Can preflight tests get people flying again?
The International Air Transport Association (IATA) is of the opinion. Last month, the trade association, which represents some 290 airlines around the world, called for the “development and delivery of faster, more accurate, affordable, easy-to-use, scalable and systematic” Covid-19 tests for all passengers to restore passenger confidence To bypass quarantines and reopen the borders.
Within a few weeks, United Airlines, American Airlines, and JetBlue announced plans to launch preflight testing programs for places like Hawaii, Costa Rica, and the Caribbean, depending on the airline.
At this point, Italy’s largest airline, Alitalia, was already operating two flights between Rome and Milan for passengers who tested negative before boarding.
Panama reopened its borders this week to travelers who arrive with a negative Covid-19 test in hand or who test negative after a quick test on landing.
But testing is not that easy. Just ask Iceland.
When Iceland reopened on June 15, the country exempted travelers from a two-week quarantine if they tested negative for Covid-19 upon arrival. The cases increased less than a month later.
Iceland revised its policy in August. Two Covid-19 tests are now required – one on arrival and another five days later – with quarantine in between.
In one of the pandemic’s most famous test failures, a Covid-19 outbreak broke out in the White House this month, partly due to its pandemic Practice relying on rapid tests Check visitors. The tests are known to miss up to a third of asymptomatic infections.
When asking for preflight testing Last monthIATA said that “implementable solutions are expected in the coming weeks”. Medical experts say this may be premature.
Polymerase chain reaction tests, also called PCR, can more accurately diagnose positive cases, said Dr. Peter Gulick, an infectious disease expert at Michigan State University. But these tests, which are based on a nasal swap, throat swab, or saliva, “are done in a laboratory so it can take days to come back and a patient can become infected during that time,” he said.
That is the problem with PCR testing. Test too early and the chances of a person becoming infected after testing will increase. Test too late and results may not be ready by the time you leave.
Beginning October 15, American Airlines passengers traveling to Hawaii and Costa Rica from Dallas-Fort Worth International Airport will be able to take Covid-19 tests in one of three locations: at the airport, at local emergency care facilities, or at home via a virtual one Meeting with a healthcare professional.
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Rapid antigen tests can solve the timing problem, but “they can give 20% to 40% false negative results,” Gulick said. This makes these tests better suited for confirming infection than giving an “all clear” sign for no infection.
There are fast PCR tests out there, but their production is still not meeting demand, said Dr. Shira Doron, Infectious Disease Doctor and Epidemiologist at Tufts Medical Center Hospital.
“Right now, a few companies are running rapid PCR tests,” she said. “These are sensitive and have few false positives.”
Research carried out by IATA shows that 65% of travelers believe that people who test negative for Covid-19 do not need to be quarantined. However, health professionals are not as optimistic.
“A preflight test, even if done at the security checkpoint, is not a foolproof protocol to prevent the spread of Covid-19 to the passenger’s destination,” said Dr. Makeda Robinson, a virologist at Stanford University.
Robinson said that every person infected with Covid-19 has an incubation period where the virus cannot yet be detected by tests. The average is four to seven days, but it can take up to 14 days for some people, she said.
“For comparison, with the 2003 SARS virus, people were most contagious after developing symptoms, which made it easier to identify cases and separate them from the non-exposed population,” she said. “SARS-CoV-2 [Covid-19] has more asymptomatic infections and can be highly infectious before symptoms appear. “
“This means that someone could become infected … do an initial negative test before boarding the plane and then test positive in the days after the flight,” Robinson said.
Without an effective vaccine, traveling without a quarantine period will likely cause Covid-19 cases to spread further, Robinson said.
“A possible middle ground could include a preflight test with a shorter quarantine period of around seven days in the target country and follow-up [with a] Post-flight test, “said Robinson.
Airports like Tampa International Airport also run pre-flight Covid-19 tests.
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However, the current trend is to eliminate quarantines. Beginning November 1, the Bahamas will be removing its 14-day “vacation on the spot” quarantine requirement in favor of a “triple testing” policy. Incoming travelers must receive a PCR swab test no later than seven days prior to travel, followed by a rapid antigen test on arrival and an additional 96 hours later.
Beginning October 15, passengers on certain United and American Airlines routes in Hawaii will be able to avoid a 14-day quarantine if they test negative as part of the airlines’ new testing programs.
“A test only represents a moment,” said Doron. “Someone can be negative one moment and develop the disease the next. Though [testing] reduces the likelihood of someone with Covid-19 getting on a plane and does not eliminate the risk. “
This may be enough for places battling active coronavirus outbreaks in their own populations.
However, a single preflight test is unlikely to convince countries with little or no new cases such as New Zealand, Taiwan, Thailand and Singapore to open their borders anytime soon.