Abstract
In French Polynesia, the first case of SARS-CoV-2 infection was detected on March 10th, 2020, in a resident returning from France. Between March 28th and July 14th, international air traffic was interrupted and local transmission of SARS-CoV-2 was brought under control, with only 62 cases recorded. The main challenge for reopening the air border without requiring travelers to quarantine on arrival was to limit the risk of re-introducing SARS-CoV-2. Specific measures were implemented, including the obligation for all travelers to have a negative RT-PCR test for SARS-CoV-2 carried out within 3 days before departure, and to perform another RT-PCR testing 4 days after arrival. Because of limitation in available medical staff, travelers were provided a kit allowing self-collection of oral and nasal swabs. In addition to increase our testing capacity, self-collected samples from up to 10 travelers were pooled before RNA extraction and RT-PCR testing. When a pool tested positive, RNA extraction and RT-PCR were performed on each individual sample. We report here the results of COVID-19 surveillance (COV-CHECK PORINETIA) conducted between July 15th, 2020, and February 15th, 2021, in travelers using self-collection and pooling approaches. We tested 5,982 pools comprising 59,490 individual samples, and detected 273 (0.46%) travelers positive for SARS-CoV-2. A mean difference of 1.17 Ct (CI 95% 0.93–1.41) was found between positive individual samples and pools (N = 50), probably related to the volume of samples used for RNA extraction (200 μL versus 50 μL, respectively). Retrospective testing of positive samples self-collected from October 20th, 2020, using variants-specific amplification kit and spike gene sequencing, found at least 6 residents infected by the Alpha variant. Self-collection and pooling approaches allowed large-scale screening for SARS-CoV-2 using less human, material and financial resources. Moreover, this strategy allowed detecting the introduction of SARS-CoV-2 variants of concern in French Polynesia.
Highlights
IntroductionCases of respiratory infection (coronavirus disease 2019, COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in December 2019 in Wuhan City, Hubei Province, China [1]
Cases of respiratory infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in December 2019 in Wuhan City, Hubei Province, China [1]
The traveler had to declare to have tested negative for SARS-CoV-2 by RT-PCR within 3 days prior to departure, certify to present no symptoms of COVID-19 at boarding, agree to comply with all sanitary rules required by the government of French Polynesia, certify to have a travel insurance for non-French citizens and agree to assume all health costs incurred in French Polynesia, and accept to perform a selftest for SARS-CoV-2 detection using a kit provided upon arrival
Summary
Cases of respiratory infection (coronavirus disease 2019, COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in December 2019 in Wuhan City, Hubei Province, China [1]. The first case of SARS-CoV-2 infection was detected on March 10th, 2020, in a resident of Tahiti returning from France [5]. The population of French Polynesia was confined and international air traffic was interrupted on March 20th and 28th, respectively. Residents or foreigners showing a compelling reason were allowed to enter French Polynesia provided they were quarantined on arrival. Between March 10th and June 25th, among 5,390 patients tested for a suspicion of SARS-CoV-2 infection, a total of 62 were found positive, including 32 imported cases, and no COVID-19 related death was recorded [6]
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