The International Air Transport Association (IATA) is urging governments to accept "best-in-class" rapid antigen tests to fulfill COVID-19 testing requirements following new research that claims such tests are accurate, convenient and cost-efficient.
The OXERA-Edge Health report was commissioned by IATA and found the best antigen tests provide broadly comparable results to PCR tests in accurately identifying infected travellers.
The BinaxNOW antigen test, for example, misses one positive case in 1,000 travellers (based on an infection rate of 1% among travellers). And it has similarly comparable performance to PCR tests in levels of false negatives, IATA says.
Processing times for antigen tests are 100 times faster than for PCR testing, the study says, and antigen tests are, on average, 60% cheaper than PCR tests.
“Restarting international aviation will energize the economic recovery from COVID-19. Along with vaccines, testing will play a critical role in giving governments the confidence to re-open their borders to travellers,” said Alexandre de Juniac, IATA’s Director General and CEO.
“For governments, the top priority is accuracy. But travelers will also need tests to be convenient and affordable.”
“The OXERA-Edge Health report tells us that the best-in-class antigen tests can tick all these boxes. It’s important for governments to consider these findings as they make plans for a re-start.”
Many governments, including Canada’s, do not allow rapid testing as an acceptable method of testing.
When the only options available for travellers are PCR tests (which is what Canada allows) then these come with significant costs disadvantages and inconvenience, IATA says.
In some parts of the globe, PCR testing capacity is limited, with first priority correctly given to clinical use.
“Travellers need options. Including antigen testing among acceptable tests will certainly give strength to the recovery, said de Juniac, who said the “goal is to have a clear set of testing options.”
Higher costs = lower demand
The cost of PCR testing can make travel significantly more expensive.
A family of four travelling from the UK to the Canary Islands, for example, will take a total of 16 tests at a total cost of around GBP1,600 or EUR1,850 - a premium of 160% on top of the average air fare.
IATA’s modelling shows that based on five routes studied (London-New York, London-Frankfurt, UK-Singapore, UK-Pakistan and Manchester-Canary Islands) the cost impact of PCR testing will reduce demand by an average of 65%.
Replacing PCR with antigen testing would still have a cost impact on demand, but at 30%, IATA says.
The report also pointed to the scarcity of PCR tests.
Current spare PCR testing capacity in the UK, for example, would cover only 25% of 2019 passenger levels.
“This could cause bottlenecks as and when passenger numbers rebound,” IATA says.
“When international travel reopens testing is likely to remain part of the strategy for controlling COVID. The type of testing regime chosen will make the difference in how quickly the travel industry recovers. The choice of a rapid test would be a real boost to the global travel and international business community, and our research shows it can be as effective as other testing regimes and as effective as a ten-day quarantine,’ said Michele Granatstein, Partner at Oxera and Head of its Aviation Practice.
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