We answer common questions about the coronavirus crisis. Send us an email at goatsandsoda@npr.org if you have any questions. The subject line should be: “Weekly Coronavirus Question.” You can find an archive of our FAQs right here.
I flew on a trip… and I caught COVID. What now?
You’re now one of the many millions of tourists who took off this summer to travel for conferences, vacations, and family reunions. You flew to your destination.
When you arrive, it’s great. You feel a bit off. You feel your throat scratchy. You might start to cough. Your head may feel like it’s about to fly off your body like an errant balloon.
Sigh. It’s time for a COVID test. The good news is that you are positive
What are you doing now? What do you do? If you are a candidate for Paxlovid, can you get it? The big question is: When are you able to fly home? True confession: I was there. Here are the lessons I gained from that experience as well as from subsequent interviews with COVID experts.
Before you travel, be prepared for COVID
The first question is: How did you prepare for a COVID case?
Anyone who has not yet taken a summer vacation should remember that the pandemic continues. In the U.S., surges are occurring in popular tourist destinations such as France, Spain, and Italy.
This means that your trip planning should not be limited to what to see or where to eat. It is important to consider COVID preparation. These are the steps that COVID experts recommend for pre-trip preparation:
What to do if you receive a positive test
Let’s get back to the drama: I went on vacation, and all I got was a bad case of COVID!
The Centers for Disease Control and Prevention recommends that you do not travel if you have COVID. This is done to prevent you from spreading the disease to others.
You’ll be faced with two kinds of problems: Rearranging your travel plans aEUR”, and figuring out when it is possible to return home.
Let’s start with the logistics.
Stay where you are
You may be able to extend the stay at your current accommodation. We asked hotel representatives if they would consider allowing COVID-intolerant guests to stay at their property. If the hotel says yes, they will likely tell you that there won’t be any housekeeping services at a EUR” but that you can request towels, room service, or food from a delivery app to leave your door (which should always have the “do no disturb” sign). Look for another lodging option if the hotel won’t allow COVID guests or your room isn’t available.
Uh-oh. It’s time to return my rental car!
If you are unable to drop the car off in a safe place and return it to your isolated lodging, you have a problem. Rental car companies are able to help. Really. Different companies may have different options. Avis customer service representative Gabriel says that his company may send a team to pick the car up, arrange for towing or authorise another driver to return it. They might also be able extend your rental until you are recovered, if that is the case.
You can always rely on the kindnesses of others if all else fails. My daughter’s boyfriend offered to drive us back our car for a EUR” approximately an hour. He didn’t charge me anything for the Uber ride, but I did pay for it. My daughter’s friend said that being sick is a difficult situation right now. We’d love to help.
Paxlovid (or other antiviral treatment), can be obtained
You are not permitted to bring the emergency authorization for Pfizer’s Paxlovid pills to the Food and Drug Administration. This is for those at high risk for severe diseases, such as older people or those with specific medical conditions.
Paxlovid is a time-sensitive drug. Within five days of your positive test, you should start your daily dose of three tablets twice daily. Contact your primary care doctor to get the address of a nearby pharmacy. You can also Google a telehealth portal, which will accept your information and send you a prescription. The service could run you around $75. You can also take advantage of the FDA’s new ruling. Although not all pharmacies are on board, those that offer “test-to-treat” services may be an option. To find pharmacies that are participating, use the online locator tool of the Department of Health & Human Services.
How do you get a prescription for COVID? According to the pharmacy I used, you cannot come in to pick up the pills because you have COVID. Some pharmacies offer delivery and drive-through options. Ask a friend or family member to help you. You can also use an online service such as TaskRabbit to find someone to do the job for you.
Jill Weatherhead, assistant professor of pediatric and adult infectious diseases at Baylor College of Medicine says that if you don’t have an alternative, it is worth picking it up. “Make sure to wear a N95 or KN95 mask.”
Where can I go home?
This is the big question. Infectious disease doctors also recommend the CDC’s 10-day guidance. It is definitely prudent.
