U.S. to require negative Covid-19 tests for international air passengers

https://www.reuters.com/article/us-health-coronavirus-airlines/u-s-to-require-negative-covid-19-tests-for-international-air-passengers-sources-idUSKBN29H2KD

by Element_ • 6 years ago

382 425 6 years ago

reuters.com

FreakyT• 6 years ago

I'm glad it's happening (better late than never), but they really should have started doing this a year ago.

azurezyq• 6 years ago

and the current situation is that US has more cases than anywhere else in the world.

vinay4274• 6 years ago

Per capita it's really most of western Europe and the US that are struggling, and the US is doing better on vaccinations so far while it has had a higher case and death rate than most but not all of Europe. It's rather misleading to just cite a total confirmed case count.

https://boogheta.github.io/coronavirus-countries/

surge5• 6 years ago

Tests weren't widely available a year ago. 3-6 months ago maybe.

In fact a year ago, exactly, the existence of COVID was still being denied or downplayed by the Chinese government. Very few people in the US even knew about it, and only if very plugged in to Chinese social media or non government sources.

pishpash2• 6 years ago

Wrong. It was all over Reddit but people laughed over it.

dekhn2• 6 years ago

I'm pretty sure it was being widely covered (and acknowledged by the chinese) in late January during Chinese New Year. https://www.nytimes.com/2020/01/29/world/asia/coronavirus-ch... At the time the US evacuated ~200 people from Wuhan, flew them to LAX (well, landed at a nearby air force base), made them stay in isolation, then monitored them as they returned home for 2 weeks.

josephg6• 6 years ago

The USA was doing 500k tests/day back in May, and over 1m tests/day by July. Probably couldn't have happened earlier than that, but it would definitely have been feasible mid last year.

Source: https://ourworldindata.org/grapher/full-list-covid-19-tests-...

wool_gather2• 6 years ago

It was on my radar in mid January; I know this clearly because it made me choose not to buy plane tickets for a big family celebration scheduled for the end of February.

disabled2• 6 years ago

This is no surprise, although according to CDC research, this only reduces the infection rate among these passengers by 5-9%.

A lot of EU countries require their own citizens of their countries to get a COVID-19 PCR test prior to entry. A lot of times, this has to be paid out of pocket abroad.

ruste• 6 years ago

Is that 5-9% of total passengers or 5-9% of those that have covid at the time?

mortehu• 6 years ago

What research is this? As far as I've been able to tell, CDC hasn't conducted a single randomized survey on any large group, but has only collected convenience samples.

Also keep in mind that due to compounding (keeping these people from infecting others on the plane and at home), the effect extends beyond the people prevented from traveling. You can also speculate that detectable infections are more transmissible during the journey.

calebm• 6 years ago

I've heard that the vaccine doesn't make you less likely to transmit COVID - just less acute symptoms. So getting the vaccine doesn't really help other people - just you. From this perspective, this doesn't make much sense (unless the objective is to make $ for the corporations).

bluGill2• 6 years ago

You heard wrong. Nobody actually knows if you can transmit after getting vaccinated or not. Thus far anyone who claims otherwise is a liar.

There is some evidence that some of the vaccines prevent transmissions, but we need more study before we can make a statistical determination.

We know why other vaccines have failed to stop transmission. The reasons those vaccines didn't stop transmission do not apply to the covid ones. However there is a lot we don't know about biology so until we have better evidence no expert will state that the vaccine stops transmission even though many believe it will.

dvirsky• 6 years ago

It was just published today that in Israel, where around 20% of the population has already been vaccinated with the first dose, they're beginning to see clear evidence that vaccinated people do not transmit it others.

carstenhag• 6 years ago

Anecdote from a German that visited Spain to see the family: Spains government requires <72h old negative covid test before entering the country, with 6000€ in fines if no test can be presented. Also, a form about symptoms etc had to be filled out.

After arriving at Valencia, Spain, there was a big line where we had to show the form's result QR code only. Not a single passenger was asked for the covid test.

mikeyouse2• 6 years ago

Just so silly. More theater. We're already seeing millions of new cases per week including the strains with mutations to the target spike proteins - what problem does this solve?

briga• 6 years ago

Probably would have solved maybe problems--that is, if it was implemented half a year ago. As it is now it seems like too little too late.

gojomo3• 6 years ago

In order to stop seeing "millions of new cases", every source of new cases should be reduced.

International travel is an orderly place to apply a filter, just as hospitals test all admits (even those without symptoms).

Blocking all visitors from specific places – even places with lower rates of prevalence than here! – was silly theater. This is actually well-targeted to reducing the interactions of the likely-infected with the uninfected.

(If a city or state/province even wanted to set up internal borders, & require on-the-spot quick antigen tests to enter regions of actual or attempted-infection control, perhaps even anonymously, that'd also be a well-targeted intervention far better than the other theater we've been fed so far.)

sonotmyname4• 6 years ago

just as hospitals test all admits (even those without symptoms).

Some may, but that's a county/state decision.

Exmoor2• 6 years ago

Well, it would've decreased the chances of a more infectious strain becoming widespread in the US if it had been implemented months ago. It could decrease the chances of worse strains that might originate outside the US becoming established moving forward.

outworlder• 6 years ago

Problem is, new strains can develop anywhere. They don't have to come from abroad.

Adding this rule but allowing people to run maskless because "muh rights" is not going to accomplish anything.

harigov• 6 years ago

They should have done this when there were far fewer cases. It was really surprising to hear that you don’t need any tests or quarantining when you travel from other countries. Better late than never, I guess.

surge5• 6 years ago

Well, got to remember, when there were far fewer cases, tests were still in prototype phase, not widely available, and in some cases unreliable (I think a lot of the Japanese cruise passengers that got the WHO test tested negative, then later came down with it after being released).

vorpalhex• 6 years ago

We were also trying to test existing populations in busy city centers and concerned about not having enough tests.

what_ever3• 6 years ago

Japan cruise case was in February 2020 which is about a year ago now. Testing became more reliable a long time ago.

chris112• 6 years ago

Yeah, but we could have done more. There was a lot of supply chain issues the government just ignored. I remember in early 2020 when masks were unavailable a couple domestic mas manufacturers were saying they weren't comfortable producing more. They could scale up production, but they didn't want to deal with suddenly firing people when things went back to normal.

opwieurposiu• 6 years ago

An issue with PCR tests is that most of them use a cycle threshold of 40, which produces way to many false positives.

https://www.nytimes.com/2020/08/29/health/coronavirus-testin...

chadash• 6 years ago

Just to clarify, the linked article isn't really talking about false positives. It's talking about people who are carrying the virus, but perhaps aren't contagious due to it being only small amounts.

thelean12• 6 years ago

Well at least false positives are much better than false negatives.

gojomo3• 6 years ago

This article doesn't mention PCR tests, so perhaps we're being smart enough to accept the often-more-relevant-for-infection-control antigen tests for this purpose. (I'd not yet bet on it, given how bureaucracies have made almost every wrong choice so far, but: maybe?)

But also: if PCR false-positives are a concern, the cycle standard can be reduced, or the reporting expanded to include the cycle on which a test turned positive, so that "positive" tests that are likely dubious/marginal/past-infection can distinguished from "blazing active infection".

learnstats22• 6 years ago

The rapid antigen tests have a significant problem with false-negatives: the BMJ reported that Innova tests have 49% sensitivity.

That makes it pointless to use as a border control - for every two cases, at least one gets through. (Or, potentially much worse, under this system: I throw away my positive tests and show whatever false negative one I have).

