U.S. is requiring covid-19 checks on arrival and upholding travels bans. Consultants see flaws.

The Centers for Disease Control and Prevention announced last week that the United States will require a negative coronavirus test result starting next week, generated within 72 hours of arrival for all international arrivals. The new rule is an attempt to keep a fast-moving new variant of the coronavirus out. However, with the introduction of the new health protocols, some tour groups saw the opportunity to restart some prohibited international travel.

Airlines for America, a trading group that advocates for the largest airlines in the United States, called for the new test rule to replace bans on international travelers from countries with cases of the new burden.

Without the assumption of office of a new government, the bans would have been lifted: Trump signed a proclamation, which the Biden government was quickly expelled. Trump described lifting travel restrictions on Europe and Brazil (while maintaining travel restrictions on China and Iran) as “the best way to keep Americans safe from Covid-19 while allowing travel to resume safely.”

But even if travel bans remain in place, experts say the new U.S. entry requirement, which allows for less accurate rapid antigen testing, isn’t as robust as other countries’ testing protocols – and travelers infected with coronavirus could manage to break test barriers on airplanes undetected. There have been such cases in New Zealand, Hawaii, and most recently in Australia.

The new system is being implemented as the country’s health officials try to prevent a new, highly contagious variant of the coronavirus, which has been detected in both Europe and Brazil, from dominating the US, although some experts fear rapid antigen testing are possible with the new strains to be even less effective.

Carlos Acuna-Villaorduna, an epidemiologist skilled in infectious disease modeling at Boston Medical Center, says travel bans are worthwhile during times when certain regions have high levels of infectious disease. He also notes that allowing rapid antigen tests (which are 20 percent less effective than laboratory tests) is particularly risky for the new strain, which some experts say is less detectable through these types of tests.

“We don’t know how accurate the rapid tests are for the new variety. There are several concerns, some of which can be false negatives, ”says Acuna-Villaorduna. “That doesn’t mean we have to block all travel completely, but we as a society should get the risk of travel under control. From the standpoint of modeling that allows travel out of these high infection areas, regardless of what you do, you will see an increase in cases. “

If rapid tests are just as effective for the new strain, say antigen, antigen tests are still about 20 percent less effective at detecting positive cases.

“The message has to be conveyed [the new system] will not make aircraft one hundred percent safe, ”says David Freedman, an infectious disease specialist at the University of Alabama in Birmingham. “Approximately 90 percent of the countries that require pre-departure testing require PCR [tests]. Only a small number, which now includes the US, will allow an antigen test. “

Even if the United States stopped allowing these less accurate antigen tests to be used, cases could get away. Infectious disease doctors like Freedman have long said that coronavirus tests done during a patient’s virus incubation period are negative, although the person can become highly contagious hours later.

A group of US-related coronavirus cases were found over the weekend on fully pre-tested Los Angeles to Australia flights (which require PCR testing).

Three passengers on the 18-hour trip tested positive for the virus upon arriving in Australia, despite testing negative for the virus within 72 hours of the flight. This resulted in quarantines for dozens of people and athletes traveling to Melbourne for the Australian Open next month.

Other examples of airborne coronavirus cases make it clear that you can be tested and still get the virus into a country: New Zealand, which has similarly strict rules to Australia (which requires multiple tests and quarantines to enter), has a group of Virus prevented flight-related cases from entering the country this summer, although the original case tested negative for the virus if necessary.

The incoming Biden government concurred with this sentiment, saying on Monday that it would not be possible to lift these travel restrictions immediately. The policy that requires a coronavirus test three days before departure also applies.

“With the pandemic worsening and its infectious variants around the world, it is not time to lift restrictions on international travel,” said Jen Psaki, spokeswoman for Biden, on Twitter. “On the advice of our medical team, the [Biden] The administration does not intend to lift these restrictions on January 26th. In fact, we plan to step up public health measures related to international travel to further contain the spread of COVID-19. “

On the advice of our medical team, the administration does not intend to lift these restrictions on January 26th. In fact, we plan to step up public health measures related to international travel to further contain the spread of COVID-19.

– Jen Psaki (@jrpsaki) January 19, 2021

Medical experts also say that the 72-hour schedule for testing, which does not require swabs to be removed more than three days before the flight, provides a relatively wide window of time for the virus to develop in a person’s system, which remains undetected before a flight.

A report from the International Civil Aviation Organization recently estimated that testing passengers for three days via a PCR lab (not the less effective rapid test) is about 75 percent effective in keeping infected people off the aircraft.

“In other words, 25% of the cases could get on board,” says Freedman.

ICAO estimated that 48 hours would be a safer window of time, but Freedman notes that shortening the timeframe would “pose practical problems” as travelers have little time to get a test result from the time they are appointed. PCR labs typically take two to three days to get results.

A quarantine or follow-up test requirement like the one in Australia, Acuna-Villaorduna said, would be a helpful extra layer to capture these cases. But it wouldn’t catch them all.

“Do all interventions like PCR [tests], Quarantines, symptom screening that would certainly reduce transmission, “says Acuna-Villorduna. “But it wouldn’t eliminate it completely.”

“A big part of that is keeping most of these dangerous load cases out of the US, but people shouldn’t believe that it will definitely keep any infected person out of the US,” Freedman says. “

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