The U.S. government has been in discussion with airlines this week about imposing a 72-hour testing requirement on passengers traveling to the United States, similar to the requirement put in place for travel to the U.S. from the U.K. this week.
With the virus spreading rapidly in the community already, travel restrictions have only modest public health benefit.
- Countries like Australia and New Zealand, which are containing the virus, need to continue to work hard to keep it out.
- Adding incremental cases in the U.S., which is already seeing 200,000 or more positive tests a day, doesn’t materially change the course of the pandemic here.
- However one fewer case may be one fewer person needing an ICU bed, in places where beds have become scarce.
Here, though, I’m interested in the mechanics of what this will mean for Americans returning home, since like the U.K. travel requirement it’s expected that this would apply to U.S. citizens and not just to foreign visitors. By the way this isn’t actually an argument for or against per se in this post, just tracing some of the challenges associated with the policy.
You Can’t Just Get Tested Wherever You Are
Testing in 90% of countries isn’t as prevalent as in the U.S. The U.S. has conducted over 250 million tests for Covid-19, or 3 tests for every 4 Americans. Denmark and the U.A.E. have conducted around 2 tests per person. But the U.S. has conducted more tests per capita than Hong Kong,, Spain, Italy, France, Norway, Australia, Sweden, Germany or Canada. Testing is scarce in Egypt, Mexico, and virtually non-existent in Tanzania.
Travelers Abroad May Not Be Able To Get Tested Where They Are
People are abroad now. Their trips are likely to extend past when any new requirement is put in place. For instance travelers might be given 3 days notice of the new requirement while they’re traveling home in a week. They may not even learn about the requirement before showing up at the airport.
If you’re on an atoll in the Maldives, can you even get tested? Some hotels will organize this. But uncertainty will cause many people to have to cancel their trips even though the country allows U.S. visitors with their own testing requirement.
A 72 Hour Requirement Is Really A 48 Hour Requirement
A 72 hour testing requirement from a place like the Maldives or Tanzania, or other remote destinations, may in practice be a 48 hour requirement since it can take a day from leaving a hotel or resort to get to your U.S. bound flight.
Add An Enroute To Get Tested, But Where?
Someone who can’t get tested prior to leaving their current destination may have to fly somewhere else just to get tested. But much of the world is closed to Americans, and places that are open often themselves require a negative test for entry.
While there are a handful of flights between the U.S. and Europe with predeparture testing that form a travel bubble, Americans can’t enter Europe from elsewhere. An American returning from Africa, for instance, can’t land in Frankfurt or Amsterdam and enter for a couple of days to get a test and wait for results.
Instead you might need to travel to the U.K. and self-isolate for 10 days prior to getting tested, wait for results, and return home.
Substantially Burden The Right Of Citizens To Return To The U.S.
An American citizen presenting themselves at the border is entitled to enter the country. They can be questioned, searched, and required to quarantine as a public health measure. But as a general matter citizens cannot be denied entry into the country.
Here the government places a requirement on airlines to prevent citizens from presenting themselves at the border and substantially burden the right to travel.
Next thing you know they will be putting our ID numbers on our forearms by Tattoo.
Cannot believe this is the country I grew up in.
I don’t really understand your theory here. As we’ve seen very recently, the new strand from the UK is certainly something worth protecting against, and thus, worth having a negative PCR test.
The whole mantra you keep repeating about “With the virus spreading rapidly in the community already, travel restrictions have only modest public health benefit.” is laughable. Like, seriously laughable.
N+1 is still N+1, it’s still another positive person entering that might impact the hospital system in another region. And N+1 travelling is far worse, because it’s now one person interacting with uber/taxi drivers, airport staff, airline staff, their fellow passengers, potential hotel staff, etc… Again, I’m not sure why this is so complex to understand.
So yes, I’m glad they’re considering a negative PCR test. This shouldn’t be a surprise to anyone – it’s what virtually every other modern country in the world does these days.
If an American headed abroad at this point, to the Maldives (as you exampled), then that’s on them to get stuck there if they can’t get a negative PCR test to come back.
The US government requiring airlines to prevent travel back to the US by some US citizens abroad isn’t new even when the US citizens have a valid ticket and US passport. Familiar with the operation of the no-fly list and other do-not-board indicators went from the USG to the airlines? This has been going on during the GW Bush, Obama and even the Trump Admin.
Perhaps overtime, on airport testing becomes the normal across the world. Any country that wants travelers, tourists or business, could require a test prior to arrival (or provide a rapid test), and provide rapid testing at departure.
