Airports And Temperature Checks: What's The Current Protocol?

During the COVID-19 pandemic, airports around the world implemented temperature screening for passengers to curb the spread of the virus. In 2020, four major Canadian airports in Vancouver, Calgary, Toronto, and Montreal started taking passengers' temperatures, with plans to expand to 11 more airports. Similarly, international airlines like Air France, Singapore Airlines, and Air Canada also adopted temperature checks for travellers. However, the effectiveness of temperature screening has been questioned due to the possibility of false negatives and false positives.

Temperature screening methods

Temperature screening has become a new way of life as a precaution to prevent another COVID outbreak. Fevers are one of the few main detectable symptoms of COVID. The CDC discovered that 80-99% of people infected with COVID-19 had a fever. Therefore, temperature screening is a crucial measure to identify people at risk of developing COVID or those infected with COVID to slow the spread of the virus.

Handheld Temperature Gun

This is the most common temperature screening method used by organisations. Handheld temperature guns measure someone's body temperature using infrared. They are equipped with an infrared sensor that measures bodily temperature without making any contact with the person. They are small, lightweight, easy to operate, and relatively cheap. However, they are inaccurate if not held close enough to the person's forehead. They are also unsuitable for organisations with a large number of employees or visitors as they can only scan one individual at a time.

Mass Temperature Scanning Gun

This method is similar to the handheld temperature gun but is mounted on a stand and usually used in facilities with large crowds such as airports, hospitals, and public events. It can show temperatures in degrees and thermal images. It can scan the temperature of a large crowd at once, and staff operating the device do not need to come in close contact with people to get a reading. However, it is not accurate and may miss people with unusually high temperatures.

Tablet Temperature Scanner

This method uses a tablet with a temperature sensor module attached to it. It requires individuals to show their face on the tablet screen for a temperature measurement. It is automated and does not need an operator or staff to be manning the scanner. It allows for more accurate readings with staff maintaining zero contact with the individual being screened. The accuracy of these devices can be narrowed down to ± 0.2 °C. However, it is more expensive than the other methods, with a tablet temperature scanner costing up to $3,000. It can only scan one individual at a time, making it inconvenient for venues with many people.

Thermal Cameras

Thermal cameras, also called thermal imaging systems, are devices that measure body temperature by detecting the face and looking at the tear ducts of the eyes. They do not need an operator and are highly accurate. They consist of an infrared camera, a visual camera, a heat source reference point (HSRP), a computer system, and other small components. They are more complex and require more components to be set up in the entryway of a building. They are more cost-effective for companies with more than 15 employees onsite.

Effectiveness of temperature screening

Temperature screening has been used as a measure to curb the spread of COVID-19. While it is a non-invasive method, its effectiveness has been questioned. Many people with COVID-19 experience mild or no symptoms, which makes it difficult to detect the virus. As a result, various settings, including airports and university campuses, have implemented temperature screening to reduce transmission potential.

In July 2020, four major Canadian airports in Vancouver, Calgary, Toronto, and Montreal started taking passengers' temperatures. Passengers with temperatures above 38 degrees Celsius were not allowed to travel and were asked to re-book after two weeks. This measure was implemented to supplement previous travel safety precautions, such as the requirement for all travellers to wear face masks.

The effectiveness of temperature screening has been debated, with some experts arguing that it is not an effective method for screening people for COVID-19 infection. One of the concerns about temperature screening is that it can lead to false negatives, giving infected individuals a false sense of assurance that they are healthy. It can also result in false positives, potentially exposing healthy individuals to the virus.

A study conducted at a large public university in 2020 evaluated the feasibility and effectiveness of daily temperature screening to detect COVID-19. The results showed that while daily temperature monitoring was feasible and acceptable to participants, it failed to detect the majority of potentially infectious individuals. The sensitivity of temperature screening in this study never exceeded 40.5%, indicating that it may not be reliable as a primary means of detection.

Another study conducted at a hospital in Australia found similar results, with a sensitivity of 19% for fever detection in patients with COVID-19. These findings suggest that temperature screening may have limited effectiveness in detecting infectious individuals and preventing the spread of the virus.

Despite the concerns about its effectiveness, temperature screening has been implemented in various settings, including airports, to curb the spread of COVID-19. However, it is essential to combine temperature screening with other preventive measures, such as wearing face masks and social distancing, to ensure the safety of travellers and the general public.

