The Problems With Covid Testing for Flights

Is Covid-19 testing the way to restart travel? Grades are mixed so far. Airlines and

Is Covid-19 testing the way to restart travel? Grades are mixed so far.

Airlines and tourism organizations around the world say testing is the answer and are rushing to make it happen, opening test sites at airports, adding test results to passenger records and offering flights only for tested passengers. The World Travel and Tourism Council, along with business and airport groups, on Monday called on governments to open borders with testing to reduce risk rather than waiting for vaccines to end the pandemic. The state of Hawaii, which reopened to travelers with rigorous testing requirements, says it works.

“This is save-the-industry important,” says

Nick Careen,

a senior vice president at the International Air Transport Association, which represents 290 airlines in 120 countries. “We need to start flying now. Border restrictions need to be removed or we will start seeing more airlines fail.”

But already there are problems and concerns with travel-related testing. Two passengers with negative Covid-19 tests likely infected five others on the same 18-hour trip in September from Dubai to Auckland, New Zealand, according to a scientific study of the incident published in November by the government-run Institute of Environmental Science and Research, based in Wellington.

Fake negative-test certificates are already cropping up for sale. Experts and countries disagree on how much testing and what kind of tests should be required for crossing borders.

“A negative test is a test at a single point in time. It doesn’t tell you anything about tomorrow,” says

Dr. Patrick Godbey,

president of the College of American Pathologists.

Many countries now require a negative Covid-19 test to avoid quarantine upon entry. Typically a polymerase chain reaction (PCR) test is required about 48 or 72 hours before departure. The PCR test, which detects genetic material from the coronavirus, is more accurate than most rapid tests. But both types of tests can produce false negatives. That may be a problem with at-home tests now rolling out.

Passengers arriving in Rome on some Alitalia flights undergo a rapid test after landing, one of several steps required to avoid government-ordered quarantine. Delta is joining the program and will launch its first Covid-tested flight to Rome on Dec. 19.



Photo:

andreas solaro/Agence France-Presse/Getty Images

“We know that if a specimen isn’t collected appropriately in any type of lab testing, that’s going to introduce the biggest chance for an incorrect result,” says

Dr. Christina Wojewoda,

pathologist at the University of Vermont Medical Center and vice chair of the College of American Pathologists’ microbiology committee.

Hawaii, which decided to exempt tourists with negative test results from strict quarantine beginning Oct. 15, designates not only which test but also which testing company it requires. Some travelers have been denied boarding flights because their negative tests weren’t done at state-approved labs. Others arrived with negative test results the state wouldn’t accept and had to either quarantine or turn around.

“We’ve been pretty inflexible with exceptions,” says

Hawaii Lt. Gov. Josh Green,

an emergency room physician who has coordinated the state’s testing effort.

He calls tourism testing an “extraordinary success.” Since reopening, 500,000 people have arrived in the state and Hawaii’s rate of positive tests had dropped from 2.8% to 1.7% as of last week, he says. (On Wednesday, the state’s seven-day moving average was 2.4%.) Hospitalization numbers statewide have been cut in half: 105 people were hospitalized with Covid-19 the day before the reopening, and last week that was down to 54. About 29,000 people have gone back to work out of 150,000 who lost jobs due to the pandemic.

“We hang our success on the pre-travel tests,” Dr. Green says.

It hasn’t been without bumps. With an increase in Covid-19 infections in November, the island of Kauai split with the state and reimposed a 10-day quarantine regardless of testing on Dec. 2.

There have been testing setbacks elsewhere, too. Hong Kong and Singapore tried to establish a travel bubble allowing quarantine-free trips with testing, but pushed it back to next year because of increased cases.

The airport in Fort Lauderdale, Fla., offers travelers a choice of a PCR test, which is more accurate but takes longer to get results, and a rapid antigen test.



Photo:

Marta Lavandier/Associated Press

Another concern: forgeries. Seven people were arrested by French authorities and charged with selling fake Covid-19 test results at Charles de Gaulle Airport in Paris in November, according to the Associated Press. The fake negative test results were being sold to travelers for $182 to $365.

The IATA acknowledges that testing only minimizes or reduces the risk of spreading infection. It doesn’t eliminate it. The organization, which works with member airlines on safety and sets standards for airlines world-wide on things like reservations and technology, is creating standards for a health certificate that would be included in passenger records, similar to passport and visa documentation.

Travelers could store Covid-19 test results on an app, compliant with applicable privacy laws and regulations, and share the information with airlines when checking in for flights. Trials will begin this month and into January.

Airlines are racing to roll out apps. American is testing one called VeriFLY with the government of Chile, and United,

JetBlue,

Lufthansa,

Virgin Atlantic and others are trying CommonPass.

Passengers like these arriving in Paris will increasingly face health checks along with security and passport screening.



Photo:

martin bureau/Agence France-Presse/Getty Images

United ran a trial of flights to London from Newark, N.J., where the airline tested all passengers at no cost just before boarding. Passengers who didn’t want to be tested were put on other flights.

Delta is offering what it calls Covid-tested flights to Rome and Amsterdam from Atlanta starting this week. A negative PCR test is required within 72 hours of departure for Rome and five days before departure for Amsterdam. Passengers must also take free rapid tests both before takeoff and upon arrival in Europe. Passengers on those flights don’t have to quarantine, thanks to government agreements.

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Perhaps the most extensive research of transmission after pre-travel testing comes from the New Zealand Ministry of Health, which joined with other researchers to study seven infected people who traveled aboard Emirates Flight 448 from Dubai to Auckland on Sept. 29.

Two of the seven were likely infected before traveling but had tested negative in Zurich, Switzerland, within 72 hours of departing on their trip. Four of the seven were likely infected in-flight, the study found, and another likely during mandatory 14-day quarantine in New Zealand required of all passengers.

All seven people had genetically identical strains of the virus, even though the passengers had originated in five different countries. All seven sat within two rows of the presumed spreaders, and all were in aisle seats, the study reported. Travelers reported wearing masks and some wore gloves. There were 86 passengers on the Boeing 777.

The study’s conclusion: Testing didn’t stop infection in this case. “While not definitive, these findings underscore the importance of considering all international arrivals into New Zealand as potentially infected with SARS-CoV-2 even if pre-departure tests have been undertaken, social distancing and spacing have been followed and personal protective equipment has been used in flight,” the study said.

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