Though the order excludes people who have gotten, and recovered from, COVID-19 who can provide “documentation of recovery,” it does not exclude people, like myself and my husband Tim, who are fully vaccinated. Though the distinction between having recovered from COVID-19 and having been vaccinated is unclear to me, it was clear our four-day trip to Mexico would demand a test of some kind before returning home to the Bay Area. And it’s a requirement I support.
Which COVID-19 test do I need to re-enter the U.S. from abroad?
Based on the CDC’s description of which self-tests are accepted as re-entry documentation, it seemed most of the FDA-approved options would qualify. Both antigen and molecular (or nucleic acid amplification test (NAAT) tests like the RT-PCR) are accepted, as are rapid tests and self tests.
The problem for me came from two separate, but related, issues.
First, I didn’t realize that many of what I thought were “at home” tests are actually just “self-administered” tests — meaning yes, you can buy a kit at pretty much any drugstore and collect your sample at home, but you then have to send the sample to a lab and wait up to 48 hours for results. The test itself is not processed at-home. That means these tests wouldn’t work for our international trip, since sending a sample from Mexico wouldn’t be practical (if it is permitted at all, which I’m not certain it is). There are, however, some tests that don’t require that second step. Great, I thought, I’ll get one of those.
But nope. There was one additional issue I also misunderstood. The CDC guidelines make clear that a test used for re-entry documentation “must include a telehealth service … that provides real-time supervision remotely through an audio and video connection.” The purpose of the telehealth component is to confirm the tester’s identity, observe the testing to make sure it was done correctly and to confirm the test results over video. Great, I thought, Costco sells tests that come with video observation and that specifically advertise themselves as “travel approved.” Those specific tests need to be sent away for lab testing, but I reasoned, surely there are others that don’t.
There are so many over-the-counter COVID tests out there, with video observation and without, at-home processing and mail-in lab results. It seemed impossible that there wasn’t some way for me to simply go to a pharmacy, buy a test kit, and test myself on video a few days before our return flight.
The specific test that kept coming up in my research was BinaxNOW COVID-19 Antigen Self Test from Abbott Laboratories that pairs with an app that functions as a digital record of your test results. Great, I thought, I’ll run to CVS and buy one for $24. But then I read the FAQ at the bottom of CVS’ product page. Though this test seems identical to another Abbot test with a virtually identical name, the over-the-counter version “is for personal use only and doesn’t provide a documented test result that you can display when traveling.” Well, phooey.
Then I read on: “For a documented test result the BinaxNOW COVID-19 Ag Card Home Test may be a better. Combined with the NAVICA App and with a negative result, you will have a digital result that may meet travel requirements. This test is offered by eMed, please visit www.emed.com for further information.”
Though it took me another half-hour of online sleuthing to confirm it, this was the moment I learned that despite all the options out there, the only self-test that meets the CDC requirements for re-entry is only available online — and only through one specific online pharmacy. Would I love to know what eMed, a company I have never before heard of, did to get monopoly rights to sell this test? Yes, I very much would.
Though the CDC testing requirements for re-entry don’t seem particularly onerous or complicated, they’re not as straightforward as they appear. The “Ag Card” version of the BinaxNOW test is sold only in packs of six that cost $150 — significantly more than the various over-the-counter versions that, as far as I can tell, do essentially the same thing. They’re also available only online, meaning that by the time I was hoping to buy one, a few days before my trip, it was already too late to realistically receive the test kit in time to take it with me.
We would not be self-testing our way back into the country, as planned. But you can, if you’re willing to fork over $150 to eMed and wait however many days it would take for the kits to arrive via mail — and I don’t know how long that takes because I refused to enter my information into the site in order to find out.
While I find it both frustrating and mystifying that eMed currently offers the only self-testing option for international travel from California, that seems likely to change fairly soon. EMed’s site describes its tests as the first “FDA-authorized, virtually guided, at-home COVID-19 rapid antigen test with automated results reporting,” but that suggests there can be others. And, hopefully, there will be soon. In the meantime, eMed has just started distributing the “Ag Card” version of the home test in some Walgreens in New York and New Jersey, which I’d hope means more states and brick-and-mortar retailers will follow.
If we can’t self-test for COVID-19 to re-enter the U.S., what do we do instead?
This part, it turns out, was remarkably easy. I had read that some Mexican tourist hotels were offering testing as a service for guests. Some were even offering both free testing and a paid quarantine stay for guests who test positive and, therefore, can’t return home until they’re COVID-free. Airlines also have various testing programs in place, including a partnership between United and eMed (though it’s unclear how buying a test through the United portal differs from buying from eMed directly).
We were flying Delta, so I first checked the airline’s “Testing Resources” website to see what it offered. It listed several ways to get tested in southern Baja, where we were staying. But I thought the easiest option might be contacting our hotel, the wonderful new Grupo Habita “design hotel” Baja Club, to see whether provided on-site testing. A quick email to the concierge later and I had scheduled our tests for two days before our return.
I had been given the option of either taking an antigen test with results in three hours (for 1,100 pesos or about $55) or a PCR test with a 24-hour turnaround (3,500 pesos, which would set us back $176 each). We were told that U.S. guests typically take the former, so that’s what we did as well.
The hotel testing process
That day, a technician met us in the hotel lobby, put on his protective gear, and administered a nose-tickling but largely painless antigen test. A couple hours later, we received the test results via email, while a paper version was delivered to the reception desk that afternoon. While not an insignificant expense, it was at least a seamless, stress-free process. We could, I know, have gotten the testing done for less at one of the many testing sites in the region, which includes a “last resort” test at the Los Cabos airport for 450 pesos for the antigen test. I’d guess other non-airport labs are even more affordable.
I wasn’t sure what advantage the more expensive and slower PCR test might have, but it seems the antigen test is more prone to false positives, which would have been a real problem for us — parents with young kids staying with family — had that happened. (Also worth noting: Canada requires a PCR test, while the United States allows either.) Ultimately, however, I had followed the research on vaccine efficacy closely enough that I was less concerned with contracting COVID as a fully vaccinated person (and especially as one who was also masking in transit and in most indoor settings) than I was with making sure my paperwork was in order. And that part was far less complicated than I’d feared.
At the airport
We arrived at Los Cabos airport two and a half hours before our flight home. We’d already checked into our Delta flight on the Delta app, which had asked some basic COVID-19 screening questions as part of the online check-in process. At the airport ticket counter area, there were tables set up with paper forms asking the same series of questions, which we then handed over to a Mexican health official as we passed through a temperature screening area on our way to the security check. Our COVID test documentation was not asked for at this point.
On the other side of security, as we waited to board, the Delta gate agent announced that passengers should come to the desk for a passport check. Once there, Tim was also asked for our negative COVID test paperwork, which he had wisely grabbed as well. And just like that, we were on our way.
In retrospect, the fact that the self-administered COVID tests are comparatively hard to get was to my advantage. I ended up spending less money for an easier, less anxiety-inducing process. But I can also see that, depending on where one is traveling and what infrastructure is available there, the eMed test may be the best, or even the only, option.
For our trip, we stumbled upon a better, easier, and more affordable way. The most important lesson, for me, was that the combination of my overall comfort with travel and the strangeness of not having done it for a very long time means that I should over-research, over-plan, over-worry. Where I normally fight against my inclination to anxiety, this may be a time to indulge it.
Tim and I chose Baja as our first short trip away from kids because the peninsula is driving distance from our Northern California home while still being Mexico — a country so close to me that staying away, over the last many months, was an act of love. So too was coming back.
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