Seventeenth Report Contents

Instruments drawn to the special attention of the House:

Health Protection (Coronavirus, International Travel and Operator Liability) (England) (Amendment) (No. 16) 2021 (SI 2021/1179)

Date laid: 22 October 2021

Parliamentary procedure: negative

These Regulations change the conditions for “eligible travellers” (fully vaccinated) arriving in England to allow them to use a Lateral Flow Test, rather than the more accurate Polymerase Chain Reaction (PCR) test, to prove their COVID-19 status. Those who return a positive result will be required to isolate and take a PCR test provided at public expense. The Explanatory Memorandum focuses on the traveller’s experience and provides no analysis of the potential risk to the public as a result of this change, nor any explanation of why the taxpayer should subsidise the traveller in this way and how much it might cost. The House may wish to ask the Minister to provide more details to justify this change in policy and why the legislation was brought into immediate effect.

7.These Regulations are drawn to the special attention of the House on the grounds that the explanatory material laid in support provides insufficient information to gain a clear understanding about the instrument’s policy objective and intended implementation.


8.Under previous regulations,3 fully vaccinated arrivals to England, known as “eligible travellers”, are required to take a Day 2 Polymerase Chain Reaction (PCR) test but are not required to self-isolate, take a pre-departure test or Day 8 test, provided that they have not been in a Red List country in the previous ten days. All other arrivals from non-Red List countries are required to self-isolate for ten days and take each of the three tests.

9.This instrument amends the International Travel Regulations4 to introduce a further option allowing eligible travellers to complete a Lateral Flow Device (LFD) test on or before Day 2 after their arrival in England as an alternative to PCR testing. If the LFD test gives a positive or inconclusive result, the person will be required to isolate and take a mandatory PCR test, at no cost to the individual.

10.This instrument also introduces minimum standards for these LFD tests and for the private providers of LFDs. It introduces corresponding obligations, offences, penalties and reasonable excuses for eligible travellers and providers accordingly.

11.The Department of Health and Social Care (DHSC) states that this amendment is being implemented “with a view to making travel to England more accessible and affordable to eligible non-red list travellers given that fully vaccinated individuals benefit from a reduced risk of transmission.”

12.We note that since this instrument was laid, DHSC has also laid the No 17 Regulations5 (which are described on page 11 of this Report) that remove the last Red List countries and widen the scope of the eligible traveller category–thus making the pool of people potentially using the LFD test much bigger.

Risk factors

13.The Explanatory Memorandum (EM) focuses on the conditions applying to the traveller: it does not address any potential risk to the resident population. DHSC gives no assessment of the increased number of travellers to England that the Government anticipate, nor of the travellers’ potential to transmit COVID-19. Although the Government publish data of various sorts, the EM makes no specific reference to it. 6

14.It is known that even fully vaccinated individuals can catch and transmit COVID-19. A recent study reported in The Lancet7 put the risk of them transmitting the virus to other unvaccinated housemates at about 38%, which drops to 25%, if others in the household are also fully vaccinated.

15.Eligible travellers are only required to take a COVID-19 test on or before Day 2 after they land–so asymptomatic travellers may not be aware that they have the disease until after they have arrived. We asked DHSC for supplementary information on the reason for Day 2 testing:

“It is not possible to test for exposure to the virus. One needs to be exposed, incubate the infection and have virus being secreted in bodily fluids to be able to test for infection. A Day 2 test is a before 48 hours test with the aim of picking up virus if the person is actively secreting virus. This is aiming to identify people who are infected prior to travel. Therefore, testing at or before Day 2 is hugely important for surveillance of what volume and variants of the virus are being imported into the country. To emphasise, Day 2 or before, testing is for disease surveillance. Any infection that an individual is exposed to during the journey is unlikely to incubate or lead to active infection and virus secretion in that person until at least day 5 after arrival. This is why quarantine is in place for those who are not fully vaccinated in order to break potential chains of infection.”

