{
  "abstract": "Objectives To examine outcomes from respiratory pathogens containment strategies focused on international travellers.Design We developed a compartmental model generalisable to respiratory infectious diseases, in which international travellers interact with each other and airline/airport workers during transit. We used SARS-CoV-2 Omicron surge data (basic reproduction number (R 0): 9.5) as a case example and performed sensitivity and scenario analyses, including varying the R0 for different respiratory pathogens.Settings A US high-volume airport.Participants Simulated international travellers and airline/airport workers.Interventions Projection of new and imported SARS-CoV-2 infections without intervention ( No Intervention); pre-travel screening for travellers who intend to travel (intended travellers) with PCR (Pre-travel PCR); or antigen testing (Pre-travel Ag); mask-wearing guidance for travellers and workers (Mask-wearing); and a Combined strategy (Pre-travel PCR & Mask-wearing).Outcome measures The number of new and imported respiratory disease infections over the 90-day simulation period.Results Over the 90-day simulation, the number of infected travellers entering the USA would be: 1 155 580 (27.2% of 4.2 million (M) intended travellers) with No Intervention; 709 560/4.2M (16.7%) with Pre-travel PCR; 862 330/4.2M (20.3%) with Pre-travel Ag; 1033 820/4.2M (24.4%) with Mask-wearing; and 650 480/4.2M (15.3%) with Combined. The number of new infections among airline/airport workers would be: 25 670 (73.3% of 35 000 workers) with No Intervention; 25 260 (72.2%) in Pre-travel PCR; 25 590 (73.1%) in Pre-travel Ag; 24 630 (70.4%) in Mask-wearing; and 18 770 (53.6%) in Combined. In scenario analyses, the most impactful parameters were R0 of the respiratory pathogen and population immunity level.Conclusions A Combined strategy of pre-travel PCR testing and mask-wearing would most effectively reduce respiratory infection among international travellers and airline/airport workers, but would still allow a substantial number of infections to enter the USA, especially when the pathogen is highly transmissible.",
  "authors": [
    {
      "affiliations": [
        "Medical Practice Evaluation Center, Boston, Massachusetts, USA"
      ],
      "name": "Satoshi Koiso"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts, USA"
      ],
      "name": "Hannah Lee"
    },
    {
      "affiliations": [
        "Medical Practice Evaluation Center, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Andrea L Ciaranello"
    },
    {
      "affiliations": [
        "Medical Practice Evaluation Center, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA",
        "Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Kenneth A Freedberg"
    },
    {
      "affiliations": [
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA",
        "Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Edward T Ryan"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Mohammad S Jalali"
    },
    {
      "affiliations": [
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Regina C LaRocque"
    },
    {
      "affiliations": [
        "Medical Practice Evaluation Center, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Emily P Hyle"
    }
  ],
  "title": "Effect of containment strategies for respiratory diseases on infections imported via international travel to the USA: a modelling study",
  "uid": "1937f9e5-15aa-50c9-b6a8-50d11f2314a8"
}