You ideally want to be conservative and permit some false positives at an effective border control, because you don't want to risk infectious cases getting through and causing an untraceable national breakout.

matz1• 6 years ago

How easy is it to find out the cycle threshold the provider use?

ceejayoz4• 6 years ago

"False positive" isn't really an accurate term there.

If there's no virus, you're not going to be able to amplify it. A too-high threshold may detect non-contagious levels of virus (still a concern, if you're in the early pre-symptomatic days of an infection) or non-infectious virus particles left over post-infection.

t-writescode• 6 years ago

Doesn't this presuppose that the only thing the test can detect is the virus itself and not things that highly, but not perfectly, correlate to it?

rhacker• 6 years ago

I love how in the photo there's two people with their nose outside the mask. It's clear as day why infections are up everywhere.

ralph84• 6 years ago

All of the research on masks published before it became a political issue said as much. The general public doesn't wear masks properly enough for masks to have an infection control effect.

BugsJustFindMe2• 6 years ago

That's fixable without telling people to not bother wearing masks.

ngngngng• 6 years ago

I recently had to get a negative COVID result to travel to Hawaii to see family. Hawaii only accepted tests from a very limited number of providers which complicated things, but after some effort I made an appointment and got a test. The rest of the process was very painless. We all had to keep masks on for the entire flight of course since there was no requirement that we all have a negative result before getting on the flight but it was comforting to know that nearly everyone else on the flight would have had a negative result so as to avoid the mandatory 14 day quarantine upon arrival.

Tepix5• 6 years ago

If you enter Mauritius you have to get four tests in total over several weeks. Islands are taking advantage of their isolation to get this pandemic under control.

Madeira has been very successful during all of 2020 with not letting it escalate.

rhodozelia2• 6 years ago

A similar requirement has been enacted in Canada and what has happened is that Canadians with covid can't return home to Canada and are stuck abroad. It really gives some teeth to the "do not travel" recommendation - if you get covid abroad you can't come home until you test negative. If you get covid at home and then go abroad you can't come home until you test negative. I think people who previously would have travelled and just risked it will be a lot more careful now since they can't get home if they are sick with covid. Instead of dozens of flights per day entering canada with covid cases we now have zero [1].

[1] http://www.bccdc.ca/health-info/diseases-conditions/covid-19...

eloff11• 6 years ago

I'm totally ok with covid19 positive Canadians being stuck an unable to return home until they test negative. That's fair.

But people are getting stuck because they can't get results back in the 72 hour window. That's really not cool.

regimeld• 6 years ago

"But people are getting stuck because they can't get results back in the 72 hour window. That's really not cool."

That's their problem. Should have thought of that before going on vacation, etc.

peytn2• 6 years ago

That sounds inconvenient. I’ve been ordered to stay at home off and on for almost a year, and it’s been inconvenient too.

triceratops5• 6 years ago

There are labs that guarantee < 72-hour turnaround times for travel. It costs extra but hey, that's life. This pandemic has been around for a year now so if it was that important to travel, it's worth paying extra for the test.

smnrchrds2• 6 years ago

I am terrified of the possibility of this being retained after the pandemic and expanded to cover other maladies. There already is a concept called medical inadmissibility, but it only applies to foreign nationals. It really concerns me that we are not applying it to Canadians as well.

rhodozelia2• 6 years ago

my friend's father passed away from covid three weeks after contracting it at a curling tournament which they obviously shouldn't have held, even in a small town in the middle of nowhere. he was 65 years old and had just retired. being dead is also not cool.

totony• 6 years ago

I'm totally ok with covid19 positive Canadians being stuck an unable to return home until they test negative.

I am not; your home country should never deny you entry. You're telling a citizen he is not welcome in his own country, is that how you want to treat your citizens?

Quarantine is warranted but denying entry has a weird taste to me

flictonic• 6 years ago

Keep in mind individuals can test positive for months after being infected but are not at risk for spreading the virus. It really should be a negative test or 14+ days after a positive test.

ChrisArchitect• 6 years ago

totally ok with letting them get stuck abroad. It's weird that everyone is freaking out about people travelling when the airports remain open and the guidance is totally about what ppl do inside the country. If you must keep the airport open(IMO should close them), let people leave and don't let them come back. If they leave, it's their problem (and unfortunately, some other country's). Stay at home.

nrmitchi• 6 years ago

For non-essential travel, I can 100% agree with you.

Not all travel is non-essential though (to a varying degree based on your belief of what "essential" encompasses).

drstewart3• 6 years ago

You're in an incredibly privileged position to be in to say such a thing.

triceratops5• 6 years ago

Small correction: you can't board a flight to Canada. You're always welcome at a land border without a test report in hand. In which case you'll be required to spend 14 days in government quarantine.

sonotmyname4• 6 years ago

You spend the 14 days in quarantine either way - land or air. And it's not 'government quarantine' for most people - it's just a hotel room, airbnb or wherever your approved plan says you're going to quarantine.

jtdev• 6 years ago

I'm all for this, but I'm somewhat surprised that this isn't being railed as "xenophobic"... wonder why we've suddenly had a change in heart on these topics?

mrfusion3• 6 years ago

It Seems like a good idea but I worry about the slippery slope effect.

Can they require this for flu? How will they handle false positives? What about something like HIV? What if you need to get home for medical treatment or a family emergency?

kevinmgranger• 6 years ago

None of those are really considered pandemics.

renewiltord• 6 years ago

HIV/AIDS is definitely frequently considered a pandemic, and at least a global epidemic. In any case the obvious difference is that it isn't as contagious.

BugsJustFindMe2• 6 years ago

Can they require this for flu?

I think they should. But the flu isn't as virulent as COVID.

What about something like HIV?

You can't get HIV by someone breathing on you. How many people do you usually share needles with on airplanes?

root_axis• 6 years ago

The slippery slope argument is generally regarded as a logical fallacy because the argument can be applied to anything. You should at least offer an explanation of why believe the slippery slope is a risk in this case. What interest would the U.S. have in requiring Flu or HIV tests for travel? The reasons for requiring a covid test are obvious unless you're a person that believes covid is equivalent to the flu.

agiroth2• 6 years ago

The slippery slope argument is generally regarded as a logical fallacy because the argument can be applied to anything.

Can you expand on this? I've seen the claim several times, but given the fact that (in general, not referring to covid) it is possible to point to historical examples of how things progress from A->B->C, and then you can identify a sequence of A->B currently, it becomes almost silly not to conclude the goal is C. So why is demonstrating history repeating itself a fallacy?

Granted I've placed a number of conditions there. Maybe that's what you mean. I'm just curious what the general argument is.

What interest would the U.S. have in requiring Flu or HIV tests for travel?

Humans unfortunately have a bias for "doing something" rather than nothing, even if the two actions are equivalent in consequence (which favors doing nothing - less energy).

Scream loud enough and we'll create problems where there weren't any. I mean that's basically what network news does all day every day. Then we'll respond to those problems, and create more problems. Etc. "It worked for covid, why aren't we doing it for the flu?" Even if the argument isn't valid, it sounds good, and politicians like things that sound good even if they don't do anything, creating problems and great expense for people for little to no actual gain.

addicted• 6 years ago

This makes sense. The only question is why this wasn't done as soon as travel was restarted and tests became readily available across the world.

This is at least 6-9 months too late.

baybal22• 6 years ago

That's an irony. USA is pretty much a fortress for as long as border security goes, and it had the best chance of any nation to avoid Covid impact by shutting itself off from the world using mechanisms of border security only.

