If dealing with passengers who view wearing masks as a violation of their rights was not enough, now the media is asking airline workers to be medical cops. The headline of a recent LA Times story charged, “Coughing, sneezing, vomiting: Visibly ill people aren’t being kept off planes.”

The article’s pearl-clutching outrage was fueled by a December 14 incident, when a United passenger, Isaias Hernandez, 69, took ill and died on flight from Orlando to Los Angeles. Although he reportedly filled out a form for United attesting that he did not have COVID-19, his wife said he had symptoms of the disease. Later, the coroner’s report stated COVID-19 was a cause of death. 

Will such incidents, along with a surge in COVID-19 infections, result in Federal insistence that all passengers furnish negative test results before they can fly?

The LA Times article implied that the passenger had lied about his symptoms, although it is believed a COVID-19 diagnosis had not been confirmed. The LA Times said “The only repercussion for lying on the declaration or refusing to wear a mask on the plane is getting banned from the airline, if caught.”

Should airline personnel, not medical professionals, be forced to make judgements about which paying passenger is “visibly ill?” Should passengers be allowed to launch whispering witch hunts (“I heard her cough in the ladies’ room”) against fellow travelers? Should a polygrapher with lie detector machine be stationed every departure gate?

Or should US domestic passengers be required to present a current COVID-19 negative test before they can board? A future option might be digital health passports storing passenger test and eventually, vaccine information.

The Center for Disease Control has detailed instructions for airlines reporting a serious illness or death on board. But the LA Times made an interesting discovery. Although airline pilots are required to report such information, the CDC told the reporter that it does not keep track of the reports. And both the US Department of Transportation and the Federal Aviation Administration said they do not keep track of COVID-19 cases on planes either.

Currently there is a COVID-19 test requirement for Hawaiian and trans-Atlantic flights, but this is often presented as a passenger service. With a test in hand, local officials are often willing to waive the two-week quarantine requirement.

Similarly, Airlines for America, the airline lobbying organization, sent Vice President Mike Pence a letter on January 4, 2021 asking the Trump Administration to implement a global program to require testing for travelers to the US. The Vice President has been otherwise engaged this week, so the testing program (which would rescind “current entry restrictions on travelers from Europe, the United Kingdom and Brazil”) will probably have to wait for the next administration.

Right now, a quarter of the US airline fleet remains idle, while passenger activity is off 65%, according to Airlines for America. Other statistics show airline load factor hovering around 35%. While this represents a substantial improvement over the hardy 5% who flew in April 2020, it’s less than half what it was in 2019. Airlines, which lost $35 billion in 2020, may not recover substantially until vaccines are widely available in late 2021.

Until that happens, will requiring COVID tests further depress passenger numbers?

Requiring a COVID test before a flight adds substantial cost to passengers. In Los Angeles, depending on the type of test, how fast you need results, and your insurance, costs range from $0 to $250. This one, aimed at travelers, is $175.

Getting a test also adds time and stress; my son stood on line for three hours for a COVID test last week. All this will no doubt further discourage non-essential flyers and already-hesitant vacationers. Business travelers still largely boycott flying.

Testing also has its limitations. Some tests have a tendency to provide false negative results. And the CDC recently reported 59% of COVID infectios have been spread by asymptomatic transmission—people with no symptoms. And a test is just a snapshot of a particular point in time. A test taken 24 hours before flying leave opportunities to catch COVID on the way to the airport.

Of course, tests could be administered at the airport, an expensive and traumatic venue. If you test positive, you positively will not be getting on the plane.

Meanwhile, the airline industry claims flying is safer than grocery shopping or going to a restaurant. It points to a Harvard School of Public Health study that airline efforts to dilute and remove pathogens through filtering, in combination with face masks “results in a very low risk of SARS-COV-2 disease transmission on aircraft.”

Considering all this, it is unsurprising that the airline industry seems ambivalent about adopting a “no test, no fly” standard.

“Anyone flying with us must acknowledge their wellness for travel as part of the check-in process required to obtain a boarding pass,” said a Southwest spokesperson. “This Customer Health Declaration requires acknowledgement of our face covering policy, as well as an affirmation that travelers do not have fever and have not been diagnosed or exposed to COVID-19 in the 14 days before departure.”

Southwest referenced the airline’s “robust cleaning” as well as its procedures to support distancing and contact-free interaction. Ultimately, “Our Employees are equipped to enforce policies that increase safety and bolster an ability to ensure safe transportation of everyone flying with us.”

At United, “Customers are required to complete a ‘Ready to Fly’ checklist at check-in acknowledging they have not been diagnosed with COVID-19 in the last 14 days or have COVID-related symptoms.” A spokesman said, “Currently, we do not have plans to change our requirements.”

United noted the tragic death of passenger Hernandez. “We have been in touch with his family and have extended our sincerest condolences to them for their loss.” The airline is working with the CDC to identify customers who may have been exposed in the Hernandez incident.

American, Jet Blue and Delta did not respond.

US airlines have continued to fly through the pandemic, with significant help from the Federal government. Considering the surge in infections, almost unnoticed during the nation’s political convulsions, the government may indeed require COVID tests of all passengers. For the airlines, it will just another hurdle to fly over.

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