Airport COVID-19 Testing of Travelers: An Island Destination Perspective

Purpose of Review To highlight recent literature on airport COVID-19 testing studies among travelers at international borders and to identify factors that may contribute to bias. Recent Findings Literature search shows vastly different study designs and goals for airport COVID-19 screening programs, with positivity rates ranging from 0.1 to 100%. Goals included detecting the maximum cases with enforced isolation, determining an accurate positivity rate among travelers, investigating alternative diagnostics, and evaluating pre-travel programs. Participation rates are in the low (27–40%) to high ranges (72–100%). Summary The implementation strategy differs depending on the primary goal. If the goal is to ban new cases or perform active surveillance of new variants, then it is reasonable to consider mandatory airport testing, or voluntary testing with genome sequencing and isolation. If the goal is to determine an accurate positivity rate among travelers or effectiveness of pre-travel programs, then it is reasonable to consider an anonymous, voluntary testing program (without associated isolation) to minimize self-selection bias or distortion of travelers.