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You tested positive in a foreign country. Here’s what you should do.

Advice for navigating quarantine costs and travel restrictions from people who got a positive coronavirus test overseas

(The Washington Post)

A honeymoon. A work assignment. A family visit abroad.

These and untold other trips were disrupted in the past several weeks as the highly transmissible omicron variant pushed global coronavirus cases to new highs. And as travelers stuck in France, Dallas, Dubai, Costa Rica and elsewhere discovered, getting back home after testing positive on a trip can be a tricky proposition.

Everyone who leaves the United States needs to present a negative coronavirus test or proof of recent recovery from the virus before reentering the country. But aside from that overarching rule, the nuances can vary widely.

John Rose, chief risk and security officer for the travel management company Altour, said the country a traveler is visiting may be much more strict than the one they left.

“They’re not trying to punish the traveler; they’re trying to keep their population safe,” he said. “They may have more stringent quarantine policies than the United States does.”

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And while those rules can be “all over the place,” he does have some universal recommendations, including buying travel insurance that covers hospitalization, trip interruptions and delays, and learning about travel restrictions in the destination country from a site called Sherpa.

The U.S. State Department warns citizens traveling internationally that they may have to extend, at their own expense, their stay abroad if they test positive. Travelers also are subject to the quarantine requirements in the country they are visiting. The department offers country-specific information on U.S. Embassy websites, which may include instructions for what to do in case of a positive test.

The department says citizens who test positive abroad should contact their accommodations and airlines about options for staying longer and rescheduling a flight; check embassy websites for English-speaking health-care providers if they need medical treatment; and contact the nearest embassy or consulate if they need help or have questions. Many countries will require proof of a negative test to leave quarantine, the department says.

The Washington Post spoke to several travelers who tested positive on recent trips — domestic and international — to hear their stories and learn from their experiences. Here’s what they learned.

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Prioritize a PCR test if you feel sick

For Christmas, Katie Hale, her mom and her brother traveled to Costa Rica to visit her sister, who is in the country on a work-study program. They arrived Dec. 19 with plans to leave the 29th.

That’s not how things worked out. Hale, a sophomore at the University of North Carolina at Chapel Hill, started to feel cold symptoms — congestion, but no cough or fever — the day after arriving. She was going to get tested at a clinic until her sister found a home test. It was negative.

“I was pretty convinced that I didn’t have it,” she said. Plus, she had been vaccinated and boosted.

Still, Hale, who is studying biochemistry, felt sick enough to stay put. She recovered and had no symptoms by the time she had to take the coronavirus test required for reentry into the United States. It was positive.

The health ministry informed her that she would have to quarantine for 10 days, starting the day of her test. Authorities warned her that she would be added to a no-fly list until her isolation time ended.

“I was like, that sounds really intense,” she said.

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Hale learned she would be able to get a certificate of recovery from authorities instead of relying on testing negative — tests can be positive for the virus even after people are no longer contagious — so she called a few days before her quarantine ended to make sure everything was in order. She knew her last day of quarantine would be Jan. 6, so her airline had switched her to a flight that left at 7:30 a.m. the next day.

When she checked to make sure the recovery documentation would be available in time for her morning flight, she learned the office didn’t open until 8 a.m. But her contact at the health ministry went the extra mile: “She was like, ‘Here’s what I’ll do: I’ll stay up ‘til midnight, and at 12:01 I’ll sign the form and send it to you,’” Hale said. “All of my trust was in this woman. She pulled through and she did it.”

Hale finally made it home to Charlotte on Jan. 7.

She said she would advise anyone with symptoms to get a more sensitive PCR test — not a rapid antigen test — at a clinic as early as possible. If she had tested positive at a clinic when she initially felt sick, she would have only spent two extra days in quarantine, not 10.

She also advises reading up on the coronavirus rules in your destination to learn what to expect from a positive test, how quarantine works and when it starts.

“A lot of the stress came from not knowing and trying to piece together information,” Hale said.

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Insurance is ‘fundamental’ for a long isolation

Veronica Strazzari, a 38-year-old resident of Milan, was supposed to fly back home after an organized tour in Saudi Arabia on Jan. 2 when she got her positive test result. A roommate on the trip had tested positive a few days earlier, but Strazzari, who is vaccinated and boosted, had no symptoms.

Her trip had started in Riyadh before moving to Jiddah, and she made the Jiddah hotel her home for 13 days of self-isolation.

Strazzari tested positive again several days later, then again two days after that, and finally got a negative result after a test on Jan. 13. She made it back to Milan, where she works in marketing for Prada, on Saturday.

