Rapid tests, quarantine protocols would effectively protect airline travelers from COVID-19

SAN FRANCISCO — As flights continue to take to the skies even as COVID-19 cases surge again, preventing airline passengers from spreading the virus inside the cabin is a key concern. That’s especially been the case in recent weeks as many flights are being canceled over insufficient flight crew as coronavirus cases surge. Airlines are taking precautions against virus spread including masks, rigorous cleaning, and decreased flight capacity. Still, it is entirely possible to unknowingly welcome COVID-19 positive passengers on board. Testing travelers with a rapid SARS-CoV-2 test prior to takeoff could increase the safety of all of those on board, according to a recent study.

A team of researchers from the University of California, San Francisco says rapid tests could detect as many as 90% of infected passengers. Scientists ran a computer simulation, finding that the combined efforts of testing before departure and a five-day quarantine after arrival would result in a significant reduction in the spread of the virus among passengers and flight crew.

The simulation made estimates for how many travelers are likely to be infected, how long they may remain contagious, and the efficacy of various testing methods. The resulting data estimates that approximately 100,000 travelers will contract the virus before, during, or soon after their flight, putting other passengers and airline personnel at risk. Surprisingly, the results also suggest that rapid testing is nearly equal in effectiveness to PCR tests at identifying infected passengers.

Much of the difficulty with preventing and managing the spread of coronavirus comes from the fact that many travelers are unaware that they have been exposed to the virus. This method of pandemic management addresses the possibility that passengers who are unknowingly infected may develop symptoms days after their flight has landed. When researchers ran a simulated version of their plan, a period of quarantine reduced the number of contagious days for passengers by two-thirds.

“We know from the published literature how the infection spreads, and we can simulate how likely different testing and quarantine strategies will be to protect a person from infection and also reduce their chance of being a source of transmission in the community,” says the study’s lead author, Dr. Nathan Lo, in a statement.

Though air traffic is still at a fraction of what it was before March 2020, many are quickly growing more comfortable returning to airline travel. Many destinations have enacted their own pandemic protocols, but airlines and airports are yet to develop a uniform approach to safe travel management.

“This evidence could be useful to standardize testing and quarantine policy for COVID-19 at the airline, city, and state level for travelers. Nothing will be perfectly safe, and travel will always pose a risk to the individual and for importation to states, but this is a way to substantially minimize the risk,” Lo says.

While there is no bulletproof strategy to prevent the spread of a global pandemic, implementing testing and lockdown practices for pre and post-travel is a promising way to minimize the passing of infection. “Ultimately, it’s a value judgment,” Lo adds. “These strategies are not perfect, but if we implement test-and-travel strategies, we can dramatically reduce the risk of infection when traveling.”

The study is published in The Lancet Infectious Diseases.