Yet, for some completely unfathomable reason, it didn't.

notadev• 6 years ago

Perhaps it would have been considered xenophobic?

zaroth• 6 years ago

You would need more than just a pre-travel testing requirement. You would also have needed an arrival quarantine and post-arrival testing.

I wonder what percent of asymptomatic positive cases pre-arrival testing actually catches. I’m sure that number also changes depending on how many days before traveling you’re allowed to get the test.

And to actually prevent COVID from entering the US, I think you would have needed all of that fully in place in January, or perhaps earlier.

Effectively what this would have meant is a total border closure for several months at the beginning of the year. I’m not sure if that would have literally been impossible, but I think it’s totally fathomable why that didn’t happen.

pishpash2• 6 years ago

The reason is the US has more infections than almost anywhere else so the enemy is already inside.

cavisne• 6 years ago

The US has two huge land borders that people regularly commute and trade across (not to mention cross illegally).

The only success stories with this strategy are Australia and New Zealand, which are island nations completely isolated from anywhere else.

Even single breaches of their 100% quarantine of all arrivals caused outbreaks, and they also closed state borders.

This requirement begins to make sense now there is a vaccine, as within the US the curve should bend down vs the rest of the world, without the vaccine it wouldn't have achieved anything.

InTheArena• 6 years ago

I don't know if you remember, but when Trump started to cut of china, it was immediately taken to be yet another xenophobic action.

Then it was a matter of rapid COVID tests not being available. It probably should been a few months ago.

koolba• 6 years ago

Yet, for some completely unfathomable reason, it didn't.

Let's not forget that President Trump's order for closing the borders with even just the source nation of the contagion was labeled by the incoming President-elect as xenophobic[1]:

> "We are in the midst of a crisis with the coronavirus. We need to lead the way with science — not Donald Trump’s record of hysteria, xenophobia, and fear-mongering. He is the worst possible person to lead our country through a global health emergency."

[1] https://twitter.com/JoeBiden/status/1223727977361338370

dizzystar• 6 years ago

The relationship between border towns is very tight. You would ruin the entire southern economy if you banned cross-border travel entirely.

Back in the day before Mexico required passports to enter, many people lived in Tijuana and worked in San Diego. I'm sure this still happens today, and of course, you have to consider that many migrants work in US farms, etc.

throwaway7874• 6 years ago

Unfathomable? People do have short memories. Remember this?

https://www.nbcbayarea.com/news/local/nancy-pelosi-visits-sa...

Trump floated the idea of cancelling flights, initially from China, cause that was the only hot spot, back in Winter only to be called a racist.

cblconfederate• 6 years ago

The UK is and island and they didn't do it either. It's learned helplessness: the world has given up on the idea that it's possible to contain the virus.

Supermancho• 6 years ago

USA is pretty much a fortress for as long as border security goes

More like a maginot line than a fortress.

ErikVandeWater4• 6 years ago

By unfathomable, I suppose you mean political?

generalizations• 6 years ago

The US did try and close the borders.

https://www.whitehouse.gov/presidential-actions/proclamation...

https://www.cnn.com/2020/02/02/us/coronavirus-us-travel-rest...

foolfoolz• 6 years ago

testing capacity couldn’t support it. no use doing this when the results come a week later. if this was a requirement earlier everyone would have complained it was just theater and not helping

peytn2• 6 years ago

I’m certain we could have figured out something earlier. We spend several billion dollars annually on an organization with a singular mandate to do so.

wendyshu2• 6 years ago

I'm pretty sure people would have understood that requiring a positive test before entry is not just theater.

jaynetics• 6 years ago

Maybe politicians should bite the bullet sometimes and do stuff that will not be immediately understood by every citizen.

Even without tests being widely available it would have been wise to require all arrivals to quarantine, as Taiwan has done with great success.

Yeah, sure, that would have been a nuisance for quite a few people and painful for the airline industry, true, but nowhere near as annoying and painful as things have ended up now.

netsharc2• 6 years ago

In most countries they just want a negative test from the origin country, so the country being visited doesn't have to spend a test for the tourist. But it's not bulletproof, if someone tests false negative and flies and infects a few others.

Other countries (Taiwan, NZ?) quarantine you for 14 days on arrival, and also test you...

what_ever3• 6 years ago

India has had this requirement for a long time now (more than 6 months IIRC). If you don't have the negative test, you need to quarantine at preselected hotels near the airport after arrival. Most international airports now also offer on arrival tests.

gibrown• 6 years ago

They should do it for all air travel whether international or domestic.

nostromo• 6 years ago

Covid testing hasn't been, and still isn't, universally available. Mexico, to pick one neighboring country with a lot of cross-border traffic and cultural ties to the US, has done 97% fewer tests than the US has, for example.

graeme4• 6 years ago

Do you mean per capita? If mexico did 97% less as an absolute number that would mean they test more than the US per capita.

jen20• 6 years ago

The only question is why this wasn't done as soon as travel was restarted

I'm not sure there was a point where travel was ever _stopped_? At least not for US citizens or residents. This is not to say the test requirement should not have been imposed (much) earlier, however!

SergeAx• 6 years ago

This doesn't make any sense. Requiring a test on entry to country with full-fledged epidemia is like asking for an umbrella on entrance to the swimming pool.

asah• 6 years ago

Which direction? /s

liquidify2• 6 years ago

This seems like a scheme that will be ripe for gaming / outright fraud. How exactly does the U.S. verify anything? Basically the only way to do this would be to have control over some kind of verification system that comes from vetted and registered hospitals.

Even then you have so many problems. There is no realistic way to even partially guarantee that forgeries won't happen regardless of your vetting system. And add to that the fact that the U.S. government has no control over regulations in foreign countries, so there is no way to force validators into compliance.

This sounds half baked to me.

temporalparts• 6 years ago

A half-baked plan that will screen out only some COVID carriers is better than the status quo where we screen out none of the COVID carriers.

In Hawaii, they have limited partnerships and Hawaii verifies the result directly with the labs. It says on the website they'll prosecute anybody that submits forgeries, but it's true that this is much easier to do when everything is within the same country.

mandelbrotwurst• 6 years ago

It doesn't need any of that to be nearly entirely effective. The vast majority of people traveling into the country are not going to attempt to falsify documents.

a13n• 6 years ago

I mean the number of people who are willing to commit forgery and lie to border patrol is probably pretty small. This is a huge step in the right direction that will prevent loads of air transmission. We don't really have time to wait years for a "fully baked" solution, and this is a solid compromise.

jackson1442• 6 years ago

When I got the PCR COVID test administered when I had a suspected case, I was required to fill out a form stating my name, DOB, email, phone, physical address, full social security number, and student ID (I'm a college student). Since these are all attributes bound to identity, I'm sure it's not too difficult to make a database of test results.

liquidify2• 6 years ago

...Just from the thought of it, forcing other countries to store your private info would be a terrible idea considering they probably could care less about it being stolen.

But, you are entirely missing the point. The U.S. cannot mandate that other countries maintain a database with U.S. citizens personal info, even if your idea didn't have massive gaping holes in it regarding security. It is simply impossible.

Mediterraneo10• 6 years ago

Forgeries of the international yellow fever vaccine certificate happen regularly. (For example, backpackers to Africa from Eastern European countries where the yellow fever vaccine was perennially unavailable at our local clinics printed out their own copy on yellow paper and put a fake stamp on it.) Nevertheless, the yellow-fever certificate requirement is believed to work well enough regardless. With COVID, too, one could argue that something is better than nothing.

snakeboy2• 6 years ago

My experience flying from the US to France through Portugal was that an agent at the gate looks over whatever paper you give them and highlights "PCR", "NEGATIVE" and the date and then hands it back. Then in Portugal they asked for the paper and waved me through, and the same at the French border.