A Dutch court just ruled that returning citizens to The Netherlands CANNOT be compelled to provide any COVID-19 test and CANNOT be denied entry. The only thing the state can do is to test and quarantine on arrival.
I am sure the Supreme Court of the US will rule in a similar manner if a case is broad forward.
I can’t see this being implemented for U.S. citizens. Seems highly doubtful and few others are reporting it as a result. At that point, given the logistical nightmare it will present to travelers around the world, the U.S. might as well just shut down all passenger international flights. Which, frankly, I would not oppose for a 30 day period to try and get this thing under control without a more contagious mutation entering even more than it probably has.
Yes, there is a VERY dangerous virus going around, Stuart. It is called HIVID-20, “Hysteria-Inducing Virus ID 2020”! It is extremely contagious. Mortality rate is unknown as of yet, but most likely induces high blood pressure leading to death and exploding heads.
Perfectly fine with requiring a test even it has to be on arrival (I think prior to departure makes more sense). I hope they would give at least a weeks notice before implementing the requirement so as not to strand people. Recently flying from NBO to the US, everyone was asked for a negative test document at the terminal entrance but I was probably one of the few people not required to have one and even the airport security fellow was surprised when I explained I was going to get tested on arrival (by choice). I dont think testing is 100% secure measure but any mitigation helps.
kq747, we need to place COVID testing portals at every house door, at every store, building etc.!!! That will help a lot!!! Hope you like living in your bedroom for the rest of your miserable life.
@Ed – daily record cases, exploding numbers of deaths, and overflowing ICU beds would tell you to “go piss off”
Looks like this thread is full of fact-denier and hysterics. You can recognize them when they use Ad Hominem.
Air travelers contribute a tiny fraction to COVID cases. That’s a fact. Having overflowing hospitals show you how little capacity there is. It doesn’t change THE FACT that COVID has a 3% mortality rate. Not 100%, not 50%, not 10%.
Destroying an entire economy because you failed to have a functioning health care system is not idiotic, it is criminal. People DO NOT HAVE THE RIGHT to destroy the livelihoods of others. You do NOT have the right to treat others like filthy animals and lock them up indefinitely.
The needs of the few DO NOT outweigh the needs of the many.
@ Santa, as I clearly said in my post, mitigation is helpful even if it’s not a 100% guarantee. Also, I recently traveled to Kenya and back to the US but exercised as many precautions as I could including multiple tests. I wish we had rapid testing available to everyone everywhere but we don’t so I hope people will use the testing that is available to them. I do not believe we have to shut ourselves up at home but we do need to exercise caution as we live our lives in this new normal. Also, I LOVE my bedroom 😉
Pre-travel testing for flights is said by some experts to provide no more than a 5-9% reduction in the risk of a traveler spreading SARS-COV-2. That’s a very marginal return on testing. Way more effective to mandate and enforce a quarantine on arrival at the destination and having an enforced mandatory testing and contract tracing system.
So @ Heathrow T2 and T5 airside you can get LAMP tests. A LAMP test (apparently) takes 80-90 minutes to give results. Cost is in the $100 region. Now — pretty sure you could connect @ Heathrow – stay airside, not have to clear customs/passport check / enter/exit the UK – yes your bags etc. would be re-xrayed etc. but pretty sure you could connect – get a LAMP test and then board a flight for the US. You’d need a long connection 4 or more hours probably but it should work. Heathrow is probably the only place you could do this though as most of the European counties have denied connecting in them as well without proof of a negative test.
No vaccine, no travel for you. Tough crap. I love the Trumptard, freedumb crowd who think it’s perfectly acceptable 3000 of their fellow Americans are dying daily because of the ignorance of Dear Leader, who effed this up from day 1. GFY, you friggin scumbags! Stay home and STFU!
Quarantine should be required or quarantine plus testing on arrival.
Better yet, allow vaccination plus short quarantine with an arrival test
Canadians should be banned from entering the US even for essential trips because Canada does that to Americans. They routinely deem essential trips as non-essential
I’m a US citizen living in London. I had planned a post-Christmas trip to NY, where I have a small apartment. I had a PCR test scheduled (and paid for) prior to departure, and I intended to self-isolate for four days after arrival, followed by another test in NY. But I cancelled because I wanted to preclude any chance that I might take this new coronavirus variant to the US. Sure, it might already be there. But why add any more, when it’s so virulent? Covid admissions at St Thomas’ Hospital, my local hospital in London (across the river from Parliament), have gone from 3 a day to 30 a day in the past 10 days. A third of the hospital’s beds are now taken by Covid patients, up from less than 10% two weeks ago. It’s much worse elsewhere. And there’s no sign, at least not yet, of any levelling off.
