On December 2, the U.S. Centers for Disease Control and Prevention (CDC) issued new recommendations for quarantines and travel: Rather than quarantine for 14 days after exposure to someone with COVID-19, the agency now advises that the quarantine period can end after 10 days if no symptoms are experienced, or after 7 days if a negative COVID-19 test result has been obtained.
Just before Thanksgiving, the CDC rolled out new recommendations for international travelers and now says that advice applies to all travel. Those who need to travel during the coronavirus pandemic should get tested twice for COVID-19—once before and once after their journey—and should stay home for one week after arrival.
The travel recommendation stops short of using the term quarantine (it’s not a requirement after all), but the advice is that travelers stay put for one week post-travel.
Here’s what the CDC now recommends for travel:
- Get tested 1–3 days before your flight—make sure to have actual results (not pending results) prior to traveling.
- If you have a positive result, do not travel.
- Get tested 3–5 days after your flight.
- Stay home for 7 days after traveling, even if you test negative.
- If you test positive for COVID-19 after you travel, isolate yourself and follow public health recommendations. Do not travel until you are no longer considered a transmission risk—this includes your return trip home.
“If travelers do not get tested after traveling, CDC recommends reducing nonessential activities for 10 days,” Dr. Henry Walke, director of preparedness and emerging infections at the National Center for Emerging and Zoonotic Infectious Diseases, said during the CDC’s telebriefing on December 2.
“Testing does not eliminate all risk, but when combined with reducing nonessential activities, symptom screening and continuing with precautions like wearing [a] mask, social distancing and hand washing, it can make travel safer.”
The CDC notes that travelers should always defer to federal, state, and local government travel restrictions and requirements. Some of those restrictions can include COVID-19 testing requirements and mandatory quarantines that can often be as long as 14 days.
The agency also reminds travelers that a negative test result does not mean that they can or should forego other public health precautions.
“A negative test does not mean that you were not exposed or that you will not develop COVID-19. Make sure to wear a mask, stay at least 6 feet from others, wash your hands, and watch your health for signs of illness while traveling,” the CDC advises.
The same applies to the forthcoming vaccine rollout: “Even as [coronavirus] vaccines become available, taking these protective actions is critical until COVID-19 vaccination becomes widely adopted,” added Dr. Walke.
What is a quarantine and how are quarantines enforced?
Before we tackle some of the issues surrounding quarantine, let’s refresh our memories as to what exactly a quarantine entails—and how quarantines are enforced. A quarantine is intended to “separate and restrict the movement of people who were exposed to a contagious disease to see if they become sick,” per the CDC.
That differs from isolation, which separates people who are known to be infected with a contagious illness from those who aren’t infected.
In the United States, there is an ever-evolving list of states with quarantine requirements. The list and requirements have changed frequently during the course of the pandemic, so be sure to check the latest requirements.
The enforcement of these domestic quarantine orders ranges from reports of Hawaii arresting nearly 200 visitors for quarantine violations during the summer (Hawaii has since moved to a pretravel testing program, save for Kauai, which is back to requiring a 14-day quarantine) to New Jersey’s order, which states that a “self-quarantine is voluntary, but compliance is expected” for travelers from states with significant COVID-19 spread.
Across the Atlantic, the United Kingdom requires that anyone coming from countries and territories that aren’t on a list of exempted nations should quarantine for 14 days—save for England, which is allowing travelers to reduce their quarantine time with COVID testing. However, travelers who fail to quarantine when required can be fined up to £1,000 (or approximately US$1,270). If they don’t provide accurate contact details, they can be fined up to £3,200 (about US$4,070).
Despite reports about the chaos that changing quarantine rules in the U.K. has created (when countries are removed from the exempt list, for instance, with very little advance notice), British media report that little enforcement is actually taking place.
What should travelers do when quarantines aren’t required?
When quarantines are required, travelers should “absolutely” comply, says Dr. William Miller, an epidemiologist at Ohio State University.
But when they aren’t, that’s when the situation becomes a bit more nuanced.
“If they have been somewhere with a high rate of COVID-19, yes, they should. If they’ve been to a low incidence place and drove there, no,” says Miller. “If their only risk is the plane—and if they went to a low-risk place—I would say no, it isn’t necessary but I would suggest being highly vigilant.”
Infectious disease and medical experts echoed that sentiment of increased vigilance during and after travel, even if a quarantine isn’t required or recommended.
Those who might come into close contact with people who are at high risk for becoming severely ill from COVID-19, such as people with immunosuppression or chronic conditions, or senior citizens, “should self-quarantine and avoid coming into close contact with high-risk people,” advises Dr. Hanh Le, senior director of medical affairs at medical information site Healthline.
Le says that the way you travel should also factor into the decision to quarantine or not. She offered an example of a potentially low-exposure scenario: traveling in your own car or a recreational vehicle (RV) with stops limited to gas stations and take-out restaurants.
“However, if your travel required exposure to a lot of fellow travelers in crowded areas, such as airports, airplanes, crowded train stations, buses, or mass transit, especially if the other travelers were not wearing masks and practicing physical distancing, then your risks are much higher,” says Le. Following those higher-risk encounters, she advises a self-quarantine.
Ahmad Varoqua, a developer and designer for the Human Agency, a digital solutions firm, did just that after he returned to California in early August from a trip to see relatives in New Jersey. He underwent a two-week self-quarantine in his house despite the fact that it isn’t required in California. (The governors of California, Oregon, and Washington issued a joint statement in November asking—not requiring—visitors and residents returning to the Western states to quarantine for 14 days.) He said he did it to protect his family.
“I decided to quarantine after my trip to New Jersey with more than a little encouragement from my wife, in order to protect her and my son,” says Varoqua. “Flying cross-country and going through two major airports felt intrinsically riskier than my weekly Costco run in terms of exposure. While it was the longest two weeks of my life being unable to hug my son, it was a small price to pay to ensure that he and my wife weren’t exposed.”
Why testing shouldn’t replace vigilance
The CDC now recommends a two-test process for travelers to reduce the chance of spread. In fact, testing has become a method governments have used to help travelers bypass quarantine requirements in places such as Hawaii, Croatia, South Africa, and in numerous Caribbean destinations.
For those who would consider geting tested for coronavirus before and/or following their travels to minimize the risk they pose to others, there are some things to consider. The first is that tests aren’t always widely or readily available, especially as destinations experience an uptick in cases and demand for testing. Diagnostic tests for COVID-19 can also result in false negatives—meaning individuals can test negative even though they are infectious. A June study by Johns Hopkins researchers found that testing people for COVID-19 too early in the course of the infection is likely to result in a false negative test.
The other issue is that coronavirus has “a 14-day incubation period, so if you get tested on day 5 or 6, which we know is the average incubation period, and that’s negative, that doesn’t mean suddenly the rest of those 14 days are a free-for-all. Be mindful that you have a 14-day window, and try to make smart decisions during that time,” says Saskia Popescu, senior infection prevention epidemiologist at George Mason University.
Whether travelers decide to quarantine or get tested or not after they travel, Popescu says that ultimately the relative safety of travel—and reducing the risk of contracting and spreading coronavirus while traveling—really boils down to being a responsible traveler, both during and after your trip.
How should you do that? Wear a mask. Avoid crowds and large gatherings. Maintain a social distance from others. You know, everything we should all be doing whether we are on the road or not.
“Travel is important, mental health is important. Is it totally safe? No. Nothing is zero risk right now. Everything is varying levels of risk,” says Popescu. Lowering that risk “is so reliant on people being vigilant.”
This story was originally published on August 20, 2020, and was updated on December 2, 2020, to include current information.
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