So logistically, pretty easy to fake (unless you're stupid enough to be trying to buy the fakes in the airport like some guys who got caught in Paris a few months ago) but I agree with other commenters it's better than nothing and will almost surely improve the rates of testing/precaution around travel.

nomercy400• 6 years ago

Good idea. However, don't be surprised if other countries will also require negative tests for incoming US air passengers.

vinay4274• 6 years ago

Most of the countries that have sane case rates and many that are doing terribly with respect to case rate already require this. Some such as the Netherlands added it relatively recently for transit passengers as well, although most only require it for arrival passengers.

raldi2• 6 years ago

I should hope so.

swampthing• 6 years ago

That seems like a good thing for incoming US air passengers. It lowers the risk of infection from the flight.

wzy3• 6 years ago

This will now place a strain on the testing facilities of small countries (islands) that are a popular destination of American tourists.

In Jamaica, every lab that has been approved to conduct the PCR test has been overwhelmed by a flood a Canadian tourists who now need a negative PCR test result to return home. Mind you, smaller countries have been having an uphill battle with procuring the reagents needed for the PCR tests because countries like the US is grabbing up everything COVID related, and not using them.

Had the US implemented these measures 9 months ago, the entire world would have looking at the tail-end of this pandemic, instead of waiting for the US to catchup with what every other country considers as a best practice.

raldi2• 6 years ago

That's not a bug; it's a feature.

vinay4274• 6 years ago

Every other country? Have you looked at the recent COVID-19 case and death rates in much of western Europe? Many of those countries, one of which I live in (which still doesn't require testing arrival passengers), are still changing their policies on incoming travelers with respect to quarantining and testing. There isn't some global consensus that the US is blind to.

wzy3• 6 years ago

I am glad you picked up on the substantive point of my argument.

danielfoster• 6 years ago

I don’t know about other islands but I’m in Aruba at the moment and you can get a PCR test in 8 hours. I imagine those days will soon be over.

wzy3• 6 years ago

We have 2 private labs that can handle PCR tests and the turn-around is 24-48 hours, best case. Now, 1 of the 2 is booked out till February.

f4305• 6 years ago

Are these PCR based tests? What is the accuracy rate? I was told it is far from 100%.

So is it possible that someone might test negative but then is actually asymptomatic?

This is exactly what happened last year in South Korea. People were tested many times and they were negative but turned out they were asymptomatic that the test kit failed to pick up.

ogre_codes3• 6 years ago

Nothing about the virus is going to be 100% effective. It's a matter of compositing things that are 60% effective and 90% effective and 50% effective.

If they require testing which is 80% effective, and masks which are 80% effective, and get vaccination up to xx%... etc etc. You eliminate vectors for the virus one at a time and eventually there aren't enough vulnerable people contacting each other in ways that are contagious.

(Percentages are guesses)

f4305• 6 years ago

It isn't even 80% effective from the scientific journals I've read last year, the best they can do is 40% and lower, I think there is some inherent limitation in its accuracy.

I'd like to point out that many countries aren't running multiple tests to make up for this low accuracy like South Korea. It is the general consensus among experts that the actual case numbers are far far higher than what is reported

So if the 40% rate is true then the law of large number suggests the screening test is completely useless because it misses the 60% of the time. It's just like the Casino where the virus has a huge edge over our detection and prevention measures.

slumdev4• 6 years ago

So is it possible that someone might test negative but then is actually asymptomatic?

No, with PCR, the opposite is true. It is most likely that someone who is "positive" but asymptomatic has such a miniscule amount of virus in their system that they're not infectious.

f4305• 6 years ago

asymptomatic has such a miniscule amount of virus in their system that they're not infectious.

https://www.advisory.com/daily-briefing/2021/01/11/asymptoma...

60% doesn't seem miniscule

outside1234• 6 years ago

Serious question - is it allowed to travel to Europe or Asia right now from the US for non-relocation purposes?

I'm always stunned when I see these questions because I am like "People are traveling internationally - test or no test????"

netsharc2• 6 years ago

Most if not all of Europe is closed to tourism: https://reopen.europa.eu/en

But they'll let people in who have long term residency permits, or to visit long term partners, sick family members, or e.g. if their young children live there.

For Switzerland I know there's even a clause that lets you in if you have to go there for business. Kanye West was spotted in the country last month, I guess he was allowed in because he's building a villa there.

6nf3• 6 years ago

All countries have various levels of business travel, for example obviously all courier services and shipping still happens and other exceptions are made all the time depending on the situation. Diplomats can still travel. Kanye West can probably come up with a legitimate reason to travel to Switzerland even if he spends half his time on the ski slopes.

Ericson23142• 6 years ago

I'm pretty sure that there is enough domestic Covid that this is pointless now?

SpicyLemonZest• 6 years ago

Right this second, probably, but it'll become relevant again as vaccines start to clamp down on the spread.

Ericson23142• 6 years ago

I don't know, even then, the "herd resistance" (not immunity) applies to new arrivals and residents alike.

Best advantage I see is perhaps plane ventilation is bad, but that would purely benefit other passengers and air transportation workers, not the general public. I doubt such narrow beneficiaries is their goal.

standardUser4• 6 years ago

It's not clear to me how this works. What if you've recently recovered from a confirmed case of COVID-19? People can still test positive up to 90 days after recovery, even though all guidances say they stop being contagious 10 days from the onset of symptoms (assuming symptoms have improved and no fever).

And what about people who have been vaccinated. Wouldn't proof of vaccination be sufficient and spare limited testing capacity?

raverbashing• 6 years ago

What if you've recently recovered from a confirmed case of COVID-19?

Then you wait until your test comes clear

People can still test positive up to 90 days after recovery

In very rare cases

standardUser4• 6 years ago

A positive test result from > 10 days ago and a temperature check should be sufficient. Otherwise, we're just asking people to get tested over and over (and most guidances say don't get tested within a few months of a positive result).

standardUser4• 6 years ago

Turns out, you can fly if you have proof of a positive test in the past: https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-...

6nf3• 6 years ago

The vaccine question is going to be interesting. On one hand, if I'm vaccinated then I should be able to fly right? But no vaccine is 100% effective so do I need to get tested anyway? Are we just gonna have to get used to supplying a DNA sample every time we buy plane tickets?

karmasimida• 6 years ago

Then they shouldn't go on a flight. Simple as that.

Traveling to another country is not a right but a privilege, many of HN commenters always like to throw this line.

standardUser4• 6 years ago

That's not actually an answer to the question, just a lazy way of dismissing it that adds nothing.

EDIT: People who recover can in fact fly: https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-...

eloff11• 6 years ago

The US is basically the center of this pandemic now. This is a joke. It's too little too late.

What they should do is test people leaving the US for other countries - spare the rest of the world.

turing_complete• 6 years ago

Well, don't discard Europe too early. We just surpassed you in total deaths!

drstewart3• 6 years ago

You misspelled the UK and Europe, the new centers of the pandemic for the second time

eloff11• 6 years ago

My bad. I'm behind the news cycle.

breck• 6 years ago

This is moronic. We have between 30M and 130M cases here. There is no mathematically possible way in hell that international passengers could bring COVID here in any noticeable way at this point.

