The US, per the CDC, now requires that if you plan to travel internationally you will need to get a COVID-19 viral test no more than one day before you travel by air into the United States and you must show this negative result before you board your flight. With lines getting ridiculous all around the world, how can you prepare before you leave the US?

The CDC amended its requirements on October 25, 2021 to include all air passengers who are 2 years or older to get a test within 1 day of your flight departure:

All air passengers 2 years or older with a flight departing to the US from a foreign country at or after 12:01am EST (5:01am GMT) on December 6, 2021, are required show a negative COVID-19 viral test result taken no more than 1 day before travel, or documentation of having recovered from COVID-19 in the past 90 days, before they board their flight.

https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html

When do I need to get the test exactly?

Every different country is different when it comes to defining what a “day” is. The US has decided to use “1-day” instead of “24 hours” to provide flexibility and therefore it does not depend on the time of day the flight is as long as it’s the day of, or the day before.

So for a 1pm flight on a Friday, you just need to show a test that was taken any time on the prior Thursday (or the morning of Friday if you like to live dangerously).

Who does this order apply to?

This order applies to all passengers attempting to fly into the US including citizens, green card holders, visa holders, and visitors to the United States (unless you are individually exempt).

Yes, this Order applies to all air passengers 2 years or older traveling into the US, including US citizens and lawful permanent residents (Green Card holders) unless exempted.

https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html#general

Exemption information for this requirement can be found here, but know that getting these exemptions is a very timely and difficult process so be prepared to work hard if this is the path you want to take.

What type of test is required to re-enter the US?

The good news for us is that despite the need for a test to re-enter the US, the CDC has made the requirements for which test exactly that is required relatively broad.

The strict words from the CDC are:

You must be tested with a viral test to look for current infection – these include an antigen test or a nucleic acid amplification test (NAAT).

https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html#anchor_1635127081

This means that it can include all of the following: Rapid antigen, Viral antigen, and Antigen Chromatographic Digital Immunoassay, Antigen Chemiluminescence Immunoassay, or Antigen Lateral Flow Fluorescence.

It can also include all of the following acronyms: NEAR, TMA, LAMB, HDA, CRISPR, and SDA.

Overall the requirement is that:

The test used must be authorized for use by the relevant national authority for the detection of SARS-CoV-2 in the country where the test is administered.

https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html#anchor_1635127081

Can I use an at-home antigen test to enter the US?

In short, yes, but with a few big caveats (for the formal language, click here):

  1. The test must be authorized with Emergency Use Authorization (EUA) from the US FDA (or the relevant national authority where the test is administered)
  2. The testing procedure must include a tele-health service affiliated with the manufacturer of the test that provides real-time supervision remotely through an audio and video connection.
  3. The telehealth provider must confirm your identity, observe the sample collection and testing procedures, confirm the test result, and issue a report that meets the requirements of the CDC’s Order (more about that below)
  4. Airlines and other operators must be able to review and confirm your identity, and the test results, and you must be able to present the documentation of test results to US officials at the port of entry and local/state health departments, if requested.

All in all though, this does mean that the tests you are allowed to take include the at-home antigen tests and you don’t need to line up for hours to get a PCR on your last day abroad.

You do need to make sure about all of the above requirements though, including that you need to have someone attached to the test watching you take the test online. It’s not enough to just do it on the phone with a random doctor either.

What is required to prove that you’ve done the test and what do you need to show?

If you’ve followed all of the above requirements you will end up with a written document (paper or digital copy is fine) which includes:

  1. Type of test (indicating it is a NAAT or antigen test)
  2. Entity issuing the result (e.g., laboratory, healthcare entity, or telehealth service)
  3. Sample collection date
    • A negative test result must show the sample was taken no more than 1 day before the flight.
    • A positive test result for documentation of recovery from COVID-19 must show the sample was taken within the 90 days before the flight.
  4. Information that identifies the person (full name plus at least one other identifier such as date of birth or passport number)
  5. Test result

If it’s me, I’d recommend printing it out and having a copy (or three) on paper, along with a digital copy on your phone so that you absolutely don’t lose it.

You also need to show your evidence of being vaccinated, so don’t forget that CDC card!

What about if you’ve recently recovered from COVID-19?

The CDC has particular conditions for this:

If you have had a positive viral test on a sample taken during the past 90 days, and you have met the criteria to end isolation, you may travel instead with your positive viral test results and a signed letter from a licensed healthcare provider or a public health official that states you have been cleared for travel. The positive test result and letter together are referred to as “documentation of recovery.”

https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-international-air-travelers.html

That being said, you need to review this very carefully as it’s going to again require some leg-work from you.

How can I get one of these tests before I leave?

The bad news about all of this is that the tests are still really hard to find all over the world as there are now more people traveling demanding these.

So, my recommendation is to order them before you fly, not after.

One that I just ordered myself is this one from OptumStore. It arrived to my place in New York City within 2 days!

, Finding a COVID test to re-enter the US (tips before you leave the country)

Abbott BinaxNOW™ COVID-19 Ag Card Home Test with eMed Telehealth Services – 2 Pack for Travel

The test includes the online eMed requirements and ships quickly and easily. I just ordered two prior to a trip we’re taking and they don’t expire until towards the end of the year!

Important to note that the box makes it very clear you cannot open it until you are online with eMed, so DO NOT OPEN THE BOX!

What happens if you test positive?

If you test positive you cannot fly and your airline will reject you from boarding. Do not attempt this! You will have to reschedule.