Abandon the weak US COVID entry test requirement today

It makes no sense for the CDC to say fully vaccinated Americans cannot enter the US without another test.

COVID-19 testingThe daily number of new cases of COVID-19 in the U.S. has been dropping in most states since vaccinations began to be administered to the population at large. The percent of vaccination and dropping daily case counts are not equaled in many other nations. But the US COVID entry test requirement is still enforced, even for fully vaccinated citizens. It makes sense that the U.S. should continue with some kind of COVID-19 screening for travelers to the nation. The question is, however, what kind of screening requirement should be in place. Travelers United says a vaccination certificate is all Americans need to return home.

While airports across the globe might have additional screening, such as questionnaires and temperature checks, for the US COVID-19 entry screening is accomplished by COVID-19 testing as specified by the Centers for Disease Control and Prevention (CDC). All air travelers coming to the U.S., two years of age and older, including U.S. citizens, must have a negative test result for COVID-19 from a “viral test” taken no more than three days prior to boarding one’s flight. Rapid viral tests and some viral self-tests are permitted. Those who have recently (three months) recovered from COVID and are cleared to travel are exempt, but travelers who are fully vaccinated for COVID-19 are not.

The CDC test requirement has problems with who must be tested, what tests are used and who is exempt from testing.

Irritated by hotel resort fees?There are three major problems with the CDC testing requirement:

The CDC requirement allows multiple kinds of COVID-19 tests to be used, even ones that produce significant percentages of false negatives:
“Passengers must be tested with a viral test that could be either an antigen test or a nucleic acid amplification test (NAAT).” This means that the “gold standard” test to determine if someone is infected with COVID, the RT-PCR test, can be used, it’s not required. Other tests, including rapid tests that are far less effective in determining if a traveler is infected with COVID-19 are permitted.

Even RT-PCR testing produces negative test results that are false four times out of every ten.

That’s a major problem, since even RT-PCR has significant limits of effectiveness itself.

In the American College of Physicians Annals of Internal Medicine (AIM), a study of false-negative rates of PCR testing of COVID-19 (SARS-CoV-2) was published in August, 2020. The purpose of the study was to “estimate the false-negative rate by day since infection.” The study estimated that during the four days of infection prior to symptoms, typically the fifth day, the probability of getting a false negative test result ranged from 100 percent on the day after infection to a mean of 67 percent on the fourth day. On the fifth day, when most people infected with COVID-19 first have symptoms, the false-negative rate is still 38 percent. So, when someone is infected with the virus for five days with or without symptoms, a negative result for an RT-PCR test will be wrong four times out of every ten.

False-negative test results occur even more frequently from other types of viral test methods.

Exacerbating the testing accuracy problem is the fact that variants apparently can cause problems for COVID tests. We already know that the mutation in the U.K. variant of the virus “can result in an undetectable S-gene target” for some real-time PCR testing methods. That means that some of the PCR tests used to detect if people are infected with COVID may have increased false negatives when testing someone infected with the U.K. variant. Tests to determine if false-negative test results occur at an increased rate with other variants are being conducted now.

The CDC testing requirement doesn’t cover travelers entering the U.S. by land or sea.

The CDC testing requirement only covers travelers entering the U.S. by air:
While those entering the U.S. by air are required to produce a negative COVID-19 test, those entering by land or sea have no such requirement at this time.

There is no testing exemption for travelers who are fully vaccinated:
The testing requirement has an exemption for those who have had COVID-19 within three months of travel to the U.S. and have a positive viral test as proof of it or documentary proof of recovery and have met the criteria to end isolation. Recovered travelers also need a letter from their healthcare provider or a public health official that states they’re clear to travel. They are presumed to be immune from infection.

There is no exemption for fully vaccinated travelers. Considering the high degree of effectiveness that the COVID vaccines have, particularly the Moderna and Pfizer mRNA vaccines, it is unfathomable that fully vaccinated travelers are forced to find and pay for testing at their international destinations, from which they will fly to the U.S.

The U.S. COVID test requirement for those entering the U.S. is inconsistent and doesn’t adequately protect the US. 

The inconsistent application of a testing requirement for all international travelers coming to the U.S. and the lack of an exemption for vaccinated travelers, especially considering the exemption for some COVID recovered travelers, makes little sense and doesn’t adequately protect the U.S. from COVID-19-infected travelers.

The U.S. should either drastically modify its COVID testing requirement for incoming travelers or rewrite it entirely. At the least, all travelers should be covered by any COVID traveler entry requirement, regardless of the mode of travel. In addition, required testing should be limited to test methods producing the lowest false-negative rates possible. Finally, those who have been fully vaccinated by COVID vaccines, approved by the FDA under full or emergency approval, should be exempt from the testing requirement. These changes should be instituted immediately.

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