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Cited by 417COVID-19 epidemiological studiesMathematical and Theoretical Epidemiology and Ecology ModelsCOVID-19 Prevention and Impact

Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19

Open access
Gostic, Katelyn, Gomez, Ana CR, Mummah, Riley O, Kucharski, Adam J, Lloyd-Smith, James O·2020·eLife
DOI 10.7554/elife.55570PMC PMC7060038

Published version of a preprint

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Abstract

Traveller screening is being used to limit further spread of COVID-19 following its recent emergence, and symptom screening has become a ubiquitous tool in the global response. Previously, we developed a mathematical model to understand factors governing the effectiveness of traveller screening to prevent spread of emerging pathogens (Gostic et al., 2015). Here, we estimate the impact of different screening programs given current knowledge of key COVID-19 life history and epidemiological parameters. Even under best-case assumptions, we estimate that screening will miss more than half of infected people. Breaking down the factors leading to screening successes and failures, we find that most cases missed by screening are fundamentally undetectable, because they have not yet developed symptoms and are unaware they were exposed. Our work underscores the need for measures to limit transmission by individuals who become ill after being missed by a screening program. These findings can support evidence-based policy to combat the spread of COVID-19, and prospective planning to mitigate future emerging pathogens.

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  • The large numbers of false-positive and false-negative results from thermal sensors mean that this is unlikely to have a substantial effect beyond increasing awareness.

    “The large numbers of false-positive and false-negative results mean that this is unlikely to have a substantial effect beyond increasing awareness 51,52 .”

    From Digital technologies in the public-health response to COVID-19 (2020) · cites this paper as [51]

    The Results (Individual probabilities of detection; Parameters, uncertainty and sensitivity analyses) describe missed infected travellers and imperfect sensitivity of thermal scanners. The Discussion mentions false positives from less stringent risk questionnaires, not thermal sensors. It does not assess whether screening's only substantial effect is increasing awareness; it attributes most screening failures to cases with no detectable symptoms or known exposure. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Gostic, K., Gomez, A. C., Mummah, R. O., Kucharski, A. J., & Lloyd-Smith, J. O.
Affiliations
  • University of Chicago (US)
  • University of California, Los Angeles (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
Corresponding author
Gostic, Katelyn
ORCID
Venue
eLife
Publisher
eLife Sciences Publications, Ltd
Published
2020-02-24
Volume
9
ISSN
2050-084X (ISSN-L)
DOI
10.7554/elife.55570
PMC
PMC7060038
OpenAlex
W3008049045
Cited by
417
References
8
Citations by year
2026: 7 · 2025: 10 · 2024: 15 · 2023: 38 · 2022: 67 · 2021: 130 · 2020: 150
FWCI
15.30
Type
journal article
Language
en
Open access
Licence
Locations
  • eLife (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • PubMed Central (submittedVersion, cc-by-nc)
  • Knowledge@UChicago (University of Chicago) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eScholarship (California Digital Library) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
  • University of Chicago (cc-by)
Funders
  • James S. McDonnell Foundation (Postdoctoral fellowship in dynamic and multiscale systems)
  • Wellcome (206250/Z/17/Z)
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Science without borders fellowship)
  • National Science Foundation (DEB-1557022)
  • Defense Advanced Research Projects Agency (PREEMPT D18AC00031)
  • Strategic Environmental Research and Development Program (RC-2635)
Topics
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
  • Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
Keywords
COVID-19 pandemic, symptom screening, risk screening, screening effectiveness, asymptomatic transmission, undetected cases, emerging pathogens, mathematical model, disease transmission prevention
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Disease Outbreaks, Humans, Mass Screening, Pneumonia, Viral, Travel, Infection Control, Coronavirus Infections, Risk Assessment, Asymptomatic Infections

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