Roberta Aguirre
In response to the emergence of the coronavirus in late 2019, the US government issued a Level 4 Do Not Travel advisory, discouraging citizens from traveling to China. By mid-January, the Centers for Disease Control and Prevention (CDC) had established screening protocols at 20 US airports for passengers arriving from China. These screenings included temperature checks and assessments of respiratory symptoms. Despite these measures, the effectiveness of airport screenings in preventing the spread of coronavirus has been questioned, with studies suggesting that screenings may miss more than half of infected individuals due to the incubation period of the virus. While screenings may not entirely stop the spread, they can provide valuable time to implement other measures and raise awareness about the disease. As of January 2024, the US Transportation Security Administration (TSA) has screened more than 1 million passengers in a single day, indicating a potential increase in demand for air travel.
| Characteristics | Values |
|---|---|
| Number of airports screening | 20 |
| Airports included | John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Hartsfield-Jackson Atlanta International Airport, O'Hare International Airport, DFW Airport |
| Screening methods | Full-body scanners, metal detectors, face-recognition technology, thermal cameras, sanitation booths |
| Screening effectiveness | Screening may miss more than half of people exposed to the virus, especially during the flu season |
| Screening benefits | Can help discourage ill travelers from traveling, raise awareness, and educate travelers about the spread of disease |
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What You'll Learn
Screening methods and their effectiveness
The World Health Organization (WHO) recommends real-time reverse transcription-polymerase chain reaction (rRT-PCR) as the preferred laboratory method for diagnosing and screening SARS-CoV-2 infection. Immunoassay methods are also important for pandemic control and can be used as supplemental tools to identify cases missed by rRT-PCR or as first-line screening tests in areas with limited medical resources.
Nucleic acid amplification tests (NAAT) have consistently outperformed all other diagnostic methods, with a pooled sensitivity of 98% and a pooled specificity of 99%. Point-of-care (POC) serology tests have moderately high sensitivity (69%), while laboratory-based serology tests are more sensitive at 89%; both have high pooled specificity (96–98%). Imaging methods such as CT and x-ray are highly sensitive but limited by their low specificity in detecting COVID-19, as there are no defined features to differentiate it from other respiratory conditions.
In the context of airport screenings, the CDC employed non-contact temperature screening and assessed travelers for coughing or breathing difficulties. However, the effectiveness of entry/exit screenings has been questioned, as asymptomatic individuals may slip through, as evidenced by the Ebola outbreak in 2014. Similarly, border screenings for SARS and H1N1 influenza were unsuccessful due to the inability to identify infected individuals without symptoms, the lack of trained personnel, and the challenge of detecting incubating cases.
While airport screenings may not entirely prevent the spread of a disease, they can help slow it down and provide time to implement other measures. They also serve to discourage ill travelers from boarding flights, raise awareness about the disease, and educate travelers on protective measures. Additionally, airlines and industry organizations have called for TSA to introduce coronavirus screening measures to restore passenger confidence.
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Screening technologies
In the US, the Centers for Disease Control and Prevention (CDC) have been conducting screenings at five airports across the country, with passengers redirected to these hubs if they are coming from impacted regions. These airports included John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Hartsfield-Jackson Atlanta International Airport, and O'Hare International Airport.
Screening methods include the use of thermal cameras, sanitation booths, and full-body scanners. CDC employees take the temperature of passengers using hand-held scanners that do not touch the skin, and assess travellers for any signs of coughing or breathing difficulties. Passengers arriving from high-risk countries may also be asked to complete a short questionnaire about their travel, symptoms, and contact information.
Despite improved technology, there are limitations to screening methodologies, and passengers who are incubating the disease but show no symptoms may pass through checkpoints undetected. The World Health Organization does not recommend thermal screening, stating that it "offers little benefit while requiring considerable resources".
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Airports without screening
In 2020, the US Centers for Disease Control and Prevention (CDC) initiated screening at five international airports for passengers arriving from China. These airports included John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Hartsfield-Jackson Atlanta International Airport, and O'Hare International Airport.
However, some US airports did not implement coronavirus screening measures. Notably, three major airports in the DC area—Ronald Reagan National Airport, Baltimore-Washington International Airport, and Dulles International Airport—were without screening efforts. These airports primarily served domestic and international destinations outside of Asia, where the coronavirus was prevalent at the time.