Countries that screen temperatures

During the COVID-19 pandemic, several countries implemented temperature screening measures at their airports to curb the spread of the virus. Here is a list of countries that have conducted temperature checks on arriving passengers:

Canada

Four major Canadian airports in Vancouver, Calgary, Toronto, and Montreal introduced temperature screening for passengers as part of their COVID-19 safety measures. Transport Canada announced plans to expand this screening to 11 additional airports by September. Passengers with temperatures above 38 degrees Celsius were not permitted to travel and were advised to re-book after two weeks.

China, South Korea, India, and Russia

Customs agents in these countries routinely took the temperatures of arriving passengers at airports during the COVID-19 pandemic. In China, temperature screening was also conducted outside supermarkets and pharmacies. These countries utilized various methods, such as infrared scanners and handheld thermometers, to detect passengers with elevated temperatures.

Barbados

A traveller arriving in Barbados from Canada reported that his temperature was taken by soldiers upon arrival. At the time of his travel, Barbados had not reported any cases of COVID-19.

Guinea, Liberia, and Sierra Leone

During the Ebola outbreak, these countries implemented temperature screening at airports for passengers departing the country. They were on the lookout for "unexplained febrile illness."

Other Countries

Russia, Australia, and India also conducted temperature screening for passengers arriving from or with a travel history of West Africa during the Ebola outbreak. These countries aimed to prevent the spread of the virus by identifying individuals with elevated temperatures for further screening.

Countries that don't screen temperatures

Many countries have implemented temperature screening at their airports in response to the COVID-19 pandemic. However, there are some countries that have not adopted this strategy and have raised questions about its effectiveness. One notable example is Canada, where some travellers have expressed surprise and concern at the absence of temperature screening upon arrival at airports such as the Pierre Elliott Trudeau airport in Montreal. While countries like China, South Korea, India, and Russia have routinely conducted temperature checks at their airports, Germany has also taken a strong stand against it.

In March 2020, the International Air Transport Association (IATA) emphasised the importance of temperature screening at airports during the COVID-19 pandemic. They recommended that airport staff be equipped with calibrated, non-contact infrared thermometers to identify passengers with fevers, collect their personal information, and notify the appropriate authorities for quarantine and reporting. Despite these recommendations, the Public Health Agency of Canada has not implemented mandatory temperature screening at airports. Instead, they have introduced other measures, such as providing kits with masks and instructions to travellers who exhibit symptoms in-flight, and escorting them through the airport to ensure they remain separated from other passengers.

Dr. Mylène Drouin, director of the Montreal Public Health Department, explained that their strategy focuses on intercepting travellers with symptoms through quarantine agents and testing. She stated that asymptomatic travellers do not require testing, and they currently lack the capacity for widespread temperature screening. Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, also recommended against temperature screening as an ineffective method for screening COVID-19 infections. He acknowledged that while thermometers can detect fevers, they are not an effective tool for identifying COVID-19 cases.

However, not all experts agree, as Dr. Anne Gatignol, a microbiologist at McGill University, supported the idea of temperature screening at airports. She suggested that it would help sensitize passengers to the risk they pose to the population if they have a fever. Gatignol also noted that some travellers might ignore the recommended two-week quarantine, and temperature screening could help increase the proportion of people adhering to it.

While temperature screening has been a topic of debate, it is important to recognise that it is just one aspect of a multifaceted approach to managing the spread of COVID-19 and ensuring the safety of travellers and the public.

Alternatives to temperature screening

While temperature screening has been used in airports around the world to help curb the spread of COVID-19, it is not a foolproof method. A recent study suggested that almost half of COVID-19 cases would be missed by temperature screening alone, as some travellers may be infected but not yet showing symptoms such as a fever.

• Enhanced border measures: The Canada Border Services Agency (CSBA) has implemented a series of "enhanced border measures", including providing travellers who are found to be ill in-flight with a kit that includes a mask and instructions, and escorting them through the airport to ensure they are kept away from other passengers.
• Quarantine instructions: In Montreal, Canada, the city's chief public health officer announced that teams would show up at the airport to insist that arriving travellers self-quarantine for 14 days. Thermometers would also be provided to those self-isolating so they could monitor their own temperatures at home.
• Exit screening: A 2019 systematic review found that exit screening may be a higher priority than entry screening. This approach has been used previously for the H1N1 influenza pandemic, Ebola, and SARS.
• Educating travellers: Research suggests that temperature screening may provide an opportunity to educate travellers about COVID-19 and what to do if they develop symptoms.
• Collecting other relevant information from travellers: The World Health Organization (WHO) recommends that if temperature screening is implemented, governments should also take other measures such as collecting other relevant information from travellers and having systems in place to act on the data collected.

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