherings) may be more beneficial in slowing the spread of the disease.

The following sections provide guidance on:

  • How and what to communicate with travelers about COVID-19
  • Limitations of POE screening
  • Checklist for countries to know if they are able to conduct public health screening at POE
  • Additional considerations for countries considering ground crossing or shipping port inspection

Opportunities for health officials to communicate with the traveling public

The entry points provide health authorities with important opportunities and places to communicate with travelers about the risk of COVID-19 in their countries and in other countries, how to protect themselves while traveling and what to expect after the trip, especially if they are Have done so was in a country with active community transmission of COVID-19.

The following are some recommended communication strategies that countries should consider developing in addition to or alongside other public health actions initiated at POE.

Some of the most important pieces of information you can share with travelers include:

  • Symptoms of COVID-19
  • How to self-monitor for disease and what to do if symptoms appear
  • Public health measures at departure and destination POE
  • How to prepare for upcoming international travel, including:
    • Measures to stay healthy and reduce the risk of infection while traveling
    • Recommendations for periodically reviewing information posted on official government websites of the destination country to learn:
      • Presence of ongoing community transmission of COVID-19
      • Screening and regulatory measures (i.e. isolation, quarantine) are in place
      • Availability of health services at destination
    • Screening and regulatory measures that they should expect when they return to their country of origin.

Communication methods for travel-related messages include:

  • Distributing Travel Health Alert Notices (T-HAN) – a paper handout for arriving or departing travelers with information about COVID-19
  • View health notices that will see most international travelers entering or exiting the POE.
  • Creation of audio or video messages for airlines to broadcast in flight with information on COVID-19 and public health measures applied at the destination's POE.
  • Dissemination of news, e.g. B. via social media

Limitations of Public Health Screening at POE

Public health screening in POE has several limitations and should be complemented by increased community surveillance and other public health measures

The following restrictions on public health screening for POE should be noted:

  • Screening is most effective in identifying travelers who are overtly ill. Travelers who are infected but show no signs of illness (e.g., presymptomatic or asymptomatic) may be overlooked during POE screening, especially if they do not report possible exposure themselves (see 3rd restriction below).
    • It is known that COVID-19 transmission occurs from presymptomatic and asymptomatic infected people. This reduces the effectiveness of public health screening in POE, especially exit screening, since asymptomatic travelers could infect fellow travelers or other people within the POE themselves.
  • Several factors affect obtaining reliable temperature readings, including:
    • The environment in which the temperature is measured. If the environment is extremely hot or cold, body temperature readings can be affected regardless of the temperature measuring device used.
    • Proper calibration of the thermometers according to manufacturer standards. Incorrect calibration can lead to incorrect temperature values.
    • Proper use and reading of thermometers. Non-contact infrared thermometers, often used for health exams, must be held a certain distance from the temporal artery in the forehead in order to correctly measure the temperature. Holding the device too far from or too close to the temporal artery will affect the reading.
  • Screening depends on travelers behaving in ways that contradict their immediate personal interest. To avoid travel disruptions, individuals may not divulge information about their symptoms or exposure history, or try to mask symptoms by taking medication.

Implementation of the COVID-19 screening at a POE

These questions are intended to guide countries through reflection on the capacities required to conduct public health screening at POE. CDC recommends this Countries do not screen until they can answer “yes” to all yes / no questions and have mechanisms in place to respond to suspicious cases identified at POE, also for isolation or quarantine for up to 14 days.

Does the COUNTRY have:

Does the POE:

Additional considerations for countries considering ground crossing or shipping port inspection

  • In contrast to airports, which have the established infrastructure, resources and the ability to guide travelers via controlled pathways to enforce compliance with control regulations, ground crossings and shipping ports often lack the infrastructure and resources to systematically carry out control.
  • Screening at ground junctions slows down the journey and can easily be bypassed by making a detour around the screening point, which will result in travelers crossing unoccupied sections of the border. Travelers who do not want to be delayed or ill and do not want to be prevented from traveling can try to bypass POE screening.
  • Countries should assess their available resources and take a risk-based approach in determining which POEs to select for public health screening activities. Some factors to consider are:
    • The volume of travelers through the POE
    • Types of travelers (demographic information, where they are coming / going / stopping from, purpose of the trip)
    • The connectivity of the POU to geographical areas with a known community
    • Transmission of COVID-19
    • Whether cases have occurred nearby and / or in densely populated areas
    • Screening feasibility (Is there a way to guide travelers through the screening process? Can screening staff easily access the specified location? Can sick travelers be safely isolated at POE and transported to a referring health facility?)
  • Screening should only be performed at POE where the safety of both travelers and screening staff can be ensured (e.g. screening should not be performed in areas prone to violence or outside areas in lacking shade or protection from the elements).
emanalazab22 3421 posts 0 comments
You might also like More from author

Comments are closed.