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While vaccines roll out worldwide, testing is still a critical requirement
for getting air travel off the ground
Vaccines are slowly moving into position as the answer for the global pandemic. Until they are ubiquitous, testing passengers for COVID-19 will still be essential for enhancing the safety of domestic and international air travel—and for reassuring passengers that you are doing all you can to help protect their health while in-flight.
The U.S. and Canada require all passengers to have a negative COVID test prior to entry. The CDC requires that passengers take a test within 72 hours of boarding.1 Other countries have similar requirements.
The International Civil Aviation Organization (ICAO) has collaborated on guidelines with the CDC and World Health Organization (WHO) and has created the "Manual on Testing and Cross-border Risk Management Measures".2 They stress the importance of pre-departure testing.
Recommendations and protocols for air travel testing
Updated guidelines from the CDC and WHO currently recommend testing 24–48 hours prior to travel for domestic and international flights and testing post-arrival per country protocol.
One of the most streamlined and accurate models for passenger testing is for airlines to link to a full-service lab provider that can provide a turn-key, end-to-end solution for the traveler at the time of booking.
Beyond testing, a full-service lab provider coordinates all parts of the testing process: collecting the sample, running the tests, and sending the results to the people being tested and to digital health passport vendors. The passenger can then show proof of a negative test from the vendor at the time of boarding.
Infographic: The ideal airline testing process
Within 24—72 hours before boarding: | |||||
|---|---|---|---|---|---|
Step |
1. Airline recommends a testing lab to air traveler |
2. Air traveler submits a sample to a testing lab: saliva or nasal swab |
3. PCR test is run at testing lab |
4. Results are provided to the air traveler via mobile app or other method and may be sent to a digital health passport vendor |
5. At boarding, air traveler presents a QR code with a link to a negative test result certified by a digital health passport vendor |
What Happens | Recommending testing providers at the time of booking streamlines the process for air travelers. | Labs with inperson, supervised sample collection sites are preferred for accuracy, security, and proper sampling. | Up to 380 samples can be tested on each PCR instrument at the same time while producing individual results. | Digital health passports can provide a simple, secure method for demonstrating testing compliance through secure access to health data from multiple labs, in a way that maintains personal health record privacy. | A secure, digital test result quickly assures the airline that the passenger is cleared for take-off. |
Which COVID-19 testing technology?
The ability to detect the virus when there are no symptoms is key.
People who are carrying the virus without showing symptoms have low viral amounts but can still spread the disease. A COVID-19 test needs to be highly sensitive to detect these low viral amounts. Polymerase chain reaction (PCR) tests are the most sensitive and accurate available.3 For that reason, PCR is considered the gold standard technology for COVID-19 testing.
Infographic: Comparing technologies for air travel testing
Attribute | What Matters | PCR | RADT |
|---|---|---|---|
How They Work
| COVID-19 testing technologies can either detect the genetic material of the virus, or check for antigen sassociated with the virus. | Polymerase chain reaction (PCR) tests detect virus genetic materials. Small amounts of the virus are amplified to make them easier to detect. | Rapid antigen detection tests (RADT) look for specific viral antigen proteins on the surface of the virus. |
Test Sensitivity & Accuracy
| COVID-19 tests should be highly sensitive, meaning that they can detect the low viral amounts that may be present in people who can spread the virus even if they don’t have symptoms. | PCR tests are the gold standard—the most sensitive and accurate tests available.1 Real-time PCR is most sensitive, and Direct/Fast PCR is also highly sensitive. | RADT tests are less sensitive than PCR tests. Because of this, they can produce false negatives, clearing people who are actually carrying the virus.2,3 RADTs are more appropriate for testing people with symptoms, due to their higher viral load levels. |
Time-to-Results and Scalability
| Air travelers need test results within 48-72 hours before boarding their flights. The testing method must scale up efficiently to handle the quick turnaround and high volume demands for air travel tests. | PCR tests are scalable. One instrument can run up to 382 samples simultaneously while providing individual results for each air traveler, within the 24-72 hour window. | RADT tests take approximately 15-30 minutes and are run one at a time on each piece of equipment, so they may not be scalable if a large population needs to be tested. |
The Verdict
| Air traveler testing requires:
| PCR tests are sensitive, highly accurate, and can produce results for air travelers within 24-72 hours before their flights. | RADT tests are suitable for smaller groups of people who are displaying symptoms. |
Get the complete COVID-19 passenger testing guide for airlines
This guide explains the testing options for the airline industry, the best practices for testing, and the additional resources needed by airlines, labs, government agencies, and digital health passport vendors.
Access a comprehensive network of testing solutions
Thermo Fisher Scientific empowers labs and full-service lab providers with reliable, accurate COVID-19 testing technology by offering a comprehensive network of testing solutions. We are also working to connect labs and digital health passport vendors so that airlines can work with organizations that provide a complete, efficient COVID-19 testing workflow for their passengers.
References
- Centers for Disease Control and Prevention. Requirement for Proof of Negative COVID-19 Test or Recovery from COVID-19 for All Air Passengers Arriving in the United States.
- ICAO. Manual on Testing and Cross-border Risk Management Measures. Second Edition (Advance unedited), 2021.
- Smyrlaki I, Ekman M, Lentini A et al. (2020) Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-PCR. Nat Commun 11(1):4812.
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