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After months of staying at home in New York City during the pandemic, travel writer Sarah Khan called her general practitioner for advice on getting tested for the coronavirus before a potential train trip to see her aging parents.
For more than a week before taking off, Khan followed a strict self-quarantine at home, leaving only to take the coronavirus test at an urgent care clinic. The day after getting her negative test result, she left for Massachusetts, confident she wouldn’t be spreading the coronavirus onboard — but conscious that the risk for contracting it was still present.
“It’s obviously not foolproof,” Khan says. “You shouldn’t feel infallible from [a negative test]. But I do think that it’s an important step in our preplanning process now. Just like we have our packing list like, ‘Do I have my passport and everything?’ I feel like now would be like, ‘Did I take my covid test?’ ”
In an email, a spokesperson for the Centers for Disease Control and Prevention told The Washington Post: “Travel-associated testing is a worthwhile concept under active discussion in the U.S. and internationally to reduce the risk of transportation-associated COVID-19 infection and the translocation of the virus from one location to another."
Khan is not alone in wanting to get tested for traveling during the pandemic. I’m in the same boat, too. For my first flight in eight months, I juggled the same concerns as Khan and others. Do I get a test before I fly? After? Will the test accurately assess my coronavirus status?
Here’s testing advice from health experts for would-be travelers.
Where to find a coronavirus test before (or after) you travel
There’s a variety of places offering coronavirus testing, including urgent care centers, travel clinics, fire stations, pop-up sites, most hospitals, pharmacies and a few airports.
Lin Chen, a doctor and director of the Travel Medicine Center at Mount Auburn Hospital in Cambridge, Mass., says potential travelers should check in with their primary care provider, who may know the best options for testing in their area. Other options include looking at city and state health department websites for testing resources.
While some people may have success walking into testing sites without an appointment, Chen advises against waiting until the last minute to arrange your test. Appointments in some areas may be limited, and because of testing supply and manpower shortages, Chen says testing sites may test only high-priority, at-risk people and turn away travelers.
If you can’t find an in-person testing site, you can order one to be delivered to your house. One such option is Pixel, an at-home nasal swab collection kit from LabCorp for individuals 18 years or older who meet criteria to warrant a test. The FDA-authorized RT-PCR kit arrives in about two days, and results are returned within a few days.
Depending on the site, and whether a traveler has insurance, the price of a coronavirus test will vary.
What kind of coronavirus test to expect
As the world scrambles to figure out how to understand, treat and stop the coronavirus, multiple methods of getting tested for the coronavirus have emerged. Viral tests are designed to detect a current infection, while an antibody test will tell you if you’ve had the virus in the past.
“There are so many different kinds of tests … and there’s also so many variables that would make somebody test positive or negative that it’s just ripe for confusion,” says Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security.
Opt for a viral, or diagnostic, option like the RT-PCR test to find out whether you actively have the coronavirus before traveling. This can be administered by nasal or throat swabs, as well as by taking saliva samples.
“The PCR test tends to be more sensitive,” Gronvall says. “That means they pick up lower amounts of virus. … But the downside, of course, is that it usually takes longer to get results.”
Another option is getting a rapid diagnostic test, with results ready in as little as 15 minutes. There are two types of rapid tests, molecular and antigen, and the latter has come under fire for its questionable accuracy.
“Rapid antigen tests tend to be a little less sensitive,” Gronvall says. “They tend to miss some people who are actually infectious.”
A test’s efficacy can also depend on the level of infectiousness of the traveler. “If you are very infectious, you tend to have a lot of virus in your nose, and so it’s easier for any of the tests to pick it up,” Gronvall explains.
How to time your coronavirus test for a trip
Travelers need to find a sweet spot for their coronavirus testing before a trip. Plan it too early, and you have more time to get the virus before your trip and nullify your test result. Plan your test too close to your departure date, and if there’s a delay getting your results back, you’ll risk spreading the virus or being denied entry to a destination.
As you plan your test strategy, note that different tests will come with different wait times for results. Khan’s results came back in four days. I’ve gotten RT-PCR test results back in two days. Rapid tests can return results in minutes. On the other end of the spectrum, some people have waited weeks.
Even if you’re promised a timeline for your results, there may be a delay, which may be a bigger issue for those attempting to travel to a destination that requires proof of a negative test.
“I’ve certainly seen that in some of my travelers: a lot of anxiety about the right timing for the test and getting the test scheduled,” says Chen, who is also president of the International Society of Travel Medicine.
Having a flexible travel schedule, or planning some buffer time between when your test results return and the start of your trip, will help alleviate that timing anxiety.
Should you get tested before, during or after a trip?
Getting tested before a trip could help you avoid spreading the virus. According to a CDC spokesperson, “The pre-travel testing would reduce the risk of allowing COVID-19 infected people on airplanes and other forms of public transportation, provided that the results of the testing are known and acted upon before travel begins.”
David Myers, a product manager for the federal government, has gotten multiple coronavirus tests before traveling during the pandemic. Like Khan, he was given a nasal swab test at his One Medical appointments, but his swabs were shorter than what he’d seen in the news. He felt like it would be irresponsible to travel without getting a test first. Having a negative test result gave him peace of mind while traveling.
Getting a test during, at the end or after a trip can also help you avoid spreading the virus while you’re traveling or at home. A post-arrival test may also be recommended by your state’s coronavirus task force.
“Post-arrival testing can help reduce the risk of infected persons spreading the virus at their destination (whether at home or at their travel location),” the CDC spokesperson said.
In November, the CDC released new guidelines recommending domestic and international travelers get tested one to three days before departure and three to five days after travel. They also recommend quarantining for seven days upon return, even if your test is negative.
A negative test doesn’t guarantee your safety while you travel
As the CDC says, a negative coronavirus test result means you didn’t have the virus when you took the test (or you were tested too early in the infection for the virus to be detected). It doesn’t protect you from future infection after you leave the testing site and take a plane, train, bus or car on a trip.
And Chen warns would-be travelers that coronavirus tests aren’t always accurate.
“Some people will turn out to be falsely negative even when they do carry the virus,” she says. “I think it’s a little bit reassuring if somebody tests negative, but it’s not an absolute guarantee."
Instead of letting their guard down after a negative test, Chen advises travelers to remember coronavirus-protection basics: wearing a mask in public; avoiding crowds; keeping physical distance from others; washing and sanitizing hands frequently; and not touching one’s eyes, nose and mouth, or common surfaces.
Before deciding whether to take a trip, Chen says, people should also consider their health background and whether they have an increased risk for getting sick while they’re away.
“Travelers should think about the health care where they’re traveling to, whether it will be adequate if they should come down with covid,” Chen says. “Will their health insurance cover them? Because health insurance may not cover [when] people are advised not to travel.”
Travel during the pandemic: