Entry Screening Research Articles

Prize‐winning abstracts from BSACI/WAO 2022 meeting

Prize‐winning abstracts from <scp>BSACI</scp>/<scp>WAO</scp> 2022 meeting

Implementation and challenges to preventing the re-establishment of malaria in China in the COVID-19 era

BackgroundThe rapid emergence and global spread of COVID-19 have caused substantial global disruptions that have impacted malaria programs worldwide. Innovative strategies to enable countries aiming to eliminate malaria as well as those that are already certified as malaria-free, are needed to address malaria importation in the context of the COVID-19 pandemic. China was certified as malaria-free in 2021 and now aims to prevent the malaria re-establishment. Nonpharmaceutical interventions such as entry screening, quarantining, and health education for individuals returning from international travel during the COVID-19 pandemic present both opportunities and challenges to the management of imported malaria. This study aimed to describe and analyze the operational challenges associated with an integrated surveillance and case management program in which malaria re-establishment prevention measures were incorporated into the COVID-19 program in China.MethodsAfter the integration of malaria re-establishment prevention activities into the COVID-19 program for 10 months in Jiangsu Province, China, a focus-group discussion of public health workers working on preventing malaria re-establishment and controlling COVID-19 was held in June 2021, aiming to explore the operational challenges and lessons learned from the integrated approach.ResultsFrom 01 August 2020 to 31 May 2021, 8,947 overseas travelers with Yangzhou as the final destination underwent 14-day managed quarantine and 14-day home isolation. Of these travelers, 5,562 were from malaria-endemic regions. A total of 26,026 education booklets and materials were distributed to expand malaria-related knowledge. Twenty-two patients with unknown fever were screened for malaria with rapid diagnostic tests, and one patient was confirmed to have imported malaria. The challenges associated with the implementation of the integrated malaria surveillance and case management program include neglect of malaria due to COVID-19, lack of a standard operating procedure for malaria screening, mobility of public health providers, and difficulties in respecting the timeline of the “1–3-7” surveillance strategy.ConclusionsChina’s experience highlights the feasibility of integrated case surveillance and management of existing infectious diseases and new emerging infections. It also demonstrates the importance of a sound public health infrastructure with adequate, trained field staff for screening, testing, contact tracing, and providing health education, all of which are crucial for the success of both malaria re-establishment prevention program and the effective control of COVID-19.

Retrospective identification of key activities in Uganda's preparedness measures related to the 2018-2020 EVD outbreak in eastern DRC utilizing a framework evaluation tool.

Uganda has engaged in numerous capacity building activities related to outbreak preparedness over the last two decades and initiated additional just-in-time preparedness activities after the declaration of the 2018-2020 Ebola Virus Disease (EVD) outbreak in eastern Democratic Republic of Congo (DRC). When Uganda faced importation events related to the DRC outbreak in June-August 2019, the country's ability to prevent sustained in-country transmission was attributed to these long-term investments in preparedness. In order to help prepare countries for similar future scenarios, this analysis reviewed evidence from Uganda's response to the June-August 2019 importation events to identify preparedness activities and capacities that may have enabled Uganda to identify and isolate infected individuals or otherwise prevent further transmission. Content from 143 grey literature documents gathered via targeted and systematic searches from June 6, 2019 to October 29, 2019 and six interviews of key informants were utilized to inform a framework evaluation tool developed for this study. A conceptual framework of Uganda's preparedness activities was developed and evaluated against timelines of Uganda's response activities to the June-August 2019 EVD importation events based on the applicability of a preparedness activity to a response activity and the contribution of the said response activity to the prevention or interruption of transmission. Preparedness activities related to coordination, health facility preparation, case referral and management, laboratory testing and specimen transport, logistics and resource mobilization, and safe and dignified burials yielded consistent success across both importation events while point of entry screening was successful in one importation event but not another according to the framework evaluation tool. Countries facing similar threats should consider investing in these preparedness areas. Future analyses should validate and expand on the use of the framework evaluation tool.

