The Perfect Enemy | COVID test for travel: the people testing positive and boarding their flights anyway.
August 11, 2022

COVID test for travel: the people testing positive and boarding their flights anyway.

COVID test for travel: the people testing positive and boarding their flights anyway.  Slate

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In the spring, Brian, a 34-year-old New York–based antiques dealer, took his first big international trip since COVID hit. (Brian isn’t his real name.) He visited the U.K. on business before heading to Croatia to meet up with his girlfriend. All was going according to plan until just before they were set to return home, with a planned stop in Amsterdam, and they got the news that every traveler dreads in 2022: Brian’s girlfriend had tested positive for COVID-19.

“We had this tricky situation,” Brian said. “It seemed like Croatia was probably not going to be a very good place for her to bottle up and stay just because of limited access to all the things that she would need.”

At the time, the United States still required a negative test for entry into the country, but there were no test requirements for intra-European travel. So they decided to board the first flight to Amsterdam together. With no proof of a negative test, she remained there. He feared he might be on the verge of getting sick, too—but decided to travel home to the United States anyway.

“I had a negative COVID test, but I also knew there was a significant likelihood that I had been infected and therefore might be contagious anyway,” he said. “I also thought, ‘Well, I had better get back into the country while I have this negative test, because otherwise I could be stuck in Amsterdam for God knows how long.’ ”

“It turns out, I flew back to the U.S., and the next day tested positive.”

Meanwhile, his girlfriend recovered in Amsterdam, but was still testing positive. She tried to obtain a certificate of recovery, a doctor-approved statement affirming she was safe to fly. But when she ran into problems with that, she decided to just use fake results to get back to the U.S.

“It was absolutely no problem,” Brian said. “In retrospect, I wish we had done that from the very start.”

International travel is back, and COVID entry restrictions are now a thing of the past in much of the world. But the coronavirus hasn’t gone anywhere—or rather, it continues to be everywhere. Every traveler who books a trip this year knows that getting sick is a significant possibility. Many isolate before trips, hoping to avoid expensive cancellations after more than two years of limited travel. But when they test positive on their trips, travelers are taking very different approaches—and the “right” and “wrong” thing to do is proving to be less well-defined than you might think.

For Brian’s part, he told me, “We weren’t terribly concerned about it from a public health, responsibility perspective for a variety of reasons largely having to do with the effectiveness of one-way masking, effective ventilation on aircraft, that sort of thing.” (The risks on planes are complicated.)

“I’m hearing a lot of folks who are traveling and get COVID-19 and then have to isolate on their trip, figure out how to isolate away from family,” said Saskia Popescu, an infectious disease epidemiologist in Arizona. “Lots of folks returning home to test positive within a few days.”

Take it from Sam and Giselle. (Those aren’t their real names.) The married couple, both 65, split their time between Maryland and Massachusetts, where he is a professor; she’s retired. At the end of June, they set out for Portugal.

“We had been dreaming about this trip since 2019,” Giselle said. “My concern was that no one get COVID before we left. That was my biggest source of anxiety. It never occurred to us that we would get sick in Portugal.”

But get sick they did, a few days into the trip. They were staying in an AirBnB in the Alentejo, a region of southern Portugal, with their two adult daughters and their partners, and instead of activities like boat rides, hiking, and visits to nearby cities, they decided to quarantine and minimize contact with their kids so they wouldn’t get sick, too.

They quarantined for five days. When it came time for their flight home, they were still feeling a little sick. Sam was still testing positive, and while Giselle had tested negative, she wasn’t well.

“The thought of traveling back before testing negative was really a huge concern,” he said. They knew they Centers for Disease Control only required five days of quarantine, but they still felt uneasy about it. (The Biden administration had dropped the negative test requirement in early June, with a plan to reassess after 90 days.) “We really wrestled with what the consequences of our decision might be.”

They decided to fly home. “We were pretty confident that we were no longer infectious, but there was no proof of that,” Sam said. On the flight, “I was quite worried,” he said. “I was uncomfortable flying knowing my condition.”

