Airline guidelines for Covid tests could set global bar for reliability

The ICAO manual on testing and cross-border risk management, due this month, will offer technical guidance and is expected to recommend passengers be screened using a test with a sensitivity of 95% so there are few false positives and negatives

by Allison Lampert and David Shepardson
Airline guidelines for Covid tests could set global bar for reliability
Health workers wearing protective gear wait for passengers to be tested for Covid-19 on arrival at Charles de Gaulle Airport in Roissy, near Paris, France on July 31, 2020. Photo: Reuters /Christian Hartmann.

A global aviation manual now under review by a UN body suggests global guidelines calling for the use of highly reliable tests when screening passengers to detect the novel coronavirus ahead of flights, three sources familiar with the matter have said. 

Carriers and airports are pushing for uniform global testing guidelines to waive strict quarantine requirements that are decimating travel, with airline trade group IATA forecasting a 66% decline in 2020 air traffic because of the pandemic.

Travel restrictions and the use of testing now vary globally. Certain airlines require passengers to obtain a negative test, but some countries allow visitors in without quarantine, while others bar all non-essential foreigners.

The International Civil Aviation Organization (ICAO) Manual on Testing and Cross Border Risk Management Measures, expected in November, would offer voluntary technical guidance but not oblige countries to remove quarantines.

The manual is not expected to suggest specific tests, such as antigen or polymerase chain reaction (PCR), the sources told Reuters. Instead, it would recommend passengers be screened using a test with a sensitivity and specificity of 95% so there would be few false positives and negatives, the sources said.

Some rapid tests are less sensitive and therefore more likely to miss positive cases than PCR alternatives, although the accuracy gap has narrowed.

One of the sources said a range of tests, with reliability as low as around 80% to close to 100%, had initially been considered.

Another proposal is that passengers be tested up to 48 hours ahead of travel but not necessarily at the airport, the sources said. The sources declined to be identified as the discussions are confidential.

US Federal Aviation Administration (FAA) deputy administrator Dan Elwell said on Wednesday that the manual would not be "heavy handed" or provide a prescription for testing. He did not confirm specific details about the manual.

"It's like 'Look, if you are going to do pre-departure testing or arrival testing or quarantine, here’s how we think you should do it,'" said Elwell, who heads an ICAO working group on issues like testing and quarantines.

ICAO said in an emailed statement the manual would provide countries with a risk management framework for evaluating testing options and factors to consider, should a country elect to implement testing. 

While the United States "would like to get to a point where quarantine is not necessary," Elwell said, it would be difficult to create global guidelines for removing travel restrictions through testing since countries have individual concerns," he said. 

"There are a lot of mixed feelings about quarantines." 

(Reporting By Allison Lampert in Montreal and David Shepardson in Washington; Editing byn Steve Orlofsky)

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