8 do’s and don’ts ahead of your trip

Maria DeMartini started trying to book COVID-19 test appointments five days before her flight to Hawaii in mid-November.

The Chicago nurse checked Walgreens. None available.

Then CVS. Everyone in her group of four had appointments two days later, the timing they needed to meet Hawaii’s entry requirements, but they all had to go to different stores.

And that was only the start of the problems. The morning of their tests, DeMartini and her boyfriend got alerts from CVS that their tests were canceled because the pharmacy’s systems were down.

They were able to get in later that day, but by the day of their travel, only DeMartini had proof of a negative test because she had done a rapid test at her hospital as a backup.

A mechanical delay in Chicago saved her 50th birthday celebration in Kauai. The group missed their connecting flight to Hawaii and had to spend the night in San Francisco.

DeMartini’s daughter received her results late that night, leaving two others without results. United offers rapid testing to Hawaii-bound passengers at San Francisco International Airport so they headed there just before it opened and, despite a line of 10 people, were able to get tested and received negative results before their flight, albeit for $250 per person. No one had to quarantine in Hawaii. (At the time of their trip before Thanksgiving, the state allowed travelers departing without their results to quarantine just until the results arrived, a risk DeMartini was willing to accept. The rules have since changed, and travelers without results before their flight departs must quarantine for 14 days instead.)

“It was very stressful,” she said. “Going there (to Hawaii) was the reward.”

It doesn’t always work out.

Testing backlogs, traveler procrastination and general confusion or ignorance about testing requirements have delayed or ruined many a vacation for those traveling during the coronavirus pandemic and headed to destinations that require a negative COVID-19 test to visit or to bypass mandatory quarantines. DeMartini didn’t receive her CVS results for 16 days.

The woman who scanned my COVID-19 results and other health information at Honolulu International Airport in Hawaii in November said she’d just sent a passenger home who arrived without proof of a negative COVID-19 test and didn’t know about the quarantine rules. My Uber driver told a similar tale of delivering a crying passenger back to the airport a day after arriving because she couldn’t leave her hotel room during the quarantine.

Airline social media feeds are sprinkled with posts from travelers confused about the testing requirements or worried about not receiving results in time.

The problem is likely to intensify as the Christmas and New Year’s travel season begins this month.

Here’s why: The Centers for Disease Control and Prevention last week urged Americans who go against its advice to avoid travel during the winter holidays to get tested for COVID-19 twice in a bid to make travel safer, though far from risk-free. The agency says travelers should get a viral test (PCR or rapid antigen test, not an antibody test) one to three days before travel and three to five days after travel, regardless of where they are headed. The PCR test is considered more accurate but generally takes longer for results than a rapid test.

If travelers concerned about a surge in coronavirus cases heed the CDC’s advice to get tested before and after travel, something the agency did not mention when it recommended against Thanksgiving travel, demand for tests will likely spike.

“Whether that is a small bump or large bump is unknown,” said Dr. Christopher Sanford, associate professor of family medicine and global health at the University of Washington in Seattle and founder of the travel medicine clinic at the University of Washington Medical Center. “It depends on A) how many people travel and B) how many of those people get tested.”

Despite the CDC’s advice to stay home for Thanksgiving, millions of travelers hit airports across the country, setting pandemic records on a couple of days.

Sanford is all for testing before and after travel but cautions that it’s not a protective measure. The “smartest thing” people can do right now, he said, is to avoid travel.

“People are dropping dead from this thing. It’s a juggernaut. It’s a snowball that gets worse every day,” he said. “The vaccine is a good thing, but that’s not going to be a sudden switch.”

The United Kingdom became the first western government to start vaccinating on Tuesday, and the U.S. could begin its own mass vaccination within days.

New York's LaGuardia Airport offers free rapid COVID-19 tests in a corner of a parking garage at Terminal B.
New York’s LaGuardia Airport offers free rapid COVID-19 tests in a corner of a parking garage at Terminal B.

Here’s what travelers getting a COVID-19 test before holiday travel need to know

Do your research. If you’re traveling to Hawaii, the Caribbean, or other destinations that require a negative COVID-19 test for entry or to bypass quarantine, make sure you understand the type of test and the timing required. If you are confused, check with testing providers (Carbon Health in Seattle had a helpful live chat when I had questions about a test required for Hawaii) about the specifics. Check tourism websites for your destinations and note any different requirements for children versus adults. Several airline websites also list entry restrictions and requirements and, where applicable, links to any testing partnerships they have for specific routes. After online research, check with your doctor for any lingering questions. “The doctor doesn’t have 40 minutes to tell you all the different rules,” Sanford said.

