Review of COVID-19 Testing Guidance for Travelers to the U.S.

December 08, 2021

As of December 6, 2021, all air passengers 2 years or older (regardless of vaccination or antibody status) with a flight departing to the United States from a foreign country are required to show a negative COVID-19 viral test result taken no more than one day before travel, or documentation of having recovered from COVID-19 in the past 90 days, before they board their flight. The CDC Order uses a one-day time frame, instead of 24 hours, to provide more flexibility to air passengers and aircraft operators.

All passengers will be required to confirm in the form of documentation that the information they provide is true. All air passengers must be tested with a viral test that could be either an antigen test or a nucleic acid amplification test (NAAT). 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. Examples of available NAATs for SARS-CoV-2 include but are not restricted to:
  • Reverse transcription polymerase chain reaction (RT-PCR),
  • Reverse transcription loop-mediated isothermal amplification (RT-LAMP),
  • Transcription-mediated amplification (TMA),
  • Nicking enzyme amplification reaction (NEAR), and,
  • Helicase-dependent amplification (HDA).
Air passengers are permitted to perform a self-test so long as the test has received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration. The test procedure must also include a telehealth service affiliated with the manufacturer of the test that provides real-time supervision remotely through an audio and video connection. The telehealth provider must confirm the individual’s identity, observe the sample collection and testing procedures, confirm the test result, and issue a report that meets CDC’s requirements for negative test documentation.

The test result must be in the form of written documentation (paper or digital copy), and include the following information:
  • Type of test (indicating it is a NAAT or antigen test)
  • Entity issuing the result
  • Sample collection date
  • Information that identifies the person (full name plus at least one other identifier such as date of birth or passport number)
  • Test result
If an individual has recently recovered from COVID-19, and has met the criteria to end isolation, they may travel instead with their positive viral test results and a signed letter from a licensed healthcare provider or a public health official that states they have been cleared for travel. However, the letter does not need to specifically clear the individual for travel. If an individual received a letter from a health care provider or public health official that clears them to end isolation for purposes of returning to work or school, that would be permitted so long as it is signed and dated on official letterhead during the last 90 days. If the individual has recovered from COVID-19 but is not able to obtain documentation of recovery that fulfills the requirements, they will need to show a negative COVID-19 viral test result from a sample taken no more than 1 day before their flight to the U.S. departs.

Exemptions from this requirement may be granted on an extremely limited basis when emergency travel must occur to preserve someone’s life, health against a serious danger, or physical safety and testing cannot be completed before travel. The CDC will grant humanitarian exemptions on a very limited basis under similar circumstances. Individuals will need to submit information to the relevant embassy or consulate when applying for a humanitarian exemption.

To read the CDC’s new travel order, please click here.

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