Travel in the Shadow of COVID

By Chuck Dinerstein, MD, MBA — May 23, 2022
COVID has made travel more difficult. Between a shortage of pilots and other staff, changeable weather, and varying mask rules, travel days between one place and another are often grueling. I know because I just finished a bit of an extended vacation. The CDC’s current guidance is not especially helpful.
Image courtesy of Kranich17 on Pixabay

The CDC’s recommendations include:

  • Taking a COVID test as close to the time of departure as possible,” no more than three days ahead of travel within the US – for those both up-to-date and not-so-much with vaccinations [1]
  • Taking a COVID test after returning from domestic travel if you experienced “higher exposure.” That would mean areas of greater case numbers or more crowded situations. Before returning from abroad, one must have been tested for COVID within 24 hours of departure.
  • If taking a cruise ship, you must be tested anywhere between 3 days or less before boarding and should use a mask in crowded indoor areas.

That is just the tip of the iceberg, as I learned flying to Europe, then aboard a cruise ship, and finally, flying home.

Getting out of the US on a plane

My destination, Portugal, requires documentation on where I will be staying and how I can be reached for contact tracing. Additionally, I needed proof of my vaccination status and a valid passport.

To avoid problems upon arrival, my airline required all those requirements to be met before I boarded the aircraft. All documentation could be uploaded online through a convenient app on my phone. Unfortunately, as a bit of a techno-feeb, just uploading an image of my passport took 15 minutes. Uploading my vaccination information, handily maintained by a separate app provided by New York State, only took 10 minutes and was a snap once I figured out where the image of the vaccination card was stored in the phone to be subsequently uploaded. The contact information for Portugal was relatively easy, assuming you knew off-hand, your seat assignment on the aircraft, and the address of where you were staying. Altogether, 35 minutes to prepare myself to be “Travel Ready.” In retrospect, I was one of the lucky ones. A line snaked back 20 feet of passengers, not “Travel Ready,” awaiting assistance from the airlines at the airport.

While there was no mask mandate at the airport, there was one on the plane. So, mask on for my 6-hour journey.

Getting onto a cruise ship

The cruise line required a negative antigen or PCR test 24 hours or less before boarding. For those traveling directly from the plane to ship, testing could be done at the airport - $250, no insurance accepted, and that is assuming you could find the testing site in a different terminal and get an appointment. We chose to spend a day or so in Lisbon, so we arranged to get an antigen test through our hotel.

Of course, my fear and that of my beloved spouse was that a positive test would result in our isolation at the Holiday Inn Lisbon. So we took precautions. In the weeks leading up to our trip, one of those COVID variants grew ever closer, as one after another of our close friends “got COVID.” To be protective, we kept reducing the size of our pandemic pod until we were basically shut-ins for the last week before departure. My wife, a nurse before running a successful small business, insisted we do some in-home testing to be safe. She gently but insistently performed a nasal cavity search with those swabs. Remarkably, despite the growing COVID cases among our friends, we remained negative.

The last hurdle before being on our cruise was that final antigen test at the hotel. We needn’t have been concerned. The technician, unlike my wife, gently inserted the swab somewhere in the vicinity of my nostrils. The only way that test could have been positive was if I was visibly dripping the virus from my nose. The test was more safety theater than an actual test – but we were both down with that.

That moment of safety theater would be repeated on the cruise. On day one, everyone was pretty compliant with wearing masks while walking the corridors, and it was required for all excursions involving travel by bus. By day two or three, the masks dropped below the nose and then, for most, disappeared. The cruise line chose to make sure no one was getting sick by requiring a daily temperature check using one of those thermal scanners. SCIENCE NOTE: The data on thermal scans suggests that they may be unreliable measures of an elevated temperature, and additionally, “normal” temperature has a range, not a number.

Because we were disembarking from the ship and flying directly home, we required a negative antigen or PCR test within a 24-hour window before leaving the ship. In one of the most efficient moments of our trip, the cruise ship lined us up, performed another antigen test, and provided the results by email within 2 hours. Like the test in Lisbon, that swab made just a nodding acquaintance with my nose, very different from the nasal cavity search conducted by my wife. There is no advantage to a positive test; you are quarantined in some foreign land, possibly without DoorDash or UberEats.

Flying home

Just one last COVID hurdle, once again making myself “Travel Ready.” Having done this before, I knew it would be a snap. I was wrong. We were no longer in a port but at sea with less than reliable Internet service. Even though I had all the steps down, it took 30 minutes to upload images of my passport. Loading the vaccination documentation was easy because I now knew where to look for the download on my phone. The unexpected hurdle was that negative antigen results were password protected; for my safety and privacy. It only took 15 minutes with my mad skills using Abobe’s PDF software to create a copy that was not password protected that could be uploaded and read by the airline’s software. All that remained was a 2-hour ride to the airport and a 4-hour wait to get on the plane. [2] As we went through Customs after 15 hours of travel, we were asked if we had anything to declare. “Yes,” I said, “I am happy to be home.”


[1] Being up-to-date is considered to having had both the first two vaccinations and at least one booster

[2] The spell-checker repeatedly required me to say get on the plane. But in the words of the great George Carlin, “Evil Knievel gets on a plane, I get in a plane.”



Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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