Canadian International COVID-19 Surveillance Border Study

In early September 2020, McMaster HealthLabs launched a month-long study to test arriving international passengers at Toronto's Pearson International Airport for COVID-19. The study was supported by Air Canada and the Greater Toronto Airport Authority. The study assessed the feasibility of enrolling arriving passengers, the acceptability and quality of self-collected specimens for detection of COVID-19 infection, and the scale-up of robotic testing for time-efficient and cost-effective COVID-19 testing. Participants self-collected specimens at the airport on arrival, and weekly at home during 14 days of quarantine. Current data as of September 30, 2020 demonstrated the feasibility for a robust and cost-effective COVID-19 surveillance program for arriving passengers using self-collection, with enrollment of ~8,000 passengers and collection of ~13,000 specimens. COVID-19 results were available within 12-24 hours, and SARS-CoV-2 virus was detected in ~1% of passengers. In the current study proposal, we will expand study enrollment for a further 4-6 weeks, to complete 14-day follow-up on 10,000 passengers. We will add additional resources to regularly contact participants by email or telephone, in order to improve adherence with specimen collection, completion of questionnaires, and to better assess compliance with quarantine. Our study will provide important data on COVID-19 infection on arrival, the development of infection during 14-days of quarantine, and compliance with quarantine. These data will inform policy for quarantine requirements, while demonstrating the feasibility of incorporating passenger testing into decision-making algorithms for travelers arriving in Canada.