Keri Althoff, an epidemiologist from the Johns Hopkins Bloomberg School of Public Health, says that “We have isolation protocols aEUR” in order to reduce spread. There is also a risk of spreading if you are sitting next to another person on a plane or other transportation such as a bus or train. The person next to you could be suffering from COVID or have other underlying conditions.
The 10-day rule is not enforced by any authorities in the United States.
It can be difficult to wait 10 days before you are able to get rid of your isolation.
It is not ideal to be far from your home. According to Dr. Preeti Maani, an infectious disease doctor at the University of Michigan, home is more comfortable. It can be difficult to stay a few hundred miles away from your home while you have COVID.
Althoff says, “Don’t underestimate how mentally difficult it can be to decide when to go home.” “It’s emotional, it’s mental, it’s financial. It’s hard.” It’s difficult to make these decisions when you aren’t feeling well.
CDC’s advice can be confusing. It recommends that you isolate for 5 days after an infection. This is if you are at home, and not traveling. For those who don’t travel, CDC advises that people with COVID-19 should isolate themselves for five days. If they become symptomatic (with fever for less than 24 hours), then they should wear a mask for five days. This will reduce the chance of spreading infection to others.
Many people make their own decisions about when and where they want to travel.
Some people who have just been tested positive for COVID may say that they are going home. BAD CHOICE. They are putting others at danger, and they might find that the flight is too long for them to get sicker. We heard it from all the experts we spoke with:
(Aside: Our panel of experts also suggested that uninfected travelers should assume that there will be at least one person with COVID on board a train, plane, or bus. This is an excellent reason to keep your mask on while traveling.
Others might be able to drive after a few days so they would cancel their flight and rent a car aEUR contact-free and then head home. It’s much easier to do this if you have an 8-hour drive to make than a 3-day trip that requires finding safe places to stay and eat.
There are also people who decide that it’s okay to stay in isolation until they feel better. Then they can make the return trip home. Maybe it’s quicker than 10 days.
Weatherhead says that the two days before a positive test are the most contagious and the five days following it.
She says, “If you feel better and your symptoms have subsided after the 5-day period [when it is most infectious], traveling is not recommended aEUR”, but she suggests that you take an N95 with you while you travel.”
However, symptoms don’t always give you a good indication of your condition. She adds that it is difficult to determine how infectious someone is. Although coughing is an effective way to spread the disease, “a lot people have had theirs for weeks. That doesn’t necessarily mean that you are infected.”
Are tests worth the effort?
A negative COVID test might be interpreted as a positive and the traveler is allowed to return home. However, you can test positive even if symptoms have subsided for several days. One NPR colleague observed a positive line for 20 days. The doctors that we spoke with said that you are unlikely to have enough viral load to spread the virus to others. Althoff says that even if you test positive for the virus after a week, there is still a low chance of transmission if your symptoms are not severe.
Let’s assume your symptoms have gotten pretty severe aEUR” since the last time you tested positive. It’s been oh, 5-7 days. How can you travel safely without putting yourself at risk?
Baker says, “If you feel sick, don’t go on vacation.”
If you feel confident enough to travel, a mask aEUR”, preferably an N95, is recommended. Baker says, “In the name and goodness, think about others around you.”
Do you need to share your diagnosis with your seatmate?
An interesting question was asked by a colleague. A colleague asked me a question: Should you tell an unmasked passenger on your flight home, for example, one week after you have tested positive?
Baker says, “I believe that would cause pandemonium aboard the plane.” I would wear my mask and just let it go. You might also consider having a snack or a drink in a quiet area of the airport before you board the plane. This will ensure that you don’t have to take off your mask for a bite, or even a sip.
It’s also important to remember how far we have come, even though we are all still pandemic-weary. Malani says, “If you had told me two years ago that we would have tests that we could put in our pockets aEUR” and that if we got sick, we would be able to call up a virtual portal to get an antiviral prescription five minutes later… nobody could have predicted that!”
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