Now that entry into the United States requires a negative coronavirus test result taken within 72 hours, travelers have been scrambling to secure coronavirus tests abroad — with many opting for speedier, though less-accurate, rapid tests. And most travelers probably do so under the assumption that their test will come back negative, allowing them to board their flight home without issue.
But what if that test comes back positive?
Even if you have been cautious throughout your trip, doctors say it is worth considering that your test result could be positive — effectively stranding you abroad for anywhere from days to weeks, until you can acquire a negative test result.
Here’s how to ensure you have a backup plan in place for a potential quarantine if you test positive for the coronavirus abroad, and what experts say you should keep in mind about rapid tests.
Officials say you could get stuck abroad
Centers for Disease Control and Prevention and State Department officials have said in recent weeks that those attempting to board flights into the United States without a negative test result in hand will be denied. That includes Americans who “could be stuck in an extended way” overseas if they test positive, says Martin Cetron, the CDC’s global migration and quarantine director.
Those who test positive for the coronavirus abroad are not permitted to travel back to the United States until they test negative within 72 hours of a secured commercial flight home. Depending on the country they are in, testing and/or another flight could be difficult to secure.
The State Department has also said it will not be offering medical assistance to Americans who test positive or require a coronavirus test abroad because of the department’s “limited medical resources” outside the country. That means that Americans who become sick or stranded outside of the United States should not rely on a nearby U.S. Embassy to assist them. The most the State Department offers is a directory of places where you can acquire a test, which can be found on the embassy website for the country a traveler is visiting.
Rapid tests are easier to find, but how accurate are they?
Considering those logistical challenges and the narrow 72-hour window of time allowed for a pre-departure test to be acquired, the United States is allowing rapid antigen tests, which are less accurate, for entry. Experts say that while the bigger problem with rapid tests are false negatives returned from asymptomatic people, some rapid tests return a number of false positive results to healthy individuals.
Shira Doron, an infectious-disease physician and hospital epidemiologist at Tufts Medical Center in Boston, says new at-home tests in the United States are more accurate than early iterations — but they do still see a single-digit percentage of false positives.
“Even if you’re talking about half a percent [resulting in false positives], apply that over the thousands of travelers per day and that’s a lot of people,” Doron says. “And there are rapid tests with false positive rates even higher, about five percent. That’s a lot of people every day getting kept out of the country, and to me it just says ‘stay home.’”
Even if you suspect your positive is false, you will be denied boarding and required to quarantine as usual.
The advantage of rapid antigen tests are first and foremost their speed. Rapid tests are “fast, cheaper and require far less resources than lab-based PCR tests, which take several hours to process,” says Tony Lemmo, CEO of BioDot, a manufacturing company that produces rapid testing materials.
While accuracy varies between different brands of rapid tests, Lemmo says false positives can occur and that positive rapid test results should be confirmed by a PCR test when symptoms are not present.
How to prepare for a positive result before you travel
Travel agents are advising people to plan for a positive test before they depart by purchasing third-party travel insurance that can cover the costs associated with 14 days in quarantine and/or additional testing.
Christine Sikes, an executive vice president for travel agent service Direct Travel, recommends talking to a travel insurance provider about which policies may be sufficient for covering expenses associated with quarantining, meals and potential medical expenses. Policy costs for those plans will depend on the purchaser’s age, travel destination and desired inclusions, Sikes says.
Travel agents are also advising travelers to pick a hotel that covers some or all costs associated with 14 days in quarantine for guests who test positive, which could be thousands of dollars for just the hotel stay. Hotel and resort chain Karisma, for example, is ensuring quarantine accommodations are free of charge at 17 of its properties for guests who test positive “until a doctor certifies clearance for travel with a negative test result for a period not to exceed 14 nights,” a Karisma spokesperson says. The offering is for all Karisma hotels in Mexico, Jamaica and the Dominican Republic.
The free quarantine lodging appears to be popular with resorts in Mexico, where other properties including Marival Resorts and the Palmaia — House of Aia hotel are also offering complimentary stays of up to 14 nights for any covid-positive guests. In all of those quarantine programs, guests are not permitted to use hotel facilities outside of their room.
Sikes calls the free quarantine stays for coronavirus-positive guests “the exception and not the norm,” and she says that guests should know their hotel’s offerings and policies before they arrive. More often, hotels will discount a percentage of a quarantine stay offer on-site coronavirus testing for a fee — and PCR tests are more expensive. Conrad Hotels by Hilton, for example, charges $65 for a rapid coronavirus test and $185 for a PCR test.
“You can still travel safely. You just need to plan and know what the ramifications are if you test positive,” Sikes says. “Hopefully no one does, but if they do, then they must have a plan.”