Abstract

BackgroundInternational air travel plays an important role in the global spread of SARS-CoV-2, and tracing of close contacts is an integral part of the public health response to COVID-19. We aimed to assess the timeliness of contact tracing among airline passengers arriving in Vietnam on flights containing COVID-19 cases and investigated factors associated with timeliness of contact tracing.MethodsWe included data from 2228 passengers on 22 incoming flights between 2 and 19 March 2020. Contact tracing duration was assessed separately for the time between the date of index case confirmation and date of contact tracing initiation (interval I), and the date of contact tracing initiation and completion (interval II). We used log-rank tests and multivariable Poisson regression models to identify factors associated with timeliness.ResultsThe median duration of interval I and interval II was one (IQR: 1–2) and 3 days (IQR: 2–5), respectively. The contact tracing duration was shorter for passengers from flights where the index case was identified through mandatory testing directly upon arrival (median = 4; IQR: 3–5) compared to flights with index case detection through self-presentation at health facilities after arrival (median = 7; IQR: 5–8) (p-value = 0.018). Cumulative hazards for successful tracing were higher for Vietnamese nationals compared to non-Vietnamese nationals (p < 0.001).ConclusionsContact tracing among flight passengers in the early stage of the COVID-19 epidemic in Vietnam was timely though delays occurred on high workload days. Mandatory SARS-CoV-2 testing at arrival may reduce contact tracing duration and should be considered as an integrated screening tool for flight passengers from high-risk areas when entering low-transmission settings with limited contact tracing capacity. We recommend a standardized risk-based contact tracing approach for flight passengers during the ongoing COVID-19 epidemic.

Highlights

  • International air travel plays an important role in the global spread of SARS-CoV-2, and tracing of close contacts is an integral part of the public health response to COVID-19

  • We aimed to assess the timeliness of contact tracing among airline passengers arriving in Vietnam on flights with at least one confirmed COVID-19 case on board during March 2020, and explored factors associated with timeliness of contact tracing

  • We included 22 flights arriving to Vietnam between 2 and 19 March 2020 in our analysis, with a total number of passengers of 2228; of these, 25 were index cases (1.1%)

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Summary

Introduction

International air travel plays an important role in the global spread of SARS-CoV-2, and tracing of close contacts is an integral part of the public health response to COVID-19. International air travel plays an important role in the global spread of COVID-19 [2]. Since the beginning of the epidemic, many countries implemented different policies to prevent the importation of COVID-19, including complete closure of borders for international travel [3], systematic passenger testing, and mandatory quarantine at arrival [4]. In March 2020, Vietnam saw a surge in COVID19 cases among returning nationals and tourists, which subsequently triggered a series of public health measures to trace passengers from flights on which an infected passenger had been detected [8]

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