The agency that arranged the trip handled the changes to her travel plans and walked her through the steps she needed to take. A contact at the Italian Embassy also provided support.

Thankfully for her, she had insurance to cover the extra time in the hotel and any flight changes. The policy covered an additional 15 days beyond the original end date of her trip — a limit she nearly reached.

“The insurance during the trip is fundamental,” she said.

Strazzari said she loves travel and plans to continue, though she said it is also important to be well-versed in the rules in case of a positive test abroad. She said she brought her laptop, knowing there was a possibility of getting stuck, and worked long days from isolation.

“It was a hard situation, I know, but you can learn from it,” she said from her hotel the day before leaving. “You think about the importance of freedom.”

Be prepared for bureaucratic headaches

Eric Sussman was feeling “brazen, confident and ready to party” with his three Pfizer shots, he said, when he headed to Dubai to teach an international business class.

The Los Angeles-based professor ended up getting an education in the emirate’s covid-19 protocols after testing positive during the trip and spending 10 days in isolation, many of them in a cruise-ship-turned-floating-hotel.

“Where would you most want to be when you have covid?” he said during one of the many covid diary updates he posted on social media. “That’s right, stuck on a cruise ship.”

He said his positive PCR test triggered an alert to the authorities, who transferred him to the quarantine hotel. Sussman, 55, who teaches accounting, finance and real estate at the UCLA Anderson School of Management, had no idea what the rules were when he arrived in Dubai.

He was supposed to return to Los Angeles on Dec. 23, but he ended up returning a week after that. He suffered what felt like a nasty head cold along with a sinus infection.

The real stress came when it was time to leave after quarantining for 10 days. He said the health authority promised to provide documentation saying he was free to leave the country by 2 a.m. on the day of his departure. He still didn’t have the paperwork as he prepared to head to the airport for his 8:30 a.m. flight. He figured he would show them his original positive test and the bill for the quarantine hotel, and someone at the airport would call the health authority to confirm.

“That’s where the bureaucratic quagmire begins,” he said.

He was at the airport for seven hours and missed his flight. He finally got the necessary certificate later that day, and the next day the airline employees said they had to charge him a $600 no-show fee for checking in to the earlier flight but not boarding. He fought the charge, and the airline ultimately dropped it.

But he did have to pay a “boffo” change fee to switch his original flight. Between that and the quarantine hotel stay, his trip cost grew by $5,000. Because the trip was insured, he said, he will be reimbursed that amount.

Looking back, Sussman said, he would not have trusted the health authority to come through with the certificate clearing him to fly on the morning of his trip home. He said he should have asked the hotel to stay on top of the clearance that he needed.

Though he worked during his isolation, he also had plenty of time to fill.

“Make sure you’ve got all your streaming services available and at the ready,” he said. “If you’re in quarantine for 10 days … you’re going to watch a [boat]load of TV.”

Turn to telemedicine for proof of recovery

Molly Brown plans other people’s travel for a living, but, as she found out during her honeymoon in France, even an expert might find it dizzying to navigate a coronavirus diagnosis abroad.

Brown, 29, arrived in Paris on Dec. 27 and started looking for a coronavirus test over New Year’s weekend. By the time she found one, she was a few days past the first symptoms. The slight itch in her throat was so mild she initially thought it came from secondhand smoke.

After starting the trip in Paris and unsuccessfully trying to find a test there for several days, she tested positive on a rapid test in Annecy, near the Swiss border, and then stood in line for six hours to confirm with a PCR test. She and her husband had a vacation rental in the small town and isolated there, though her husband never tested positive.

She passed the time trying to figure out what was required for her to get home — and to get into Switzerland, where her return flight was scheduled. The CDC had just changed its guidance to tell people to isolate for five days; France had lowered its own isolation time to seven days for fully vaccinated people.

“It was really a game of ‘How do we get home? What does that look like?’” she said.

Brown discovered that by the time her flight home was scheduled, she could get a document of recovery. Ten days would have passed since her first symptoms, and she had improved. After clarifying what documentation of recovery would include, she turned to the telemedicine service QuickMD.

She got an appointment within 24 hours with a practitioner licensed in her state, had a telemedicine appointment through an app, and got a letter with the necessary documentation within an hour. Insurance covered the $75 fee, she said.

Her advice: Make sure you know what the airline will require, and decide which route works for the particular situation. If you meet the health criteria, it may be easier to obtain proof of recovery than a negative test. Brown made her original flight back, and she has been back home in Denver since Jan. 8.

“I feel like all things considered, it was pretty lucky, even though we did have to isolate for like a week on the honeymoon,” she said.

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