Potential New Demand and Partnership Opportunities for Clinical Laboratories as Airlines Begin Offering COVID-19 Testing to Travelers

Airlines are starting to offer COVID-19 testing to their customers, bringing both positive and negative news for clinical labs

As the COVID-19 pandemic crisis continues to unfold across the world, one area that has been significantly impacted is the travel industry. With nations and states restricting travel, both across borders and within their local regions, travel is particularly difficult. Many states and countries mandate a 14-day quarantine upon arrival with various degrees of enforcement. These restrictions have led to a significant decline in travel, especially air travel.

The prolonged impact of travel restrictions now affects airlines’ revenue in a meaningful way, driving some airlines to pursue initiatives to promote travelers’ safety and convenience during and after travel. COVID-19 precautions must still be followed during air travel, but travelers now have opportunities to take COVID-19 tests.

The first airline to offer COVID-19 testing to its customers is the German air carrier, Lufthansa. For Reuters, Bjoern Becker, a Lufthansa executive explained that the airline is also considering opening testing centers at some airports in the United States and Canada. Preflight testing will initially only be offered to business-class and first-class passengers due to the limited supply of testing supplies, but testing is expected to expand when possible.

One method available for Lufthansa airline travelers is RT-PCR (reverse transcription polymerase chain reaction) in Germany, according to the company’s website. However the full extent of the types of coronavirus tests used and accepted at destinations worldwide may vary and is unclear. In the US, rapid diagnostic point-of-care (POC) antigen tests are rapidly rolling out now.

United Airlines announced that the airline would begin offering COVID-19 testing using the Abbott rapid antigen test in partnerships with GoHealth Urgent Care and Color, according to a company press release. United will initially only offer testing for flights to Hawaii, due to Hawaii’s strict quarantine rules, but plans are to expand testing to other flights soon as well.

Moreover, American Airlines has made similar arrangements. American now offers three ways to get tested, according to the company’s website: an at-home test from LetsGetChecked (48-hour-turnaround time); in-person testing at select CareNow urgent care locations in the Dallas-Fort Worth (DFW), Texas, area; and onsite rapid testing at DFW airport, administered by CareNow. American also states that travelers may also use their own local testing provider, although there may be no guarantee that a provider will be compliant with a destination’s government mandates.

Rolling Out Rapid Antigen Tests as a Systematic COVID-19 Screening Method

The sudden interest in offering testing to travelers comes within days of the International Air Transport Association (IATA) recommending this course. “Quarantine measures are killing the industry’s recovery,” Alexandre de Juniac, IATA’s Director and CEO told The Washington Post. “Some 83% of travelers in a recent 11-market survey said that they will not travel if there is a chance of being quarantined at their destination. That is a very clear signal that this industry will not recover until we can find an alternative to quarantine.

“Public opinion polls [published at IATA] show that an overwhelming majority of travelers are willing to undergo testing as part of the travel process and believe that a negative coronavirus test should be mandatory for all travelers,” de Juniac said. De Juniac also highlighted the potentials of rapid antigen tests, specifically those being offered by Roche and Abbott. “The speed at which testing capabilities are advancing tells us that we will have deployable options in the coming weeks,” he said.

Clinical laboratories may benefit from this additional testing. Even with the large decrease in the number of air travelers, there is still a large population that will now start testing. Clinical laboratories may be able to help airlines set up antigen testing and could consider partnering with airlines to perform PCR testing on antigen-positive individuals.

As airlines begin to offer COVID-19 testing, it seems possible that this may increase COVID-19 test volumes for clinical laboratories. The potential downside, however, is that the decision to lean on antigen testing seems to further highlight the more widespread reliance on rapid, simple COVID-19 testing and, thus, the shift away from clinical laboratory-based PCR testing.