Covid-19 coronavirus detection at the airport was costly and underperforming

It did not appear to be very effective. But at the very least, it took a lot of effort, caused inconvenience, and cost a lot of money.

That’s what a study just published in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) seemed to conclude about CDC’s efforts at U.S. airports. Screen travelers for Covid-19 coronavirus infections from January 17, 2020 through September. February 13, 2020. Such efforts ended with the detection of 766,044 travelers, yet only found nine people positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). That’s just 0.001% of all people tested or roughly one in 85,000 people. That’s far worse than your chances of finding a pearl in an oyster (about one in 12,000) or getting hurt by a toilet (about one in 10,000). They’re not exactly numbers that scream “it’s worth it!”

This was an evaluation of a particular airport screening program, the one implemented in the United States by the CDC in conjunction with the United States Department of Homeland Security (DHS). The program basically put travelers through the following three steps:

1. Determine who traveled from a location that was considered higher risk at the time: Like his playlist of Justin Bieber songs, the list of locations that met the “highest risk” criteria increased over time. It started with Wuhan, China, on January 17, and then spread to all of mainland China on February 3. During the following months, the list grew to include Iran (on March 2), 26 countries in the European Schengen Area (on March 14), the United Kingdom and Ireland (on March 17), and Brazil (on May 28). ). So basically, if you were at a location that was on this list in the 14 days before you arrived at the airport, the US Customs and Border Protection officers will refer you to Step 2, initial review.
2. Take an initial assessment: This is where you will be checked for signs of illness and your body temperature will be measured to see if it is equal to or greater than 100.4 ° F (which is approximately 38 ° C). Temperature sensing would occur through a non-contact device, such as a thermometer gun, because measuring so many people with an oral or rectal thermometer could be a bit tricky. You would also have to fill out a questionnaire asking what symptoms you may have had in the previous 24 hours and if you have been exposed to someone else with Covid-19 in the previous 14 days. If anything suspicious arises in Step 2, proceed to Step 3.
3. Refer to those considered higher risk in Step 2 for further evaluation: If you reached this stage, you would go to an on-site exam room or a local health care facility for a more comprehensive evaluation by a doctor or other healthcare professional.

Now doing all this is not cheap. Think about what it would entail, such as paying all of the CDC staff and contractors who have to conduct and assist with such an assessment. The number of inspectors per airport peaked at around 750 on March 20, when travel from higher-risk countries was the most active. In addition to personnel costs, the CDC also transferred about $ 57 million to DHS to cover things like equipment and lodging for quarantined travelers. To give you perspective, that’s enough money to buy more than 8.4 million avocado toasts.

That’s a great toast to miss out on when the result was that only 298 of the 766,044 travelers made it to the third step, 16 because they had been to Hubei province, four because they had reported contact with someone with Covid-19, and 278 because they had signs or suspicious symptoms. Of those with suspicious signs or symptoms, 73% reported a cough, 14% fever, and 13% shortness of breath. Less than a fifth (17%) had an elevated body temperature as measured. Only 35 travelers ended up being tested for SARS-CoV-2 and nine tested positive. There were another 14 that tested positive for Covid-19 but were identified by other means in addition to airport screening programs (i.e., six through airline or airport partner processes and eight prior to travel)

Again, that’s not a very high return considering how much was involved in doing the screening. The study did not even take into account all the disruptions and delays the airport inspection may have caused.

All of this is further proof that simply screening people for fevers and symptoms may not detect too many cases of the Covid-19 coronavirus. I have already written for Forbes on how to measure body temperature is not a great way to detect Covid-19 coronavirus infections. Just because your body temperature is within the normal range does not mean that you are not infected with the Covid-19 coronavirus. You may not have a fever yet or may never develop one. You may be taking something to suppress the fever, such as acetaminophen, ibuprofen, or cowbell.

Furthermore, the recent US elections and the polls that preceded them showed how honest people can and cannot be when answering questions. If someone has made it to the airport despite having symptoms, how likely is it that they will say, “Oh right, I have a fever and diarrhea.”

It may be “airplane” naive to hope that the airport inspection alone is enough to prevent the Covid-19 coronavirus from boarding the planes. Viruses don’t need boarding passes because they are less than two years old and very, very small. And they can easily go through temperature checks and questionnaires. Ultimately, this control is not going to overcome the need for social distancing at the airport and on the plane.