Airport testing won’t save Britain’s summer holidays

Luis Alvarenga / Stringer / WIRED

As lockdown has eased, Britons have been granted permission to engage once again in their favourite pursuits, and many have opted for a familiar passion: leaving Britain to holiday in sunnier climes.
But last week, after an outbreak in the Spanish regions of Aragon and Catalonia, the government abruptly changed travel rules. Now anyone returning from Spain will have to quarantine at home for 14 days. Although not as much of a summer destination, Luxembourg has also been added to quarantine list.

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The news, a disaster for the recovery of the tourism industry, has been met with dismay. Airlines, including British Airways, easyJet and Jet2, and airports, including Heathrow, Gatwick, Manchester and Luton, wrote to the prime minister, demanding a “nuanced” policy. John Holland-Kaye, the chief executive of Heathrow Airport, said the government must urgently introduce a passenger-testing regime or face playing a game of “quarantine roulette”. Conservative grandees, including former Brexit secretary David Davis, and Iain Duncan Smith have echoed this criticism.
So what are the alternatives? One idea is that compulsory quarantine could be substituted with universal airport testing. Rather than assuming that every returning tourist might carry the virus, the argument goes, testing would make it possible to single out those who are infected, and let the others carry on as normal. Private testing companies such as Swissport and Collinson say that this would involve a nose and throat swab at the airport, delivered on arrival by a trained nurse, then processed in seven to 24 hours. Heathrow proposes a similar testing program that would cost £150 per person. Passengers would be expected to foot this bill.
Those with negative test results could leave the quarantine, and would only need to self-isolate if they subsequently developed symptoms. Other countries already have similar schemes. Iceland, for instance, requires that anyone entering the country must either self-quarantine for 14 days or get tested for Covid-19. In Germany, mandatory testing from high-risk areas will come into force next week.
Unfortunately, the idea that testing could simply replace quarantine is not supported by science. The average incubation period of the virus is around five to six days, with a maximum of two weeks; a test will show up positive around a day before the onset of symptoms. Not even taking into account the fact that no test is 100 per cent accurate, and that many are asymptomatic, if you are tested on your return to the UK and have just caught the virus, you will test negative.

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“It’s pointless and a waste of money,” says Keith Neal, emeritus professor of the epidemiology of infectious diseases at the University of Nottingham. “People are most likely to be infected in the airport, or plane, or coach to the resort on the way out and the way back. If they’re [infected] on the return journey, the test will be negative. This can not be sorted with our current technology, whatever politicians or airport managers suggest. ”
“I think testing itself at an airport, could be introduced as well, but certainly not instead of the quarantine period,” says Michael Head, a senior research fellow in global health at the University of Southampton. “We know that the best way to stop the virus in its tracks is distancing. So if people who may be infected are at home and not contacting other people, then that’s an extremely good way to greatly reduce the risks of transmission around the community.”
This Spanish resort perfected covid-friendly holidays. Then Britain pulled the plug

This leaves us with little choice but requiring quarantines; the alternative is to let Covid rip through the population. “Certainly in terms of people coming back from abroad from high-risk areas, such as parts of Spain, it would be quite reckless to not impose a quarantine at this point,” Head says.

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One alternative the government could try, however, is to abandon “blanket” orders over entire countries: it may have been unnecessary to include the Balearic Islands and the Canary Islands when adopting the new measures on Spain. In the Netherlands, for instance, people coming from specific parts of the UK with high levels of infections – such as Leicester – are urged to self-isolate.
This process is fraught with difficulty, though. “I think defining an area is actually very problematic because it’s got to be acceptable to the people on both sides of the boundary,” says Neal. “And people coming back from the Madrid airport may have been in these other areas – we don’t know.”
The quarantine roulette, then, is likely to persist throughout the holiday seasons and beyond. Belgium and Croatia, most recently, may join Spain and Luxembourg on England’s Covid-19 quarantine list. The Covid-19 rate has almost tripled in Belgium this month, from 5.3 to 15.1 per 100,000 of the population, with the number of cases up from 615 to 1,751. Luxembourg’s rate of infection is 15 times higher per capita than the UK’s.
But it’s not an exact science as to how you choose the next place to put under quarantine. “Well, can you put a number on it? The answer is no – because everybody is doing their testing differently,” Neal says. “Luxembourg has a very high rate, but they’ve done loads of testing.” The test positive rate is also important, explains Neal – if Luxembourg is testing thousands of people at a one per cent positivity rate, that’s way below the five per cent threshold set by the WHO.
The question remains then: should you go on holiday? At this stage, this is largely your choice and depends on your own levels of risk. What travellers need to be aware of is that they may risk a 14-day quarantine, or, if they cannot face this quarantine, cancelling their holiday and suffer a financial loss.
“We’re getting to the stage of too many people wanting the government to tell you what to do all the time, and then complaining about the nanny state,” says Neal. “Quite clearly, people have now got to the state where they have to make their own decisions based on facts, but the facts will change day-to-day. I think the answer is, to put it bluntly, if you want to go abroad, it’s your choice. You have to assess the risks.”
Will Bedingfield is a staff writer for WIRED. He tweets from @WillBedingfield
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