Purpose

To assist Ministries of Health and their point-of-entry (POE) partners in determining whether and how to conduct traveler screening at POE for coronavirus (COVID-19).

Introduction

This document is meant to assist Ministries of Health and their point-of-entry (POE) partners in determining whether and how to conduct traveler screening at POE for coronavirus (COVID-19).

The objective of screening is to reduce the international spread of communicable disease by detecting departing travelers who are sick or who have been exposed to the disease and preventing them from leaving the country they are in (exit screening) or by detecting them upon arrival and directing them to appropriate care and follow up, as needed (entry screening).

Public health screening occurs in two stages:

(1) Primary screening, which includes observing travelers for obvious signs of illness, measuring temperature, and collecting information on travel and exposure history; and

(2) secondary screening, which includes having a healthcare or public health professional (whenever possible) conduct an additional public health assessment of ill or potentially exposed travelers identified through the primary screening process.

In addition to detecting ill travelers, public health screening at POE provides an excellent opportunity for countries to educate travelers about the signs and symptoms of COVID-19, how to protect themselves and their families from infection, and what to do if they become ill.

Public health screening at POE can be resource intensive, but it is a flexible intervention that can be scaled up or down according to the needs of the country and the status of the outbreak. It is important that countries continuously monitor the evolution of the pandemic globally, nationally, and locally, and adjust screening processes according to current needs. For example, screening may be most important and effective early in an outbreak, when it presents an opportunity to slow the geographic spread of a disease of public health concern, allowing further time for unaffected areas to prepare their health systems, citizens, and social institutions (e.g., schools, businesses) for possible disease importation.

Countries may wish to adopt different screening strategies after a communicable disease has been introduced and there is sustained transmission in local communities. At that stage, entry screening may no longer be the best use of limited human and other resources; traveler education and community mitigation strategies (e.g., social distancing, closing schools, canceling or postponing of mass gatherings) may be more beneficial at slowing the disease’s spread.

The sections below provide guidance on the following:

  • How and what to communicate with travelers about COVID-19
  • Limitations of POE screening
  • Checklist for countries to know if they have the capacity to implement public health screening at POE
  • Additional considerations for countries considering implementing screening at ground crossings or shipping ports

Opportunities for Health Officials to Communicate with the Traveling Public

Points of entry provide important opportunities and venues for health officials to communicate with travelers about the risk of COVID-19 in their countries and in other countries, how to protect themselves during travel, as well as what to expect after travel, especially if they have been in a country with active community transmission of COVID-19.

The following are some recommended communication strategies for countries to consider developing in addition to, or apart from, other public health measures instituted at POE.

Key information to share with travelers includes:

Methods of communication for travel related messaging include:

Limitations of Public Health Screening at POE

Public health screening at POE is subject to several limitations and should be supplemented with enhanced community surveillance and other public health measures.1

The following limitations of public health screening at POE should be kept in mind:

Implementing COVID-19 Screening at a POE

These questions are meant to guide countries through considerations about the capacities needed to implement public health screening at POE. CDC recommends that countries do not implement screening until they can answer “Yes” to all “Yes/No” questions and have mechanisms in place to respond to suspected cases identified at POE, including for isolation or quarantine up to 14 days.

Does the COUNTRY have:

 

Does the POE have:

Additional considerations for countries considering implementing screening at ground crossings or shipping ports



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