I’M DREAMING OF A FLIGHT THIS CHRISTMAS

Dr. Dali Fan, UC Davis Health

By SUNITA SOHRABJI/EMS Contributing Editor

The December holidays are traditionally the most-traveled time of year for U.S. residents. Last year, even amid a surge in COVID infections, the Transportation Security Administration reported 15 billion trips made by people travelling between 50 to 500 miles, using all forms of transportation.

More travel is expected this year, including international travel, as countries around the world begin to loosen their COVID-related travel restrictions. But late last month, travel concerns emerged afresh as a new variant known as Omicron was first identified by scientists in South Africa.

“Omicron is named a ‘variant of concern’ by the World Health Organization, and is potentially more contagious than previous variants,” said Dr. Dali Fan, a UC Davis Health Science Clinical Professor who also serves as a volunteer vaccinator at California Northstate University in Elk Grove, California. “Information about the Omicron variant is still emerging, but from what we do know, caution and careful monitoring are important.”

The first confirmed case of the Omicron variant in the U.S. was identified at the end of November in San Francisco, in a person who recently travelled internationally. 12 states have subsequently confirmed at least one case of the Omicron variant, as of Dec. 3.

President Joe Biden called the variant “a cause for concern, not a cause for panic,” and has imposed travel restrictions on people traveling into the US from foreign countries. Proof of a negative test regardless of vaccination status is required within one day of departure for all passengers travelling to the US, effective Dec. 6.

Additionally, several countries have imposed or tightened their COVID-19-related travel restrictions. India, for example, will impose further testing and surveillance on travelers from high-risk countries, including the United Kingdom, Brazil, Bangladesh, China, and Mauritius, among others.

U.S. travelers will have to pay attention to restrictions by different countries.

Those travelling to India will be required to be fully vaccinated. Proof of vaccination status is required prior to boarding an airplane to the United States.

For U.S. citizens and Legal Permanent Residents (LPRs) who are eligible to travel but not fully vaccinated, proof of a negative COVID-19 test is required one day prior to their flight to India. U.S citizens and LPRs who are fully vaccinated will need to present airlines with proof of vaccination and of a negative COVID-19 test three days before their flight.

The Philippines is imposing similar restrictions: travelers who are not fully vaccinated will not be able to board a flight from the U.S. to the Philippines. Moreover, travelers will need to provide proof of a negative COVID test taken one day before traveling.

China is also imposing similar restrictions, but Zhong Nanshan, an advisor to the Chinese government, told CNN the country has “no plans to take any major action in response to the Omicron variant.”

The U.S. government had earlier advised people to restrict travel to Mexico unless absolutely necessary. In November, it issued a new advisory. Effective Nov. 8, all non-immigrant, non-U.S. citizen air travelers to the U.S. over the age of two are required to be fully vaccinated and to provide proof of vaccination status prior to boarding an airplane to the United States.

Similar to travelers to India, U.S. citizens and Legal Permanent Residents traveling to Mexico who are not fully vaccinated will need to provide proof of a negative COVID-19 test one day before their flight. Vaccinated travelers to the United States will need to provide either proof of vaccination or of a negative COVID-19 test three days before their flight.

In this FAQ, Dr. Dali Fan provides guidance for those who choose to travel during the holiday season.

EMS: Would you recommend that people reconsider plans for international travel, in light of the emerging Omicron variant? Are there countries you believe may be riskier as travel destinations?

The Biden administration issued a travel ban to seven other African countries (see above). This list is fluid and will continue to evolve, but caution is advised if you plan to travel there. Keep in mind the Delta variant remains the biggest threat to public health, so vaccination and other safety precautions like masking are best.

International arrivals to the United States must get a COVID-19 viral test (regardless of vaccination status) within one day of travel by air back into the United States. You must show your negative result to the airline before you board your flight.

If you booked an itinerary from a US state or territory to another US state or territory and the itinerary has you taking a connecting flight through a foreign country, you do not need to be tested. An example of this situation is an itinerary booked between the Northern Mariana Islands (a US territory) and the US mainland via Japan.

If you travel within the US between states and territories, the CDC has recommendations (see the answer of question 2). In general, you are recommended to test for COVID-19 if you are not fully vaccinated.
https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html

Always follow the CDC’s international travel guidelines:

• Do not travel internationally until you are fully vaccinated.
• Check your destination’s COVID-19 situation and travel requirements before traveling, because guidance may change. Countries may have their own entry and exit requirements.
• When you travel to the United States by air, you are required to show a negative COVID-19 test result or documentation of recovery from COVID-19 before you board your flight. The timing of this test depends on your vaccination status and age.
• Wearing a well-fitting mask over your nose and mouth is required in indoor areas of public transportation (including airplanes) traveling into, within, or out of the United States and indoors in U.S. transportation hubs (including airports).
• https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html

Travelers can expect states to lead their own efforts as well. For example, California is expanding COVID-19 testing at international airports and prioritizing arrivals from affected countries and monitoring for the variant’s presence.

EMS: What about domestic travel? Are some modes safer than others?

The CDC’s domestic travel guidance mostly aligns with their international guidelines: wait to travel until you get vaccinated, check the COVID-19 situation of your destination, wear a mask and cancel plans if you become sick or are exposed to COVID-19.

If you are not fully vaccinated and must travel, get tested both before and after your trip (see the end of this document for details or visit: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html

Generally speaking, passengers are at low risk of contracting the novel coronavirus while flying, but the COVID-19 virus can—and has—spread on planes with low rate. https://www.advisory.com/daily-briefing/2020/09/22/covid-flights#

Obviously, driving yourself is the safest.

EMS: How would you recommend people keep themselves safe while aboard a plane, train, or cruise ship, and in hotels or rental homes? What about safety measures while inside a private home?

In general, people should use preventive measures, including hand hygiene, physical distancing, and wearing face masks to keep themselves safe while travel. The same principles apply in other indoor settings as well, especially when you are with people you are not normally around.

Wearing a mask over your nose and mouth is required in indoor areas of public transportation (including on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on open deck areas of a ferry or the uncovered top deck of a bus).

The key is still: get fully vaccinated.

EMS: Would you recommend getting a booster before travelling? How long before travelling to get the optimal protection?

Yes, a booster is recommended to give yourself boosted protection. The COVID-19 neutralizing antibody levels started to rise within a few days of the booster shot. Schedule your booster shot two weeks before you are set to travel – this will give the booster time to be most effective. Get your booster if it has been at least six months since your second dose of Moderna or Pfizer vaccine, or two months after the Johnson & Johnson vaccine. https://www.deseret.com/platform/amp/coronavirus/2021/11/23/22798557/covid-booster-shots-how-long-does-it-take-to-work

EMS: Finally, should people quarantine or get tested for COVID once they have returned?

If you are fully vaccinated and suspect you have been exposed a possible COVID-19 case during travel, upon return, the CDC recommends you get tested 5-7 days after close contact.

• If you are not fully vaccinated:
• Self-quarantine and get tested after travel.
• Get tested with a viral test 3-5 days after returning from travel.
• Stay home and self-quarantine for a full 7 days after travel, even if you test negative at 3-5 days.
• If you don’t get tested, stay home and self-quarantine for 10 days after travel.
• If Your Test is Positive
• Isolate yourself to protect others from getting infected.
• https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html