Year: 2025
Type: preprint
Study design: Observational Study
Abstract: Summary The global spread of infectious diseases was influenced by human movement dynamics, particularly for highly transmissible diseases like COVID-19. Asymptomatic COVID-19 cases lacked symptoms before diagnosis, posing a challenge for containment. Their contribution to air travel remains understudied. This retrospective cross-sectional study investigated the role of asymptomatic COVID-19 cases in air travel and their impact on the global spread of the virus. Through our analysis of 11,775 COVID-19 cases in Hong Kong (January 2020–April 2021), log-binomial regression models assessed the association between asymptomatic status and air travel behavior 14 days before diagnosis. The Wilcoxon rank-sum test compared median flight durations between asymptomatic and symptomatic cases. Results revealed two-thirds of cases with air travel history were asymptomatic, with asymptomatic airport or flight crew ten times more likely to travel than symptomatic counterparts (adjusted PRR=10, 95% CI: 4.00–25.00). For non-crew individuals, the adjusted PRR was 1.14 (95% CI: 1.12–1.16). Median flight duration for asymptomatic cases was 4.6 person-hours shorter than symptomatic ones (p<0.01). These findings highlight the significant contribution of asymptomatic cases to air travel and suggest under-detection during initial travel restrictions. Our study emphasizes proactive public health measures early in pandemics involving airborne infections, irrespective of symptom presentation.
Source: medRxiv
Authors: Weijun Yu, Hongjie Liu, Deus Bazira, Dylan Ratnarajah, Heran Mane, Thu T. Nguyen, Cheryll Alipio, Xin He, Yulia Hutsul, Jie Chen, Quynh C. Nguyen
Institutions: Georgetown University, Stanford University
Language: English
Subfield: Modeling and Simulation
Field: Mathematics
Domain: Physical Sciences
Open Access status: green
OpenAlex ID: W4408919398