Heathrow COVID-19 detection trials

Old May 6, 20, 5:02 am
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Heathrow COVID-19 detection trials

Heathrow to drive forward development of a Common International Standard by trialling technologies and processes that reduce risk of Covid-19 transmission. Trials will assess the processes for medical effectiveness, passenger response as well as suitability to the airport environment.

The measures will consist of tried and tested processes and technology as well as innovations new to the airport environment. Concepts under review include: UV sanitation, which could be used to quickly and efficiently sanitise security trays; facial recognition thermal screening technology to accurately track body temperature; and contact-free security screening equipment to reduce person-to-person contact.

Before any new measures are rolled out across the airport, they will be reviewed to ensure that the systems are medically grounded, build consumer confidence and are practical for airports to deliver.

Source: https://www.heathrow.com/latest-news...tection-trials
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Old May 6, 20, 5:07 am
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They are ultimately going to have to do a pre flight viral test I think

Hopefully these will become improved and stream lined
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Old May 6, 20, 5:26 am
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These tests are going to be really problematic if they have any false positive rate that is more than negligible. Who's going to carry the can if you're denied entry to the airport on suspicion of coronavirus when you're not ill with coronavirus? Will airlines rebook, or refund? What about hotels?

If the passenger is made whole (financially) then that's less problematic (not nearly zero), but if the passenger is left to carry the can then will people risk any serious cost - or just continue to give up on travel?

Heathrow says "medically grounded", which is nice - we don't need any ineffective quackery. But if you administer a test to many people, few of whom are actually positive, you will end up with more people affected by false positives than actually prevented from travelling due to a true positive.

This problem already happens in anti-terrorism, as terrorists are few and far between. If coronavirus sufferers are also rare, false positives are a serious problem.
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Old May 6, 20, 6:01 am
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BBC News offer more on this

BBC Heathrow temperature checks


The boss of Heathrow Airport has told MPs that it is trialling large-scale temperature checks as the aviation industry struggles with coronavirus.

He said they are already being carried out at departure gates on people going to places where this is a requirement.

John Holland-Kaye urged the government to produce a plan on what common standards airports should adopt.

"If you want to get the UK economy started again, you have to get the aviation sector started again."
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Old May 6, 20, 6:01 am
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Indeed I think it is widely appreciated, including at HAL, that temperature checks in the context of this virus has many limitations, given that a significant proprotion of those Covid-19+ show no such symptoms. It is a system that has been used in Asia for many years now, with a fairly low level of enforcement, and so as implied by the full text, this is about HAL joining up with - and seen to be adopting - an emerging international convention in this area.I think it is fully appreciated that those with seriously high temperatures are unlikely to show up at an airport. I know how this works in Italy, since I had a false positive when travelling there recently - they do two tests with the infra red thermometer, done by people who may not have a lot of medical training, and if you fail both then a medic is wheeled out to ask questions, perhaps do in-mouth temparature test and then advise on next steps. In my case iit turned out to be that the intra-red was slightly over projecting my temperature, which was simply on the high side of normal (37.3c).
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Old May 6, 20, 6:17 am
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Ladies of a certain age run a little warm. It will be interesting how the system handles that. From personal experiance I would not want to be the one interviewing my better half mid hot flush.
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Old May 6, 20, 7:03 am
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Originally Posted by allturnleft View Post
They are ultimately going to have to do a pre flight viral test I think

Hopefully these will become improved and stream lined
Probably correct. Short of that there is nothing foolproof.

Thermal scanners are a waste of time. They've been little more than a token gesture in Asia for years and Italy installed them at the start of February, we saw how well that worked.
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Old May 6, 20, 7:43 am
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Thermal scanners will detect people with a high fever - beyond the normal human variation. So they have a certain true positive rate when used like that, and low false positive. However they will also have many false negatives as not everyone developes a high fever immediately upon coronavirus infection (or ever). Lowering the alert threshold to below the top of the normal human variation has an obvious problem of too many false positives.
Used to detect high fever, they will find some sick travellers which has an obvious benefit. They cannot detect all infected people (and nor can anything else).
Low rates of detection by those scanners may well reflect that in practice people with high fevers rarely travel, as they are obviously ill. That doesn't necessarily make them useless. It does make them insufficient for anywhere near complete assurance that no infected people travel.
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Old May 6, 20, 9:04 am
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I am a bit surprised by some comments here. Even more that HAL is only at the stage of considering trials of some measures like temperature testing under the pretext of international standards.

