The head of London’s Heathrow airport is crying foul over lack of screening procedures for arrivals and departures at his airport. He wants the U.K. government to impose “mass screenings at airports..which could include temperature checks, antibody tests and a requirement that all passengers carry health passports proving they are medically fit.”
The U.K. has a major outbreak of coronavirus. It’s already in the country. Heathrow’s boss is concerned with incremental cases coming in, while the country’s health service is concerned about the geometric growth of cases from people already there. There are no COVID-related bans on travel to the U.K., though the government asks arrivals to self-quarantine for 14 days.
Heathrow Chief Executive John Holland-Kaye says his concern is that airports are coming under criticism for lack of action. He wants internationally-agreed upon standards to follow. Then no one can criticize him. Earlier in the month he described his call to action as being “a little bit like the liquids ban” at airport security which should tell you something about the effectiveness of proposed measures.
In fact the major approaches to ensuring arriving passengers are safe and are not infected all have limitations – so severe that they may not provide much protection at all.
- Taking temperatures will only make a small difference. It does nothing to catch someone that’s asymptomatic and that’s now believed to be a major factor in spread.
- Testing at the border isn’t foolproof either. First, someone may have caught the virus but doesn’t yet shed enough of it to show up in tests. Second, testing error rates are high. Many tests currently in use in the U.S. have error rates up to 30%.
- Immunity passports aren’t foolproof either. You may have had the virus, and demonstrate antibodies to it, but we do not know yet what level of antibodies are needed for immunity, how long immunity lasts, or whether it’ll prevent infection against any variant strains of the novel coronavirus.
That’s why arriving passengers are asked to self-quarantine for fourteen days. The assumption is that anyone coming into an area might have the virus no matter their current medical condition, so they should stay away from everyone until the time they would be presumed well if they haven’t developed symptoms.
Even that may not be enough – someone may be asymptomatic but still test positive for the virus after weeks as China has learned. Others may see a resurgence in the virus up to 35 days after being cleared. These are outlier cases. One infected person entering a country may cause zero problems, with the virus dying out, or could infect several people who go on to infect several others.
The world can’t sit around in stasis until a vaccine is developed. There are a number of promising candidates, but in a best case scenario it’s unlikely one will be widely available within two years. Even if one is developed in 12 months, having a vaccine is different than manufacturing and distributing enough of it (or for that matter having enough needles to administer it, if that’s the mechanism used).
On the other hand let’s not forget the purpose of lockdowns from the outset, “flattening the curve.” We aren’t going to extinguish the virus and in many places we may not even reduce the total number of people who get it. Instead we’ve needed to keep health care systems from becoming overwhelmed, and buy time so that,
- We can scale up health care capacity, from ICU beds, to ventilators (which don’t seem to help much), to personal protective equipment.
- Develop better treatments (and treatments should come sooner than a vaccine) in order to improve patient outcomes and reduce time in hospital, further reducing the strain on capacity.
- We’re able to scale up the ability to test, isolate, and trace contacts to contain the virus once it’s under control.
In other words the point of lockdowns was to make the global pandemic more manageable so that when it spreads it doesn’t do as much damage.
There are still places in the world that will be very vulnerable even once treatments arrive. Different countries will do better – and less well – scaling up preparedness.
There will be a return to life, and even a return to travel. It won’t look like what it did before, both in terms of level of activity or the actual experience.
We probably won’t see blocked middle seats after some initial period. The real estate on an aircraft is valuable, and removing as much as one-third of seats for sale will make travel more expensive. And we probably won’t see novel seats with built-in plastic shields installed on planes. Airlines are strapped for financing as it is, major capital projects to retrofit planes with newly acquired seats seem unlikely.
However we’ll need to find ways to distance. It isn’t just on board the aircraft but in the gate areas, and the jetway. Queuing needs to be rethought. So does airport security where passengers shouldn’t be standing body to body, shouldn’t be placing their belongings on poorly sanitized equipment or walking barefoot through screening devices. And so too does immigration where queuing will be problematic as well.
Security will have to stop requiring that you hand over your ID, so that they can touch it. This should be automated. (Get CLEAR and use their iris scan, not finger prints.) TSA, airport and airline employees will need to go through the same layers of screening that passengers are put through. And government is going to need to focus on air flow and air quality in the cabin – talking about HEPA filters isn’t enough, the more we learn about how air circulation carries the virus. That work needs to start now but my sense is that it isn’t happening.
People will need to wear masks and carry hand sanitizer. And wash their hands regularly. TSA excluding hand sanitizer from 3 ounce liquid limits needs to be made permanent.
And those at the greatest risk will need to avoid gatherings. It’s not possible to completely isolate the elderly who have significant confounding conditions, after all there are people who need to care for them who may themselves get sick and spread the virus. But for most people there will be a decision about acceptable risk combined with measures that reduce spread of the virus and imperfect measures that may amount to theater (to make citizens feel their government is ‘doing something’) as much as to prevent the virus from traveling.