University Of Arizona Professor: 'Travel-Related Testing Doesn't Really Make One Safe'
STEVE GOLDSTEIN: The day before Thanksgiving — today — is typically one of the busiest travel days in the U.S. That will slow significantly because of the continuing pandemic and the spike in COVID cases. But thousands of people will still be getting on planes and landing in airports across the country, including in Arizona. Last week, Gov. Doug Ducey announced he had ordered the state Department of Health Services to work with airports in the Valley and in Tucson in offering voluntary rapid COVID testing to travelers. Joining me now to discuss that approach is Bonnie LaFleur, professor of biostatistics at the U of A. Professor, can airport testing for COVID actually make a difference?
BONNIE LAFLEUR: Well, first, let me say that it's pretty much the public health consensus that travel-related testing doesn't really make one safe. It's certainly better than temperature scans because temperature scans assume that you're symptomatic and travel-related testing are trying to capture people who are asymptomatic. But testing is just a snapshot. You can be infected and more importantly, infectious, and be outside the window that the test will pick up your infectivity. So how well the test picks up infectious individuals really depends on the tests that's used. And currently, we have a lack of real world-based test performance of these tests in asymptomatic individuals, and so it makes it really difficult for us to assess how accurate they really are.
GOLDSTEIN: I want to come back to what you said about the window, which I think is fascinating for people in these eight or nine months, that the general public has been following this closely. Yes, there is that — there's that window of time, whether you're showing symptoms or not, that you could, in fact, be carrying this and make it an issue. So much depends on when someone has been exposed. And at the same time, again, I'll emphasize the fact that this would be a voluntary testing situation.
LAFLEUR: Yes, exactly. So I like both of those points. First of all, with respect to the window of time, we certainly will capture people who are going to test positive at the airports. And it's great to remove those people from, from travel and from airplanes. The, the problem is that there are people who actually are going to test positive at, at the airport who may actually not even be infectious and their travel plans also will be impaired. But more importantly are going to be those few individuals — and it doesn't take very many — who will test negative but who actually are infective. And when you're traveling to the degree that it looks like people are this Thanksgiving, that's a really difficult situation for all of us.
GOLDSTEIN: And this is a time where, you know, we've heard the phrase "pandemic fatigue" so many times and certainly people want to see their families. The message has been sent that, you know, please only stay within your, your tiny circle. Please don't travel. We're obviously seeing travel is going to be huge. How concerned are you that we're going to see these numbers spike even more because more people are just going to choose to travel?
LAFLEUR: We're all very concerned about this right now. I think that the, the general consensus is, again, that, that travel right now is just not safe. Testing is only — and going back to testing — testing is only a small part of a larger strategy for trying to minimize infectivity into the community. Other strategies that have to be adhered to are mask wearing, social distancing. And for people who are traveling right now, they might need to consider quarantining when they get home. This is particularly going to be the case for people who will be staying with any other individuals in their household who are at risk for severe COVID, severe COVID response, if you will, due to age, whether they're immunocompromised or have other COVID-19 related comorbidities like diabetes, lung disease and possibly obesity.
GOLDSTEIN: Talking about people and, and how infectious they may be coming from other parts of the country, based on the maps we keep seeing, it almost feels like 47 of the 50 states are hotspots at this point. So it doesn't feel like travel would be safe coming or going anywhere.
LAFLEUR: Absolutely. That was going to be my next point, that, that we all have to recognize that most travelers are going to be coming from areas in the country where there's high community transmission levels. So, again, going back to my statement about erring on the side of caution when you go home in terms of adhering to the social distancing, mask wearing. And if you're going to eat with your bubble of people, which should be a very small bubble, please, then, you know, maybe you should think about eating outdoors. And when we talk quarantine, you know, people often envision this strict adherence to, you're sitting in your bedroom and you're not doing anything. Maybe you don't need to be quite that strict, but you should wear your mask and social distance from your family for seven days if you're coming from any area or going into any area where there's large amounts of community transmission.
GOLDSTEIN: Coming back specifically to the airport travel part of this, one of the things that also is striking is let's say you are someone who's listening and you've practiced mask habits. You are staying 6 feet away from people. You're staying with your small group. You're planning a very small Thanksgiving situation. But there are going to be hundreds and thousands of people in the airport. So even that would seem like that is a poor recipe for expanding this.
LAFLEUR: Absolutely. I mean, most of my, my colleagues and, and my husband always say we just assume everyone around us is positive right now just because of the community transmission. And you go to an airport and you know that even if they have testing, which, as you say, is actually not mandatory but voluntary, you should just assume that everybody around you is either carrying or has this virus because we really don't know who does and who doesn't. So even if you are very safe, you probably need to assume that when you get to your destination that there's a very high degree of probability that you have been exposed.
GOLDSTEIN: That is Bonnie LaFleur. She's a research professor of biostatistics at the U of A's BIO5 Institute. Professor, thanks so much and happy Thanksgiving and stay well.
LAFLEUR: Thank you. You as well.