It is clear that no unique measure will detect an infected patient with certainty and no false positive. PCR tests are quite reliable but costly to administer and take time to process. Fever is only one symptom of Covid and that clearly does not apply to newly infected patients and asymptomatic ones. But temperature checks do allow to detect quite a few cases. Domestic travel in China has resumed at a rapid pace since the succesful containment/eradication of Covid-19 and temperature checks have been an important arm in the arsenal.

Temperature checks have been installed at Hong Kong airport after SARS (2003) and been enforced well over the past ten years.Cameras installed in the ceiling screen every single arriving pax. This is to detect fever, not only high fever. The bar is currently set at 37.6C. If you are over that, it is manually checked with a thermometer gun and you have to be checked by a medical professional. It is clearly not a good idea to travel if you have fever for any kind of reason. Nor if you have any respiratory symptom such as coughing.

As a side note, restaurants never had to close in Hong Kong, but the restaurant has to check your temperature with the thermometer gun (you also have to wear a mask when entering and there is gel to wash your hands). Please note for a population of 7.5 million people, HK only has a thousand cases and 4 deaths (none in the past seven weeks)

Again, this will only detect symptomatic cases and is not foolproof, but a useful element in detection. Similarly, there is no single way to avoid transmission but a superposition of several measures (masks, social distancing,..) help. Even American airlines are now imposing masks on FAs and pax.

The laxity of LHR, and many European airports, is surprising.when you live in Asia. Of course, it was too late for Italy to implement thermal tests when infection was already exploding and land borders within Schengen fully open. same for LHR. But to resume international travel, thermal tests for departing/arriving pax will be necessary but not sufficient.

Last edited by brunos; May 6, 20 at 9:13 am
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Old May 6, 20, 9:05 am
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'Bout two months late.
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Old May 6, 20, 9:55 am
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Originally Posted by brunos View Post
But to resume international travel, thermal tests for departing/arriving pax will be necessary but not sufficient.
Not sufficient is an understatment. They don't work. Here are some selected quotes from https://www.sciencemag.org/news/2020...ad-coronavirus (Note to Holland-Kaye if you're watching - a lot of this data is from the studies you were asking PHE to provide)

"eight passengers who later tested positive for COVID-19 arrived in Shanghai from Italy and passed the airport screeners unnoticed"

"By 23 February, 46,016 air travelers had been screened; only one tested positive and was isolated for treatment,"

"Thermal scanners and handheld thermometers aren’t perfect. The biggest shortcoming is that they measure skin temperature, which can be higher or lower than core body temperature"

"Between August 2014 and January 2016, the review found, not a single Ebola case was detected among 300,000 passengers screened before boarding flights in Guinea, Liberia, and Sierra Leone, which all had big Ebola epidemics."

"Taiwan, Singapore, Australia, and Canada all implemented entry screening for severe acute respiratory syndrome (SARS), which is similar to COVID-19 and also caused by a coronavirus, during the 2002–03 outbreak; none intercepted any patients."

"During the 2014–16 Ebola epidemic, five countries asked incoming travelers about symptoms and possible exposure to patients and checked for fevers. They didn’t find a single case either."

"China and Japan mounted extensive entry screening programs during the H1N1 influenza pandemic of 2009, but studies found that the screenings captured small fractions of those actually infected with the virus and both countries had significant outbreaks anyway,"

"Researchers at the European Centre for Disease Prevention and Control concluded that approximately 75% of passengers infected with COVID-19 and traveling from affected Chinese cities would not be detected by entry screening."


And from https://edition.cnn.com/2020/02/19/h...cks/index.html

"At least one country has found airport temperature checks so unhelpful that it decided not to do them during the novel coronavirus outbreak. Israel used them in previous years for Ebola, SARS and H1N1, but found that they didn't work.
"It is ineffective and inefficient," said Dr. Itamar Grotto, associate director general of Israel's Ministry of Health."
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Last edited by Schind; May 6, 20 at 10:02 am
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Old May 6, 20, 10:21 am
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They are ultimately going to have to do a pre flight viral test I think
I must also ask what is going to happen if a passenger fails that test.
If the airport is running these tests, the airline will just fob the passenger off when it comes to a free rebooking.

Imagine you have a mild flu or maybe even a non-communicable disease + have a non-refundable fare -> you are screwed.
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Old May 6, 20, 10:29 am
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I am loosely involved in the drive to identify and develop rapid COVID testing technologies, so can speak to this area a little.

