Air passenger testing schemes

Safely opening up the skies is a fundamental pillar of the nation’s economic recovery. Yet worryingly, the UK is being held back from reducing the 14-day quarantine and introducing a testing regime modelling has not been updated to reflect the most recent evidence. 

This is the conclusion of our independent analysis, research and new modelling with Oxera - link to reports below.

Summary

  • Oxera, Edge Health and Dr Kit Yates have partnered to bring together their analytical, modelling, epidemiological, health sector and aviation expertise in order to review papers from Public Health England (PHE), the London School of Hygiene & Tropical Medicine (LSHTM) and the Animal and Plant Health Agency (APHA) that form the basis of the UK government’s current quarantine policy.

  • The PHE paper, which underpins government decision making, concludes that testing on arrival at an airport would identify only ‘7%’ of virus cases. However, this significantly underestimates the effectiveness of passenger testing.

  • The PHE model assumes that all travellers who are infected and detectable with a test prior to departure do not board flights to the UK. Therefore, the 7% cited by the government only accounts for travellers who become detectable during the course of their flight. Instead, Edge Health and Oxera estimate that up to 63% of infected passengers attempting to enter the UK could be prevented from doing so with a testing scheme—vastly higher than the 7% figure offered by PHE.

  • The PHE paper is based on a theoretical model and is not calibrated to real-world data. It does not consider actual infection rates in the country of origin and therefore fails to provide any real insight into the relative risk that inbound travellers pose to the UK population.

  • Case studies of regimes in other countries shows air passenger testing after five days of quarantine in Iceland is between 83% and 90% effective. Testing after seven days in Toronto and Paris is between 84% and 90% effective. Real world evidence supports a significant reduction in current UK 14-day quarantine policy.

  • Single tests on arrival in Canada (Toronto-Pearson Airport), France (Paris-Charles de Gaulle Airport), Jersey and Iceland detected between 54% and 76% of infected travellers—far higher figures than claimed by a Public Health England (PHE) paper, which concluded that airport testing would identify only ‘7%’ of virus cases.

  • Innovative new modelling by Oxera and Edge Health takes account of quarantine non-compliance evidence to analyse the effectiveness of passenger testing versus 14-day quarantine and introduces an improved measurement of risk of community transmission – the number of ‘infectious days screened’.

  • Based on this new modelling, the UK Government’s 14-day quarantine policy is least effective at preventing Covid-19 from entering the community, compared to all forms of passenger testing.

  • The new modelling finds a single test on arrival is twice as effective as the 14-day policy with a test three days pre-departure also 44% more effective than current policy.

  • If a ‘test and release’ regime is applied, three days of quarantine is significantly more effective to minimise infectious days (by 60%) compared to ‘test and release’ after five days (53%) or seven days (45%).

  • The papers by Oxera and Edge Health have been submitted as evidence to the UK government’s Global Travel Taskforce to support the development of a passenger testing regime policy to replace 14-day quarantine.

 

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