Why would they do this? I'll tell you the one and only one reason: some people are making tons of money off it. I just flew back to Hawaii from California and had to pay $170 for a COVID test, even though I'm already immune.

selimthegrim2• 6 years ago

We don't want to import any more new more infectious strains if we can help it

6nf3• 6 years ago

Unless the new more infectious strain also has a much lower mortality rate?

bitcurious• 6 years ago

I think it’s more about protecting the passengers who are in an enclosed space together for 6+ hours than preventing spread within the US. I find it a big reassurance.

wendyshu2• 6 years ago

Why wasn't this done months ago? Seriously, is there any good reason?

vondur• 6 years ago

Surprising it took so long. I wonder if you are going to get some sort of certificate that proves you have been vaccinated for COVID once they roll out to everyone.

balozi• 6 years ago

By now people can purchase negative Covid PCR test results at many international airports, sometimes for as little as $0.50. Entrepreneurial spirit is hard to tame.

tinyhouse• 6 years ago

Most US states already require a negative test or quarantine, with some exceptions. The only issue is that almost no one is enforcing it (maybe some airports do, I'm not sure). It makes sense if it becomes like visa where airlines wouldn't let you board the plane without it (until things are under control). It can be an issue for emergency travel though. Thinking about it, this should be of interest of airlines to protect their staff.

jeffbee• 6 years ago

Right. Santa Clara County, California, has a mandatory 10-day quarantine for anyone arriving from more than 150 miles from its borders. This notice is posted in the airport but aside from that there is no framework for enforcement. It is not even all that easy to figure out what territory is outside this zone and the county does not provide a map.

ryandrake2• 6 years ago

Yea, we really should stop saying things like the government “requires” or “orders” something, if at the end of the day it’s not being enforced. No US state [EDIT except maybe Hawaii?] seems to have any kind of actually enforced public health rules around COVID besides business closures, where enforcement is spotty at best.

vmchale• 6 years ago

You'd be more likely to catch it here than pretty much anywhere else in the world lol.

umanwizard• 6 years ago

Why?

esoterica• 6 years ago

The infection rate in the US is so high that the average arriving international traveller has a lower chance of being infected than the average US resident. What exactly is the point of this? Constitutionality aside, you would literally make a bigger impact on mitigating the virus spread by testing random people on the street. Like DUI checkpoints or stop-and-frisk but for covid.

rodgerd2• 6 years ago

It's interesting to that see the volume of science denial on HN surrounding COVID continues.

ashtonkem• 6 years ago

I get why they’re doing this, but I fear as a society we’ve learned the wrong lessons about testing.

These tests have a pretty high failure rate. That’s probably ok for social level spread tracking (with wide error bars) or low volume contact tracing (where quarantining a few extra people is worth it). It’s far better than nothing of course, but it’s also far short of what we expect from something like a pregnancy test.

But as a means to sign people off as safe to travel? Yeah, not so much. So many people have had the “one negative test so I can go party” only to discover what a false negative is.

cbg03• 6 years ago

These tests have a pretty high failure rate.

The rapid ones maybe, the PCR ones are quite accurate.

slumdev4• 6 years ago

PCR is sensitive, but at the cycle thresholds most labs use, it is not specific.

jedberg11• 6 years ago

I don't understand why we don't implement the isolation procedures of countries that have gotten this under control, following these procedures for both foreign citizens AND US citizens:

- When you arrive in the US, you either spend two weeks at a government approved hotel, at your expense, which is monitored by federal agents to make sure you don't leave your room. You pay for room service for two weeks to get food. This is what Singapore does.

- If you don't want to stay at the government hotel, you agree to let the government track your cell phone for two weeks to make sure you stay in your home, and randomly call you twice a day to make sure you didn't ditch your phone. This is what Taiwan does.

As a plus, all the hotels near airports would be so thankful for all the forced business to make up for the loss of travel business.

They should have been doing this for the last nine months.

Edit: And obviously combine these rules with a relief bill that helps the industries that are hurt by these rules, or you know, everyone.

cbg03• 6 years ago

I don't understand why we don't implement the isolation procedures of countries that have gotten this under control

I'd hazard a guess that it's because they don't want to completely kill off tourism, an industry which is hurting pretty bad because of covid (see TSA arrivals screened https://www.tsa.gov/coronavirus/passenger-throughput)

No tourist would be interested in coming over to stay two weeks on their own dime locked in a hotel, only then to be able to do some actual traveling.

josephg6• 6 years ago

Speaking as an Australian, I'm not allowed to travel to the US at all right now, unless I'm moving there permanently. Keeping everything open (and thus keeping covid rates high) isn't doing your international tourism sector any favours.

jedberg11• 6 years ago

I don't think a lot of tourists are interested in coming right now anyway, given that our virus load is most likely worse than their home.

That being said, this obviously needs to be paired with a relief bill that helps those businesses survive.

totalZero• 6 years ago

If you've stayed in a hotel during the pandemic, you know that the tourism industry is doing abysmally anyway.

us0r• 6 years ago

Tourists have been banned since March I believe.

This was international arrivals at LAX August 11 (the worlds third busiest airport):

https://imgur.com/a/fFsVSXf

Fernicia• 6 years ago

But there is no tourism in the U.S. right now. ESTAs and Visas haven't been approved since April.

flukus2• 6 years ago

No tourist would be interested in coming over to stay two weeks on their own dime locked in a hotel, only then to be able to do some actual traveling.

Depending on where they're coming from they'll have to do that on the way home, so they're not interested in coming anyway.

Tepix5• 6 years ago

Our media tells us that in the US, wearing masks is a policitized topic, which is crazy.

Noone I know is considering a US vacation since mid 2020.

deanclatworthy• 6 years ago

I think is a case of a little too late. There's probably a higher risk of a traveller coming to US leaving with it, than arriving with it - currently. If this had happened 9 months ago, there might have been a chance of this working - with better leadership in other areas - as other child comments have pointed out.

usremane• 6 years ago

Hope the two random phone calls are video calls and not just audio. Otherwise people would leave the phone with someone at home to answer for them.

SulfurHexaFluri2• 6 years ago

I assume this is combined with some kind of mandatory GPS tracking. The GPS tracking knows the phones location and the call confirms the user is next to their phone.

Tepix5• 6 years ago

Otherwise people would leave the phone with someone at home to answer for them.

Or they would just do the sensible thing and not break quarantine.

josephg6• 6 years ago

We do that in Australia too and its worked great. (Well, except for a notable quarantine breach 6 months ago due to mismanagement.)

The problem is all this is closing the fence after the horse has already bolted. The average person arriving into the united states is less likely to have covid than a resident. Currently 2.7% of the US population is infected with covid19, compared to 2.4% of people in the UK, 0.9% in Italy, 0.2% in Canada, and ~0% in Australia, NZ, Singapore, India, China, etc.

Almost all new infections in the US come from domestic transmission.

chii• 6 years ago

it should be departures from the US that require quarantine (pre-departure), not arrivals!

mercutio2• 6 years ago

0% in India seems like you must have mistyped, or something.

India's infection rates are not comparable to the island nations that have successfully contained the virus.

dhnajsjdnd• 6 years ago

Where did you get those numbers? I read this comment earlier today, quoted 2.7% to a friend later, then realized I didn’t know what the source was and dug up your comment again.

syshum4• 6 years ago

I know its probably crazy to ask, but tell me where in the US Constitution does the federal government have the power to force me into a hotel at my expense

I know in "times of emergency" people seem to think the constitution is suspended and the government as "unlimited power" but last I checked Emperor Palatine was a fictional character, and saying "Singapore does" well Singapore is an Authoritarian nightmare IMO, one i do not really want to replicate here in the US. I pass taking public policy lessons from Singapore

jedberg11• 6 years ago

It's part of protecting the borders. The Supreme Court has already determined that anything within 100 miles of the border is the "border zone" and gives the government broad authority to enforce border protection within that zone.

