key: cord-0946077-ij39ecfu
authors: Torres, Jaime R
title: Are rapid antigen SARS-Cov-2 tests effective for mass screening of travelers at airports? The Olympic experience
date: 2021-09-03
journal: J Travel Med
DOI: 10.1093/jtm/taab135
sha: 31d473d54fd70f85f67f4ba38772e1bbd3d0b236
doc_id: 946077
cord_uid: ij39ecfu

Usefulness of mass screening of arriving travelers at airports through rapid antigenic tests to reduce importation of SARS-Cov-2 into low incidence settings remains unproven. Recent successful Olympic experience indicates the need for additional strategies, including supervised quarantines, frequent retesting and close follow up of positive individuals to achieve this goal.

Mandatory RT-qPCR testing briefly before boarding or rapid antigen testing upon arrival and repeated testing during quarantining, may also be used to mitigate case importation risk, reduce quarantining duration and cut the risk of spread into communities. 5 With a sensitivity about 91% and very high specificity, some rapid antigen testing may offer an acceptable alternative to RT-qPCR to detect asymptomatic carriers at busy airports. One significant caveat is the fact that passengers must be advised to avoid eating drinking, gargling, and smoking in advance and upon landing. Besides, appropriate instructions for saliva collection are necessary to standardize procedures.

With more than 50,000 people directly involved, the Olympics possibly represents the largest global activity of this kind since the pandemic began.

The Organizing Committee of Tokyo Olympic Games recorded 430 Games-related infections since July 1. They carried out close to 624,000 screening tests with an infection rate of 0.02%. Only 32 of those positive were people who stayed in the village and 29 of them were athletes. The largest portion of the total were contract workers followed by games participants (236 and 109 individuals, respectively). 6 The organizers created an Olympic "bubble", a set of venues, hotels and the media center to which those participating in the Games were mostly confined. The situation inside the "bubble" stood in sharp contrast to outside, where a surge in infections fueled by the Delta variant reached daily records in the host city. Indeed, there were no serious cases of COVID-19 in the Olympic village, where more than 10,000 athletes lodged during the Games. 6 While is not possible to pin point any specific measure that worked best, a combination of factors including a vaccination rate of more than 70% among the Olympians and other participants, extensive daily testing, social distancing, as well as a ban on domestic and international spectators, undoubtedly played a pivotal role in the low number of infections observed.

In conclusion, despite efforts by health authorities around the world a significant number asymptomatic carriers will fail to be detected through mass screening of travelers at airports by means of rapid antigenic tests, unless additional strategies, such as 

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