A Dempster-Shafer-theory-based entry screening mechanism for small and medium-sized enterprises under uncertainty

The evaluation of star-up small and medium-sized enterprises (SMEs) is an important part of ensuring the success of development, but it is not an easy task because of the multiple criteria to be considered and uncertainties caused by incomplete decision information, limited individual perceptions and differences in perceptions of experts. By integrating Dempster-Shafer theory into a probabilistic linguistic setting that takes into account the uncertainties in the evaluation process by combining linguistic terms with subjective probabilities, this study proposes a multi-criteria decision-making model for the management of SMEs. We incorporate different decision factors regarding (a) the risk attitude of decision makers, (b) the relative importance of criteria, (c) the unreliability and incompleteness of evaluation on alternatives in one preference model of multi-criteria decision making. The applicability of the proposed preference model is validated by a case study of the entry screening of SMEs for business incubators. Through comparative analysis and sensitive analysis, the reliability of the proposed model is verified, which can not only express uncertain evaluation information, but also avoid information loss and defuzzification in the aggregation process.

Antigen identification and high-throughput interaction mapping by reprogramming viral entry.

Deciphering immune recognition is critical for understanding a broad range of diseases and for the development of effective vaccines and immunotherapies. Efforts to do so are limited by a lack of technologies capable of simultaneously capturing the complexity of adaptive immune receptor repertoires and the landscape of potential antigens. To address this, we present RAPTR (Receptor-Antigen Pairing by Targeted Retroviruses). RAPTR combines viral pseudotyping and molecular engineering approaches to enable one-pot library on library interaction screens by displaying antigens on the surface of lentiviruses and encoding their identity in the viral genome. Antigen-specific viral infection of cell lines expressing human T or B cell receptors allows readout of both antigen and receptor identities via single-cell sequencing. The resulting system is modular, scalable, and compatible with any cell type. These techniques provide a suite of new tools for targeted viral entry, molecular engineering, and interaction screens with broad potential applications.

Effective Leadership Enhancing Financial Sustainability and Good Governance in Public Sector South Sudan, Juba: Case Study of Juba County

The study examines the relationship between effective leadership, financial sustainability and good governance at all levels in private, public and civil organizations, it is impossible to achieve and to sustain effective good governance; without an effective leadership we may not ensure good governance in its totality, the current situation shows by the results discuss below. the research design used across sectional designed with the study populations of 368,501 beneficiaries from Juba County and sampling size were 350 beneficiaries, however Sampling Technique were purposive and simple random sampling and Measurement of Variables was 5-point Likert Scale, the study used closed end structure questionnaires after data collection the questionnaires were coding, entry and processing. Data entry screens were design using EPIDATA Program. This was one of the data entry programs. After entry, data was exported to SPSS for data management and processing used into analysis. Regressions, coefficients, factor analysis, ANOVA and Spearman correlations were used to find the degree of associate relationship of three variables. Which created a positive relationship between effective leadership and good governance (r= 0.538, p- value &lt; 0.01) the result showed that there is significant positive relationship between financial sustainability and good governance. (r= 0.651 p-value &lt;0.01) Therefore the more you developed effective leadership the more financial sustainability and good governance (R=0.538, 0.651, 0.752, p-value &lt;0.01) The factor analysis result of effective leadership variable, five factor were extracted component one explain 39.75% the second shows 39.11%, third presented 43.04%, fourth presented 42.74%, and the fifth presented the 57.24% of the variance and the result of financial sustainability variables, four factor were extracted attribute one explain 54.8% , the second with 47.6%,while third with 41.2% and fourth with 54.4% of the variance therefor the factor analysis result of good governance variable, four factor were extracted component one explain 53.2%, the second component explain 43.2%, while third explain 48.4% and fourth one given the 59.5% of the variance of the good governance. The regression shows the relationship between effective leadership, financial sustainability and good governance (F= 229.896, sig=0.000) effective leadership and financial sustainability extremely explain good governance. Change in financial sustainability will increase the good governance by ( ) change in financial sustainability will increase level of good governance by ( and change in effective leadership will increase good governance by ( ).

Suspicion, screening, and diagnosis of wild-type transthyretin amyloid cardiomyopathy: a systematic literature review.

