Advisory Bulletins

Key points on testing and quarantine

Montreal, 18 December 2020 – The lifting of travel restrictions and quarantine is a vital element for the restart of aviation. The International Civil Aviation Organization (ICAO) has provided recommendations for action to States through the Council Aviation Recovery Task Force (CART) and developed guidance on health matters using advice from aviation medical and health experts from governments and industry through the Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA).

Participants have included 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).

CAPSCA has prepared the  ICAO Manual on Testing and Cross-border Risk Management Measures which is available in the six UN languages through the ICAO website.

This Advisory Bulletin highlights some of the key issues from the Manual for airports and provides support for discussions with regulators and government officials on the necessary steps and policies to enable the safe restart and recovery of the industry.

Restarting Air Travel

  • Air connectivity is essential to enable economic recovery. As States re-start international travel, we recognize that they need effective strategies for managing the risk of active case importation and disease transmission within the air transport system.
  • Risk management strategies include transmission suppression and control, testing, and other tools such as symptom screening.
  • COVID-19 testing, if applied according to the Manual, could reduce reliance on quarantine, restriction of air services and movements of persons arriving in countries for essential business and tourism that are, for some States, dependent on inbound tourism for their economic sustainability.

Risk Management

  • Reducing risk to zero is impossible, but testing can be one measure in the risk management strategy. In implementing testing as a component of their overall COVID-19 risk management strategy, States should 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.
  • Faced with a fast-evolving pandemic, the risk assessment process must be regularly repeated. Measures should be adjusted depending on the results of the assessment. This may include adding or removing measures.
  • States should share risk assessments with other States and harmonize their measures to the extent possible to help with public understanding, confidence and compliance with requirements.


  • When addressing higher risk scenarios and applying testing as part of the multi-layer risk management strategy, States should take into account the test result when considering the need for and duration of quarantine.
  • Testing should be performed by individuals trained to perform the test at a site approved by the appropriate authorities. The test outcome should be a confirmed test result that the traveller can present to authorities.
  • Post arrival screening, in conjunction with pre-departure testing, can result in risk reductions. Consequently, as part of a State’s risk assessment and determination of risk tolerance, it may consider reducing quarantine time frames.
  • One specific type of test is not recommended over another. The minimum values of 95% for sensitivity and specificity, however, will allow for a wider range of tests to be used that are currently available. This range also allows for the use of rapid antigen tests as a screening device which are more accessible and practical for application in the aviation environment; and are faster and cheaper to use. In addition, it would reserve the more expensive RT-PCR tests for use in clinical settings.


  • If States choose to implement quarantine measures for all passengers upon arrival, they should do so based upon a risk assessment and consideration of local circumstances. States choosing to implement a quarantine regime should do so after assessing all the implications, including non-health related effects, and considering them in accordance with their own national decision-making processes.
  • On a careful analysis of the risks and evidence, as well as the government’s risk tolerance, if the prevalence of infection at the point of origin of the passenger is less than (or equal to depending on risk tolerance) to the local prevalence at destination, and the passenger is not ill and/or has a negative test for COVID-19, governments might consider relaxing, reducing (possibly through a test to release protocol) or avoiding quarantine measures.

ACI Position

Surveys have shown that there is considerable suppressed demand for air travel and tourism but that quarantine is seen as the biggest single impediment to individual travellers.

ACI has supported members by developing the Airport Health Accreditation programme and by adding health and hygiene specific questions to the tablet version of the Airport Service Quality (ASQ) programme.

The ICAO Manual on Testing and Cross-border Risk Management Measures provides a significant step forward in helping States assess and manage risk so as to reduce requirements for quarantine, or even for testing, depending on their specific circumstances.


  1. Airports Council International (ACI), the trade association of the world’s airports, was founded in 1991 with the objective of fostering cooperation among its member airports and other partners in world aviation, including the International Civil Aviation Organization, the International Air Transport Association and the Civil Air Navigation Services Organization. In representing the best interests of airports during key phases of policy development, ACI makes a significant contribution toward ensuring a global air transport system that is safe, secure, customer-centric and environmentally sustainable. As of January 2020, ACI serves 668 members, operating 1979 airports in 176 countries.