Test or no test at the airport, the moral obligation of a passenger who, either has symptoms or is unwell, is to opt out of the flight even if a false reading clears him to travel.
by Dr. Ruwantissa Abeyratne in Montreal
Over the past few days, the media has been presenting to us various epidemiologists, immunologists and other scientists who have been consensual in their opinion that a vaccine for the Covid-19 virus will not be introduced for use till at least Spring 2021. Most have considered this chronology too early. Until such time as the vaccine arrives, many practical measures have been recommended by reputable international Organizations as well as groups of States to circumvent a total lockdown.
The Council Aviation Recovery Task Force (CART) of the International Civil Aviation Organization is ICAO’s response to the pandemic. According to ICAO, this body is “aimed at providing practical, aligned guidance to governments and industry operators in order to restart the international air transport sector and recover from the impacts of COVID-19 on a coordinated global basis”. Its most recent initiative, according to a recent Reuters report, might be to recommend more testing at airports. According to an article in Airways Magazine, airlines and airports have been wishing that CART would recommend to States that Negative Polymerase Chain Reaction (PCR) tests be required of travelers within 48 hours of travel that would obviate the usual 14-day quarantine period.
On 11th September The European Commission proposed a common traffic light system for member states of the European Union aimed at coordinating border controls and remedying the ongoing disparate and confusing patchwork of coronavirus restrictions on travellers across Europe. Ekathimerini.com positioned in Greece reported: “under the proposal, the European Centre for Disease Prevention and Control would produce a weekly map with every region or country coloured green, orange or red…restrictions, whether a quarantine or a test, would be appropriate for those coming from red zones, although the measures should be the same for all red zones, whether inside or outside the country. Countries would be free to determine what measures to take.
The colour coding is based on two criteria - no restrictions for people from areas with 50 or fewer COVID-19 infections per 100,000 people in 14 days, or where the percentage of positive tests is below 3%, unless the number of cases exceeds 150. Red zones denote regions or countries with over 150 cases per 100,000 or over 50 cases if at least 3% of COVID-19 tests are positive”.
Amidst all these developments, Alitalia has introduced a pilot project on its flights between Rome and Milan, using PCR tests at the departing airport, where the results will be known in 30 minutes and only passengers who test negative will be allowed on the fight. The significance of this measure is that authorities in Italy, much to their credit, have not waited for CART to come up with a global recommendation.
If this practice spreads far and wide in the air transport world, it could prove an effective measure in alleviating the economic constraints faced by the industry. It is possible that the PCR testing process could spread to international transport and consequent easing of restrictions on air travel.
Of course, these measures would not attain fruition without international cooperation between States as well as between States and international organizations concerned. A key support area would lie in financing, particularly poor countries and the provision of critical commodities to them. Needless to say, air transport would be playing a key role in this endeavour, which is all the more reason to have a contingency plan for the sustenance of global air transport in a crisis situation.
Covid-19 was unique in the context of earlier outbreaks of an influenza pandemic. Firstly, the world had been warned in advance by preceding outbreaks of communicable diseases. . Secondly, this warning gave us ample opportunity to prepare for an outbreak. WHO observed that, since late 2003, the world had progressively moved closer to a pandemic since 1968 when the last pandemic of the twentieth century occurred. WHO also said that, during 2005, ominous changes have been observed in the epidemiology of the disease in animals. WHO advised that, as a response to a pandemic threat, the world should take advantage of the gradual process of the adaptive mutation of the virus and implement early intervention with antiviral drugs, supported by other public health measures.
Severe Acute Respiratory Syndrome (SARS) in 2003/2004 was a clear harbinger of things to come and now we have ample experience to develop such measures. During the SARS outbreak stringent and effective measures were taken amidst robust international cooperation. On 18 November 2005, temperature screening of people arriving at Hong Kong at Lowu and Lok Ma Chau were activated using infra-red thermo imagery techniques. This measure amply demonstrated that, from an air transport perspective, technology was available to combat an outbreak of flu around the world.
With the PCR test passengers on board would be comfortable in the belief that all passengers in the cabin had been tested to be negative for the virus. Another comforting thought, which the passengers should be educated on is the fact that the ventilation system in the cabin and the filters used reduce the risk of a pathogen being communicable. As commentator J. May has observed: “there is nothing about an aircraft cabin that makes it easier to contract a communicable disease. In fact, quite the opposite appears to be true. The ventilation patterns on aircraft, combined with the circulation of air through High Efficiency Particulate Air (HEPA) filters reduces the spread of airborne pathogens, especially when compared with other public places”.
While all this is well and good, the question is whether, as was experienced during the outbreak of SARS in Toronto, where two Toronto residents brought SARS from Hong Kong to Toronto after travelling by air, the international community should be more concerned with the transmission of the disease across boundaries, which is the real danger and not merely within the aircraft itself.
Another, arguably significant factor is that there is no 100% guarantee of the accuracy and diagnosis of a PCR test (or any test for that matter). Therefore, while scientific evidence takes priority over anything else, a wide discretion should be given to States in quarantine procedures and policies. The international health dimension of Covid-19 involves human rights issues as well. International human rights law has laid down two critical aspects relating to public health: that protection of public health constitutes legitimate grounds for limiting human rights in certain circumstances (such as detention of persons or house arrest tantamount to quarantine exercises would be justified in order to contain a disease); and individuals have an inherent right to health. In this context it is not only the State or nation that has an obligation to notify WHO of communicable disease, but the human concerned as well, who has an abiding moral and legal obligation. In 1975, WHO issued a policy statement which subsumed its philosophy on health and human rights which stated: “The individual is obliged to notify the health authorities when he is suffering from a communicable disease (including venereal diseases) or has been exposed to infection, and must undergo examination, treatment, surveillance, isolation or hospitalization. In particular, obligatory isolation or hospitalization in such cases constitutes a limitation on freedom of movement and the right to liberty and security of person”.
Test or no test at the airport, the moral obligation of a passenger who, either has symptoms or is unwell, is to opt out of the flight even if a false reading clears him to travel.
It is critical for an evaluation of the health and aeronautical implications of Covid-19 that the term “health” be defined in context. While the WHO Constitution identifies as an objective of the Organization “attainment of the highest possible level of health”, the state of health is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. From an aeronautical perspective, this is a tough act to follow, as international responsibility in the carriage of persons extends only as far as the obligation to prevent injury, wounding or death, and not to the physical or mental well-being of a person. This principle does not carry much weight in the Covid-19 context as the mental well being of a passenger on board a flight is crucial, that would give him the assurance that he is traveling in a clean aircraft.
In air transport, all factors: public health; human rights; communication as well as the confidence of the passenger who embarks on a flight, are equally important.
Dr. Abeyratne, an aviation consultant and visiting professor at McGill University, is the author of 33 books on aviation law and economics. He is currently writing his latest book titled Aviation and Pandemic Law.
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