ICAO 10152 PDF

FOREWORD

This manual has been prepared by aviation health experts led by the International Civil Aviation Organization (ICAO) with support from the United States Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control (ECDC) and others, with contributions from the World Health Organization (WHO) as well as aviation medical and health experts from governments and industry. Together they form the Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA). CAPSCA brings together international, regional, national and local organizations to work together to improve preparedness planning and response to public health events that affect the aviation sector.

CAPSCA developed this guidance in close collaboration with the ICAO Council Aviation Recovery Task Force (CART), which requested updated guidance on the inclusion of COVID-19 testing and its interdependencies with other risk mitigation tools for those States that choose to include testing as an element of their overall COVID-19 risk management process.

The CART has published updated recommendations to States in the High-Level Cover Document (HLCD) including Recommendation 13 on testing: “While testing is not universally recommended by public health authorities as a routine health screening method, States contemplating testing in their COVID-19 risk management strategy should apply the approach outlined in the ICAO Testing and Cross-Border Risk Management Measures Manual”.

Updates to the CART Take-off Guidance for Air Travel through the COVID-19 Public Health Crisis (TOGD) focus on the evolving technological and medical advancements in the fight against COVID-19 and providing targeted guidance to effectively support States in their efforts to control the pandemic while pursuing the restart and recovery of aviation. In this regard, specific attention is being brought to testing as a potential means to alleviate quarantine measures and thus facilitate international movement of people and goods, as part of a multilayer risk management strategy.

This guidance supplements the measures already outlined in the CART HLCD and TOGD and provides a risk management process to facilitate States’ assessment of the applicability of a combination of measures available today.

COVID-19 testing, if applied according to the guidance contained in this manual, could reduce reliance on measures that restrict air travel and the movement of persons arriving in a country, such as quarantine, which evidence suggests is a disincentive to several important categories of travel of which the following list is non-exhaustive: pilot certification, pilot simulator training, essential business flights and tourism for some States which are dependent on inbound tourism for economic sustainability.

In implementing testing as a component of their overall COVID-19 risk management strategy, States are advised that an effective application of a multi-layered risk strategy, including testing, is one in which:

a) States perform a risk assessment using epidemiologic criteria including but not limited to disease prevalence, disease trajectory, national testing strategy, screening capabilities, hospital capacity and robustness of contact tracing;

b) States share the results of the risk assessments, the local epidemiology and transmission scenarios in the departure and destination countries or areas as well as the public health and health system capacity and performance to detect and care for returning travellers and their contacts; with other States to facilitate the opening of air routes;

c) States consider their risk tolerance as a part of their risk assessment;

d) States use their risk assessment and risk tolerance in determining the application of a multi-layered risk management strategy;

e) States that select to utilize testing for screening purposes apply a cut-off value for sensitivity and specificity as high as possible (with a minimum of 95 per cent) to reduce false positive test results;

f) States, when addressing higher risk scenarios and applying testing as part of the multi-layer risk management strategy, take into account the test result when considering the need for and duration of isolation or quarantine; and

g) States harmonize their procedures to the extent possible.

This manual describes the risk management measures which can be applied; how epidemiology can be used to advise States in developing a risk management strategy; possible testing protocols which might be put in place where there is differential prevalence, and therefore risk; and a series of examples to help States in their decision-making process.