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Travelers to the U.S. may soon need a negative Covid-19 test if the country adopts a the recommendations of public health officials.

Airline trade group Airlines for America (A4A) backed a Centers for Disease Control and Prevention recommendation that the U.S. ditch blanket travel restrictions in favor of a mandatory testing regime for all arrivals, in a letter to Vice President Mike Pence on Monday. All of the large global U.S. carriers, including American Airlines, Delta Air Lines and United Airlines, are members of A4A.

If the U.S. adopts the CDC recommendation, it would be the largest country so far to implement mandatory testing on international passengers.

Testing rules would apply to all international arriving passengers, as well as replace blanket restrictions on travelers from Brazil, Europe and the UK, wrote A4A President and CEO Nicholas Calio in the letter. He called such a regime a “more effective way” of controlling the spread of the coronavirus. In addition, the industry recommended a 14-day implementation timeline in order to notify flyers and train staff on the new requirements.

The premise of testing-based arrival rules is simple. A traveler must present proof of a negative Covid test taken in a set time window, say 24- or 72-hours, in order to board a flight to the country in question. Some countries also require a negative Covid test in a set period after arrival as well.

Hawaii implemented a testing-based regime to generally successful results in October. The state requires all inbound travelers to present proof of a negative Covid test taken 72-hours before their flight, or agree to quarantine for 10 days after arrival.

A testing-based approach to international travel is seen by many as key to reopening borders. The trade group the International Air Transport Association (IATA) has called for this since at least October when director general Alexandre de Juniac said testing would “allow governments to open borders without quarantine.” Such a move is seen as critical for global carriers that rely primarily on international travel to restart flights and begin recovering from the crisis.

For example, after Hawaii replaced a mandatory quarantine with its new testing rules, the number of flights from the mainland U.S. to the islands doubled overnight to roughly 50 a day, data from Cirium schedules shows.

A nascent universe of digital health passports has even emerged to support testing-based rules. The World Economic Forum and The Commons Project have developed the CommonPass app, which has backing from the country of Aruba as well as airlines like JetBlue Airways and United Airlines. IATA has developed its own Travel Pass app that Singapore Airlines is trialling on routes between its namesake country and Malaysia.

Whether the U.S. adopts the CDC’s recommendations for testing-based entry requirements remains to be seen. Pence, the letter’s recipient, is set to leave office in just over two weeks on January 20. The new administration of president-elect Joe Biden is expected to take a more public health-oriented approach to combating the coronavirus than the current administration.

“We need governments to think in terms of achievable risk management, currently many are aiming for risk elimination,” de Juniac said in December. “The social, economic and health costs of this approach are enormous and it’s becoming clear that the goal itself is practically unachievable.”

Photo Credit: Delta Air Lines is trialling mandatory Covid-19 testing in place of quarantines on select flights to Amsterdam and Rome. Courtesy of Delta Air Lines / Delta Air Lines