16.We also enquired about any increased risk from the change in the type of test used. DHSC replied:

“A study by [Public Health England] PHE and the University of Oxford found the Innova LFD had an overall false positive rate of 0.32% (test specificity of 99.68%), although this was lowered to 0.06% in a lab setting. This compares to the test specificity for PCR of 99.8%. The false positive rate of LFDs and PCRs is therefore similar. Alternatively, the same study found that the Innova LFD had a false negative rate of 23.2% (test sensitivity 76.8%), compared to PCR sensitivity of 98.6%. This shows that LFDs are more likely to give false negatives compared to PCRs.8

17.This indicates that LFD tests have an error rate of more than 20% in identifying people who are infected with the disease.

18.These Regulations are to encourage more people to come to England, but propose to use a less accurate test even though it is known that fully vaccinated individuals can still transmit the disease. The House may wish to ask the Minister for further explanation setting out in detail the assessment of the risks involved that was used to inform this policy decision.

Follow up tests at public expense

19.The rationale given for the change is to make travel to England more affordable for the eligible travellers. LFD tests are significantly cheaper to buy than PCR tests and so it is likely that most travellers will use this option.

20.However, these Regulations provide that if the Day 2 LFD test returns a positive result the traveller must self-isolate and take a PCR test “at no cost to the individual”. We asked DHSC about the rationale for this:

“Given that fully vaccinated individuals benefit from a lower Covid-19 transmission risk and are themselves less likely to become infected, it is anticipated that the number of PCR tests required to be publicly provided will be low.

This amendment was implemented with a view to making travel to the UK more accessible and affordable to eligible non-red list travellers by allowing them to use an LFD as an alternative to a PCR test on day 2. Therefore, the policy would not be able to achieve this principle aim if the use of an LFD required a follow-up PCR at cost to the traveller. Individuals must obtain, take and return a free follow up PCR test from NHS Test and Trace to confirm their result. This confirmatory PCR test can be obtained by visiting or by calling 119. This test will be free of charge and sent as a home test kit.”

21.Even though the number of publicly-funded PCR tests required are predicted to be “low”, this is essentially a transfer of cost from the individual traveller to the taxpayer to benefit the travel industry. In the absence of any cost/benefit analysis to illustrate the public benefits of this change, the House may wish to ask the Minister to explain this further.

Testing standards

22.We note that the Government are publishing a list of LFD test providers on the website.9 We also note that these Regulations include standards to be met and some form of approval by DHSC which will come into effect on 12 November, three weeks after the rest of the Regulations have taken effect. Given that the travel testing process has not been without its difficulties, and the bulk of the instrument deals with requirements for providers, we were surprised that there is no explanation of these aspects in the EM. We requested supplementary material from DHSC on how providers of the tests will be approved, and their compliance checked: this is included at Appendix 1.

Emergency legislation?

23.These Regulations were laid before Parliament at 1pm on Friday 22 October and brought into effect at 4am on Sunday 24 October. We can see no justification for bringing them forward as emergency legislation.

24.Eligible travellers can already come to England if they take a PCR test, these Regulations just provide a cheaper alternative. Most travellers would have booked a PCR test in advance and so may not be able to take immediate advantage of the relaxation. Emergency legislation should be used for genuine emergencies such as preventing the spread of infection. Here it appears to be being used to promote commercial interests. The House may wish to ask the Minister to justify why this change was brought into immediate effect.

3 See Health Protection (Coronavirus, International Travel and Operator Liability) (England) (Amendment) (No. 13) Regulations 2021 (SI 2021 1107) as amended by SI 2021/1130 both in our 15th Report of this session.

4 Health Protection (Coronavirus, International Travel and Operator Liability) (England) Regulations 2021 (SI 2021/582).

5 See Health Protection (Coronavirus, International Travel and Operator Liability) (England) (Amendment) (No. 17) Regulations 2021 (SI 2021/1210) on page 11 of this Report and SI 2021/1213 which amends it.

7 The Lancet, ‘Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study’:–3099(21)00648-4/fulltext [accessed 02 November 2021].

8 Oxford University, ‘Oxford University and PHE confirm lateral flow tests show high specificity and are effective at identifying most individuals who are infectious’: Oxford University and PHE confirm lateral flow tests show high specificity and are effective at identifying most individuals who are infectious | University of Oxford [accessed 02 November 2021].

9 Gov.UK, ‘Find a coronavirus (COVID-19) travel test provider if you’re arriving in England’:–11-11-oxford-university-and-phe-confirm-lateral-flow-tests-show-high-specificity-and-are [accessed 02 November 2021].

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