Testing Times mean Time to Test

A colleague who missed the Government’s deadline on her return from Croatia says nobody was on hand to check her public health passenger locator form at Stansted. Nor was there any hint that she had to self-isolate. Reports from other travellers suggest she and her fellow passengers were far from alone. Had she failed to submit the form online before catching her flight home she could have ignored the quarantine requirement. I hasten to add that, as a socially responsible citizen she would have still obeyed the rules. Others may not, even those whose forms are checked, and who run the risk of heavy fines if they’re caught.

What this demonstrates, if it has not been obvious for some time, is that there is no foolproof way of preventing the import of Covid-19 and that to question the Government’s policy of applying ‘ruthless’ blanket restrictions to countries deemed to be a risk is hardly flying in the face of the science. In any case, you might wonder: whose science? Are the Germans, once praised to the skies for limiting the impact of the pandemic, now wrong to apply a more nuanced approach to quarantine, applying restrictions only to specific areas where infections have risen sharply? At the time of writing, for example, the authorities there regard the Ile de France, including Paris, and the Provence-Alpes-Cote d’Azur region as risk areas. The UK Government, in contrast saw danger in a family returning by car from a self-catering property in that country’s rural heartland and compounded its hyper caution with the utter absurdity that if they had missed a 4am deadline by five minutes they would have been confined to their home for 14 days.

On top of blanket quarantine requirements, we have Foreign & Commonwealth Office advice not to travel to the countries concerned for non-essential reasons. The ‘advice’ is just that. There is no law against going. Why is such advice necessary when returning travellers have to self-isolate? All it does, in most cases, is to invalidate travel insurance policies, making a bad situation potentially worse. If people perceive that there is little risk to themselves – and self-isolation on return does its job – why not let them make up their own minds whether or not to go? And if that’s too big a mouthful for Ministers and their advisers to swallow, why can’t the FCO stick to its own nuanced advice? When quarantine restrictions were slapped on Spain, it exempted the Balearic and Canary Islands from its advice, only to add them soon afterwards, dare I assume, because Ministers feared the general population might be confused.

Test for Covid-19At the very least the Government should tell us how many people are known to have been infected in those countries taken off the travel corridor green light list. Tens of thousands of people have seen their holidays or holiday plans ruined. Worse, with the peak summer season damaged beyond repair, thousands of jobs have been lost in the travel industry and many companies are facing a grim struggle to survive the winter. Though it is already too late to do more than alleviate this year’s pain, there has to be a better way – and it needs to be taken now. The way is testing.

Nothing new there, I hear you retort. But testing on arrival, being pushed by some observers, could be self-defeating if applied to visiting as well as homecoming travellers. Obviously if all countries followed that course, leisure travel would slow to a trickle again. Who would want to risk a positive test that could mean wasting their whole time on holiday – or even a large part of it – in quarantine? What is needed is testing before departure.

One prominent commentator has urged adoption of Iceland’s new regime. Tourists arriving there must either self-isolate for 14 days or take two tests – one when they arrive and another five or six days later. If both are negative they may proceed with their holidays as planned. But although this ups the chances of avoiding disruption, it doesn’t remove the risk of a ruined trip completely.

To do that, European countries need to come up with a mutually approved test and certificate of health that could be made readily and cheaply available to visitors within 72 hours before they leave for their holidays and again as they prepare to head for home. Those with proof of negative tests could be required to take another test after five days, say, after their return. One source tells me: “I can’t see the Government accepting foreign testing”. But if Ministers swallowed their apparent aversion to cooperation with Brussels and common standards were agreed it’s hard to see why not. Perhaps I am over optimistic but surely, when it comes to protecting the economy, even those most obsessed with ‘taking back control’ could see the sense of compromise.

That said, testing isn’t yet perfect either. False negatives remain a risk. Conversely, expert opinion suggests that false positives might send many travellers into quarantine or self-isolation unnecessarily. Professor Carl Heneghan, Director of the Centre for Evidence-Based Medicine told BBC Radio 4’s Today programme recently that with the infection rate low there was a significant likelihood that people who had contracted Covid-19 some time previously, and had RNA fragments in their systems might receive a false positive result. “Right now with a positive test there’s about a 50-50 chance you actually have the Covid-19 infection”, he said.

Fine tuning looks likely to minimise this problem. Sir John Bell, Regis Professor of Medicine at Oxford University, said: “The more sensitive a test you make the more likely you are to have false positives. So you have to find the right point on that scale where you get an acceptable number of false positives but it’s also sensitive enough to make this meaningful. It’s going to take perhaps a couple of months to identify tests that work at that level that we will be able to roll them out and people will be able to use them regularly.”

In fairness to Ministers and their health advisors, settling on an equation between optimum safety and minimum further economic damage to the travel industry and its customers is horribly complicated. I accept that, given the virus’s incubation period (thought to be 3 – 14 days), 14 days’ isolation remains a strong safety first measure. But it has been used too indiscriminately. For those inclined to absolute faith in officialdom, I give you the FCO’s initial Twitter response to questions whether people would still need to quarantine if they drove across France from a country still on the safe list. Not if they didn’t stop and didn’t get out of the car.


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Roger Bray

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