Travelers all over the world are facing similarly tough calls. Some people in Sam and Giselle’s shoes opt to get on a flight home as soon as they get sick, positive test be damned, so they can get better at home and perhaps salvage what they can of the money they spent on the trip. As some have pointed out, by making it costly to cancel or reschedule a trip, airlines effectively incentivize travelers to fly sick. People who get sick later in a trip have to decide whether they can afford to extend their stays, with all that entails: more nights in a hotel, more days of work missed, changing plane tickets.

That was the situation that Ayla, a 34-year-old from Vancouver who also didn’t want to use her real name, found herself in at the end of her trip to Italy. She was about to leave when she tested positive for COVID. “I was alone, without a phone, because it broke, and I don’t speak Italian,” she said.

She eventually was able to find a hotel room with a terrace so she could have a little air, room service, and an English-speaking concierge, and she camped out there for a week in early July. “People would be like, ‘Oh, that’s amazing, you’re stuck in Rome!’ ” she said. “I’m not going to go to the Coliseum. I have nothing to do, and I’m alone.”

The jury is out on whether being sick in an exotic locale is better than being sick at home, by the way. Contra Ayla, Mary Hickey, 67, of Washington, D.C., said she appreciated the novelty of being laid up in a cottage in the Irish countryside at the end of June. “We kept saying, ‘Well, if you’re going to be lying around anywhere, it’s certainly nice to look out and see Galway Bay,’ ” she said. (Luckily, she recovered by the time she was scheduled to fly home.)

Ayla said that all she really did during that extra week in Italy was watch a lot of Chicago Med. For the pleasure of doing do, she ended up spending about $3,500 Canadian, she said, between the hotel, food, and flight costs.

But even she had a limit. After all that quarantining, she didn’t want to test positive again and have to wait another seven or 10 days in the country. “I flew home without going back to test,” she said. “That’s the part I feel a little iffy about.”

Experts cautioned against flying back while positive, but acknowledged it was probably happening with some frequency.

“Everybody should push themselves to do their best, and that often includes testing if you’re feeling sick, not going on the trip if you’re feeling sick, and wearing a mask in any questionable situation,” said Ashley Ritter, a nurse practitioner and CEO of Dear Pandemic, an online resource and community for COVID-19 information. If you must fly, Ritter said, “It’s incredibly important to think about as many options as you have to delay the time of getting on that airplane from the time that you become sick. Getting to Day 5 and flying is better than the day of your positive test and flying.”

Masking helps, but it isn’t fool-proof, especially when so many people take their masks off on long flights, added Popescu, the epidemiologist. “While airplanes have great ventilation and filtration systems, if you’re within close proximity of some one for a long period of time, that’s going to increase the risk.”

On the money side, the most concrete way to protect against COVID ruining your vacation, apart from not going, is travel insurance, specifically a plan that covers COVID (not all do). Several of the people I spoke to said they planned to purchase policies for future trips.

Not incidentally, business is booming for travel insurance companies. Daniel Durazo, director of communications at Allianz, told me in an email, “We certainly saw new interest and increased awareness around travel insurance when the pandemic began, and that interest has continued throughout 2022, especially during this busy summer travel season as more international destinations re-opened.”

“One interesting shift has been that we are receiving more claims for post-departure benefits—trip interruption, travel delay, baggage loss/delay—than during the height of the pandemic, when we received more cancellation claims,” he said.

Durazo said travelers can expect an insurance policy to cost about 8 to 10 percent of the total trip cost. But travelers’ insurance will only get you so far.

In April, Greg Wood, an infrastructure architect from Minneapolis, tested positive for COVID (on his 49th birthday, he lamented) a few days into a tour of Ireland. His girlfriend wasn’t showing symptoms, so they got her a separate hotel room and she started looking at flights home—neither of which the policy covered.

“Trip insurance covers COVID, but trip insurance doesn’t cover avoiding getting COVID,” Wood explained. His girlfriend ended up getting COVID anyway, and their 10- or 11-day visit ended up being 17.

“We still have yet to get reimbursed from our insurance company for the trip, which was like an additional $5,000,” Wood said. “They’re so backlogged with other cases that anytime I email them, I get a page-long out-of-office reply.”