It is a prime defensive measure against viruses and has previously proved effective in controlling previous major infections. It is a key part of the measures now being suggested to support the return of global international air travel as Covid-19 fears appear to subside across many of the countries where it has been most prevalent.
The International Air Transport Association (IATA) last week called for temperature screening by trained government staff at entry points to the terminal building and, if required by authorities, also at the arrival airport as part of a multi-layered approach of protective measures. Many believe that some form of testing at the start of the travel process would create a seemingly ‘sterile’ travel environment that would reassure travellers and governments.
But while it may build confidence in passengers, it cannot – as IATA has suggested – be used as a standalone safety measure. While, it may be able to distinguish those travellers that are displaying a high temperature and remove them and risk out of the travel funnel, it does not remove all risk.
As the European Union Aviation Safety Agency (EASA) and the European Centre for Disease Prevention and Control (ECDC) have identified in their Covid-19 Aviation Health Safety Protocol: ‘Operational Guidelines for the management of air passengers and aviation personnel in relation to the Covid-19 pandemic’ it may give “a false impression of safety with negative effect on compliance with other measures”.
The issue is firstly that fever can easily be treated with medication, but more significantly that many symptomatic persons do not have fever and a large percentage of transmission of Covid-19 occurs by asymptomatic or pre-symptomatic cases.
Scientists from Singapore's National Center for Infectious Diseases and the Academy of Medicine found that an infected person is contagious around two days before symptoms show. Researchers also say 25% to 50% of people with Covid-19 are unaware they have the virus and are asymptomatic. Almost 75% of people on board the Diamond Princess cruise ship hit by Covid-19 may have been asymptomatic, a study by the London School of Hygiene & Tropical Medicine discovered.
That is why a layered approach, while more costly and more inconvenient has to be adopted. The EASA and ECDC follows this to offer guidelines that provide a source of best practice on how airlines and aviation authorities can ensure the safety of passengers and personnel whilst minimising the risk of virus transmission.
Some of the main points of the guidelines are:
- Only passengers, crew and staff should be permitted to enter the airport terminal buildings. The only exception being to assist any passengers with special needs;
- Airport operators to clearly mark the point beyond which accompanying persons are not permitted to pass;
- Passengers to be told not to travel if they are displaying any symptoms and to be offered incentives to encourage them not to turn up;
- Social distancing measures to prevent queuing and ensuring a 1.5m distance is kept between everyone;
- Contact to be minimised with use of mobile check-in and non-contact boarding;
- Face masks should be recommended for all passengers and personnel from the moment they enter the terminal at departure airport to when they exit terminal at destination;
- Enhanced cleaning procedures in both the airport and aircraft are recommended, especially for frequently-touched surfaces;
- Staff who interact with the passengers should wear medical face masks, gloves and change their uniform daily, or if that’s not possible then a protection suit should be made available;
- Security agents performing body checks should wear face shields in addition to face masks to further mitigate the risk of droplet inhalation;
- Protective screens should be installed to protect staff and passengers where possible;
- Passengers should be regularly informed via visual and audio messages to adhere to the preventative measures and advised that if they do not they may be denied boarding;
- Airlines to advise passengers to minimise the amount of baggage taken onto the aircraft in order to expedite boarding and disembarkation. To this end it is recommended that airlines implement incentive policies to encourage passengers to check in bags where possible;
- Where allowed by the passenger load, cabin configuration and mass and balance requirements, airlines should ensure, to the extent possible, physical distancing among passengers. Family members and individuals travelling together as part of the same household can be seated next to each other;
- If physical distancing cannot be guaranteed because of load factors then passengers and crew should adhere to all preventative measures such as the wearing of face masks and strict hand hygiene;
- No duty free or other non-essential product sales onboard;
- Reduced food and drink service;
- Preference for pre-packaged and sealed food and drink products, such as canned drinks;
- Wherever possible, payment procedures involving touch or contact, such as cash payments, should be avoided to mitigate transmission between crew members and passengers;
- Discourage use of toilets and reserve one for use of crew;
- While passengers should be encourage to bring sufficient masks for their journey, with a recommendation that a new mask be used every four hours, airlines should carry sufficient on board to provide passengers. A safe mask disposal process should be put in place.
It’s a long list of preventive measures but these are expected to be gradually reduced over time in line with a reduction of the risk level. There is also the potential that reliable mitigating measures will become available, such as fast testing of passengers, these will be considered as alternatives in order to alleviate the burden on passengers and staff, whilst maintaining the appropriate level of health safety in accordance with the level of risk.
It is all a small price to pay to help kick-start the air transport industry and the return of travel, a powerful driver of global economies.