Wild‐type transthyretin amyloid cardiomyopathy (ATTRwt CM) is a more common disease than previously thought. Awareness of ATTRwt CM and its diagnosis has been challenged by its unspecific and widely distributed clinical manifestations and traditionally invasive diagnostic tools. Recent advances in echocardiography and cardiac magnetic resonance (CMR), non‐invasive diagnosis by bone scintigraphy, and the development of disease‐modifying treatments have resulted in an increased interest, reflected in multiple publications especially during the last decade. To get an overview of the scientific knowledge and gaps related to patient entry, suspicion, diagnosis, and systematic screening of ATTRwt CM, we developed a framework to systematically map the available evidence of (i) when to suspect ATTRwt CM in a patient, (ii) how to diagnose the disease, and (iii) which at‐risk populations to screen for ATTRwt CM. Articles published between 2010 and August 2021 containing part of or a full diagnostic pathway for ATTRwt CM were included. From these articles, data for patient entry, suspicion, diagnosis, and screening were extracted, as were key study design and results from the original studies referred to. A total of 50 articles met the inclusion criteria. Of these, five were position statements from academic societies, while one was a clinical guideline. Three articles discussed the importance of primary care providers in terms of patient entry, while the remaining articles had the cardiovascular setting as point of departure. The most frequently mentioned suspicion criteria were ventricular wall thickening (44/50), carpal tunnel syndrome (42/50), and late gadolinium enhancement on CMR (43/50). Diagnostic pathways varied slightly, but most included bone scintigraphy, exclusion of light‐chain amyloidosis, and the possibility of doing a biopsy. Systematic screening was mentioned in 16 articles, 10 of which suggested specific at‐risk populations for screening. The European Society of Cardiology recommends to screen patients with a wall thickness ≥12 mm and heart failure, aortic stenosis, or red flag symptoms, especially if they are >65 years. The underlying evidence was generally good for diagnosis, while significant gaps were identified for the relevance and mutual ranking of the different suspicion criteria and for systematic screening. Conclusively, patient entry was neglected in the reviewed literature. While multiple red flags were described, high‐quality prospective studies designed to evaluate their suitability as suspicion criteria were lacking. An upcoming task lies in defining and evaluating at‐risk populations for screening. All are steps needed to promote early detection and diagnosis of ATTRwt CM, a prerequisite for timely treatment.

What is the true place of the SARS-CoV-2 rapid point-of-care antigen test in the hospital setting? Lessons learned from real life.

To assist in the clinical management of patients and to support infection control, we tested the use of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) point‐of‐care antigen test (AgPOC) for unplanned hospitalization, coupled with a nucleic acid amplification test (NAAT) using specimens collected at the same time upon arrival. The aim of this study was to assess the performance of the AgPOC in this specific use compared to NAAT for SARS‐CoV‐2 diagnosis, in the context of the low prevalence of infection. For 5 months (between two peaks in France of the SARS‐CoV‐2 pandemic), all patients admitted who undertook the AgPOC/NAAT paired tests were included in the study. AgPOC performances were determined considering the clinical status and the delay of symptoms onset. NAAT and AgPOC results were available for 4425 subjects. AgPOC results showed a homogeneous specificity (>97%) but a low sensitivity at 45.8%. Considering the national guidelines, sensitivity dropped to 32.5% in cases of symptomatic patients with symptoms older than 5 days or more. This study shows the poor performance of AgPOC for entry screening of patients in hospitals. AgPOC may represent a useful tool in the hospital setting only if the use is restricted to patients with consistent symptoms less than 4 days old.

Screening children for mental health difficulties in school settings

Rates of probable mental health problems in children and young people in England are increasing while failure to identify and address mental health difficulties early in life affects individuals' long-term functioning and wellbeing. Despite reported benefits of early identification and intervention, there is no school entry screening programme. The aim was to review the evidence for mental health screening and identification programmes based in schools against the UK NSC criteria. We found mixed evidence of the feasibility and acceptability of screening and limited evidence on programmes' effectiveness and cost effectiveness. While there is evidence of effective interventions, there is work to do to enable timely and equitable access to mental health support. Currently there is insufficient evidence to recommend a universal screening programme and any use of validated screening tools in schools should be accompanied by a clear pathway into early intervention services and a robust evaluation of the whole programme.

Bringing externalization home: the International Civil Aviation Organization and ‘entry screening’ in Australia

ABSTRACT This paper examines the previously unexplored question of the role of the International Civil Aviation Organization (‘ICAO’) as a forum for the development and implementation of practices of externalization in the civil aviation space. Since 1947, ICAO has played a key role in the legal development of international air travel, including through formulating Standards and Recommended Practices (‘SARPs’). SARPs have principally focussed on the safety, regularity and efficiency of civil air travel while leaving state obligations under international refugee law largely outside of that structure. The Australian policy of ‘entry screening’ international travellers at Australian airports, whereby people with protection claims may be removed from the country without full consideration of the claim, serves as a case study. Entry screening reveals how (1) States have used the reframing afforded by ICAO’s SARPs on passenger facilitation to chip away at observance of the obligations of non-refoulement and non-penalization; and that (2) the interaction between civil air law and international refugee law implicates important questions of treaty interpretation.

