Momentum is building towards systematic testing to allow international borders to open without the need to quarantine.

The message came from the head of Iata as the airline trade body welcomed the publication of a document from International Civil Aviation Organisation (ICAO) providing governments a risk-based assessment tool for using testing regimes that could “alleviate” quarantine requirements.

A number of global studies all point in the direction of testing being an efficient means to limit the spread of Covid-19 through air travel, according to Iata.

The organisation is in the final development phase of a digital health pass that will support the safe reopening of borders.

Iata and British Airways owner International Airlines Group have been working together in the development of the solution.

A trial is planned to demonstrate that the platform combined with Covid-19 testing can reopen international travel and replace quarantine

Iata director general and chief executive Alexandre de Juniac said: “Data show that systematic testing can reduce the risk of importing Covid-19 through travel to very low levels – not zero, but very low.

“Certainly in most cases it would reduce risk to levels that mean that arriving passengers are less likely to be infected than the local population and therefore do not add meaningfully to the prevalence of Covid-19 in most places.

“Efficiency will increase. Advances in technology are happening every day that will improve testing performance.”

He added: “Momentum is building in support of our call for systematic testing to safely re-open borders without quarantine measures.

“ICAO, working with health authorities and industry, has produced a high-level framework.

“Health authorities are beginning to explore how testing could supersede quarantine to stop the cross-border spread of the virus.

“Encouraging results from testing pilot programmes should now give states the confidence to move forward quickly.”

His comments coincided with the UK government cutting quarantine restrictions for arriving passengers by more than a week from December 15 in a ‘Test to Release’ strategy.

For testing to be incorporated into the travel process it must be fast, accurate, scalable, easy to use and affordable, Iata believes.

Iata does not recommend a specific test type, but says laboratory reported accuracy for the rapid antigen test (RAT) meets its criteria. The Oxford/Public Health England study indicates 99.6% specificity along with very high sensitivity for RAT.

“Public opinion supports Covid-19 testing. They see it as a far better option compared to quarantine which kills travel. And they feel comfortable that if you are tested and found negative you don’t need to quarantine,” said de Juniac.

He added: “Our mindset must be focused on managing the risks of the virus while maintaining the overall well-being of the population.

“That would be a shift from current government policies entirely focused on risk elimination until a vaccine is available and at any cost to people’s lives and livelihoods.”

But he said: “Even with recent encouraging news, it will be well into 2021 before we can expect large scale vaccination. In the meantime, denying people the freedom of mobility will do irreparable damage to jobs and our way of life.

“Strategies with risk-based testing offer a pathway which can safely facilitate an economic revival benefitting from the rewards of a re-connected world.

“Governments could further reduce the risk by investing in effective contact tracing and health monitoring programmes to quickly isolate any potential community transmission. And there could even be benefits to controlling the disease by large scale testing of travellers who are not displaying symptoms.”

Significant advances in technology will help governments implement testing for travellers without compromising the availability of tests directly related to the healthcare sector, particularly polymerase chain reaction (PCR) testing.

The World Health Organisation’s international health regulations emergency committee chair, Dr Didier Houssin, foresees a role for testing as a means of re-opening international travel without quarantine measures.

He said following a WHO emergency committee meeting last month that “clearly the use of the tests is certainly now supposed to have a much larger place compared to quarantine, for example, which would certainly facilitate things considering all the efforts which have been made by airlines and by airports”.