Ultimately, sensitive and specific rapid tests for COVID suitable for use in an airport setting do not yet exist, and probably wonít for a number of months. I imagine there would be particular interest in a rapid antigen test (which identifies the virus directly from a spit sample) in an airport setting. These are being developed and some are currently under evaluation in a number of settings (for anyone interested in a good overview see https://www.finddx.org/covid-19/sarscov2-eval-immuno/), but are not expected to be widely available until the end of the year at best. Indeed, they may never make it... we just donít know if theyíll be sensitive enough.

There are a few other alternatives, but these often involve expensive equipment and operator training and, critically, up to an hour to run and analyse. I just canít see how it would work en masse at an airport. The whole temperature scanning thing is practically pointless - you may pick up one or two cases, but every single person has a slightly different immune response which renders this route pretty much useless.

I donít know what the answer is, particularly in the short term. I certainly donít envy those making the decisions.
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Old May 6, 20, 1:38 pm
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Temperature testing in isolation is a pretty meaningless data point, the variation due to other factors (as mentioned upthread) and a lack of continual data relating to each person means it can't be an accurate measure as you could still be below the 'cut off' but still be well over your norm. There also seems to be a disregard for the lowering in average body temperatures which was in the news earlier this year [1].

[1] Are Human Body Temperatures Cooling Down? https://www.scientificamerican.com/a...-cooling-down/
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Old May 6, 20, 11:13 pm
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Originally Posted by Schind View Post
Not sufficient is an understatment. They don't work. Here are some selected quotes from https://www.sciencemag.org/news/2020...ad-coronavirus (Note to Holland-Kaye if you're watching - a lot of this data is from the studies you were asking PHE to provide)

"eight passengers who later tested positive for COVID-19 arrived in Shanghai from Italy and passed the airport screeners unnoticed"

"By 23 February, 46,016 air travelers had been screened; only one tested positive and was isolated for treatment,"

"Thermal scanners and handheld thermometers arenít perfect. The biggest shortcoming is that they measure skin temperature, which can be higher or lower than core body temperature"

"Between August 2014 and January 2016, the review found, not a single Ebola case was detected among 300,000 passengers screened before boarding flights in Guinea, Liberia, and Sierra Leone, which all had big Ebola epidemics."

"Taiwan, Singapore, Australia, and Canada all implemented entry screening for severe acute respiratory syndrome (SARS), which is similar to COVID-19 and also caused by a coronavirus, during the 2002Ė03 outbreak; none intercepted any patients."

"During the 2014Ė16 Ebola epidemic, five countries asked incoming travelers about symptoms and possible exposure to patients and checked for fevers. They didnít find a single case either."

"China and Japan mounted extensive entry screening programs during the H1N1 influenza pandemic of 2009, but studies found that the screenings captured small fractions of those actually infected with the virus and both countries had significant outbreaks anyway,"

"Researchers at the European Centre for Disease Prevention and Control concluded that approximately 75% of passengers infected with COVID-19 and traveling from affected Chinese cities would not be detected by entry screening."


And from https://edition.cnn.com/2020/02/19/h...cks/index.html

"At least one country has found airport temperature checks so unhelpful that it decided not to do them during the novel coronavirus outbreak. Israel used them in previous years for Ebola, SARS and H1N1, but found that they didn't work.
"It is ineffective and inefficient," said Dr. Itamar Grotto, associate director general of Israel's Ministry of Health."
Sure, this is not perfect.
Nowadays, one can easily find on the web dozens of articles pro or con any covid measures based on small samples and anecdotes. IN some way, that reminds me of the early controversy about wearing masks.

Sure, some people take fever-suppressant drugs. Sure, it will not stop spreading the disease.
Maybe it will only catch 20 or 30% (a number totally out of the blue) infected patients. It will also act as a deterrent for feverish people to travel.
Hong Kong has found quite a few British students who boarded flights (when UK closed schools/universities) suspecting they had Covid. If LHR had some detection, they would have been prevented to board. While a country might accept sick nationals, it will not accept sick visitors.The vast majority of HK cases (well over 90%) in the past months where returnees detected at the airport or soon thereafter in quarantine facilities.

I believe that you are mistaken f you think that travel restrictions for visitors (tourism or business) will be lifted in the near future without a range of precautions being taken at the departure airport. LHR basically lets anyone in and out and I doubt that it will continue.
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