An emergency of circulation: entry screening in the UK during the 2014 Ebola epidemic

ABSTRACT The rise of emergency governance in global public health has driven a number of changes in this field. In this article, we investigate one of the practices of emergency governance – border screening – and identify a new form of screening that emerged in the UK during the 2014 Ebola epidemic in West Africa. Analysing the UK’s deployment of Ebola entry screening and the public debate that emerged around it, we show how this technology was constructed to identify potentially risky individuals, assess their risk level and pre-accelerate future response to potential cases. Engaging with Foucault’s notion of a ‘crisis of circulation’, we argue that this approach expresses a response to an emergency of circulation: the alarming prospect of a concrete threat with the potential to infiltrate the population through circulation systems. We show that entry screening, in this case, addresses such a problem by enabling, rather than diminishing, circulation.

Unintended health and societal consequences of international travel measures during the COVID-19 pandemic: a scoping review.

Background/ObjectiveInternational travel measures to contain the coronavirus disease of 2019 (COVID-19) pandemic represent a relatively intrusive form of non-pharmaceutical intervention. To inform decision-making on the (re)implementation, adaptation, relaxation or suspension of such measures, it is essential to not only assess their effectiveness but also their unintended effects.MethodsThis scoping review maps existing empirical studies on the unintended consequences, both predicted and unforeseen, and beneficial or harmful, of international travel measures. We searched multiple health, non-health and COVID-19-specific databases. The evidence was charted in a map in relation to the study design, intervention and outcome categories identified and discussed narratively.ResultsTwenty-three studies met our inclusion criteria—nine quasi-experimental, two observational, two mathematical modelling, six qualitative and four mixed-methods studies. Studies addressed different population groups across various countries worldwide. Seven studies provided information on unintended consequences of the closure of national borders, six looked at international travel restrictions and three investigated mandatory quarantine of international travellers. No studies looked at entry and/or exit screening at national borders exclusively, however six studies considered this intervention in combination with other international travel measures. In total, 11 studies assessed various combinations of the aforementioned interventions. The outcomes were mostly referred to by the authors as harmful. Fifteen studies identified a variety of economic consequences, six reported on aspects related to quality of life, well-being, and mental health and five on social consequences. One study each provided information on equity, equality, and the fair distribution of benefits and burdens, environmental consequences and health system consequences.ConclusionThis scoping review represents the first step towards a systematic assessment of the unintended benefits and harms of international travel measures during COVID-19. The key research gaps identified might be filled with targeted primary research, as well as the additional consideration of gray literature and non-empirical studies.

Entry Screening at Airport as a COVID-19 Surveillance Tool: Evaluation of Thiruvananthapuram International Airport in Kerala, India

Introduction: As part of coronavirus disease 2019 (COVID-19) control strategies, entry screening was established at International airports. An assessment of the screening system will inform decision-making for improving entry screening for infectious diseases. Methods: Assessment of entry screening at Thiruvananthapuram international airport done during pre and post-lockdown phases. Observation, interviews, and secondary data analysis were the methods employed. The number of passengers screened, their symptom profile, the yield of screening, actions taken, staff pattern, perceptions, training, and infection control practices assessed. Chi-square test and t test were used for testing significance. Results: Out of the 46139 passengers screened pre-lockdown, 297 (0.64%) had symptoms, 23 (0.05%) were positive in thermal screening. Six (2%) among them tested positive for COVID-19. Out of the 44263 passengers screened post lockdown, from May to July 2020, 671 (1.5%) were symptomatic, and 12 (0.03%) were positive in thermal screening. COVID-19 was confirmed in 45 (6.7 %) patients identified through the screening. With the surge in cases, the proportion of passengers opting for institutional quarantine increased significantly (P&lt;0.001). None of the staff contracted the disease. Infection control practices followed by them were optimal. Conclusion: Though the yield of thermal and symptom screening is low, entry screening is an opportunity to identify travelers at risk of COVID-19 infection. In addition, it helps in raising awareness to ensure quarantine and guides public health authorities in preventing disease spread to the community.

