Testing Requirements for Travel to the US? Here’s What to Know

As countries, including Canada and Britain, have lifted their Covid testing requirements for vaccinated visitors in recent months, some Americans are irate that they are still showing a negative test to board a flight back to the United States.

Jason Miller, a 37-year-old software engineer who lives in Texas, is so frustrated with the rule that he recently sent letters to the White House and several lawmakers and began encouraging others to do the same. “I support the CDC, still wear a N95 mask when in crowds and when I travel,” he said. But, he no longer feels that the rule provides value, in large part because “the testing has not stopped variants from entering the country.”

Other travelers have posted similar comments on social media, and a good portion of the travel industry in the United States has made it clear it feels the same way.

But they have got little satisfaction from the Biden administration and public health officials.

On May 6, Jen Psaki, then the White House press secretary, said she was “not aware of a timeline” for ending the testing requirement and that the administration would base its decision on a Centers for Disease Control and Prevention recommendation. As to what, exactly, the CDC is using to determine if testing is still necessary, an agency spokeswoman offered the vague explanation that it was “looking at different indicators” and “evaluating all guidance and orders based on the latest science and state of the art.” pandemic. “

The obligatory test has not just created logistical hassles, it has fundamentally shifted the experience of traveling internationally, travelers say.

“It was always in the forefront of my mind,” said Danielle Bradbury, 42, who recently spent 12 days working for Israel on medical devices while her husband cared for their two children back in Boston. “Every time I left the hotel, I asked myself, how much risk of not being able to get home I’m putting myself in?”

In January 2021, when the CDC first instituted a rule that all US-bound travelers 2 years and older had a negative test or boarding before boarding a recovery, the United States joined a sea of ​​countries experimenting with different ways to slow down. the virus’ s spread across borders. A statement from the State Department announcing the requirement played up the difficulty in getting a test abroad, suggesting that the rule also aimed to discourage Americans from traveling internationally. At that point fewer than 10 percent of Americans were vaccinated and case counts were rising, hitting a record more than 300,000 new cases on Jan. 8.

Testing was not the first travel limitation the United States had deployed. In the winter of 2020, President Trump banned visitors from China, much of Europe, Brazil and Iran. When President Biden took office the layoffs on the travel requirements of the travel bans. (He also expanded the ban to India.)

In late 2021, the United States pivoted away from country-specific bans and doubled down testing, shortening the window within three days of traveling for one day, even for vaccinated Americans. By then it had become clear that vaccinated people could also spread the coronavirus. (Most unvaccinated visitors from abroad were prohibited from entering the country, even with testing.)

It depends on how you define success, said Jeremy Goldhaber-Fiebert, a professor of health policy at Stanford University. If success was reducing the number of infected people who fled to the United States, he said, the testing requirement was achieved.

“It’s certainly prevented people who tested positive from getting on planes and it almost certainly prevented some amount of transmission on aircraft and in airports,” he said.

The exact number of infected people who were prevented from boarding planes is unknown, however, because no one tracks whether a passenger cancels a flight because of Covid. Most of the evidence is anecdotal; Lots of people have stories about testing positive before flying home.

If success means keeping new variants out of the country, then it fails, said Dr. William Omrice, chair of lab medicine and pathology at the Mayo Clinic.

“The reality is that none of these measures have prevented the rapid global spread of any variant concern,” he said.

But if success was not preventing the arrival of new variants, but rather delaying their arrival so that hospitals and authorities could be more prepared, then it might have worked. Mark Jit, a professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine, who has studied the effectiveness of travel requirements, said this is what tests do well.

“Testing can prevent the peak from being reached so quickly,” he said.

Still, once a variant is already widespread in a country, it is found, a travel test has little effect.

Explanations from authorities include readiness to enter a new phase of pandemic, high vaccination rates and a determination that new variants are manageable.

“The current variant is making people less ill and the number of people being admitted to intensive care is limited,” the Netherlands government said in a statement in March, as it ended travel testing, among other Covid-related recommendations.

The primary argument is that it is not good enough to rationalize the hassle.

Dr. Tom Frieden, who was the CDC director during the Ebola outbreak of 2014, was among those who made this point. “Between super-effective vaccinations that we have and Paxlovid, which is a super-effective treatment, Omicron is less deadly than flu for many years and we don’t need people to test for flu before they get on a plane,” he said. “If a more dangerous variant emerges,” he noted, “that is a very different situation.”

Others argue that it doesn’t make sense to inconvenience so many people have a system that’s full of holes. Antigen tests – an option for travelers to the United States – are notoriously unreliable in the early-stage infection, said Anne Wyllie, a microbiologist at the Yale School of Public Health. For this reason she called the requirement “hygiene theater.”

The testing requirement is not just annoying for travelers, it is economically damaging, according to the US Travel Association, a trade group. In a recent letter to Dr. Ashish K. Jha, the White House Covid Coordinator, signed by more than 260 businesses, including airlines, cruise operators, casinos, tourism boards, Disney Parks and a zoo, the group said, “The economic costs associated with maintaining the measure are significant. “

“Given the slow economic recovery of the business and international travel sectors, and in light of medical advances and improved public health metrics in the US, we encourage you to immediately remove the inbound testing requirement for vaccinated air travelers,” the group wrote.

A survey commissioned by the group found that 46 percent of international travelers would be more likely to visit the United States without a requirement. A similar survey by the Points Guy, a site that specializes in traveling with credit card points and miles, found that more than half of its participating readers would be more likely to travel abroad without a requirement.

Meegan Zickus, who runs a Facebook group for people with weak immune systems, said that testing has become more important since the mask requirement has gone away. Without a testing requirement, most travelers are not going to bother to test or stay home, even if they suspect they are infected, she said.

“Judging by the past two years, the only way to protect others is by some kind of enforced testing,” she said, because “the moral compass points directly to self.”

Dr. Seema Yasmin, a public health doctor and director of the Stanford Health Communication Initiative, echoed this point. “I would say it can give a high level of reassurance when 75 percent of people aren’t wearing a mask and maybe even coughing and sneezing loudly,” Dr. Yasmin said.

(Although airplane ventilation systems appear to significantly reduce the spread of the coronavirus, research suggests that people sitting inside a few rows still pose a risk to one another.)

“Some testing is better than none,” said Nathaniel Hafer, a molecular biologist at UMass Medical School.

Many countries also use vaccine to incentivize vaccinations by requiring vaccinated people, said Meghan Benton, a research director at the Migration Policy Institute, which tracks travel requirements. The United States encourages vaccination in its own way by prohibiting most unvaccinated visitors from entering abroad.

Given that there are currently at least four pending lawsuits that challenge the international trial requirement, some wonder if it may be struck down by a judge’s decision, as the requirement is to wear a mask on airplanes and other forms of transportation in April.

Lawrence O. Gostin, a professor of global health law at Georgetown Law, doesn’t think so. The CDC may require visitors from entering the country to travel abroad because of the Public Health Service Act, which was explicitly created to prevent the introduction of dangerous infectious diseases in the United States, he said.

The rule, he said, “would be exceedingly difficult to successfully challenge in the courts, even for the most conservative judges.”

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