The time has come to end this disruptive, anxiety-provoking ritual that does little to protect the nation’s or travelers’ health.
The time has come to end this disruptive, anxiety-provoking ritual that does little to protect the nation’s or travelers’ health.
A s Covid-19 cases, hospitalizations, and deaths continue to plummet, lawmakers around the country are beginning to lift restrictions. The Biden administration, however, is clinging to outdated policies that never made much sense and are now simply absurd. Exhibit A: the requirement for proof of a negative Covid-19 test before international air travel into the U.S.
This is not testing for a deadly pathogen like Ebola that kills half of those it infects. It is testing for a virus that has already infected more than half the country and against which more than two-thirds of the country is vaccinated. A virus that, excluding the vulnerable elderly, the immunosuppressed, and people with multiple underlying medical conditions, has a mortality rate equal to or lower than the flu.
Outside of the early days of the pandemic when there was the (mistaken) hope that the then-mysterious new disease could be confined to China, there has never been much justification for travel restrictions. The SARS-CoV-2 virus that causes Covid is so transmissible and usually so mild or asymptomatic that it spreads easily well before news of new variants disseminates. This is particularly the case with the highly transmissible Delta and even more transmissible Omicron variants that spread rapidly despite the panoply of government mitigation measures.
News that the new and even more transmissible Omicron subvariant “BA.2” is increasing overseas — in the U.K., for example — does not justify testing travelers. BA.2 already accounts for 23 percent of U.S. cases and appears to be as mild as the original Omicron. Testing will not spare the nation from the introduction of this new variant or its further spread.
Continued airline Covid testing is not protecting the country and offers little protection to travelers. First, the tests are not foolproof. PCR tests can stay positive for weeks or months, long after a person stops being contagious and posing a risk to others. While rapid antigen tests are as good as or better than PCR tests in determining whether a person is truly positive and infectious, the rapid tests have a higher rate of producing false negative results. The predictive values of both tests depend on the pretest probability of positive results. If Covid prevalence is high and the subject is symptomatic, the pretest probability and test accuracy are high. But test accuracy is likely to be low when everyone, symptomatic or not, is tested in today’s low-prevalence environment.
Second, airplanes are the safest nonmedical, indoor environments in existence. Half of the cabin air is passed through high-efficiency particulate air filters that are 99.9 percent effective at removing viruses, and the other half is virus-free, fresh air from outside. The air is changed 20 to 30 times an hour, two to three times more often than in office buildings. Potential airborne spread is limited because the air flow is from top to bottom, not along the length of the cabin. Tests by aircraft makers show that airplane passengers seated side by side have lower potential exposure than people staying six feet apart in other environments.
While testing has little benefit, it imposes major burdens. Travelers have to scramble to obtain testing the day before takeoff and worry about the results. A false positive result can ground a passenger, disrupting personal and business plans. Airlines are forced into the role of medical bookkeeper, tasked with collecting passengers’ test results. I, for one, am more concerned with them maintaining their attention to the safe operation of the aircraft. Finally, someone, whether passengers personally, insurers, or taxpayers, has to pay for all those unnecessary tests.
The CDC may feel virtuous by continuing the travel-testing charade. But the time has come to end this disruptive, anxiety-provoking ritual that does little to protect the nation’s or travelers’ health.