Also, it could reasonably argued that it is part of their "protect life" job.

DeRock2• 6 years ago

Borders (and airports) are already a constitutional twilight zone. Just to get into (or sometimes out of) one I have to go through an X-ray scanner or manual groping that on its face would violate the Fourth Amendment. But at the same time, nobody is forcing me to go there.

ErikVandeWater4• 6 years ago

Because this is a violation of the 5th amendment and the 1st amendment right to peaceably assemble.

jedberg11• 6 years ago

The Supreme Court has already ruled that neither of those apply at the border. Nor does the 4th.

maxerickson3• 6 years ago

Isn't there an argument from principle that violating a quarantine during a pandemic is not actually peaceable?

iamEAP• 6 years ago

This would require a level of coordination and leadership at CBP that we just haven’t seen, at least under the current administration.

balls187• 6 years ago

I don't understand why we don't implement the isolation procedures

Because the largest driver of infections isn't foreign travelers. It's far and away due to the people who are already here.

jedberg11• 6 years ago

Sure, but we got that new strain from a foreign traveler. It still cuts off a vector of transmission.

deeeeplearning2• 6 years ago

I don't understand why we don't implement the isolation procedures of countries that have gotten this under control, following these procedures for both foreign citizens AND US citizens:

Because that would be communism!! /s

drstewart3• 6 years ago

Why are Canadians so scared of communism then, given they haven't done this? Or Germans? Or Finns?

bokchoi• 6 years ago

Yep, this is working great in Taiwan.

Before you get on the plane you need a negative test, but even then there is a mandatory 14 day quarantine. When you arrive you are required to have a SIM card. During quaratine, they track your device and call randomly one or twice a day to be sure your phone is on you. Breaking quarantine is a big fine (up to $33k USD) and there is a carrot if you complete quarantine without any incidents ($500 or something?). Individuals are provided quarantine housing if they can't pay but employers are expected to pay (e.g, workers from Indonesia).

anewaccount2021• 6 years ago

Covid isn't remotely impactful enough to create de-facto internment camps.

Tepix5• 6 years ago

If you don't want to spend two weeks locked into a hotel, you can stay at home instead.

vincentmarle• 6 years ago

U.S. officials do not plan to drop restrictions that were adopted starting in March that ban most non-U.S. citizens who have been in most of Europe, the United Kingdom and Brazil as soon as possible, the sources said.

Does anyone know if the EU travel ban is going to get lifted anytime this year (with the Biden administration)?

ls612• 6 years ago

I’d sure hope it would be this year. Keep in mind we should have the ability to vaccinate every American adult by the late spring so the pandemic should be reduced to very low levels.

top_post• 6 years ago

The country most ravaged by COVID-19 where the spread is entirely localized, requires international passengers... good thanks.

nilkn6• 6 years ago

I have an interesting anecdote related to this.

As it happens, I currently have COVID. When I first noticed I was getting sick, I was scheduled to fly in the near future, so I got a rapid COVID test that delivers results in 15 minutes.

It was negative. I got another one, and it was negative too. I had thus intended to go ahead with the trip under the assumption I had a minor cold.

Later, a few days before I was to fly, I lost all smell and taste. Now I didn’t know what to think. I wasn’t particularly congested, and the loss of smell was total. I’d never experienced this before. Could both tests have been false negatives?

I delayed the flight (free of charge luckily, so no big deal) and got a test that had to be sent to a lab for analysis. A week later, the positive test result came back.

Take from this what you will. I'm not a scientist or a doctor and frankly there's nothing remotely intelligent I can say about the various tests out there for COVID. But if the rapid tests are as unreliable in general as they were for me, it’s sort of no wonder COVID is spreading like wildfire. I was very, very close to boarding a plane with an active case of COVID, and I would have if I hadn’t acted out of an abundance of caution.

dragonwriter• 6 years ago

Rapid tests are known to be unreliable and particularly have a high false negative rate. That's why all the guidance has been that rapid tests can be used to indicate infection but not rule one out, and none of the screening processes based on exposure and symptoms accept “but I also had a negative rapid test” as neutralizing a flag on any screening factor.

I would have if I hadn’t acted out of an abundance of caution.

The bare minimum of caution with a rapid test is treating a positive as a true positive and a negative as an indicator that you need a regular test. That you understood your actions to be an abundance of caution demonstrates a failure to effectively communicate on some level (I'm not saying that you are culpable; the information is out there's but delivery is...mixed, even before considering how it is muddled by misinformation from various sources.)

nilkn6• 6 years ago

I definitely think there's a communication deficiency or breakdown happening, because none of the medical professionals indicated to me that the rapid tests were that unreliable when it comes to producing false negatives. I also feel personally guilty for not having been as well-informed as I should have been. I'm just glad I experienced a tell-tale symptom (loss of smell/taste) and was able to act on it before boarding a plane.

Another interesting aspect of this is that prior to experiencing loss of smell/taste, I was more or less told by urgent care staff that I didn't have COVID, and they were pretty resistant to testing me -- hence I only got rapid tests. Yet I actually was right in the midst of an active case.

pvarangot• 6 years ago

Thanks for your anecdote. When SF was doing better and the possibility of big outdoor events with testing on the door were something that was being discussed, I looked at rapid tests together with some friends and the accuracy is really appalling. People relying on this to "safety socialize" may be one of the issues making cases rise in California, the math adds up. Many people reached to the government saying they should stop sponsoring and advertising rapid test sites because the false sense of security may be really doing more harm than good.

One of the rapid tests that we considered has, as advertised by its own manufacturer, a 10% false positive rate on basically all the population, and a 50% false negative rate even on symptomatic individuals with high viral load. Do the math, but using that type of test in something like for example a 100 person event or a restaurant will result in people being turned out of the door daily even if they were not symptomatic, and at least one or two people with high viral load being admitted into your place. I can't find the link of the test now, but there's better data about how harmful rapid tests are when not used together with PCR testing, for example here: https://www.bmj.com/content/371/bmj.m4941 and here: https://asm.org/Articles/2020/November/SARS-CoV-2-Testing-Se...

That's why most countries that really thought this through require a recent PCR test result for admittance.

It's really not clear what benefits rapid tests have if you don't have a model for population behavior. I think at lest the SF government is only doing them to save face now that the cat is out of the bag.

jonny_eh• 6 years ago

I hope you get well soon!

DeRock2• 6 years ago

Whether a test is positive or not depends highly on what type of test it is, and when you are tested relative to symptom onset. You can absolutely be carrying the COVID virus but still test negative. Heres a paper with a handy chart: https://jamanetwork.com/journals/jama/fullarticle/2765837

I think you testing negative was a combination of the rapid test being unreliable, as well as getting tested early with respect to symptoms.

jedberg11• 6 years ago

This rapid tests have a very high false negative rate. The result you get back should really be "You have COVID" or "You may have COVID, get a PCR test".

graeme4• 6 years ago

Rapid tests are at their most accurate when someone is at their peak infectiousness. Accuracy declines swiftly before or after that.

So the use you made of them didn’t fit their ideal use case, as you used them several days before travel.

Even then, with symptoms, I am not sure they would be enough to rule out a positive. The biggest use of rapid tests is finding additional positives that would not otherwise have been found.

situationista• 6 years ago

Most countries which require a test for entry stipulate it must be a PCR test rather than a rapid (antigen) test. I’m currently in Lisbon waiting for the results of a 24h PCR test in order to board a flight to Azores, for example.

option• 6 years ago

note that rapid test is still useful to confirm infection. But, yes, much more unstable for ruling out one

Osmium4• 6 years ago

I'm glad the OP made the correct decision in this case and hope they get well soon.

the assumption I had a minor cold the loss of smell was total

Since there does seem to be a messaging problem about the reliability of testing, I think it's worth emphasizing: if someone has symptoms of COVID, they should proceed as-if they have COVID. CDC guidance[1] is to isolate if you have a positive test OR if you have symptoms.

