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Pre-departure Covid test dropped for incoming travellers – Expert Reaction

From Monday night, people travelling into New Zealand will no longer be required to test before leaving.

The Covid-19 Response Minister has confirmed the measure will be ditched earlier than planned because cases have continued to decline despite a rise in travellers, and 90% of international travellers are testing themselves after arriving in NZ. They will still be required to self-test on day 0/1 and again on day 5/6.

The SMC asked experts to comment on the news.

Professor Michael Plank, Te Pūnaha Matatini and University of Canterbury, comments:

“The main aim of border testing now is not to prevent infected people from coming into New Zealand but to enable us to keep an eye on potential new variants. Pre-departure tests are costly, onerous, and don’t provide any useful information about new variants. They’re also not that effective at preventing infected people from travelling because anyone testing in the incubation period is likely to return a negative result. They were a useful extra layer of defence in the past when prevalence of the virus in New Zealand was very low, but they have outlived their usefulness now.

“On the other hand, RAT testing for arrivals is important because it enables us to get samples for genome sequencing. This has already been useful in providing an early warning of new Omicron sub-variants arriving at the border. RATs are also relatively cheap and convenient for travellers, and mean that infectious people can be isolated as soon as possible.”

Conflict of interest statement: Michael Plank is partly funded by the Department of Prime Minister and Cabinet for research on mathematical modelling of COVID-19.

Dr David Welch, Senior Lecturer, Centre for Computational Evolution and School of Computer Science, University of Auckland, comments:

“The decision to stop pre-departure testing will have little impact on Covid numbers in Aotearoa/New Zealand.

“With about 2% of recent arrivals already testing positive within a week of arrival, it is clear that many people are already travelling with Covid. We should focus our efforts on encouraging compliance with RAT testing for arrivals, and PCR testing of any positive cases so that we have good surveillance of variants entering the country.

“We know that long-haul travel presents a significant exposure risk so people should still be encouraged to test before travelling and to delay travel if positive. Continued universal masking on planes will help prevent the transmission of the virus.”

Conflict of interest statement: David Welch provides advice to ESR and the Ministry of Health on genomic surveillance and analysis.

Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:

“Dropping pre-departure tests will be welcome news for travellers and workers. However this places even more emphasis on the responsibility of anyone who develops any symptoms, or becomes unwell, to test and isolate for the required period of time if positive.

“This news adds another layer of worry and concern to those most vulnerable to severe illness if they acquire Covid-19, many of whom are having to shelter-in-place even more as these other protections are removed. Continued effective mask wearing is one of the most effective non-pharmaceutical measures we have available to most, and I urge the general population to continue to mask in public indoor spaces, on public transport and in retail stores.”

Conflict of interest statement: Lesley has financial support from Health Research Council of New Zealand-funded studies on COVID-19.

 

Dr Dion O’Neale, Project Lead, COVID Modelling Aotearoa; Principal Investigator, Te Pūnaha Matatini; and Senior Lecturer, Physics Department, University of Auckland, comments:

“Dropping the requirement for a supervised pre-departure COVID test for travellers to Aotearoa is a pragmatic choice and is unlikely to have an effect on domestic COVID cases, given that community prevalence in Aotearoa is about the same as in the countries that many travellers will be arriving from. That is, we’re about as likely to export a COVID case as to import one.

“The change in risk, however, looks different from the point of view of people about to sit on a plane with other passengers for several hours. Dropping pre-departure testing removes one factor that may have been reassuring some travellers that air travel was safer than it could be otherwise.

“It is possible to still maintain some of that extra safety by asking people to take an unsupervised test before travelling, or indeed before engaging in any activity that has higher transmission risk due to re-breathing a significant amount of air that has recently been in other people’s lungs, whether that is being on a plane or in any other crowded indoor environment.”

Conflict of interest statement: “I, along with others from COVID Modelling Aotearoa, am funded by the Department of Prime Minister and Cabinet to provide advice on the COVID response and from a Health Research Council grant to look at equity related to COVID in Aotearoa.”

 

Professor C. Michael Hall, Department of Management, Marketing and Entrepreneurship, University of Canterbury, comments:

“The removal of the requirement for pre-departure tests will undoubtedly be welcomed by airlines and the tourism industry as it facilitates greater ease of travel.

“Although such requirements have not been particularly onerous, they nevertheless act as a psychological barrier in people’s travel decisions, especially for short-break type travel.

“The removal of the requirement reflects the gradual rolling back of COVID-19 related departure and arrival conditions which reflect the normalisation not only of international travel but also of COVID-19 as a disease.

“As a result, we can expect to see further changes in travel requirements around the world which will be based on broad-based assessment of risk with more countries getting rid of arrival requirements as well.

“Given present global economic conditions, it is likely that, in focussing on the economic benefits of tourism, we will see such changes occurring rapidly in international travel in the next few months.”

No conflict of interest.

Professor Michael Baker, Professor of Public Health, University of Otago, Wellington, comments:

“The decision to remove the requirement for pre-departure testing for Covid-19 is understandable but should be carefully reviewed against alternative policy choices. As with all decisions about managing this pandemic, it needs to be based on explicit risk assessment and management.

