Travel in the Time of COVID: A Review of International Travel Health in a Global Pandemic

Flaherty, Gerard; Hamer, Davidson H.; Chen, Lin H.

doi:10.1007/s11908-022-00784-3

Cited by 25 publications

(21 citation statements)

References 104 publications

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“…6) The requirement of a negative test result to undertake particular activities or enter particular settings [14,15]. Of these, the need for negative tests before international travel was common [16][17][18]. 7) Testing of identified at-risk individuals.…”

Section: (A) Uses Of Testing Tracing and Isolatingmentioning

confidence: 99%

Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review

Littlecott,

Herd,

O'Rourke

et al. 2023

Phil. Trans. R. Soc. A.

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We conducted a systematic literature review of general population testing, contact tracing, case isolation and contact quarantine interventions to assess their effectiveness in reducing SARS-CoV-2 transmission, as implemented in real-world settings. We designed a broad search strategy and aimed to identify peer-reviewed studies of any design provided there was a quantitative measure of effectiveness on a transmission outcome. Studies that assessed the effect of testing or diagnosis on disease outcomes via treatment, but did not assess a transmission outcome, were not included. We focused on interventions implemented among the general population rather than in specific settings; these were from anywhere in the world and published any time after 1 January 2020 until the end of 2022. From 26 720 titles and abstracts, 1181 were reviewed as full text, and 25 met our inclusion criteria. These 25 studies included one randomized control trial (RCT) and the remaining 24 analysed empirical data and made some attempt to control for confounding. Studies included were categorized by the type of intervention: contact tracing (seven studies); specific testing strategies (12 studies); strategies for isolating cases/contacts (four studies); and ‘test, trace, isolate' (TTI) as a part of a package of interventions (two studies). None of the 25 studies were rated at low risk of bias and many were rated as serious risk of bias, particularly due to the likely presence of uncontrolled confounding factors, which was a major challenge in assessing the independent effects of TTI in observational studies. These confounding factors are to be expected from observational studies during an on-going pandemic, when the emphasis was on reducing the epidemic burden rather than trial design. Findings from these 25 studies suggested an important public health role for testing followed by isolation, especially where mass and serial testing was used to reduce transmission. Some of the most compelling analyses came from examining fine-grained within-country data on contact tracing; while broader studies which compared behaviour between countries also often found TTI led to reduced transmission and mortality, this was not universal. There was limited evidence for the benefit of isolation of cases/contacts away from the home environment. One study, an RCT, showed that daily testing of contacts could be a viable strategy to replace lengthy quarantine of contacts. Based on the scarcity of robust empirical evidence, we were not able to draw any firm quantitative conclusions about the quantitative impact of TTI interventions in different epidemic contexts. While the majority of studies found that testing, tracing and isolation reduced transmission, evidence for the scale of this impact is only available for specific scenarios and hence is not necessarily generalizable. Our review therefore emphasizes the need to conduct robust experimental studies that help inform the likely quantitative impact of different TTI interventions on transmission and their optimal design. Work is needed to support such studies in the context of future emerging epidemics, along with assessments of the cost-effectiveness of TTI interventions, which was beyond the scope of this review but will be critical to decision-making. This article is part of the theme issue ‘The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence’.

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Section: (A) Uses Of Testing Tracing and Isolatingmentioning

confidence: 99%

Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review

Littlecott,

Herd,

O'Rourke

et al. 2023

Phil. Trans. R. Soc. A.

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“…It is essential that these guidelines orient a coordinated response among all the competent authorities involved, which often include a wide network of agencies, such as local, national, and international health surveillance offices, port operators and companies and operators of vessels from different nationalities. (26) As indicated by the IHR, clearly defining the responsibilities of all the parties regarding the required measures, including isolation and quarantine, is critical for effective response. (17) The measures adopted by some vessels before departure (e.g., testing and quarantine) were not enough to impede COVID-19 outbreaks from occurring, showing that they have limitations.…”

Section: Enclosed Environments Vaccination and Covid-19mentioning

confidence: 99%

COVID-19 outbreaks among crew members in non-cruise vessels anchoring in Salvador, Brazil, 2021

Cardoso

Souza

Teles

et al. 2022

Mem. Inst. Oswaldo Cruz

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BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected the maritime sector due to virus transmission onboard and traffic restrictions. However, reports of SARS-CoV-2 transmission on board have been mostly restricted to those occurring on cruise ships. OBJECTIVES To report COVID-19 outbreaks in eight non-cruise vessels and discuss measures to prevent and control the onboard transmission of SARS-CoV-2. METHODS We investigated outbreaks of COVID-19 on vessels anchoring in Baía de Todos-os-Santos, Salvador, Brazil, between February and November 2021. FINDINGS Most vessels were cargo ships that had docked several times before anchoring in Salvador (five had docked in ≥ 9 ports). The crew ranged from 22 to 63 members. The infection attack rate on each vessel ranged from 9.7 to 88.9%. The risk of symptomatic infection largely varied among the crew of each vessel (0 to 91.6%). Overall, the risk of developing COVID-19 signs and symptoms was lower among crew members vaccinated (age-adjusted risk ratio: 0.19; 95% confidence interval 0.06-0.65). SARS-CoV-2 variants not previously identified in Salvador were detected (C.14, B.1.617.2 and B.1.351). MAIN CONCLUSIONS Despite maritime guidelines to avert COVID-19 on board, outbreaks have happened. The multiple stopovers of non-cruise vessels during their routes may contribute to the spread of SARS-CoV-2 variants worldwide. Reducing the onboard transmission of SARS-CoV-2 depends on joint efforts by the crew and local health authorities and, equally important, achieving high vaccination coverage to prevent infections and illness.

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“…The number of international tourists is expected to rise by 3.3% per year through 2030 to reach a total of 1.8 billion tourist arrivals [3]. The COVID-19 pandemic has reiterated the importance of the health of international travelers and the need to provide proper travel health services and preventive medicines for travel-related illnesses [4,5]. Consequently, given the increased risks associated with international travel, travel health services are very important for the health and safety of travelers [6].…”

Section: Introductionmentioning

confidence: 99%

Types and outcomes of pharmacist-managed travel health services: A systematic review

Alrasheedy

Leggat

et al. 2023

Travel Medicine and Infectious Disease

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Travel in the Time of COVID: A Review of International Travel Health in a Global Pandemic

Cited by 25 publications

References 104 publications

Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review

Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review

COVID-19 outbreaks among crew members in non-cruise vessels anchoring in Salvador, Brazil, 2021

Types and outcomes of pharmacist-managed travel health services: A systematic review

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