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With cooler weather approaching amid rising coronavirus cases for the second year in a row, you might be wondering when to test for the coronavirus before travel—even if you’re vaccinated. Amid the Delta variant many destinations have re-imposed testing requirements for entry (regardless of vaccination status). But testing for coronavirus both at home and abroad can be complicated, with rapid tests selling out at pharmacies across the U.S. amid returns to in-person schooling, and private testing operations abroad often charging tourists a hefty price.
Experts say that while free testing is in a better place than it was last year, it’s important to know entry requirements for international travel in advance and to continue checking them up until departure in case of any sudden updates to those rules. Italy, for example, recently began requiring coronavirus tests of all visitors following new travel recommendations made by the European Union Council. And equally important is knowing how to decide if it’s a good idea to acquire a test even if one is not required—for example if you’re visiting a high-risk individual or traveling with unvaccinated children—and how much it will cost. Here’s what doctors say you should consider.
Testing in the U.S. and for international travel: What to know about PCR testing
Experts say the first thing to know about testing for travel abroad is that most testing requirements outside the U.S. now stipulate a PCR (polymerase chain reaction) lab test; not a rapid antigen test. Knowing the difference between the two is crucial: While Americans can acquire a rapid test (which does not need to be sent to a lab for processing) for re-entry into the United States, very few nations allow rapid test results for foreign entry due to the fact that they are less accurate, and instead require samples be lab analyzed.
Luckily, Americans should still be able to find free PCR testing in their area thanks to the Health and Human Services Families First Coronavirus Response Act, and testing is in a much better place than it was last year. And while there’s no guarantee you’ll get your results in 72 hours as many destinations now require, the time for the test results’ return are better than they were last year.
“As far as getting a test in the U.S. before traveling, I just traveled and went to a CVS for a drive-through PCR test, you could do the same thing at Walgreens,” says Dr. David Freedman, an emeritus professor of infectious diseases at the University of Alabama at Birmingham who recently traveled to Canada and needed a negative test result for entry. “I had proof of a result on my phone in less than 24 hours” says Freedman.
But not all testing sites are created equal. Dr. Gigi Kwik Gronvall, an immunologist at Johns Hopkins Center for Health Security, says securing pre-summer-camp testing for her under-12 son at a mass testing site in Baltimore this summer was returned a total of 74 hours later. A back-up CVS drive-through test luckily came back within 24 hours to save the day, but Gronvall notes that securing a last-minute appointment “can be challenging because a lot of the time slots are full right before weekend travel."
In general, you’ll of course need a negative result if testing is required, but Gronvall also says it’s a good idea to take any test you can acquire if you’re feeling sick, even if it’s not required by your destination. While rapid tests are overall less accurate than PCR, they are more effective in test subjects who have symptoms of COVID-19, and can be a good signifier of a clean bill of health in the event that your airline questions you about your symptoms, especially if you’re traveling with kids who are unvaccinated.
Since the U.S. has not standardized a vaccination certificate for use across states or internationally, Gronvall says, "There is no vaccine passport or testing passport, and the tests themselves have become their own form of passport, even for vaccinated people.”
The Centers for Disease Control and Prevention currently advise that anyone who has left the country, vaccinated or unvaccinated, test for coronavirus three to five days after they return. Unvaccinated travelers are advised to quarantine until they test negative.
Testing abroad and what to know about rapid tests
While ample free testing is currently available in the United States, the situation varies broadly in other countries. Hotels in tourist-frequented spots like Mexico and the Caribbean, for example, are frequently including free rapid testing in their nightly rates, but getting a PCR test there is likely to incur a high charge, and typically is more complicated since it requires processing at a health lab.
Gronvall and Freedman say for-purchase PCR tests at foreign airports and other private sites (like urgent cares) can be very expensive; somewhere between $120 to $200 per test. This is why most Americans are opting for rapid tests, which cost as little as $40, deliver results in minutes, and include remote-monitoring services that pair you with a health professional who oversees the swabbing and results via a telemedicine video call to verify who has taken the test, a process which typically takes under 30 minutes (and doesn't alway require an appointment). These services, which are included in the cost of Ellume and BinaxNOW COVID-19 Antigen Home Test swab kits, then create a verified negative result for officials to confirm, typically via your smartphone. If you’re planning on taking a rapid test abroad for return into the U.S., it’s important to make sure you have strong enough Wi-Fi for a video connection so you don’t waste the test. These types of test are in high demand, and as a result often sell out at many providers, which include CVS, Walmart, and Walgreens. (Note that self tests that do not include remote health monitoring are not accepted for official travel purposes, they just give you some peace of mind if you have the sniffles.)
While testing abroad may seem easier since Americans can more easily acquire a rapid test for re-entering the United States, Freedman says there’s an important caveat to consider: False positives. Rapid tests have been known to draw some incorrect results, which is why it’s smart to complete your rapid test early on in the 72-hour window so that a follow-up PCR test can be done if you receive a positive result and suspect it is false. “It gives you time to go out and find a negative PCR that will prove that,” Freedman says.
While some rapid tests are hard to find right now, testing is still in a better place than it was during 2020, and both Freedman and Gronvall say that it’s unlikely it will ever return to the long wait times seen before vaccinations mounted in the U.S., even if cases do continue to rise into the colder months. “It's easier and better to test now,” Freedman says, “and the testing is really becoming ingrained into the travel experience.”
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