Call to end inbound international flight testing is correct, for all the wrong reasons

Airline executives and travel industry leaders have asked the Biden administration to end mandatory COVID-19 testing for passengers on inbound international flights. They cite the impact that mandatory testing has had on the travel industry and the economy, discouraging people from abroad to fly into the United States. Although their request has merit, the reasons that they offer do not. 

Asking passengers to provide proof of a negative test within one day of their flights sounds like a way to keep infected people off of airplanes. Unless the tests are administered at airports by authorized personnel immediately prior to a flight, it is possible to misrepresent a test result for a person that is infected, even with all the requirements for virtual verification.

For Americans and residents set to return home to the United States, asking them to stay abroad for as many as two additional weeks, at their own expense, is something that most people will not find acceptable. For foreign visitors, denying them entry to the United States is also not in their own best interest, likely disrupting a vacation or business trip.

This means that the direction that most people will take is to find a way to report a negative test result, independent of their infection status. 

Then how can airlines keep infected people off airplanes? The simple answer, although not a popular one: they cannot.

If a person is asymptomatic, which as many as one-third of infections have proven to be, trying to stop them from taking a flight is near impossible.

If a person is infected and obviously symptomatic, they can and perhaps should be denied boarding, with an at-home test administered by airline personnel at the airport to determine their infection status. This is an option that airlines should have the ability to exercise at their discretion. 

So, what can travelers do to limit their risk of becoming infected on an international flight, or for that matter, on any flight? 

Being vaccinated and boosted (or double boosted if over 50 years of age) continues to provide the primary line of defense against severe disease. Wearing a quality N95 face mask throughout the flight continues to offer substantial risk reduction benefits (packing a straw to take a sip of water under a mask is a good idea). Mandates of any sort are not necessary. These guidelines are just smart protocols to follow for anyone seeking to reduce their risk of infection, or for many people, reinfection with a new variant. 

As the pandemic continues to move toward an endemic phase, people will continue to be at risk of infection. Anytime a person purchases an airplane ticket, they will need to accept the risk that comes with it, or simply choose to not fly. 

The number of air travelers is now over 90 percent of the levels seen in 2019, with several recent days exceeding 2.3 million travelers. Air travel is back with a vengeance. 

At the same time, airlines are facing unprecedented challenges. Jet fuel costs are at an eight year high, and airfares are climbing beyond pre-pandemic levels. Airlines are struggling to meet surging demand due to pilot shortages. Indeed, the biggest challenge to travelers may be finding an affordable seat on an airplane, something they have less control over, rather than remaining infection free once they find that seat, which they have measures that they can take to reduce their risk. 

The summer travel period is certain to be fraught with flight delays, flight cancellations and high airfares. Asking international travelers to provide proof of a negative COVID-19 test prior to boarding adds more fuel to an already chaotic air travel environment, without any measurable benefits.

Sheldon H. Jacobson, Ph.D., is a founder professor of Computer Science and the Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public health policy.