Don’t wait to make an appointment. This is perhaps the most important advice. For a flight from Seattle to Honolulu, I scheduled my COVID-19 test with an Alaska Airlines partner in downtown Seattle 10 days in advance. There were no appointments in the next seven days, so travelers who waited would be out of luck if they were counting on that option. Conversely, I was able to nab an appointment within 24 hours at an urgent care facility in Phoenix ahead of another flight and had a minimal wait for my rapid test, with results delivered in the office. Those who didn’t make an appointment were camped out in their cars in the parking lot while they waited for an opening. Keep this in mind for your pre- and post-trip tests as recommended by the CDC.

Do inquire about test turnaround times. Sanford said the University of Washington Medical Center is delivering PCR results in 24 hours, which he says is good nationally but that turnaround times can vary dramatically. It does no good to get a test on Monday for a Wednesday flight if the results don’t arrive until later in the week or longer because you could be spreading the infection without knowing it, he said.

Don’t count on a last-minute airport test if you must have a test. DeMartini got lucky with United’s airport testing option in San Francisco (the airline’s website says no walk-up tests are allowed, and there were no advance appointments available in the time period I checked). In New York in early November, I was able to breeze through the free COVID-19 testing in a parking garage at LaGuardia Airport’s Terminal B, where appointments are not necessary. I had my results within a few hours. XPresSpa Group, best known for airport spa and salon services, has opened XPresCheck testing locations at four airports: Phoenix Sky Harbor International, JFK International Airport, Newark Liberty International Airport and Boston Logan International Airport. They take appointments and walk-ins but be sure to see what tests are offered. Phoenix does not yet offer a rapid test, so results won’t be immediate.

LaGuardia Airport in New York offers free COVID-19 testing in modular offices in a parking garage in Terminal B. Travelers visit three windows, with the test conducted at the last one.
LaGuardia Airport in New York offers free COVID-19 testing in modular offices in a parking garage in Terminal B. Travelers visit three windows, with the test conducted at the last one.

Do have a back-up plan if you must have a test. Some rapid testing providers catering to travelers require prepayment, so double booking is out of the question unless your budget is unlimited. But CVS, Walgreens, urgent care centers and others generally don’t. Make sure you ask about the estimated time for results. And make sure to cancel your appointment if you don’t need it.

Do check out at-home testing options, but read the fine print (and the reviews). American Airlines this week said it will offer passengers headed to U.S. destinations with coronavirus travel restrictions, including New York, Chicago, Maryland and Connecticut, the option of ordering an at-home testing kit through LetsGetChecked. The nasal swab PCR test is $129. The airline already offered the option for passengers headed to some destinations, including Hawaii and the U.S. Virgin Islands.

American recommends ordering the kit at least five days before departure and says the turnaround time for results is 48 hours on average. There are step-by-step directions on the airline’s website, so brush up before ordering one.

Hawaiian also offers at-home tests for Hawaii flights, and United recently added a $119 mail-in test option for select flights between its Houston hub and the Caribbean and Latin America.

Costco sells a saliva PCR testing kit for travel for $140 online, and notes that it is approved for Hawaii travel. But it has several dozen one-star reviews of 156 reviews, with most complaining about delayed shipping and poor customer service from provider AZOVA. Note that Costco also says travelers are not allowed to physically take the test in Nevada, Maryland and Pennsylvania.

One one-star review posted a few weeks ago: “If you have a time-sensitive test (for travel with restrictions) this is not the kit for you. You are unable to check times available for observation until buying and opening the kit. The day we needed to take the test for travel was entirely filled. Now we’ve spent $280 for nothing. Can’t take the test on the weekend (when observation times are available) because it has to be mailed same day. The unopened kit for my husband can’t be returned. What a waste of money. Also ‘overnight delivery’ to receive kit took over 2 days.”

Do include the potential cost of a test in your budget. The airport tests can run as high as $250 per person. My test in Seattle was a discounted $135 because I was flying Alaska Airlines and they had a partnership with the lab. Check with your insurance to see what is is covered in advance so there are no surprises. Check for any special programs, too. In Phoenix, the city is covering airport tests through the end of the year for residents without insurance.

Cash in miles? This airline will allow you to swap airline miles for COVID test

Don’t board a plane if you tested positive. This sounds like a no-brainer, but U.S. airlines won’t ask for proof of a negative COVID-19 test when you board. They only ask you to confirm via an online health questionnaire that you aren’t positive or experiencing any symptoms and haven’t had exposure to someone who is infected. That doesn’t mean they won’t find out you tested positive as a Hawaii couple learned the hard way and a Maryland family nearly did.

This article originally appeared on USA TODAY: COVID travel test: 8 things to know about coronavirus testing

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