Impact of Policy and Funding Decisions on COVID-19 Surveillance Operations and Case Reports - South Sudan, April 2020-February 2021.

Early models predicted substantial COVID-19-associated morbidity and mortality across Africa (1-3). However, as of March 2021, countries in Africa are among those with the lowest reported incidence of COVID-19 worldwide (4). Whether this reflects effective mitigation, outbreak response, or demographic characteristics, (5) or indicates limitations in disease surveillance capacity is unclear (6). As countries implemented changes in funding, national policies, and testing strategies in response to the COVID-19 pandemic, surveillance capacity might have been adversely affected. This study assessed whether changes in surveillance operations affected reporting in South Sudan; testing and case numbers reported during April 6, 2020-February 21, 2021, were analyzed relative to the timing of funding, policy, and strategy changes.* South Sudan, with a population of approximately 11 million, began COVID-19 surveillance in February 2020 and reported 6,931 cases through February 21, 2021. Surveillance data analyzed were from point of entry screening, testing of symptomatic persons who contacted an alert hotline, contact tracing, sentinel surveillance, and outbound travel screening. After travel restrictions were relaxed in early May 2020, international land and air travel resumed and mandatory requirements for negative pretravel test results were initiated. The percentage of all testing accounted for by travel screening increased >300%, from 21.1% to 91.0% during the analysis period, despite yielding the lowest percentage of positive tests among all sources. Although testing of symptomatic persons and contact tracing yielded the highest percentage of COVID-19 cases, the percentage of all testing from these sources decreased 88%, from 52.6% to 6.3% after support for these activities was reduced. Collectively, testing increased over the project period, but shifted toward sources least likely to yield positive results, possibly resulting in underreporting of cases. Policy, funding, and strategy decisions related to the COVID-19 pandemic response, such as those implemented in South Sudan, are important issues to consider when interpreting the epidemiology of COVID-19 outbreaks.

How to Do Business with DHS S&T

Established by Congress in 2003 as the research and development (R&D) arm of the Department of Homeland Security (DHS), the Science and Technology Directorate (S&T) focuses on providing technology solutions and knowledge products to mitigate the adverse consequences resulting from the release of chemical, biological, and agricultural threats.DHS S&T research areas include chemical and biological defense, borders and maritime security and port of entry screening, critical infrastructure and resilience, cybersecurity, explosives detection and aviation screening, first responders, unmanned aerial systems, and tests, evaluations, standards, and systems engineering. In addition, S&T partners with academic, national laboratory, and other research organizations to address specific homeland security topics and threats and funds DHS S&T Technology Centers with subject matter experts in sensors and platforms, modeling and simulation, data analytics, hazard awareness and characterization, biometrics and identity, social sciences, and interoperability and compatibility.Innovation is the driving force behind S&T’s work. Because potential solutions may exist outside the homeland security arena, S&T casts a wide, inclusive net to find and use the best technology available. During her presentation, Dr. Angela M. Ervin will outline the current work of DHS S&T and explain the process for requirements gathering for initiation of projects and programs. She will also discuss opportunities available for academia and industry to work with S&T as well as mechanisms to apply for funding.

What are the effects of entry and/or exit screening at international borders on the spread of COVID-19?

What are the effects of entry and/or exit screening at international borders on the spread of COVID-19?

Establishment of a well-characterized SARS-CoV-2 lentiviral pseudovirus neutralization assay using 293T cells with stable expression of ACE2 and TMPRSS2.

Pseudoviruses are useful surrogates for highly pathogenic viruses because of their safety, genetic stability, and scalability for screening assays. Many different pseudovirus platforms exist, each with different advantages and limitations. Here we report our efforts to optimize and characterize an HIV-based lentiviral pseudovirus assay for screening neutralizing antibodies for SARS-CoV-2 using a stable 293T cell line expressing human angiotensin converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). We assessed different target cells, established conditions that generate readouts over at least a two-log range, and confirmed consistent neutralization titers over a range of pseudovirus input. Using reference sera and plasma panels, we evaluated assay precision and showed that our neutralization titers correlate well with results reported in other assays. Overall, our lentiviral assay is relatively simple, scalable, and suitable for a variety of SARS-CoV-2 entry and neutralization screening assays.

