• Michael Tozzi

Continuation of Pre-Flight Testing in the United States

British travelers to the United States may be surprised to learn that they still have to adhere to onerous Covid testing requirements. Despite similar requirements being phased out across Europe and Canada in recent months, anyone flying to the US currently has to provide proof of a negative Covid test within one calendar day of their arrival. In the weeks since the question of removing testing requirements was pressed by reporters at a press conference on 3 May, the Biden Administration has not provided any update on phasing out the policy. This is despite pressure from travel industry lobbying groups such as Airlines for America.


Communication from the Biden Administration about the future of this policy has been vague or nonexistent; former White House Press Secretary Jen Psaki stated that “I’m not aware of a timeline for that” when asked about when the requirement would be lifted. Meanwhile, the current Secretary of Transportation Pete Buttigeg said that he did not think that testing requirements "will be there forever", stating that the future of the policy would be contingent upon the Centers for Disease Control and Prevention (CDC) deciding that it would be safe to end it.


The rationale for this policy has been criticised as incoherent from a public health standpoint as well as damaging to the US economy; international travel and spending in associated tourism and hospitality sectors are still significantly depressed compared to 2019. The policy’s persistence is especially confusing given that international arrivals traveling by land and sea are not subject to this testing requirement; airliner air filtration systems demonstrably make air travel virologically safer than trains, buses or cruise ships.


While initial testing requirements were viewed as justified by the threat of deadlier variants of the virus in previous years prior to widespread access to vaccines and antiviral medications, the current pandemic response paradigm has evolved to one of “living with the virus”- managing the milder symptoms of more contagious variants such as Omicron and BA.2 as the virus becomes endemic like the seasonal flu.


The Biden Administration’s recent National Covid-19 Preparedness Plan brought the federal government’s approach to dealing with the virus away from “crisis mode”. Previously, a number of states had already relaxed their internal Covid restrictions, while in Europe, countries have been steadily removing travel restrictions, beginning with Denmark's decision to end restrictions in late January. The United States’ retention of preflight testing despite the termination of federal mask requirements on public transport reflects a greater dysfunction in national public health policy with its roots in an almost eighty-year-old set of laws in urgent need of update and clarification.


The primary culprit for the US government’s glacial pace of change in phasing out the testing requirement is bureaucratic overreach by the CDC and its poorly-defined relationship with other federal bodies with regard to national health policy. The 1944 Public Health Service Act (PHSA) empowered the United States Federal Government to take measures to establish quarantine measures to prevent the spread of infectious diseases; it was subsequently codified within United States Code Title 42. The CDC was created in 1946 and today acts as one of the eleven federal agencies under the umbrella executive branch Department of Health and Human Services (HHS), the director of which reports directly to the President through their Cabinet. As such, the CDC has powers regarding enforcement of quarantine measures to prevent the introduction of foreign diseases to the United States in addition to its general responsibilities to act in an advisory capacity to federal, state and local government bodies.


During the Covid-19 pandemic, Section 361 of the PHSA was invoked by the CDC to unprecedented effect for policies such as its eviction moratorium and a mask mandate on public transportation, both of which have been found to be unconstitutional by federal courts. Unfortunately, the CDC’s expansive interpretation of its nebulously defined powers to enact quarantine measures has left the United States with a patchwork of federal pandemic policies that lack strategic coherence. The result of this has been to grant unelected bureaucrats the power to make national border control decisions over indefinite periods of time. Tensions over the issue of authority have been a recurring theme of the pandemic; the CDC has been criticised by progressive legislators for not overturning an order invoking 42 US Code § 265 which rejected asylum seekers from Latin America from entering the United States since March 2020.


The dissonance between the notion that preflight testing is a necessary quarantine measure and the reality that internal community spread rather than foreign transmission drives US Covid case growth reflects the fact that the CDC is a chronically inept actor within the federal government. The organisation has come under repeated criticism throughout the pandemic for its mixed messaging on masks, vaccine booster dose, and isolation following infection. Combined with an opaque decision-making process, it is hardly surprising that public trust in the CDC is at an unprecedented low. Neither the CDC nor the White House have adequately addressed the glaring inconsistencies with current pandemic travel restrictions or provided a rationale for why such restrictions remain even as Canada and European nations have phased similar requirements out.


The juxtaposition of rigorous international preflight testing requirements with lax domestic public health restrictions within the US is symptomatic of the CDC’s simultaneous overreach and under-preparedness during the pandemic. The ability to rapidly and intelligently adapt to changing circumstances during public health crises is vital to national security and the CDC has proven equally maladroit in exiting the pandemic as entering it. Even after contending with the Trump Administration’s attempts to downplay the virus for political gain, the CDC has experienced a profound crisis of leadership under Rochelle Walensky’s tenure as Director during the Biden Administration. Current travel restrictions are based on a questionable interpretation of CDC quarantine authority; do very little to prevent the spread of the disease itself and introduce uncertainty into travelers’ lives while damaging business and tourism prospects, even as the US teeters on the brink of a recession. These missteps should prompt serious calls for Congress to impose structural reforms to better prepare for future pandemics.