Testing travelers for coronavirus a week after arriving in the UK could cover virtually all imported cases and resolve quarantine disputes in the UK, a study proposed today.
Modeled by the London School of Hygiene and Tropical Medicine, people were isolated for seven days and then tested to get 94 percent of infections from high-risk countries.
Researchers behind the study are calling on the UK government to consider implementing the strategy, fearing that people will fail to comply with the current two-week rule.
Travelers and British tourists returning from Spain were told at the weekend that they now have to isolate themselves for 14 days. Other EU countries like Belgium and Luxembourg could be removed from the safe travel list tomorrow due to growing outbreaks on the continent.
The government is under increasing pressure to cut quarantine times as it fears ruining summer vacations and preventing British vacationers from earning wages when they get home.
Heathrow Airport bosses suggested today that border tests could be the answer to remove the 14-day quarantine rule and prevent the travel industry from bleeding money.
But LSHTM researchers poured cold water on the plans. Warning swabs at British airports would only catch half of those infected and let thousands pass by.
They also said that infected people who get negative results at the border may get false confidence in the test and ignore their symptoms as they develop.
It may take a few days after infection for Covid-19 to begin testing. A negative result on arrival does not mean that the passenger does not get sick later.
Modeling by the London School of Hygiene and Tropical Medicine has shown that upon arrival at UK airports, only 50 percent of infections are tested for Covid-19. Pictured: A passenger is tested by a doctor at a coronavirus screening station at Düsseldorf West German Airport
However, testing travelers from high-risk countries a week after their arrival in the UK could cover virtually all imported cases and resolve the quarantine disputes in the UK. Pictured: A security guard points to arriving passengers for a Covid 19 test in Düsseldorf
The latest study, which has not yet been peer-reviewed or published in a scientific journal, used mathematical models to simulate different quarantine strategies.
They estimated the number of infected people flying to the UK from the U.S. and Europe based on monthly flight records and disease prevalence abroad.
The team said current 14-day quarantine measures were still the most effective and could prevent 99 percent of the cases if everyone followed the rules.
However, they found that a seven-day quarantine period followed by a negative test could reduce the number of cases imported from the EU to zero to three per week and from the United States to zero and four.
Their mathematical model indicated that a reduction to five days would result in 80 percent of the cases being caught, as the disease still incubates in a fifth of travelers who had caught it just a few days before the flight.
The lead researcher Dr. Sam Clifford revealed the results of the study at a virtual press conference today, saying, “The recommendation is that you need to be quarantined for at least a week.
“However, a PCR test means that it doesn't have to take a full two weeks. Of course, we need to be clear about how people will respond to a long period of quarantine. & # 39;
The epidemiologists also modeled the effectiveness of screening incoming travelers for the disease at UK airports.
Belgium and Luxembourg could be removed from the safe travel list tomorrow, and Croatia could also be at risk. Luxembourg has the highest incidence of coronavirus cases per 100,000 people in Europe
BUT THE GOVERNMENT insists that there is no alternative to 14-day quarantine
Ministers today warned that there is currently no "viable alternative to 14-day quarantine" for travelers returning to the UK from high-risk countries.
Boris Johnson is believed to be concerned that a second increase in infections could occur in the UK within 14 days after he raised concerns about an increase in cases across Europe.
Mr Johnson insisted that the United Kingdom reserve the right to impose short-term travel restrictions to prevent the domestic corona virus from growing.
However, the travel industry is asking the government to shorten the 14-day quarantine period to make travel abroad more practical in the face of these uncertainties. The head of Heathrow Airport suggests border tests could be the answer.
Minister of Culture Oliver Dowden poured cold water on the plan today when he said there is currently no "viable alternative" to the fortnight in self-isolation.
He said, "The challenge we have here is that you can't just test someone and be sure they don't have the disease."
He added: "It can incubate for a period of time, so there is no silver bullet just to test immediately at the border."
Mr. Dowden said he understood the "frustration" of the travel industry with the current quarantine system, but there was currently no "viable alternative".
He told BBC Radio 4's Today broadcast: "I have heard comments from Mr. Holland-Kaye and understand his frustration and his desire that we should not quarantine.
"If we could avoid imposing quarantine as it is safe, we would of course do so so we will keep checking."
He added: “Of course we will continue to examine all alternatives, but we have not reached the point where there is a viable alternative to 14-day quarantine.
"In fact, in your question you pointed out that testing does not affect everyone even after a week."
Mr. Dowden said that people should "continue to book vacation" but should be aware of the risk of quarantine.
The managing director of London's Heathrow airport has asked people from high-risk countries to get a swab on arrival to abolish the raw 14-day rule.
John Holland-Kaye said today that the mandatory swabs could restore British confidence in foreign holidays this year and prevent the travel industry from taking another blow.
However, the LSHTM study found that testing passengers on arrival would only include 50 percent of those infected.
Dr. Clifford added, “There is evidence that people who get a negative test early on feel that they are likely to be fine and not as strict (with quarantine).
“There is a lot of behavioral research that needs to be addressed. We only modeled epidemiology. We have not modeled how people comply with these different quarantine measures. & # 39;
In response to the results, independent scientists welcomed the finding that reducing quarantine times could keep the epidemic under control.
Dr. Andrew Freedman, an infectious disease expert and volunteer at Cardiff University, said: “It is clear that a single negative PCR test on arrival is not sufficient to detect COVID infection in travelers from higher risk countries to the UK come to exclude incubation period, which can be up to two weeks.
However, this model study by the London School of Hygiene and Tropical Medicine provides a strong argument for reducing the quarantine time from the current 14 days to eight days by performing a test on the seventh day after arrival.
& # 39; This would have a significant advantage for both the individual traveler and the entire travel industry. It remains to be seen whether the British governments are ready to adopt such a strategy. "
Prof. Mark Woolhouse, professor of epidemiology of infectious diseases at the University of Edinburgh, added: “This is a welcome example of the principle that tests can be used to reduce quarantine needs.
& # 39; One scenario that is not considered in this article is testing on arrival and again a few days later. It is possible that a double test strategy is almost as effective as a 14-day quarantine.
"The paper does not further investigate the impact of imported cases on public health, but this is another key issue.
“If the R number is less than one (as is currently the case in the UK), imported infections do not trigger major outbreaks – they pose no higher risk than UK infections.
"However, this changes dramatically when the R number rises above 1. In this case, any infection, whether imported or not, can cause a serious outbreak and much more caution is required."
Mr Johnson warned yesterday that there were "signs of a second wave" of coronavirus in Europe when he defended Britain's decision to reintroduce quarantine travel rules for Spain.
A senior government source said the prime minister was "extremely concerned" about domestic and international outbreaks.
However, the decision to quarantine Spain again and the government's threat to do so in other European countries are causing chaos in the travel industry.
Government advisors have warned that it can take a few days from the time of infection for the tests to produce a positive result. This means that a negative test on arrival does not mean that the passenger will not develop any symptoms later.
However, Public Health England and the Department of Health and Social Affairs are believed to have spoken to travel assistance company Collinson to understand the proposed test pilot it is developing with Heathrow.
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