To do otherwise is to gamble with the health and lives of the people they meet, and the people those people meet, and so on. It may prove almost impossible to show who caught COVID from whom, but that doesn't mean that ignoring guidance won't lead to deaths. A statistical death is still the death of a real person, even if we can't put a name to them.

[1] https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/is...

nilkn6• 6 years ago

To be clear, the order of events was such that I did not have loss of smell/taste at the time of the rapid tests. There was no indication at that time of anything that wasn't completely consistent with and expected from a cold, and I even encountered resistance when I tried to get tested prior to the tell-tale loss-of-smell symptom appearing (hence the rapid tests only at that point). I had a mildly uncomfortable phone call with an urgent care center where they discouraged me from pursuing testing because they didn't think I had enough symptoms.

I knew exactly from whom I had contracted whatever illness I had, and that person had also tested negative for COVID (upon further questioning, their test had also been a rapid one, and they too had not been informed of its unreliability for any negative determination).

throwaway0a5e• 6 years ago

The heck is the point of a test if not to confirm or rule out covid? He took two tests, came back negative and assumed his "cold or covid" symptoms were cold until he had reason to believe they were covid. Other than the tests sucking everything in the fact pattern is perfectly reasonable.

koyote• 6 years ago

A week later, the positive test result came back

Which country do you live in that it takes a week for the PCR test to come back? It's around 24 hours here and I thought that was the case in all developed countries.

I hope you recover quickly!

nilkn6• 6 years ago

I'm in the US. The test was taken on a Sunday evening at about 7:30PM, and the results were delivered via text message the morning of the following Friday.

My guess is there's a lot of variability in how long it takes to get results. I know folks who've taken the same test and they got results back within 48 hours.

toomanybeersies2• 6 years ago

The turnaround when I got a test just before Christmas in Melbourne was under 6 hours, only had to wait in line 5 minutes for the test too.

glandium• 6 years ago

Note that even PCR tests have a relatively high rate of false negatives.

arcticbull2• 6 years ago

If you still have yet to test positive for COVID you may not have COVID. A loss of sense of smell and taste is a common symptom of a viral infection.˜ [1]

[1] https://www.healthline.com/health/coronavirus-loss-of-taste-...

bigiain8• 6 years ago

Yeah - so you should probably go to a political rally or concert or a nightclub or something!!!

:sigh:

This is awful advice for 2021. (Even though _technically_ it's correct.)

If you have a loss of smell/taste you should 100% assume you have Covid and act accordingly, get tested immediately, self quarantine for probably 14 whole days, and get retested at around 10 days.

If you have "mild cold/flu symptoms" you should assume you like;y have covid, and should get tested (not with a "rapid test") and self isolate until you get a negative result.

Truth is, even with no symptoms, you could have Covid. If you've been in contact with anyone who has cold/flu symptoms, or been to a place where someone with a positive covid test has been - you should get tested (and probably self isolate until you get a negative result).

From: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

Results: The baseline assumptions for the model were that peak infectiousness occurred at the median of symptom onset and that 30% of individuals with infection never develop symptoms and are 75% as infectious as those who do develop symptoms. Combined, these baseline assumptions imply that persons with infection who never develop symptoms may account for approximately 24% of all transmission. In this base case, 59% of all transmission came from asymptomatic transmission, comprising 35% from presymptomatic individuals and 24% from individuals who never develop symptoms. Under a broad range of values for each of these assumptions, at least 50% of new SARS-CoV-2 infections was estimated to have originated from exposure to individuals with infection but without symptoms.

Conclusions and Relevance: In this decision analytical model of multiple scenarios of proportions of asymptomatic individuals with COVID-19 and infectious periods, transmission from asymptomatic individuals was estimated to account for more than half of all transmissions. In addition to identification and isolation of persons with symptomatic COVID-19, effective control of spread will require reducing the risk of transmission from people with infection who do not have symptoms. These findings suggest that measures such as wearing masks, hand hygiene, social distancing, and strategic testing of people who are not ill will be foundational to slowing the spread of COVID-19 until safe and effective vaccines are available and widely used.

abiogenesis• 6 years ago

They have already tested positive on their 3rd (PCR) test.

devy• 6 years ago

But if the rapid tests are as unreliable in general as they were for me, it’s sort of no wonder COVID is spreading like wildfire.

Many rapid tests are indeed not accurate[1] but they still serve a purpose, depending on the sensitivity and specificity of the tests[2].

For the rapid tests with high sensitivity and you get a positive result, it's highly likely you have COVID.

For the rapid tests with high specificity and you get a negative result, it's highly likely that you don't have COVID.

And the public health measures of testing / contact tracing ONLY works if testing results come back quick. PCR tests are neither fast nor cheap, so those are not as effective in prevention of spreading because you don't do those all the time (slow + expensive).

Medcram has a good video talking about this. [3]

[1] https://www.wsls.com/news/local/2021/01/08/cdc-study-shows-c...

[2] https://en.wikipedia.org/wiki/Sensitivity_and_specificity

[3] https://www.youtube.com/watch?v=h7Sv_pS8MgQ

kelnos2• 6 years ago

I only have data points for two different testing orgs, but in my area, GoHealth charges $250 for a rapid test, and Color charges $110 for a PCR test[0]. So it seems like that's flipped from what you're suggesting?

The Color tests can even come back in 8 hours or so, if you're not too far from a lab and the lab isn't overloaded. Not as fast as 15 minutes, and certainly higher variance, but much more useful than 72 hours people normally assume.

Regarding false negative rate, Hawaii is accepting some of the rapid tests (like the aforementioned GoHealth test) for pre-travel screening, which is concerning.

[0] These are both without involving insurance at all. It's possible, though, that the Color tests are partially subsidised by Google?

Reason077• 6 years ago

Rapid tests (aka: Antigen tests, or lateral flow tests) are high specificity, low sensitivity tests.

That means they’re biased towards the negative side: they’re unlikely to return false positives, but quite likely to give false negatives.

Such tests are useful for epidemiological studies, or for answering the “do I have Covid antibodies?” question.

But they’re not a reliable way to actually test for Covid. You need a PCR test for that!

anonytrary• 6 years ago

If you don't mind, can you please share your age or a ballpark estimate? It seems like you are doing well and just had the minor symptoms.

nilkn6• 6 years ago

Sure, I'm in my early 30s. I do believe I had a pretty mild case all things considered, and I'm pretty much fully recovered at this point but still plan to quarantine for another week.

What I experienced was basically indistinguishable from a mild cold except for the loss of smell and taste, which took over a week to show up after the onset of the initial symptom (a fever). While I know loss of smell can happen from non-COVID infections, I can say this is the only time in my life I've had a total loss of all smell and taste. I'm very fortunate that this total loss only persisted for a few days, and at this point based on my subjective experience my smell and taste senses appear to be normal again.

lol768• 6 years ago

They've been using these lateral flow tests in the UK quite a bit - particularly for university students returning home/to campus (or at least, that was the plan!).

But I'm not convinced the data on their effectiveness really supported using the tests in this way: https://twitter.com/deeksj/status/1340975400726478849

But it was a political "win".

maxerickson3• 6 years ago

What entity approved the test for distribution?

argonaut• 6 years ago

There are many different rapid tests. Some are reliable and some are unreliable.