So I’m personally in favor of Covid-related restrictions on travel to the US, whether a citizen or not. Slowing the spread of the new variant will give the country more time to get more people vaccinated, which could make a huge difference.
@Ed
As a practicing physician on the front lines all this year, let me see if I can educate you.
1. “Having overflowing hospitals show you how little capacity there is”
Hospital capacity is determined by community needs. At least on the community I live, that capacity was adequate until COVID hit. You can not just create an unlimited amount of hospital beds far exceeding community needs, is not economically sustainable. This virus has overwhelmed the healthcare capacity on almost every country around the world, not just the US, the problem being not the lack of capacity but rather the unprecedented demand for hospital beds brought by the rapidly rising number of people infected.
2. “THE FACT that COVID has a 3% mortality rate. Not 100%, not 50%, not 10%”
Frankly, I’m tired of hearing ignorant people making this idiotic statement over and over again. While the fact is that the recorded overall mortality from this virus is somewhere around 1-2%, that fails to tell the entire story. The number of people coming on a daily basis to the hospital with extensive pneumonia and respiratory failure is not comparable to any other respiratory virus we’ve seen in recent years. The reality is that without hospital care and support, many of these patients will experience a higher degree of mortality. And that does not take into account the additional burden these high number of sick people place on the entire healthcare system–we are stretched to the limit, we are tired, many of us are getting sick and some have died providing care for the never ending wave of COVID patients that keep coming everyday to our hospitals. Many patients that have COVID will get few or no symptoms, but a significant number of the ones that require admission to the hospital have very prolonged recovery that often requires a skill nursing facility. Many suffer from shortness of breath, chronic fatigue and pain for weeks or months, making them unable to return to work in some instances. Many of the more severe cases (young and old a like) usually develop severe permanent pulmonary damage from COVID along with other major lifelong complications.
3. “Destroying an entire economy because you failed to have a functioning health care system is not idiotic, it is criminal. People DO NOT HAVE THE RIGHT to destroy the livelihoods of others. You do NOT have the right to treat others like filthy animals and lock them up indefinitely.
The needs of the few DO NOT outweigh the needs of the many.”
People with your persuasion love to talk about your rights this and your rights that. Defending your rights is a great thing, and I applaud you sense of civic responsibility. I personally don’t agree with all the actions from our government regarding this pandemic; in their defense this is a very uncommon disease that took everyone by surprise, was difficult to foresee the full effects of it at the beginning. But next time you talk about rights, please understand that other people have rights as well. Your rights end where mine and other’s begin. Me and countless like myself, have there right to remain healthy and have a reasonable chance NOT to get infected by people that refuse to wear a mask or practice any kind of precautions regarding containment. If you don’t believe the COVID is real (and I’m not saying you do) I won’t force you to protect yourself against this infection, the only thing I ask is for you to protect everyone else’s right not to get infected by you.
I know none of these will change your mind about the pandemic, some will continue to believe this is fake or containment efforts are unnecessary. Is impossible to get someone to see facts when they refuse to open their eyes at all. I just ask you to please wear a mask in public and keep some distance, not to protect you but to protect your fellow Americans, just in the odd chance that COVID is actually just as bad as the media claims.
@C Arthur – excellent post. Thank you for your hard work in a brutal year.
It’s just sad that ~35% of the US lives in an alternate world. Maybe some can be saved after the Charlatan In Chief is unemployed in 3 weeks.
The answer is simple: mandatory testing and quarantine on arrival. Korea and other countries have been doing this all year. Setup the infrastructure and strictly enforce compliance.
The US’ covid problem is largely domestic. There is a cultural problem. Incentivize (yes, pay) people to stay home as much as possible. Requiring contact tracing and symptom screening at every public place. Make testing casual and widely available. Blast out confirmed cases and hot spots as emergency alerts on phones.
We need to start treating this like we’re in war time and put our collective needs ahead of our selfish wants:
The sooner we do these things, the sooner life will start to become normal again. Vaccine is promising, but it’s a long ways out until we’re at mass inoculation.
@UA-NYC Fake news that ~35% live in an alternative world and support the Charlatan in Chief.
Many liberals have risky behavior for Covid-19. Many think they are acting safely by doing some measures but could actually reduce their risk significantly. There’s not a monopoly on risky behavior by Republicans.
Look at the more than 8 million that flew over Christmas. All Trump supporters? Hardly.