The absence of screening at these airports raised questions about the effectiveness of thermal scanning in detecting infected travelers. Studies have shown that infected individuals without symptoms can slip through entry and exit screenings, as was the case during the SARS epidemic. Additionally, the World Health Organization has stated that entry screening offers little benefit while requiring considerable resources.
While screening may not stop the spread of the virus entirely, it can slow it down and provide valuable time to implement other measures. Screening has additional benefits, such as discouraging ill travelers from traveling, raising awareness, and educating travelers about protecting themselves and others.
As of January 2024, the US Transportation Security Administration (TSA) has not introduced specific coronavirus screening measures. However, they have implemented checkpoint modifications and continue to screen over one million passengers per day, indicating a tentative sign of demand recovery for air travel.
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Screening protocols
In January 2020, the Centers for Disease Control and Prevention (CDC) established screening protocols at three US airports for passengers arriving from China. These entry points were expanded to 20 airports, including DFW Airport. However, as of January 2020, the CDC was only conducting screenings at five airports across the country, including John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Hartsfield-Jackson Atlanta International Airport, and O'Hare International Airport.
The CDC's screening protocols include taking passengers' temperatures using hand-held scanners and assessing travellers for any signs of coughing or breathing difficulties. Airports in the US and overseas are also testing thermal cameras, sanitation booths, and other technologies for passenger screening to slow the spread of the virus and reduce the risk of exposure for airport screeners.
While screening may not be very effective in preventing the spread of COVID-19, especially during the early stages of an outbreak, it can provide indirect benefits. Screening can help discourage ill travellers from travelling, raise awareness about the spread of disease, and educate travellers on ways to protect themselves.
The US Transportation Security Administration (TSA) has implemented checkpoint modifications in response to the COVID-19 outbreak. However, as of January 2024, the TSA has not introduced coronavirus screening measures, despite calls from airlines, trade organisations, and unions to do so.
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Screening benefits
Screening at US airports for coronavirus has been in place since early 2020. Initially, the CDC conducted screenings at five airports across the country, including John F. Kennedy International Airport, Los Angeles International Airport, and San Francisco International Airport. Later, Hartsfield-Jackson Atlanta International Airport and O'Hare International Airport were added to the list. These screenings aimed to prevent the spread of the virus by identifying potentially infected individuals.
Despite the efforts, researchers have argued that airport screening is "ineffective" in detecting infected travelers, especially those in the incubation phase of the virus, who exhibit no symptoms. However, screening can still provide several benefits. Firstly, exit screening, which involves evaluating and quizzing passengers before boarding, may prevent those who are sick or exposed to the virus from traveling. This discourages ill travelers from boarding flights and helps slow down the spread of the virus. Additionally, entry screening at the destination airport provides an opportunity to gather contact information, which can be useful for contact tracing if an infection spreads during a flight. Screening can also raise awareness and educate travelers about the spread of the disease and the precautions they can take to protect themselves.
Furthermore, screening at airports can provide valuable time to implement additional measures, such as distributing test kits or setting up quarantine facilities. It can also help gather data on the spread of the virus and identify potential hotspots. Screening measures can inspire confidence in passengers and encourage air travel, benefiting the struggling airline industry.
While screening may not entirely prevent the spread of coronavirus, it is a crucial step in a comprehensive approach to managing the pandemic. It provides an opportunity to identify symptomatic individuals, raise awareness, and implement additional measures as needed. By combining screening with other strategies, such as contact tracing, social distancing, and proper hygiene practices, we can more effectively mitigate the impact of the virus.
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Frequently asked questions
The CDC initially conducted screenings at five airports: John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Hartsfield-Jackson Atlanta International Airport, and O'Hare International Airport. Later, the CDC expanded screenings to 20 airports across the US.
US airports use thermal cameras, sanitation booths, and other technologies to screen travellers for coronavirus. CDC employees also take passengers' temperatures using hand-held scanners and assess travellers for any signs of coughing or breathing difficulties.
Airport screenings may not be very effective in preventing the spread of coronavirus. Research shows that screening will likely miss more than half of the people exposed to the virus, especially during the flu season. However, screenings can provide indirect benefits, such as discouraging ill travellers from travelling and raising awareness about the spread of the disease.
Some challenges include the inability of testing methodologies to accurately identify infected individuals, a lack of sufficiently trained personnel, and the difficulty of detecting individuals who are incubating the disease but are not exhibiting symptoms.
