For Those Contemplating Travel to England: A Cautionary Tale

From Kaiser Health News today, originally titled

Travel in the Time of Covid: Getting There Is Easy — It’s Getting Home That’s Hard

I’m being held captive in England by the U.S. government.

On the day my wife and I were to fly home from London after a brief visit, we took a covid-19 test, as required by the Centers for Disease Control and Prevention to travel to the U.S. The United States will not allow anyone to fly into the country who has tested positive for covid, and it is up to the airlines to enforce that.

My wife’s test was negative. 

My test was positive.

She flew out.

I stayed put.

I stayed put and tried to figure out what to do next. And as anyone who considers traveling overseas should realize, the hard part isn’t getting there. It might not even be avoiding covid, though that’s getting tougher. It’s getting back to the United States.

I am not allowed to fly for 10 days. After that, if I have a negative test, I’m free to go.

But while in Britain, I don’t have to quarantine. The British government says I’m free to do whatever I want. I can ride the stifling Underground, visit beautiful museums, or stand in line for a crowded indoor concert. I could go full Typhoid Mary, if I wanted, and wander into quaint pubs, all without a mask. Hardly anyone in England seems to bother to wear one.

What I can’t do is ride an airplane, with air recirculated every three minutes, among people required to wear masks the whole time. Had I caught covid while in the U.S., I could freely fly from Washington, D.C., to San Francisco — masked, of course — without a problem. But not over the Atlantic.

So I was looking at 10 days of hotels, which are not cheap in London. It’s not as if I can call a friend here and say, “Hey, I got covid. Can I crash on your living room sofa?”

But a colleague who travels often to London made a suggestion: Go to Brighton, the classic beach town on the English Channel. Hotels cost a third less there. Brilliant. (It’s seedy and charming and historical. Worth a trip.)

I rode the train down, and what had only been a scratchy throat did develop into a dry cough, some sneezing, a loss of appetite, and maybe even a slight fever. I wore a mask whenever I went out.

Meanwhile, covid cases were rising rapidly in Britain. Hospitalizations, too.

The British government estimated that nearly 3.5 million people in England tested positive last week, about 6% of the population. British doctors on Twitter are warning again of stressed hospitals. Drugstores had masks, lots of sturdy masks, but not a single covid test. All Boots stores, the British equivalent of CVS or Walgreens, had printed signs that said they were all out and to try again tomorrow. Those signs were never taken down during my stay,  and I hit several stores every day. While masked.

My symptoms quickly went away, and after four days I felt fine again. I continued to wear an N95 mask. My Johnson & Johnson vaccine and the half-dose Moderna booster recommended by the CDC apparently did the trick.

But, now, how do I get back? Here’s the problem. There is a chance that some little piece of the virus remains in my body. So if I take another test and it’s positive, I’m stuck here again — with no symptoms except a bleeding wallet. I didn’t want to take that risk.

Fortunately, a Facebook friend happened to post something about her husband, who was caught in a similar circumstance. His solution was to pay a private doctor to attest that 10 days after his first symptoms, he no longer was contagious. For $185 he got a legitimate “certificate of recovery” that deemed him “fit to fly.” And he got home.

I’m going to try that. Wish me luck — because if there’s one thing I’ve learned about traveling to another country during covid, it’s this: You may not get horribly sick, but your personal finances will feel the pain.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Subscribe to KHN’s free Morning Briefing.

Typhoidmerrily Yours,

-ACP

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16 thoughts on “For Those Contemplating Travel to England: A Cautionary Tale”

  1. Dr. P, I’d like you to weigh in on the benefit of supplements. And I love the comment suggesting flying to Mexico!

    Reply
  2. It’s too late for this trip, but the only way I know of to avoid this source of financial pain is travel insurance that includes Covid delay-related expenses.
    Too, if the traveler is 65+ and on Medicare, travel insurance is a good idea because Medicare does not cover medical expenses (of any sort) outside the U.S. The downside is that it can add 10% to the cost of a trip.

    Reply
  3. Fly to Mexico and come across southern border. Don’t need no stinking test to enter US there.

    Reply
  4. I personally have written ‘Letters of Recovery’ and there is nothing preventing a physician in the US (TSC for example) from writing this letter and emailing it to the Connecticut Yankee. The letter needs to document a positive Covid test (any kind) within the last 90 days and ‘recovery’ from symptoms. It is not clear how long you have to wait after the positive test- I recommend 5 days after a positive test with no symptoms or 5 days after symptoms begin to abate.

    Reply
    • Dan,
      Perhaps I should start promoting myself as a “letter of recovery” doctor. Seems like a small amount of work for $185
      Dr P

      Reply
  5. I guess you could have had your wife send you some rapid-result antigen tests by FedEx (or equivalent). But if you did that, how would the test be “monitored” to be valid for airline purposes?

    Reply
    • Henry,
      It seems to me it would be very easy to create a negative COVID rapid antigen result-just don’t stick the swab in your nose. Very difficult to monitor that.
      Dr P

      Reply
  6. I thought it was you who was sick/stuck. Glad it wasn’t.
    Having just gotten back from England, I can verify the general masklessness and lack of concern there.

    Reply
  7. From HRS
    Well written, thoughtful and interesting article. ACP is an excellent poster. For immune “protection” I recommend prophylactic 5,000 IU D3/day, vitamin C 500 mg twice a day, selenium 200 ug/day, zinc 50 mg/day, lactoferrin 500 mg/day, quercetin 500 mg/day, sulphoraphane 300 mg a day–all supplements 5 days a week “to give the body a break”. Just a debatable best guess based on the published literature. HRS, MD, FACC

    Reply
    • Interesting.

      It’s strange because all along I had heard how far ahead the UK was of the US with regard to having tests widely available, at least when it comes to LFTs (the antigen tests), but maybe this poster needs a PCR test for the airplane trip. Also I’ve heard the cases there are quite high right now, which may be why there’s a run on them.

      I’m not sure about the concern regarding international vs domestic travel or the rationale for it at this point, except perhaps to limit a new variant if one were to emerge? On the other hand, it seems like we always find out about new variants after they have already spread internationally and that they will spread internationally regardless of what we do.

      Hawaii just ended its requirement on March 26 for domestic (US) travelers to provide a negative trip for entry.

      Reply

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