Happy new year. Just curious. Is the word “enroute” somehow now a noun? Last I looked it was two words and an adverb.
@derek – did I ever say it was 100% of Dems and 0% of Republicans exhibiting good behavior? No. There are plenty of bad behavior Biden voters and good behavior Trump voters.
Yet it’s pretty clear, en masse, who is mask wearing and who isn’t – https://news.gallup.com/poll/315590/americans-face-mask-usage-varies-greatly-demographics.aspx
And yes, a good chunk of the country somehow thinks doing literally the bare minimum (mask wearing) is somehow a massive affront on their personal freedoms…GMAB.
Ed
Fair points C Arthur, but YOUR rights also end where others’ begin. You cannot dictate how other must live. Besides, it is easy to oracle from an ivory tower when you live in luxury as a well-paid professional while millions of Americans are starving because government shut down their small businesses.
That said, it now is simply a function of time. I can imagine that more and more people are getting fed up with the current situation and want it to be resolved. NOBODY on this planet has an unendless supply of patience. And more and more people are getting angrier by the day with politicians who are destroying their livelihoods while being hypocrites and ignoring their own rules (hello Newsom). It is only a matter of time before a majority of the population gets so angry that mass violence will break out.
@Ed
Are you sure you are just one person? It’s hard to believe that much stupidity can exist in 1 body.
About time but it’s not going to help the 1 in 1,000 Americans already dead and the many more with lifetime medical issues.
For all of you who don’t understand the Constitution, it’s a document for “we the People” not for “me, me, me, whaaah, me, me, me who cares about the People, me, me, me, whaah!”.
You fly to Tijuana and enter by land. Duh.
Typical right wing twits wittering on about their freedoms and rights but not about the responsibilities that come with freedom and rights
Does the US have a “avoid non essential travel” advisory in place?
In Canada we do, and have also put the same pre return travel Covid test in place effective Jan 6th (?)
Regardless of what your stance is on any/all of the restrictions, IMHO if you were told not to travel and now you get stuck or have to take additional steps to get your test done, then too bad for you! You were advised not to leave in the first place.
In this exact situation. US citizen living in South Africa. Have to leave due to visa expiring. However labs down here will not run PCRs for travel purposes due to shortages.
If this is enacted we would be denied boarding to leave, but it would also be illegal for us to stay.
@Ed
I really enjoy when a person answers an argument with an ad hominem attack or comment, just undermines his/her weak position and limited capacity for rational thinking.
Yes Ed, I am a well paid professional as you state, don’t understand how this piece of information is anyway relevant to the discussion here. As I stated on my post, I don’t agree with all the steps taken by the government regarding containment.
And no Ed, I don’t live on an Ivory Tower as you suggest, I’m not an academic physician living in a bubble. I’m an actively practicing physician, I specialize in pulmonary medicine/critical care so I’m the guy that will see you when you come to the ER with COVID pneumonia and can not breath. I’m the guy that has seen countless of people like this all year long, have taken care of them in the ICU when they need ventilatory support, and I’m the gut that has seen many of these patients go through major complications and even die despite our best efforts. I’ve seen the devastation severe COVID has on patients and families alike.
And not that is any of your business but I don’t have to apologize to you nor anyone else for making a lot of money on my line of work, for my degree I worked very hard through years of college, medical school and several years of hard and grueling training to get where I am today. I took loans like anyone else and paid a lot of money for my education. I work between 12-18 h on a typical day to make what I make. So forgive me if I fail to give a damn about your opinion regarding my well paid position… I earned it!
And yes Ed, like many of you I have not seen my family for an entire year, I didn’t travel on any of the Holidays this year to avoid the risk of infecting anyone of them in case I was infected but with no symptoms. You know why, because I love them and care not to get them infected.
So there you go Ed, next time choose a better target.
@ED….well said and thank you for taking the time to put a pragmatic and insightful post on the subject. I might also add how much it pains me that one of the popular soundbites the trump base seems to be using is that Doctors are using the Pandemic as a way to line their pockets…..Trump even said it in a campaign speech.
I find it incomprehensible that the frontline medical workers who are risking their lives to save others and are stretched to the limits are being attacked for political reasons without any basis in fact…..that’s tantamount to the 9/11 first responders being called a bunch of looters for going into those burning buildings.
How the hell this country got to a place where a huge segment of the population cannot see to the fact that simply wearing a mask protects others and is the right thing to do is beyond me.
Darn!! I meant C Arthur! not Ed….Ed you are simply wrong