April 13, 2021

The ultimate test

Denis Kinane, Chief Medical Officer at Cignpost ExpressTest, believes fewer but smarter tests are the key to a travel restart

As the vaccine rollout continues to progress successfully, it must be kept in mind that a key facet in our ongoing fight against the coronavirus will be to test. Whilst an incredible tool in preventing serious illness, vaccines will not stop people catching or transmitting the virus. This is why it is imperative that the Government focuses on a strategy that prioritises the use of both regular and accurate coronavirus testing alongside the mass vaccination of the population.

The concept of testing on arrival is commonplace in many countries across the world but the UK has only recently recognised the benefits that testing will bring in expediting the return to whatever normal may look like. Whilst it is the fervent belief of virologists and immunologists that testing plays a crucial part in preventing the spread of new virus mutations from abroad, when it comes to business travel excessive or unnecessary testing could be as equally damaging as it is facilitatory. 

There is some debate about the cost of testing but the emphasis must be on PCR testing as opposed to lateral flow tests. Whilst costlier than lateral flow tests, the gold standard PCR test is the way to go due to being significantly more accurate in its results. As the recent Cochrane Review reveals, Lateral Flow tests only pick up 50% of positive cases among asymptomatic individuals and at current prevalence rates would result in around 72% of positive cases being wrong.   

As it stands, the UK Government expects business travellers to take a multitude of tests to ensure that they are able to travel. Under the existing rules, anyone travelling abroad and returning needs to take four Covid-19 tests and is required to isolate for 10 days. It is not only the excessive number of tests that will ensure business travel remains impossible but also the unnecessary quarantine procedures. 

Government restrictions require most travellers to quarantine for 10 days upon return to the UK. Whilst there are some exemptions for this – including those conducting essential state business and those involved in BBC broadcasting services – the majority of workers will be forced to quarantine on their return. There is an option to take a fifth test on day five of their isolation to shorten quarantine by a few days but employees will still be required to isolate for a week or more on average.  

One eminently achievable solution to these challenges, which the Government must seriously consider as part of its announcement to restart international travel, is to test smarter rather than more regularly.  

This would mean opting for gold-standard PCR tests, which can detect the viral load of individuals with high sensitivity and specificity. One test on departure from the UK, another before the return trip home and then a final test two days later is sufficient to confirm travellers are free from the virus. There would then be no need for people to isolate when they are back in the UK. Such a change in the rules would enable employees to travel abroad and then go straight back to work on their return. What is more, if the situation changes and we want to prevent new mutations coming into the UK, we can always increase testing requirements and strain assessment for those countries. 

IATA is also proposing a digital travel pass and standardisation of rules to help streamline the process and get travel moving again. The EU’s proposal of the ‘Digital Green Certificate’ will be particularly beneficial here and will comprise of vaccination certificates, negative test certificates and medical certificates for people who have recovered from Covid-19 in the last 180 days. It is essential that the UK follows suit if we are to get the economy back up and running.  

Businesses must keep abreast with any official changes to policy but there also lies a responsibility on individual businesses to adopt a stringent testing regime that is guided by science. By using the gold-standard PCR test, individuals with low levels of the Covid-19 can be identified before they become infectious.  

Therefore, the best solution is to use to use a local private facility and obtain a gold-standard PCR test that will be recognised in all foreign destinations. A smarter, evidence-led strategy like this can make the business travel process as simple and safe as possible.

It is possible for big companies to cut the costs associated with PCR through economies of scale, such as companies with a mobile lab on site testing thousands of employees, and varying the frequency of testing and who gets tested. It is also probable that the price of testing will come down over time and this has already happened as a result of changes to processes Cignpost has introduced, like any business.

cignpostdiagnostics.com