As the COVID-19 pandemic continues to accelerate around the world, the majority of developing countries are still encountering supply shortages with COVID-19 diagnostic testing. Many have no domestic manufacturing capacities so they rely heavily on imports. With a limited supply available at premium costs, only economically advantaged countries are able to invest more to import diagnostic tests. Testing remains the foremost determinant of a country’s success in containing the coronavirus. A lack of testing can paralyze any plan to curb the outbreak, since tracing and isolating COVID-19 suspected cases is best carried out following a rapid response to testing.
In responding to this challenge, the Indonesian Ministry of Transportation is ready to introduce rapid COVID-19 breath tests for domestic air travel on 1 April 2021. Four airports in Medan, Bandung, Yogyakarta, and Surabaya will be the first to start using a breath analyzer device that can electronically ‘smell’ the novel coronavirus and detect infection almost immediately. The Ministry is also anticipating that the device will be used for mass screening in high-traffic areas such as seaports, train stations and airports, and various other applications.
The COVID-19 breath analyzer device was developed by a group of Indonesian scientists at Gadjah Mada University in Yogyakarta. These researchers claimed that it is a faster, cheaper, non-invasive, and reliable way to detect ongoing COVID-19 infections. The device uses artificial intelligence to analyze a breath sample and identify a unique volatile organic compound (VOC) exhaled by a person infected by COVID-19. The Indonesian government granted a distribution permit for the device in December 2020; the device is currently patent-pending.
The COVID-19 Breath analyzer
During diagnostic trials last year, this device achieved a high sensitivity of 89-92%, slightly lower than the WHO recommendation for the molecular test (minimum of 95%), but higher than rapid antigen tests (minimum of 80%). The COVID-19 breath analyzer also scored a relatively high specificity of 95-96%, comparable to the WHO recommendation for molecular tests (minimum of 95%) and slightly lower than rapid antigen tests (minimum of 97%). It should also be noted that it is an artificial intelligence-based device, meaning that it can be trained to recognize the distinctive response pattern of COVID-19 VOCs. As such, the breath analyzer’s sensitivity and specificity rates can be further improved by increasing data input from the valid measurement results.
But what makes this device a game-changer is its ability to detect COVID-19 infection much faster and more affordable than other COVID-19 tests. According to its researchers, this rapid testing procedure can display results in less than three minutes, much faster than any rapid antigen tests, which can take up to 30 minutes. The cost is less than USD2 per test, which is remarkably cheaper than the rapid test-PCR, which can cost as much as USD250 per test. The breath testing procedure for COVID-19 is also non-invasive and therefore, can be performed repeatedly as required.
This breath analyzer’s technology has the potential to make COVID-19 testing more accessible, affordable, and rapidly available. If trials are successful, the design will contribute to not only further increasing Indonesia’s testing capacity, but will also enable the restart and recovery of domestic and thereafter, global aviation.
This progress is consistent with the ICAO Council’s Aviation Recovery Task Force (CART) recommendations, which encouraged States to consider affordable testing means to minimize travel costs for passengers, in accordance with the World Health Organization’s International Health Regulations. Further, ICAO CART recognized that implementing a proper testing procedure, accepted by all the role players, may reduce the burden of quarantine measures, which evidence suggests is very detrimental to the confidence in air travel. In the future, this device may be presented to the various role-players (universities, research centers, other States) for acceptance.
Airports Council International (ACI) awarded “The Voice of the Customer” certificate to 27 Indonesian airports in recognition of their efforts to obtain data from passengers related to their needs and expectations during this novel coronavirus (COVID-19) pandemic. This device will further contribute to our efforts.
The COVID-19 breath analyzer is designed to complement Indonesia’s multi-layered risk mitigation strategies in addressing the COVID-19 pandemic and to ensure a safe and expeditious return to domestic and global aviation activity. As a member of the global aviation community, Indonesia is taking steps to ensure the research and trials continue to meet the ICAO requirements, protocol, minimum dataset, and implementation approaches as outlined in the Manual on Testing and Cross-Border Risk Management Measures (Doc 10152).
About the Author
Indra Sipayung is an Alternate Representative of Indonesia to ICAO. A career foreign service officer, Indra Sipayung has served in Darwin and Bogota. His work has centered on economic, trade and investment issues in bilateral, regional, and multilateral settings. He earned a Master’s Degree in International Law from Melbourne University, Australia. In addition to representing Indonesia at the ICAO Council, he is a member of the ICAO Review of ICAO Rules for the Settlement of Differences Working Group.