Aerial view: Istanbul August 2017
It is a new year and after 2020 most of us would like to have flipped the switch to a new reality in 2021, but the covid-19 pandemic rages on. Even though the vaccine is being rolled out and distributed rapidly in many states and countries, the RT-PCR COVID-19 test is still required by airlines for international travel. It is also required for some domestic travel depending on the state you are traveling from and that which you will be flying to. It is certain the COVID-19 test will play a role in international travel at least until the desired results from a vaccine are realized. With that in mind, here is the information you need to incorporate COVID-19 testing into your family travel plans. Several states and countries mandate quarantine and/or documented proof of a negative COVID-19 test upon arrival. Some international airports such as JFK in New York have requirements for all traveling passengers to complete a health screening form before exiting the airport. State and local travel requirements vary and to see a detailed requirement on your desired location, the CDC has a link where travelers can find complete guidelines for every city and state before they travel. https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-planner/index.html
When traveling through airports, there will be long enough lines at airport check in counters, security checkpoints, and boarding gates. All passengers are required to wear masks aboard flights, and with recommendations for washing hands or using sanitizers, staying six feet apart when boarding a well-ventilated airplane, the last avoidable risk of transmission of the covid-19 virus is in sharing the space aboard the plane for the duration of your flight. For the protection of all passengers, pilots and crew members, most airlines have required COVID-19 testing on international flights where the flight times and supposed exposures are longer than most. Lastly, it is agreed by most health organizations that accurate, reliable and rapid testing eliminates the need for quarantine of COVID-19 negative travelers upon arrival.
There are different types of COVID-19 tests: the antigen test, the antibody test and the RT-PCR test. The International Air Transport Association (IATA), whose members represent 82% of global air travel, considers the RT-PCR (Real-time Reverse Transcriptase Polymerase Chain Reaction) test to be the gold standard and is the test required for travel.
What is the difference between these tests?
The antigen test detects the presence of parts of the coronavirus protein to determine infection but is less sensitive and may require a higher viral load for protein detection. This test is typically performed and resulted within a few minutes. The antibody test which tells more about immune response is not relevant for screening purposes as it does not convey information pertaining to active or current infection. Lastly, the RT-PCR test which is the “gold standard” for SARS-CoV2 (COVID-19 virus) detects RNA or genetic material specific to the virus even in the asymptomatic individual. This test typically takes 2-3days to result but can be resulted within 24hours depending on lab processing capabilities. It must be taken and resulted within a specified timeframe of travel typically 72hours.
This timeframe is important to consider with international flights especially since some travel itineraries have long layovers which shorten the timeframe of the validity of the documented test result. In some instances, airlines such as Egyptair have extended this timeframe to 92hours depending on the country or travel origin. Another airline, Emirates, allows up to 120hours (5days) within arrival of a documented negative RT-PCR test. There is also variation in the age of the passenger required to test with testing being waived for passengers anywhere from 2years to 12 years old. Documented test results are reviewed by the airlines either at flight check-in or prior to boarding, and these are checked again before exiting the airport at your destination. Failure to follow guidelines when traveling can result in denied boarding, entry, and in some cases mandatory institutional quarantine.
When traveling with children, the best travel experiences involve a lot of planning and preparation. By now most children are familiar with the idea of wearing a mask but if your child is a toddler or younger, it may be harder to have them keep a mask on through the duration of the flight. In our experience, the airlines understand these challenges and have not been sticklers for young children struggling with consistently keeping their masks on but provide gentle reminders throughout the flight. The pediatric face shield may be a substitute covering but can be irritating for your child when they doze off on the flight. Hopefully, your kids have had a mask up routinely when engaging in activities outside your home, so the idea is not completely foreign to them and the process of keeping a mask on less daunting.
Performing a COVID-19 test in a child like any other medical procedure can be anxiety provoking for the child and for us parents as well. Feeling unsettled or anxious is a normal response. However, like any new process, preparing your child by setting reasonable expectations and explaining what they can anticipate makes a great difference in how they feel about and the experience the test. We love to travel as a family and now that travel has the added requirement of COVID-19 testing, helping your child understand why it is needed for travel like you would explain for a passport or visa is the beginning to normalizing that process as part of your pre-travel routine. Children are very perceptive and to an extent their attitudes and behaviors are shaped by ours. When children observe their parents navigate travel hurdles and negotiate perceived impasses successfully, it should strengthen their confidence in traveling and problem-solving abilities. Last of all, performing the COVID-19 test together as a family can transform this potentially dreaded activity into yet another activity you accomplished together as a family.
While most airlines require documented proof of a negative RT-PCR test upon country arrival, some countries also require repeating the test upon arrival such as UAE and Cameroon. Test samples are taken with a nasal swab and back of the throat but can also be obtained with an oral saliva swab to the back of the throat as well. Although most local jurisdictions offer free COVID-19 testing, it may be worth paying for testing to ensure you are able to get scheduled and resulted RT-PCR testing within your travel timeframe. Even though the IATA along with the WHO supports the requirement for governments to cover the cost of mandatory testing associated to travel, this is not often the case as travelers have routinely paid for tests on arrival which can be relatively expensive such as $150 per test per passenger upon entry to Ghana.
To conclude, guidelines and requirements continue to change and so for the most accurate and up to date test and screening, refer to the specific, airline or country. For more information on COVID-19 testing and international travel visit the IATA website https://www.iata.org/en/pressroom/pr/2020-06-16-02/.
For tips on preparing your child for the COVID-19 test – https://mgsfl.com/preparing-your-child-for-a-covid-19-test/ and on how to help make the COVID-19 test more comfortable for children, visit https://www.childrensmn.org/2020/08/04/tips-make-covid-19-tests-comfortable-children/
More travel resources:
CDC guidelines on testing around domestic travel – https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html