tetano
Editor, Senior Moderator
BMJ Open
. 2024 Nov 29;14(11):e085332.
doi: 10.1136/bmjopen-2024-085332. Evaluation of risk-based travel policy for the COVID-19 epidemic in Scotland: a population-based surveillance study
Isobel McLachlan[SUP] 1 [/SUP], Selene Huntley[SUP] 1 [/SUP], Kirstin Leslie[SUP] 1 [/SUP], Jennifer Bishop[SUP] 1 [/SUP], Christopher Redman[SUP] 1 [/SUP], Gonzalo Yebra[SUP] 1 [/SUP], Sharif Shaaban[SUP] 1 [/SUP], Nicolaos Christofidis[SUP] 1 [/SUP], Samantha Lycett[SUP] 2 [/SUP], Matthew T G Holden[SUP] 1 3 [/SUP], David L Robertson[SUP] 4 [/SUP], Alison Smith-Palmer[SUP] 1 [/SUP], Joseph Hughes[SUP] 4 [/SUP], Sema Nickbakhsh[SUP] 5 6 [/SUP]
Affiliations
Objectives: We aimed to assess the effects of risk-based travel restrictions on (1) international travel frequency, (2) SARS-CoV-2 case importation risk, (3) national SARS-CoV-2 incidence and (4) importation of SARS-CoV-2 variants into Scotland.
Design: Population-based surveillance study.
Setting: The study utilises SARS-CoV-2 community testing from February 2021 to May 2022 in Scotland, UK and spans the introduction of the UK's 'traffic light system' policy in May 2021.
Primary outcome measures: Travel-related cases of COVID-19 were defined as PCR-positive Scottish residents self-reporting international travel within 14 days of booking a postarrival travel test. The Red-Amber-Green (RAG) status of the reported travel destination was determined through data linkage using country and date.
Results: International flight passengers arriving into Scotland increased by 754% during the traffic light period. Amber list countries were the most frequently visited and ranked highly for both SARS-CoV-2 importations and contribution to national case incidence. Rates of international travel and associated SARS-CoV-2 case rates varied significantly across age, health board and deprivation groups. Multivariable logistic regression revealed SARS-CoV-2 case detections were less likely through travel-based than community-based surveillance systems, although increased from green-to-amber and amber-to-red lists. When examined according to travel destination, SARS-CoV-2 importation risks did not strictly follow RAG designations, and red lists did not prevent establishment of novel SARS-CoV-2 variants.
Conclusions: Our findings suggest that country-specific postarrival screening undertaken in Scotland did not prohibit the public health impact of COVID-19 in Scotland. Travel rates likely contributed to patterns of SARS-CoV-2 case importation and population incidence.
Keywords: Epidemiology; Health informatics; Health policy; Public health; Risk Factors; SARS-CoV-2 Infection.
. 2024 Nov 29;14(11):e085332.
doi: 10.1136/bmjopen-2024-085332. Evaluation of risk-based travel policy for the COVID-19 epidemic in Scotland: a population-based surveillance study
Isobel McLachlan[SUP] 1 [/SUP], Selene Huntley[SUP] 1 [/SUP], Kirstin Leslie[SUP] 1 [/SUP], Jennifer Bishop[SUP] 1 [/SUP], Christopher Redman[SUP] 1 [/SUP], Gonzalo Yebra[SUP] 1 [/SUP], Sharif Shaaban[SUP] 1 [/SUP], Nicolaos Christofidis[SUP] 1 [/SUP], Samantha Lycett[SUP] 2 [/SUP], Matthew T G Holden[SUP] 1 3 [/SUP], David L Robertson[SUP] 4 [/SUP], Alison Smith-Palmer[SUP] 1 [/SUP], Joseph Hughes[SUP] 4 [/SUP], Sema Nickbakhsh[SUP] 5 6 [/SUP]
Affiliations
- PMID: 39615890
- DOI: 10.1136/bmjopen-2024-085332
Objectives: We aimed to assess the effects of risk-based travel restrictions on (1) international travel frequency, (2) SARS-CoV-2 case importation risk, (3) national SARS-CoV-2 incidence and (4) importation of SARS-CoV-2 variants into Scotland.
Design: Population-based surveillance study.
Setting: The study utilises SARS-CoV-2 community testing from February 2021 to May 2022 in Scotland, UK and spans the introduction of the UK's 'traffic light system' policy in May 2021.
Primary outcome measures: Travel-related cases of COVID-19 were defined as PCR-positive Scottish residents self-reporting international travel within 14 days of booking a postarrival travel test. The Red-Amber-Green (RAG) status of the reported travel destination was determined through data linkage using country and date.
Results: International flight passengers arriving into Scotland increased by 754% during the traffic light period. Amber list countries were the most frequently visited and ranked highly for both SARS-CoV-2 importations and contribution to national case incidence. Rates of international travel and associated SARS-CoV-2 case rates varied significantly across age, health board and deprivation groups. Multivariable logistic regression revealed SARS-CoV-2 case detections were less likely through travel-based than community-based surveillance systems, although increased from green-to-amber and amber-to-red lists. When examined according to travel destination, SARS-CoV-2 importation risks did not strictly follow RAG designations, and red lists did not prevent establishment of novel SARS-CoV-2 variants.
Conclusions: Our findings suggest that country-specific postarrival screening undertaken in Scotland did not prohibit the public health impact of COVID-19 in Scotland. Travel rates likely contributed to patterns of SARS-CoV-2 case importation and population incidence.
Keywords: Epidemiology; Health informatics; Health policy; Public health; Risk Factors; SARS-CoV-2 Infection.