The coronavirus pandemic has emptied passengers from airplanes, shuttered several airlines and threatens many tourist and travel-dependent businesses. Increasing air travel undercuts public health efforts to contain the spread of the novel coronavirus SARS-CoV-2 that causes COVID-19. To reduce disease transmission as air travel increases, the U.S. federal government should establish a Public Health Corps within the Transportation Security Agency (TSA) to test all airline passengers and crew for the novel coronavirus, beginning with airports serving coronavirus hotspots. As states with low levels of coronavirus infection wait for such federal action, their port authorities and local governments could also begin testing arriving passengers.
SARS-CoV-2 first came to our country with U.S. residents flying back from China and East Asian cruises and on flights from Europe to New York City.
Travel from New York then seeded most coronavirus outbreaks in the U.S. other than along the West Coast. In March, state government stay-at-home-orders and U.S. government restrictions on travel from China and most European countries dramatically reduced air travel within and to the U.S. As cases of COVID-19 nationwide peaked in April, air traveler volume passing through TSA checkpoints dropped to 3.3 million (down over 95 percent from 70 million travelers in April 2019) but after states eased stay-at-home orders during May and June, air traveler volumes increased each month to reach over 20 million in July.
This increasing air travel spreads the novel coronavirus mostly because people are flying from places where a high percentage of the population is infected to where there are few cases and some of these air travelers are asymptomatic coronavirus carriers. Many major tourist destinations have coronavirus infection rates much higher than the states to which tourists return.
For example, in June, over 500,000 passengers departed Las Vegas McCarran Airport and almost 280,000 domestic passengers departed Miami International Airport. During the last 7 days, 199 coronavirus cases per 100,000 were diagnosed in Las Vegas and 485 in Miami, compared to 23 coronavirus cases per 100,000 in New York, 46 in Pennsylvania, 55 in Michigan and 66 in Ohio.
Asymptomatic (or pre-symptomatic) persons account for an estimated 40 percent of SARS-CoV-2 infections and these asymptomatic carriers do not cancel travel plans because they feel unwell nor do observational medical screenings and temperature checks detect their infections. Many Americans will not fly because they are terrified of getting on a flight with who knows how many asymptomatic coronavirus carriers.
It took U.S. federal government action to secure air travel and reassure terrified travelers after hijackers flew airliners into the World Trade Center. Just as the TSA hired and trained over 55,000 federal screeners and deployed them to all U.S. commercial airports by December 2002, a TSA Public Health Corps could be similarly hired, trained, and deployed — initially to airports serving areas with relatively high levels of coronavirus infection, like Las Vegas and Miami, and eventually to all airports. Once the coronavirus testing needs of hospitals, nursing homes, public health departments and first responders are met, TSA Public Health Corps officers could begin screening travelers with FDA approved antigen point-of-care tests that provide results within 15 minutes. Those who test positive would be referred to public health authorities for additional diagnostic testing, isolation and tracing of their contacts. Ideally, all passengers, crew, airline and airport staff would be tested for SARS-CoV-2 before they enter airports, thereby reducing risks of infected passengers infecting airline staff and TSA Transportation Security Officers who could subsequently infect colleagues and other passengers.
Over 1,538 of TSA’s 49,010 screening officers have tested positive for the coronavirus and six TSA employees have died of COVID-19. With 3,138 coronavirus cases per 100,000 TSA screening personnel have more cases per capita than any U.S. state and any country other than Qatar.
SARS-CoV-2 antigen tests have been criticized for having high false-negative rates of 20 percent but identifying 8 of 10 infected travelers attempting to board departing airplanes means reducing by 80 percent the number of infected travelers potentially spreading the coronavirus at their destinations; more, if anyone else is infected during flight.
Identifying 80 percent of infected passengers and crew also reduces risks of spreading the disease during flight much more than trying to socially distance six feet apart in passenger airliners. A cross-country flight in a two-thirds-filled Boeing 737-700, with its 149 passenger capacity and cabin area of about 920 square feet, is like spending four hours with 100 people in a smaller than an average-sized new apartment.
In the next COVID-19 relief bill, Congress should appropriate funds for TSA Public Health Corps staff, coronavirus tests and personal protective equipment sufficient to test air traveler volumes up to pre-COVID-19 travel levels. Since many TSA screeners have been idled by air traveler volumes that are only 25 percent of what they were last year at this time, some TSA employees under 40 with no compromising medical conditions could volunteer to initially staff (and lead) the Public Health Corps. These TSA volunteers could train screener recruits drawn from growing ranks of unemployed young people and hired on flexible short-term contracts.
While awaiting federal action on this front, states that pushed down their coronavirus infection rates can safeguard their achievements by testing passengers arriving from states with high levels of coronavirus infection. This would be much more effective than asking passengers to sign forms acknowledging 14-day self-quarantine requirements but then being unable to enforce such quarantines.
New York State should take the initiative and work with New Jersey to establish a Port Authority Public Heath Corps that administers COVID-19 tests to all domestic and international travelers departing from and arriving at New York metro airports, which totaled 378,206 passengers in May. Hopefully, this would help inspire federal action to screen all air travelers nationwide, thereby ensuring that all domestic travelers arriving in New York have been screened for the novel coronavirus, while at the same time assuring all destinations within the U.S. and across the world that travelers departing from New York metro airports present a much lower risk for carrying the virus than the U.S. general population.
If the U.S. Secret Service division of the Department of Homeland Security can manage to test the president and anyone who gets close to him with a 15-minute coronavirus test and the Department of Defense can manage to administer 60,000 coronavirus tests per week, why can’t the DHS manage to reorganize some of its resources to enable the TSA to test passengers departing airports in coronavirus hotspots, especially if they are major tourist destinations?
If 10 states could commit to purchasing 3.5 million antigen tests, why can’t the federal government buy enough tests to make sure that all passengers who depart Las Vegas and Miami Airports are screened for the coronavirus before they get on planes bound for destinations around the country? Congressional appropriations for screeners and tests would help states and localities contain such inter-state spread of the coronavirus, protect frontline federal government employees, ensure sufficient future demand to spur private sector investment in SARS-CoV-2 test production, reduce unemployment and help save airlines and travel dependent businesses.
Rey Koslowski is a professor of political science, University at Albany (SUNY) and author of over 50 publications on international migration, travel and border security, including Global Mobility Regimes.