For the ones that are reliable (like Abbott's test), they are highly accurate at determining whether someone is currently infectious. So you could have been infected but not capable of transmitting to others yet. These tests would be highly useful for onsite testing, such as if airlines required a rapid test right at the airport.

Tainnor• 6 years ago

I have an interesting anecdote related to this.

Please don't do that.

There is enough knowledge out there about the various kinds of tests (PCR, antibody, antigene) and what they're good for and what they're not. It's perfectly understood that while rapid tests are, well, rapid, they're much less precise than PCR testing. However, they are often better than nothing (you can't give a PCR test to everyone who wants to visit relatives in a nursing home), so they serve to minimise risk, not to remove it. (They also have a tendency to be more likely to be positive while you're actually infectious, which is not the same thing as having symptoms.)

I really don't think we should be discussing personal anecdotes during a health crisis, when there's enough data around that we can actually look at.

raxxorrax• 6 years ago

The most common error with these tests is false application. Did you have someone else doing the swab? It has to feel like someone is poking at your brain.

luisvel88• 6 years ago

You were probably not contagious during those first days (at least for everyone except your partner).The threshold for the rapid test is higher than what the PCR detects. The antigen test is highly reliable for catching contagiousness, not just any viral load. Michael Mina (Harvard Biologist) presents the data in a great way if you want to check.

vermontdevil• 6 years ago

Cue black market negative tests for sale.

ghshephard2• 6 years ago

I don't at all see how this is relevant to the United States in 2021, when COVID-19 is almost completely prevalent, and we require universal vaccination to exit out of the pandemic - International travel restrictions seem meaningless to me now - though they would have been invaluable in January 2020, and maybe even February 2020 - right now the major risk of COVID-19 infection is inside the United States. A handful (or heck, even hundreds) of people coming into the country won't make any difference when we have thousands of new cases a day regardless.

There's a reason Epidemologists don't put much stock in travel restrictions once a pandemic is well underway around the world - they don't do much good.

But - generally, having widespread (ideally very sensitive) COVID testing for any type of travel outside of the home is a good thing. We should have it universally available. Ideally <$10, something that everyone could do weekly, or even daily if they travel a lot.

Just unclear what the focus on international travel is all about here.

solarengineer2• 6 years ago

Some rationale for blocking international travel - preventing the spread of international variants, and preventing the destination country from being overloaded by incoming infections.

Most nations aren't getting the vaccines yet. Vaccination distribution and delivery require complex logistics. Nations that don't have a good public healthcare infrastructure need time to gear up. Vaccinations have just started and are being given in a phased manner. Blocking International Travel (or at least mandating a 14 day quarantine) helps keep variants in check.

ghshephard2• 6 years ago

Ironically, it's in countries where there is partial vaccination that we haven't the greatest risk - partial pressure against the virus will select it for stronger ability to be vaccine resistant. It's why it's so important to give everyone two doses of vaccine as quickly as possible and vaccinate the entire population, so you don't have the virus spreading, mutating, and potentially evolving to become vaccine resistant and then endemic in the population. We only get one really good chance to hit herd immunity.

But - longer term - agree with you - wouldn't it be awesome if we had full-viral scans of travelers, international or otherwise - would shut down flu pandemics as well (most of them are imported from other countries).

cactus2093• 6 years ago

I think all domestic and international travel should have this requirement at a minimum. Nobody should be on an airplane without a recent negative test. Or working in a factory, hospital, or other indoor environment for that matter, it would be great if essential workers could all routinely get tested once or twice a week, though maybe that's not feasible.

I don't really get the international focus of this either, but it seems like a step in the right direction.

benibela• 6 years ago

But - generally, having widespread (ideally very sensitive) COVID testing for any type of travel outside of the home is a good thing.

It would also be good to test for any disease before traveling. Flu, cold, just stay home for those, too

mamon• 6 years ago

There's one thing I do not understand: they are introducing testing requirement, but still keep travel ban for all EU citizens in place. Why?

sneak• 6 years ago

Enforcing disease restrictions at borders is basically pointless in a country with massive uncontrolled spread inside its 300M+ population.

They should do this for every bar, restaurant, uber, taxi, train station, and airport inside the US; that would solve the issue right quick.

This is just xenophobia, nothing more. There's more covid danger inside the US than there is from people coming from outside of it.

throw03172019• 6 years ago

A little late?

xylophoner• 6 years ago

This appears to only be required for inbound passengers. I wish it was also required for outbound. I not only want to prevent more COVID from coming into the country, but also want to increase the chances of my outbound flight being COVID free.

angry_octet• 6 years ago

What a joke. Everyone (including Americans) should need a negative PCR test the day before they leave.

Andaith• 6 years ago

Not to be inflammatory, but why? The only benefit I can see is reducing the likelihood of new strains getting into the US, but to me this is like a swimming pool requiring people to be dry before they get in.

It would make sense as part of a national strategy, no doubt. But on it's own, I don't see the value in this?

Especially since it doesn't apply to passengers transiting through the US, so technically not everybody on the flight will have to do this, meaning you're going to spend a lot of time in an enclosed place with (as a complete guess) 80% covid negative people and 20% YOLO people. That's, err, that's exactly how covid spreads...

darkwizard42• 6 years ago

Actually, I would say this is more like taking a shower before entering the pool. It reduces the chances you are going to bring in grime into the pool.

Of course the pool itself is not very clean, but this way you improve the quality of the pool while you FINALLYYYYY put in some chemicals (vaccines) into the water.

Agreed 100% that this needs to be part of a national strategy in which testing, vaccine deployment, and strong community guidelines are used in conjunction to really beat COVID-19

mrfusion3• 6 years ago

I worry it sets a dangerous precedent if a country can start dissallowing citizens to return to their home country.

snowwindwaves2• 6 years ago

Don't leave during a pandemic then? When healthcare resources are stretched thin all around the world who is going to be able to take care of a sick foreigner or get them back to their country without endangering others?

If the world had enough N95 masks and everyone wore them this would be over, but instead we are wearing bandanas and pulling t- shirts up over our noses.

mrfusion3• 6 years ago

Have they promised this will go away after the pandemic is over?

What criteria determines when it’s over?

Is an available vaccine for the vulnerable not enough?

sershe2• 6 years ago

Interesting, what exactly are they going to do if someone doesn't have one? IANAL, but as far as I recall from "what if they want you to unlock your phone/mount your encrypted drive/... on the border and threaten to not let you in" articles that purported to be written by lawyers, they cannot not let a citizen in.

sershe2• 6 years ago

Answering my own question... CDC page has better information - https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-... this is basically at the point of departure, so the airline won't let you board in the first place, and the awkward issue of not letting citizens into their own country won't arise.

Most places in the world don't have reliable means of getting a test done within the 3-day return time. I guess when I go visit my family abroad, I am going to fly back to somewhere like Tijuana, cross the border, then fly domestic back home. I'd encourage as many people as possible to do the same.

forgingahead• 6 years ago

Long overdue! Really sad why this wasn't done earlier. Regardless of false negatives, this will certainly dent imported case numbers, though it would have had much more impact earlier on in the pandemic.

knolax• 6 years ago

Hawaii has already required passengers of all incoming flights to get tested for a while now.

mbrodersen• 6 years ago

A bit like making it hard for potential arsonists to enter an already burning building.

chubaka• 6 years ago

No one laughs at USA government for doing this too late?

And this news sounds like, only not-yet-infected people are welcome to USA. So you can bring some gifts back.

HN readers always criticize on other countries but so lenient to USA.

U.S. to require negative Covid-19 tests for international air passengers

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