At Germany's busiest airport in Frankfurt, the longest lineups these days aren't at check-in or security but at the state-of-the-art COVID-19 testing centre just outside the main arrivals hall.
Wearing distinctive red T-shirts, employees with Centogene, the private testing lab that runs the facility, usher passengers through an assembly-line setup, where they often meet Dr. Peter Bauer, the neurologist and geneticist who oversees the operation.
"We are giving back some freedom to people," Bauer told CBC News in an interview.
Since the facility opened at the end of June, Centogene said, more than 150,000 travellers have taken its rapid COVID-19 test.
"They are anxious about how to move in society, how to travel and how to meet people, and with a negative test — and most tests are negative — they get some freedom," Bauer said.
Airlines support testing passengers
Canadian air carriers Air Canada and WestJet have both recently started voluntary COVID-19 testing at airports in Toronto and Vancouver in the hopes of convincing the federal government that airport testing is a safe way to get people flying again.
And the national association that represents Canada's largest air carriers is lobbying Ottawa to consider easing the 14-day quarantine for incoming travellers in exchange for a negative COVID test, much like Germany has been doing all summer.
Germany is one of the only places in Europe that offers such testing in an airport setting that's convenient for travellers.
Some countries, such as Russia, require COVID-free certificates to enter, with tests taken within 72 hours, and Frankfurt was one of the only places that was possible.
We transited through the airport there and took the tests as part of our return to the CBC's Moscow bureau two weeks ago.
At the Frankfurt facility, both incoming and outgoing passengers have the option of getting tested — although it's mandatory for anyone arriving from a designated "high-risk" area, which includes the United States.
Results in as little as 3 hours
Passengers first register online and then wait in a physically distanced line to receive a takeout-sized red box containing several test tubes and two long throat swabs.
They then proceed down the line to a private area, where a technician scrapes the backs of their throats with the swabs — often to the sound of much gagging and coughing.
"Going through the throat, it's much less painful [than going through the nose] but with as much sensitivity," Bauer said.
Next, one of six doctors at the facility does a visual check for any signs of the typical COVID-19 symptoms: a dry cough, fever and shortness of breath. The samples are then sent to a nearby lab, and in as little as three hours the test results and doctor's certificate arrive by email.
Throughout the summer, German citizens have been given the test for free, although local media have reported that Chancellor Angela Merkel's government may alter the rules to make it a user-pay system going forward and reinstate a quarantine for those who don't take the test.
Transit travellers who require a test to reach their destination country are charged 59 euros, or about $100 Cdn. A premium test that gets results in three hours costs roughly double.
"We believe testing is the only way to make travel more secure," said Volkmar Weckesser, Centogene's chief information officer.
"When you look at the tourist industry, do we really want to destroy it completely? Do people really not want to travel anymore and just stay at home? I don't believe that," Weckesser told CBC News.
Canada's airline industry has given airport testing its full-throated endorsement.
"We would like to see Canada on a targeted basis start 'safe zones' and air bridges based on testing," said Mike McNaney, president and CEO of the National Airlines Council of Canada.
End blanket quarantine?
McNaney said it's long overdue for Canada to move out of what he calls "stage zero," which is the same place the industry was in back in March. He said a "blanket" quarantine from all countries, regardless of their health situation, no longer makes sense.
He said the volunteer testing programs that Canada's two largest airlines have initiated are a positive step and should allow government regulators to develop "science-based practices and procedures" that can provide alternatives to quarantines and blanket restrictions.
Centogene claims the tests that come back positive amount to roughly one per cent, although certain high-risk countries regularly have much higher numbers — up to eight per cent.
"We have many positives from Kosovo, Croatia and Serbia, [and other] countries like Ukraine and Russia — the United States as well — which doesn't say anything about the quality of the testing [in those countries], just that COVID-19 is there," said Bauer, the facility supervisor.
Testing could speed transmission, critics say
But airport testing has its detractors, who argue that such mass testing misses a lot of cases and could potentially speed the transmission of the virus across borders.
"Do we want COVID to spread or do we want it to not spread? And that's the line in the sand for me," said Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto.
"We know that you have a lot of false negative tests. There are a lot of different reasons," he said. "It can be because the swab was not taken well, it could be that you have not incubated enough virus."
Furness said the sensitivity rate of such tests is 65 per cent, meaning roughly a third of cases are missed.
"We need to think about travelling less," Furness said.
Centogene's Weckesser argues it's not practical to wait for a vaccine to resolve the COVID-19 crisis. He said the world needs to carry on with business — and that includes travelling.
"A vaccine may be available next year, we don't know when, and it will take quite a long time to vaccinate everybody," he said.
Beyond that, if regular vaccines provide immunity for only a few months at a time, then testing facilities like the one in Frankfurt may be around for years to come, he said.
But statements by Canada's chief public health officer haven't given the airline industry much hope of a change in the 14-day quarantine law any time soon. Dr. Theresa Tam has said that more research is needed.
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