Us Airport Covid-19 Testing: What's The Protocol?

In the wake of the COVID-19 pandemic, airports around the world have implemented various safety measures to prevent the spread of the virus. The US government issued a Do Not Travel advisory, urging citizens to avoid travelling to China, where the virus was believed to have originated. The Centers for Disease Control and Prevention (CDC) established screening protocols at three US airports for passengers arriving from China, which were later expanded to 20 airports. These screenings included questionnaires, temperature checks, and assessments of visible symptoms. The CDC also issued travel health notices, advising individuals travelling to outbreak areas to monitor their health for symptoms. Similar screening measures were implemented in airports across Europe, Canada, India, the Middle East, Australia, and New Zealand.

Screening methods and their effectiveness

Screening methods for COVID-19 include questionnaires, fever detection, and testing for antibodies. The effectiveness of these methods depends on several factors, including the natural history of the infection, the stage of the epidemic, and the efficacy of the screening techniques.

Questionnaires can be used to screen for exposure risk factors, but their effectiveness depends on the level of epidemiological knowledge about the virus and the honesty of the passengers. Fever detection is more effective for viruses with short incubation periods, such as influenza, but less effective for viruses with longer incubation periods, such as Ebola. The efficacy of fever detection also depends on the sensitivity of the equipment used, with non-contact infrared thermometers having an average efficacy of 70%.

Testing for antibodies can be done using enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), immunochromatography test (ICT), and immunosensors. ELISA is the most widely used method and can be used for both antigen and antibody detection. IFA is highly sensitive and specific but requires skilled laboratory staff. ICT is the best approach for point-of-care testing (POCT) but often has low sensitivity. Immunosensors are miniaturized integrated devices that allow rapid, easy-to-use, and point-of-care detection.

The role of the CDC

The CDC, or the Centers for Disease Control and Prevention, is the national public health institute of the United States. It is part of the U.S. Department of Health and Human Services, a Cabinet-level agency of the federal government. The CDC's role during the coronavirus crisis has been crucial in controlling and preventing the infectious disease.

On January 20, 2020, the CDC mobilized an Emergency Operations Center to help public health partners respond to the outbreak, which began in Wuhan, China. The CDC's experts monitor and share information, prepare for public health crises, and make collaborative decisions. They also mandated a two-week quarantine for Americans evacuated from Wuhan—the first time in over 50 years that the CDC has ordered quarantines.

The CDC has a broad mission to prevent and control infectious and chronic diseases while promoting good health. It has a long history of addressing global public health issues, such as the HIV/AIDS epidemic in the 1980s and the 2014 Ebola outbreak. They have sent test kits worldwide and plan to send more. For example, Vietnam will receive 4,000 test kits for hospitals and public health laboratories in Hanoi, Nha Trang, and Ho Chi Minh City. The CDC also translates health guidance into other languages, such as Russian in Kazakhstan, and trains health workers on sample collection procedures in various hospitals worldwide.

The CDC's response to the coronavirus outbreak has been swift and comprehensive, demonstrating its critical role in protecting public health and safety.

The impact on airlines

The impact of the coronavirus outbreak on airlines has been significant, with a range of safety measures and travel restrictions implemented by governments and aviation authorities worldwide.

In the United States, the Federal Aviation Administration (FAA) has played a crucial role in coordinating the response to the pandemic. The FAA established the "FAA COVID-19 Vaccine Air Transport Team" to ensure the safe and efficient transportation of vaccines across the country. The team provided guidance to manufacturers, air carriers, and airport authorities on safely transporting large quantities of dry ice, a hazardous material required to maintain the cold temperatures necessary for vaccine shipment.

To facilitate the safe transport of critical medical supplies and personnel, the FAA collaborated with other government agencies, air carriers, and aviation stakeholders. They also extended exemptions to airlines, allowing them to transport cargo secured to passenger seats or seat tracks when no passengers were on board. These exemptions aimed to ensure the uninterrupted flow of essential goods during the pandemic.

The pandemic significantly impacted airlines' operations and financial stability. United Airlines, for example, cancelled several flights from US hubs to Beijing, Hong Kong, and Shanghai, anticipating lower demand due to the coronavirus fears. American Airlines followed suit, announcing similar cancellations to Beijing and Shanghai for an extended period. The International Air Transport Association (IATA) forecasted a 13% full-year loss of passenger demand for airline operators in the Asia-Pacific region, resulting in an expected revenue loss of $27.8 billion in 2020 for carriers in the region.

The screening measures at airports also affected airlines' operations. Passengers arriving from high-risk countries or those with symptoms were subjected to health screenings, including temperature checks and assessments for other visible symptoms. While these measures aimed to prevent the spread of the virus, they also caused delays and disruptions to travel plans.

Overall, the impact of the coronavirus outbreak on airlines was substantial, with reduced demand, flight cancellations, and financial losses. Airlines had to adapt to changing circumstances and implement safety measures to protect their passengers and crew. The pandemic highlighted the complex challenges faced by the aviation industry in responding to global health crises.

International airport measures

International airports have implemented various measures to prevent the spread of COVID-19 and protect travellers and staff. These measures include:

• Screening passengers for symptoms, including taking their temperature with hand-held scanners and assessing them for coughing or breathing difficulties.
• Requiring passengers to complete a short questionnaire about their travel history, symptoms, and contact information.
• Implementing separate gates and screening measures for passengers arriving from high-risk areas.
• Increasing disinfection and cleaning procedures, especially in areas frequented by passengers from high-risk areas.
• Providing health alert cards to passengers, instructing them on what to do if they develop symptoms.
• Reducing the number of flights to and from high-risk areas.
• Encouraging passengers to reschedule or cancel their trips to high-risk areas.
• Offering travel waivers to passengers affected by flight cancellations or travel restrictions.
• Closing outbound traffic from high-risk areas.
• Quarantining travellers from high-risk areas who show symptoms of COVID-19.
• Using thermal cameras and fixed and hand-held temperature scanners to detect passengers with elevated temperatures.
• Advising residents to postpone non-essential travel to high-risk areas.
• Implementing travel restrictions on passengers from high-risk areas, including mandatory quarantines upon arrival.
• Providing protective equipment and suits for airline crew.
• Increasing the frequency of aircraft disinfection and cleaning.
• Using separate areas or terminals to screen and isolate passengers arriving from high-risk areas.
• Distributing test kits to identify infected travellers.
• Educating travellers about the spread of the disease and ways to protect themselves.

Screening at Middle Eastern airports

In 2015, a study was conducted on 28,197 Indonesian Hajj pilgrims returning from Mecca through the Juanda airport in Surabaya, Indonesia. The pilgrims were screened for the Middle East respiratory syndrome coronavirus (MERS-CoV) using a thermal detector. Those with a body temperature of > 38 °C and respiratory symptoms were sent to the airport clinic for further testing. However, despite the screening measures, no cases of MERS-CoV were detected among the pilgrims.

In response to the COVID-19 pandemic, several Middle Eastern countries have suspended all commercial flights and implemented airport closures to combat the spread of the virus. These countries include Egypt, Lebanon, Saudi Arabia, Iraq, Jordan, Tunisia, Morocco, and Sudan. The aviation industry in the region has suffered significant losses, with airlines losing more than $7 billion in revenue and potentially hundreds of thousands of job losses.

To support the industry, the International Air Transport Association (IATA) has called for emergency aid of up to $200 billion for airlines globally. Muhammad Albakri, IATA’s regional vice president for Africa and the Middle East, has emphasized the urgency of the situation, stating that "a lot of jobs are at risk, economies of the nations are being impacted, and airline business in the Middle East is taking a big hit."

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