The U.S. aviation industry is urging the government to establish COVID-19 testing protocols before international flights as a way to safely reopen travel routes that have been cut amid the pandemic.
Industry stakeholders want the U.S. to reach an agreement on pre-flight COVID-19 testing procedures with Europe, Canada or the Pacific first as part of a "limited testing pilot project." This would allow people to travel between two countries without the need to quarantine, and allow government officials to evaluate the efficacy of the program.
International travel among U.S. carriers is currently down 82% compared to last year as many countries' borders remain closed to U.S. citizens, according to Airlines for America. The World Travel and Tourism Council estimates the loss of international travel and tourism will cost the U.S. economy $155 billion.
On Tuesday, global airlines called on governments to replace restrictive quarantine measures with COVID-19 tests prior to all international flights.
"A global agreement is needed to ensure test results on departure are accepted on arrival," International Air Transport Association Director General Alexandre de Juniac said. “It will also boost passenger confidence that everybody on the aircraft has been tested.”
There are several airports and airlines in other countries working on potential travel "bubble" or "airbridge" concepts. For example, Frankfurt Airport in Germany can now test up to 20,000 people a day for anyone who is traveling to a place where they might need a negative test upon arrival.
'We just don't have the capacity'
U.S. aviation stakeholders are "cognizant of the many complexities and issues surrounding COVID-19 testing," they wrote in a letter to U.S. Secretary of Health and Human Services Alex Azar, acting U.S. Secretary of Homeland Security Chad Wolf and U.S. Department of Transportation Secretary Elaine Chao in early September.
They said testing pilots must "address key considerations, including the availability and reliability of rapid diagnostic tests that can be conducted within a reasonable time window prior to departure."
The PCR test has a reported rate of false negatives as low as 2% and as high as 37%, according to a study in The BMJ. The antigen test has a reported rate of false negative results as high as 50%, the journal Science reported.
"These rapid tests are critical for understanding community spread, doing contact tracing and helping people do their jobs, be in school and live their lives safely," ABC News Medical Contributor Dr. Jay Bhatt said. "Still, we need better tests and better access to them. The tests should have rigorous review by the FDA as soon as possible and we continue to need to improve our turnaround times for results."
United Airlines Chief Communication Officer Josh Earnest said the current limiting factor for U.S. airlines to implement these programs is not so much reliability, but availability.
"We would love to see the U.S. government work with international authorities to lower the barriers to international trade and commerce," Earnest told ABC News. "That would be good for the broader economy, it certainly would be good for a lot of U.S. citizens that are eager to travel, and obviously it would be really good for our business. ... We just don't have the capacity as a country, to do that many tests."
'Too many unanswered questions'
Aviation Security Expert Jeff Price is concerned about the pressure the scale of these operations would place on airports.
"We're talking about the installation of numerous testing stations, hiring tens of thousands of personnel throughout the country to do the testing and then implementing the infrastructure to take care of those passengers who test positive," Price told ABC News. "Do we immediately quarantine them and escort them out of the airport?"
He raised other questions such as how much longer will passengers have to arrive at the airport, how will passengers get refunds if they test positive and how long will the line be for people waiting to get tested?
"Long lines result in valid targets for terrorist bombings and active shooters," Price said. "I think a lot of people are so focused on the pandemic they forget that there are other risks out there."