The effect of border controls on the risk of COVID-19 reincursion from international arrivals

Abstract

In an attempt to maintain elimination of COVID-19, the New Zealand government has closed the border to everyone except citizens and residents. All arrivals are required to spend 14 days in government-managed isolation/quarantine and to be tested for COVID-19 on day 3 and on day 12 of their stay. We model the testing, isolation and potential transmission of COVID-19 within managed isolation facilities to estimate the risk of undetected cases and the risk of infectious cases being released into the community. We use a stochastic individual-based that includes a time-dependent probability of a false negative test result, complete isolation of confirmed and probable cases, and secondary transmission of COVID-19 between close contacts. We show that the combination of 14-day quarantine with day 3 and day 12 testing reduces risk of releasing an infectious case to around 0.1% per infected arrival. Shorter quarantine periods, or reliance on testing only with no quarantine, substantially increase this risk. It is important to avoid contacts between individuals staying in quarantine to minimise the risk of secondary transmission. We calculate the ratio of cases detected on day 3 to cases detected on day 12 in the model and show that this may be a useful indicator of the likelihood of secondary transmission occurring within quarantine. We do not explicitly model transmission of COVID-19 from individuals in quarantine to staff, but this is likely to present a significant risk. This needs to be minimised by strict infection control, use of personal protective equipment by staff at all times, and avoiding close contact between staff and hotel guests.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by the Ministry of Business, Innovation and Employment and Te Pūnaha Matatini, New Zealand’s Centre of Research Excellence in complex systems.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

No approval or exemption for this research was required.

All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

No new data is presented in this article

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