Estimating the risk of SARS-CoV-2 infection in New Zealand border arrivals.

BACKGROUND

Travel restrictions and border controls were used extensively during the COVID-19 pandemic. However, the processes for making robust evidence-based risk assessments of source countries to inform border control policies was in many cases very limited.

METHODS

Between April 2020 and February 2022, all international arrivals to New Zealand were required to spend 14 days in government-managed quarantine facilities and were tested at least twice. The infection rates among arrivals in the years 2020, 2021 and 2022 were respectively 6.3, 9.4 and 90.0 cases per thousand arrivals (487, 1064 and 1496 cases). Test results for all arrivals were linked with travel history, providing a large and comprehensive dataset on the number of SARS-CoV-2-positive and negative travellers from different countries over time. We developed a statistical model to predict the country-level infection risk based on infection rates among recent arrivals and reported cases in the country of origin. The model incorporates a country-level random effect to allow for the differences between the infection risk of the population of each country and that of travellers to New Zealand. A time dependent auto-regressive component of the model allows for short term correlation in infection rates.

RESULTS

A model selection and checking exercise found that the model was robust and reliable for forecasting arrival risk for 2 weeks ahead. We used the model to forecast the number of infected arrivals in future weeks and categorised countries according to their risk level. The model was implemented in R and was used by the New Zealand Ministry of Health to help inform border control policy during 2021.

CONCLUSIONS

A robust and practical forecasting tool was developed for forecasting infection risk among arriving passengers during a period of controlled borders during the COVID-19 pandemic. The model uses historical infection rates among arrivals and current infection rates in the source country to make separate risk predictions for arrivals from each country.