825. An Academic-Information Technology Partnership to Create an Infectious Diseases Translational Science Database

BackgroundTranslational science is the process of turning observations in the laboratory, clinic, and community into interventions that improve human health. The coordinated effort to maintain integrated, validated laboratory and clinical data is often a rate-limiting step for research laboratories, especially for multi-site studies. Previous research shows a rate of error between 2.3 and 5.2% for basic data collection in clinical databases, up to 26.9% for more complex data points. The purpose of this project was to create a translational science database prototype that would be responsive to the unmet needs of the translational research community.MethodsTranslational scientists, IT experts, and lab technicians mapped the workflow of a high-throughput research laboratory including clinical and laboratory data. Database goals were to develop processes that would minimize data entry time, avoid redundancies, and validate data in a secure environment (HIPAA-compliant). Unique to this platform was the ability to map creation of new samples (for example, PCR products) from parent samples (biologic samples). The platform was developed in an iterative process utilizing interviews, workflow study, analysis of supporting artifacts, and mock-ups.ResultsThe current prototype allows for electronic upload or manual data entry of clinical data. In a small controlled study we found the rate of error for basic data entry to be below 1% within it. Pre-populated data entry screens map laboratory work-flow with custom data entry fields produced based on laboratory results earlier in the work flow. Work-flow mapping includes microbiology, phenotypic descriptions (MIC), molecular biology (PCR), and customized experiments. Sequence data, housed separately, has data linkers stored in the database. The launch screen and data entry forms are populated based on specific criteria entered for each user.ConclusionThe Translational Science Database allows for efficient capture of high-quality data with baseline validation enabling seamless linking of translational data for single or multi-site laboratories. Future development work will expand the number of experiments and also incorporate stored biobank information into the database.DisclosuresJeffrey Beairsto, BSc Eng (ME), Populus (Employee, Shareholder) Randal Neptune, BSc., MSc., Populus Global Solutions (Employee) Beth Webster, BSc, MBA, Populus Global Solutions Inc (Employee, Shareholder) John N. Rutter, BscEng, Populus Global Solutions (Board Member, Employee, Shareholder) Tristan Rutter, BA, Populus (Employee) Kevin W. Garey, PharMD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator)

Situation of India in the COVID-19 Pandemic: India's Initial Pandemic Experience.

In this article, we investigate the impact of COVID-19 through screening and surveillance methods adopted in India, as well as the potential health system, social, political, and economic consequences. The research was done in a chronological manner, and data was collected between 30 January 2020 till 12 June 2020. Initial containment measures, including point of entry screenings and testing protocols, appeared insufficient. However, testing capacity was gradually expanded after the commencement of a nation-wide lockdown. Modeling predictions have shown varying results on the emergence of cases depending on the infectiousness of asymptomatic individuals, with a peak predicted in mid-July having over two million cases. The country also faces risks of the economic plunge by losing approximately 4% of its gross domestic product, due to containment measures and reduction in goods importation. The low public health expenditure combined with a lack of infrastructure and low fiscal response implies several challenges to scale up the COVID-19 response and management. Therefore, an emergency preparedness and response plan is essential to integrate into the health system of India.

A rapid review of the effectiveness of screening practices at airports, land borders and ports to reduce the transmission of respiratory infectious diseases such as COVID-19

Travel screening for infectious diseases is often implemented to delay or prevent the entry of infected persons to a country/area. To evaluate the effectiveness of different point-of-entry screening strategies in achieving a reduction in imported COVID-19 transmission. A rapid evidence review was conducted, systematically searching PubMed and Google Scholar and grey literature on 27 March 2020. We screened 1194 records. Nine potential full-text articles were assessed for eligibility and included. Three articles investigated the effectiveness of entry-based thermal and body temperature scanning. Entry-based infrared thermal or body temperature scanning for COVID-19 was unlikely to be effective. Two systematic reviews found no additional benefit of travel restrictions/screening. In a COVID-19 modelling study, airport screening was not effective, with exit and entry thermal scanning identifying half and missing almost half of infected travellers. Two other modelling studies found that entry-based travel screening would achieve only modest delays in community transmission, while international travel quarantine could reduce case importations by 80%. There is insufficient evidence to support entry and exit screening at points of entry, as these strategies detect just over half of the infected cases, missing almost half at entry points. The benefits of airport screening therefore need to be context specific and weighed against the resources and cost of implementation, the contribution of imported cases to total cases, and the benefits of identifying 50% of cases in the South African context with the country's high HIV and tuberculosis prevalence and limited resources to deal with a pandemic of this nature.