Coronavirus screening may miss two-thirds of infected travelers entering
U.S.


*This is part of our Coronavirus Update
<https://news.harvard.edu/gazette/story/series/coronavirus/> series in
which Harvard specialists in epidemiology, infectious disease, economics,
politics, and other disciplines offer insights into what the latest
developments in the COVID-19 outbreak may bring.*

As many thousands of students prepare to decamp for warmer climes over
spring break, a Harvard epidemiologist warned that traveler screening may
catch just one in three symptomatic cases of COVID-19, the disease caused
by the new coronavirus, meaning there already could be hundreds of U.S.
cases that slipped through earlier screenings.

Marc Lipsitch <https://ccdd.hsph.harvard.edu/people/marc-lipsitch/>, head
of the Harvard T.H. Chan School of Public Health
<http://www.hsph.harvard.edu/>’s Center for Communicable Disease Dynamics
<https://ccdd.hsph.harvard.edu/>, said Wednesday that recent modeling
compared the number of people likely exhibiting COVID-19 symptoms with the
number caught by traveler-screening programs, using the robust screening
program in Singapore as a global gold standard.

The result showed that most countries’ procedures miss two-thirds of
travelers exhibiting COVID-19 symptoms, a finding that Lipsitch said may
explain the recent appearance of a cluster of cases in Washington, where 10
people have died. Lipsitch said travelers sick with COVID-19 likely arrived
in the U.S. four to six weeks earlier and simply were missed in screening,
leading to the Seattle area outbreak.

“I think you could have certainly hundreds, if not more, cases around the
United States by this point,” Lipsitch said. “The problem with giving a
firm number … is that there’s a lot of randomness in whether a particular
case does or doesn’t spark a chain of transmission.”
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