PCR Testing: a 21st century problem

“There is no such thing as a positive PCR test in Afghanistan”, or so said a correspondent to the Facebook community, Every Passport Stamp.

This fascinating group, dedicated to visiting every country in the world, has taken Covid in its stride and continued wandering to some of the earth’s more distant points. They cross Mauritania on the Ore Train, visit Basra, Iquitos and Central Africa as if no virus exists. They navigate the thicket of regulations and must spend thousands on tests.

Mauritania PCR
Crossing Mauritania in an ambulance was hard enough, I can’t imagine crossing the desert on top of a load of iron ore

One has to wonder, however, about the motivation of the for-profit labs offering PCR tests for travel.

While, on the one hand, they should be considered above suspicion, their motivation is to sell negative test results. This is, perhaps, more important than identifying the few poor travellers who actually test positive in some far flung location.

I took a test in Barcelona yesterday. Within an hour it came back negative, as I was expecting. However, two thoughts crossed my mind: the first was “How can I get the result in under an hour when others tell me it will take forty-eight hours to complete?”. The second was “What would happen if it was positive?”

Covid And Vaccinations
French Guyana: The Negative-Test Wing on Les Isles

To the first, one can only ascribe the profit motive; pure and simple. Other than in France where the government has capped the fee for private PCR testing at €50, the fees charged for these tests range from reasonable to eye-watering. The largest variation in cost appears to be the time between test and result. Pay more and you get the result now, pay less and we will wait for forty-seven hours before sending your email.

Profit rather than public health is most certainly the major driving factor in the delivery of Travel PCR tests. As with so many instances where profit meets health care, substantial resources are syphoned off to the providers for no additional medical benefit. Which leads to the thorny issue of accuracy.

In Mexico, one of the few places that Americans can flock to a beach in large numbers, PCR tests are required to return home. Hotels, obligingly, have set up on-site facilities, and these will continue to proliferate as the winter travel season approaches.

One needs to ask, however, about the hotel’s motive.

Are they establishing micro labs to identify health risks or to encourage vacationers to visit? If the latter, then there is little incentive to find covid cases and potentially have their hotel filled with pesky isolationists who can’t go home. Worse, get a reputation as a plague-pit and watch the bookings fall away.

Far better to certify their guests as pristine and send them happily away staggering under the new sombrero and bottles of duty-free cactus liqueur.

A similar motivation must be true for city labs. Imagine that I had a positive test; finding out my poisonous status as I tried to find the perfect angle to photograph the Sagrada Familia [there isn’t one], the phone rings and the bad news is shared.

Sagrada Familia PCR
The Sagrada Familia, after fifty years of personal observation is still unfinished. Though progressing

Then what?

Am I a Man On The Run? Does the lab notify the police? Is there a chase? Where do I go?

Logic maintains that there will be hundreds of travellers that test positive, either for real or having a “false positive” result as they try to return home. At that point, do they check in to the nearest hotel and ask for a self-isolating-room for ten days? Do they head for the border? Do they try to get another test that will be negative?

I can imagine the delight on a hotel receptionist’s face as a family shows up, crestfallen, asking for a room for ten days due to their “medical circumstance”. I may be cynical, but I suspect that they would find the hotel full.

Do they turn themselves in to the local police station? Should their consulate be advised?

There are many restrictions to travel today. So many that if one does have the temerity to travel there is a niggling, underlying sensation of guilt. Travelling has assumed the mantle of minor crime and the undergrowth of restrictions proof of its societally negative sentiment.

Accurate covid tests are important. Vaccinations more so. The blight of covid will only be subdued with careful public health policy being consistently and diligently applied. The plethora of governmental health departments, usually below national level and unskilled in the arts of multilateral diplomacy are failing badly.

There is little consistency, and little motive for some private company testing to do anything by reassure travellers that they are safe to go home.

PCR tests are but one element of this new regulatory framework, but as we have already seen travellers forging their own vaccination certification, suspiciously positive testing from Caribbean beach hotel-laboratories and Afghan hospitals can surely not be far behind.