“This testing also needs to be seen in the context of all of the measures taken to protect the health of New Zealanders and the travelling public from people infected with the Covid-19 virus getting on flights to this country. These measures include pre-departure health declarations, vaccination requirements, and mask use.

“Now that the Omicron variant is transmitting widely in New Zealand and in most countries across the globe, it is important to consider the two main reasons why we need sensible measures to reduce the chance that Covid-19 infected people will get on flights to New Zealand.

“Firstly, such measures slow the arrival of new more infectious sub-variants. There are around 80 infections detected in arriving travellers every day in New Zealand. We know from whole genome sequencing that about a third of those where a genome has been identified are now arriving with the more infectious subvariants of BA.4, BA.5, BA.2.12.1. This is a much higher proportion than are being seen within New Zealand at present, so this influx will be rapidly seeding New Zealand with these subvariants and potentially bringing forward a likely second wave of infection.

“Secondly, there is the health and safety of passengers and aircrew on those flights. Long-haul flights to New Zealand mean at least 24 hours of travel, most of it in the enclosed environment of an aircraft. If we were organising an indoor gathering of several hundred people in New Zealand in these conditions, we might insist that all of our guests had a negative RAT before joining us.

“A rational policy for long-haul air travel might see responsible carriers like Air New Zealand provide a free supervised RAT prior to travel and keep the requirement for mask use in higher risk situations (for example, during boarding flights where the risk is arguably higher than when airborne and the high performing air filtrations systems on aircraft are running).

“It would be good to see the detailed risk assessment around both of these questions.

“Carefully designed policies around the use of pre-departure testing and mask use could distinguish New Zealand (and Air New Zealand) as leaders in risk assessment and management. Just as we are in the adventure travel sector.”

No conflict of interest.

Dr Hiran Thabrew, Child Psychiatrist, University of Auckland, comments:

“Despite likely anxiety about increased rates of Covid-19 in the coming months, the removal of pre-departure testing is likely to be a great relief for many New Zealanders, especially those with children who have had to bear a disproportionate cost of pre-flight testing.

“Travel can be stressful enough without the additional uncertainty of being able to return home. It will be great to see families reuniting more easily and for many immigrant families to be able to regain whānau support.”

No conflict of interest.

Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:

“It was announced today that the pre-departure testing requirements for COVID-19 will be dropped for travellers heading to Aotearoa New Zealand 11.59pm on Monday 20th June 2022. It was indicated that COVID-19 testing availability, convenience and cost presented barriers for people wanting to enter Aotearoa New Zealand.

“Although more people have now been exposed to the SARS-CoV-2 virus, reinfections have been increasing with the emergence of the Omicron variant, in a way not seen with earlier variants. Omicron’s higher transmissibility and ability to evade immune protection likely contributing factors.

“Daily reported COVID-19 figures are still very high, and continue to place added strain and pressure on our health and other support systems in Aotearoa New Zealand – actual case figures are likely higher than those being reported currently.

“Omicron is still spreading across Aotearoa New Zealand, with approximately 100 deaths associated with COVID-19 still being reported each week, and a growing total of 1350 to date – sympathies and condolences respectfully extended to all family, whanau and kāinga at this time. Yesterday, 5554 new community cases were reported, 368 people in hospital, 7 in ICU.

“Reinfections in Aotearoa New Zealand will need to be monitored carefully. Ongoing work will be needed to understand more about whether re-infections for Omicron and all its subvariants are more or less severe, when compared to the primary infection. It is still important that those who may have already had a Covid-19 infection, strengthen their immunity with vaccination as well.

“While issues with unequal global COVID-19 vaccine coverage, availability, accessibility and distribution persist, and remain unaddressed, new variants of the SARS-CoV-2 virus will continue to emerge, develop and spread.

“Addressing current inequities in health and society, preparing for future crises and monitoring for new variants of the SARS-CoV-2 virus, will be critical moving forward and will be especially important for managing potential future outbreaks caused by any new variants of the SARS-CoV-2 virus – particularly those that are resist to the current COVID-19 vaccines.

“Significant immunity gaps in Aotearoa New Zealand persist at this time, and as we move into the winter months.

“Inequities also remain evident with vaccination and booster levels and children, tamariki and tamaiki aged 5-11 years still need to be vaccinated against COVID-19 and people are still getting COVID-19 boosters, with booster doses for the COVID-19 vaccine now readily available for 16-17 year olds in Aotearoa New Zealand.

“The COVID-19 pandemic is exacerbating pre-existing inequities in health, and this includes for Māori and Pacific peoples who remain vulnerable to being disproportionately impacted and affected by COVID-19 and therefore require prioritisation with respect to COVID-19 vaccination, prevention, testing efforts.

“Overall, current evidence is indicating re-infections have been increasing with the Omicron variant of the SARS-CoV-2 virus and the risk of reinfection with the SARS-CoV-2 virus remains, especially for the most vulnerable.”

No conflicts of interest declared.