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TORONTO – Interim results from a Canadian border study found that 70% of international travelers arriving by plane with COVID-19 can be identified within 48 hours through rapid tests carried out the moment they arrive.
A very small percentage of travelers tested positive for COVID-19 just 14 days after arrival, with just under 30% after seven days.
“We wanted to look at the risk of travelers arriving in Canada carrying COVID,” Vivek Goel, a professor at the University of Toronto and one of the study’s principal investigators, told CTV News.
“We tested people on arrival on the seventh and fourteenth days. As far as we know, we are the only group with data of this size – over 10,000 travelers – that have been tested at all three time points. and we can then determine if you reduce the quarantine with a test protocol, how many cases you might lose if you let people out [of quarantine], let’s say after seven days or after one day. “
The study, run by McMaster Health Labs (MHL), was first launched in September at Toronto’s Pearson Airport and continued until November 14. Passengers arriving on Air Canada or selected Star Alliance flights were asked if they were willing to participate in a study which involved performing an airport test and then two follow-up tests at home one week and two weeks later, while they were in mandatory two-week quarantine.
Although the final report will be based on more than 16,000 participants, the interim results trace the first month of the study, from September 3 to October 2, and involve more than 8,600 participants.
These results found that 99% of the participants tested negative for COVID-19. Of the one percent who tested positive, 70 percent tested positive after the first test and knew it within 48 hours.
“A very small fraction is left and detected on day 14,” Goel said. He said these people could be falsely positive or be residual cases that aren’t actually infectious, or they may have failed to comply with the quarantine and thus caught COVID before leaving the airport.
“Or they could really be people with a very long incubation period,” he said. “But the fundamental discovery is this [a] testing strategy, especially one that gathers people on day one and day seven as Calgary is doing, will ensure that the vast majority of people [who] they are probably contagious. “
Since the beginning of November, an ongoing pilot project at Calgary International Airport has been offering rapid testing at airports. The project offers travelers the opportunity to undergo a test and isolate themselves for 24-48 hours while waiting for the results. If they are negative, they do not need to self-isolate for two full weeks, provided they agree to stay in the province for that period of time.
Goel pointed out that there are precautions in the Calgary pilot project.
“People are checked every day by local public health authorities, asked not to go to congregated living environments or visit people who are vulnerable to higher risks, but they are not asked to limit themselves for 14 days.”
Many countries test people before they board a plane, and some require landing tests, Dr Marek Smieja, scientific director of the MHL and co-author of the study, told CTV News.
In Canada, there is no need to test before boarding a plane, and outside of pilot projects, no tests are offered after you get out, Smieja said.
“Increasingly, especially for international flights, there is an interest in checking people before they get on a plane,” he said. “And secondly, there is an interest in asking, ‘Can the quarantine be shortened if tests show you haven’t developed COVID for perhaps seven days?’
“Our quarantine is 14 days and is based on the maximum incubation time for COVID. So we wanted to study it during the 14 days to ask the question:” Do we really need 14 full days of quarantine? “
International travel was how COVID-19 first entered Canada, but at this stage of the pandemic, most of the viral transmission is within the country. But that doesn’t make it less important to understand the risks of international travel and the reopening of borders.
As Canada faces a second wave of COVID-19 nine months into the pandemic, the pressure to allow more travel increases for policy makers and officials.
“We can’t travel for extended periods of time, so it’s a matter of trying to find out how we can safely live with COVID for any length of time,” Smieja said.
The two-week quarantine is a huge deterrent to travel, Goel said, adding that there are “economic, social and psychological costs of having to be in quarantine.”
Smieja pointed out that many two-week quarantines can also interfere with work for many.
“The final message is that there are ways to reduce quarantine requirements with testing protocols,” Goel said.
The final study report will be available in January 2021.
SELF-ADMINISTRATED TESTS
The study also demonstrated the feasibility of using rapid tests in an airport environment, the researchers say.
The study used a cheek and nasal swab that could be self-administered, meaning that most importantly, a healthcare professional was not needed and people could get tested at home, which they did on day 7 and day. 14 of the study.
“We asked a courier to collect it from them,” explained Goel. “So it shows that people can do self-harvest and we can do it at home.”
Smieja said the tests were processed in a laboratory after they were recovered and “only one to two per thousand were of very low quality where we could not interpret them,” showing that most people were able to follow the instructions. to test at home.
Goel pointed out that the need for a healthcare professional to administer the tests is part of the reason large formations have been seen in the testing facilities.
“So those healthcare workers who are doing more testing at assessment centers are taken away from other parts of the healthcare system and that PPE is taken away,” Goel added.
Testing is extremely important, and testing capacity in Canada needs to be increased if we are to gain control of COVID-19 again, Goel said.
“We should have more tests for health workers, they should have more tests for grocery store workers and people on the front lines.”
He said the researchers believe the rapid test that can be performed at home could be used in schools and in the workplace, for “surveillance testing.”
If a person is showing symptoms, it makes more sense for them to go to a healthcare provider to receive the standard test, he explained, but if we were able to test in other settings on a more efficient basis to find cases before people even suspect they have the virus, which could help reduce waiting times for tests in hospitals and also free up staff.
“If we had it [had] more testing capabilities in place at the end of August, we would not have been, [where] we have arrived, “said Goel.” So what I’d say is if – when – we get out of this next wave, we really need to think about building testing capacity so that we don’t come back here. And then we’ll have test capabilities to open the border when we’re ready.
“A number of provinces including Ontario [have] he is experimenting with alternative selection methodologies, “said Goel, adding that he is” confident “that this type of test can be used more in the future.
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