How to Organize for Testing Requirements for Travel to China?

In recent weeks, the news has been full of the abrupt surge in COVID cases in China due to the sudden end of the COVID-Zero protocols that have been in force there for over three years. The flood of new cases, deaths, and hospitalizations has produced many questions. Will this mean a new variant of concern in the United States? How will the surge affect travel to and from China? How effective are the current safety measures in place for regulating travel?
Here are some answers.
Traveling to China
China has been secretive about case numbers and hospitalizations, meaning that we can only estimate the true impact of the virus in the country. Experts have suggested that deaths in China due to COVID could pass more than a million by April, and leaked data has indicated that COVID cases have already soared to the hundreds of millions from cities alone. This will result in countless cases of Long COVID, further devastating Chinese businesses and the economy.
But while the rest of the world is buckling down and considering tightening restrictions in the face of what is being called a triple pandemic of COVID, the flu, and RSV, China has, perhaps surprisingly, reopened and eliminated most protocols within China itself. And, the country is allowing travelers in and out for the first time since 2019.
Traveling to China comes with much fewer restrictions right now than it has since the start of the pandemic. Visitors are simply required to get a PCR test 48 hours before departure.
So if you plan to travel to China, there are two things you should keep in mind. First, getting a PCR test 48 hours before departure to China is getting more difficult. The current requirement is to get a Covid-19 PCR test within 48 hours of departure. Testing facilities for a rapid PCR are getting more scarce in the US. What you want to search for is rapid point of care (POC) PCR testing at certified labs. Most PCR sites actually do not do testing on-site and often require days to return results. Knowing and scheduling a POC test in advance will make your travels considerably more relaxed.
Second, since the virus generally takes ~3.5 days to incubate and show a positive test result, even random testing prior to departure with a rapid antigen test or a more accurate PCR test could fail to detect COVID. To ensure you get out on time you’ll want to lay low for a few days prior to travel and test daily for the 3 days prior to your departure so you don’t have any surprises when you go to get your lab certified RT-PCR test.
In addition, remember that getting COVID is still a health risk for those 55+ and for those with comorbidities (e.g. diabetes, heart disease, cancer, immunocompromised). Individuals who may have a higher risk of death or serious illness from COVID due to these comorbidities make up roughly 20% of the population. Plus, there is the risk of debilitating symptoms of Long-Covid for the .5%-2% of those who get Covid, possibly for months, years or a lifetime. Finally, there remains the real productivity and business continuity impact of just getting and sharing Covid for many.
Finally, the way governments have defined safety and testing protocols underperforms. So, when you travel, wear a well fitting KN95 mask on the flight. Consider that 28 of 29 flights tested had Covid in the flight’s waste water in late 2022. Test frequently in advance of your flight if using rapid at-home tests. The FDA provided new guidance on the underperformance of the rapid-home tests (and Nature noted the Abbott BinaxNOW test can be just 36% accurate). So test with a high accuracy test as close to your departure as possible so you don’t get denied flight with a positive result, or run the risk and hassle of getting quarantined upon arrival. Also, frequent, high-accuracy testing prior to gathering in a crowded venue, or returning to family and friends is the best way to protect those who are most vulnerable.
Traveling from China
Many countries have similarly implemented safety measures for passengers traveling from China. The EU’s Integrated Political Crisis Response (ICPR) organization recommends mask wearing for all flights into and out of China, as well as random testing of Chinese passengers upon arrival. The U.S. has decided to require a negative PCR test 48 hours before departure.
Most of these safety measures, although various authorities have suggested they are politically motivated, have already been in play for anyone traveling to China. So the problem is less whether they are politically motivated than if they alone will be effective.
Unfortunately, the short answer is no. Alone, some are not particularly effective. While still better than the 72 hours before departure rule China has implemented, testing 48 hours before departure will only reduce transmission rates by 10% overall by most estimates. So a segment of individuals with COVID have a higher probability of still getting through the screening process and risk exposing others.
Add to that the problem of Long COVID, which could affect at least one in five of those who get exposed to and eventually contract COVID. Long COVID consists of at least one COVID symptom that lasts at least four weeks after an individual has contracted the virus. The symptoms could include anything from shortness of breath and fatigue to much more severe symptoms like frequent dizziness or even nerve or heart conditions. While most symptoms will clear up after a few weeks or months, some .5%-2% of those who get Covid will have debilitating symptoms for possibly months, to years, to a lifetime. Long COVID has proven to be a serious threat to business productivity and employee health.
As deeply concerning as COVID still is, there’s also flu and RSV to worry about. Any one of these viruses could create complications for anyone with risk factors, and contracting more than one virus simultaneously, though unlikely, could easily overwhelm your immune system. If you want to protect yourself and your company during the tripledemic, you need to go beyond the typical airport travel regulations.
Better Testing Protocols for Travelers
What should you do if you’re planning on bringing together employees or business partners from all points of the globe or nation, including China, for an event? Ultimately, whether your guests are coming from China, or another state, or country, with a high prevalence of COVID cases, best-in-class safety practices remain the same.
Ideally, you should provide high accuracy on-site rapid testing and provide on-site testing as individuals enter your event. While some event planners might be tempted to rely solely on rapid home tests, the FDA has shown that these are notoriously unreliable, and can lead to real productivity impacts for your business. New guidance suggests you can use these less-than-ideal tests with a strict regime of three tests taken 48 hours apart prior to an event, but such protocols are difficult if not impossible to implement, enforce or maintain for an event setting.
Next, make provisions for quarantining in case someone tests positive at the site of your event. You might provide hotel accommodations or negotiate possible extended quarantine stays with venues ahead of time. Otherwise, your attendees may prefer to pass on your event rather than risk having to pay a high price for an unexpected extended stay.
Finally, consider testing for RSV and the flu in addition to COVID. No one wants to risk bringing multiple viruses home to family members who are at risk, and in the case of RSV, young children may be especially affected, while influenza is a major concern for elderly people. In the new normal, taking a laissez faire attitude may get you sick, and will likely bring segments of your team and their family considerable hassles and productivity and business continuity losses.
AllClear’s rapid and highly-accurate 4-plex test allows you to test for RSV, Flu A, Flu B, and COVID simultaneously. Contact us to set up an affordable health station right at the site of your event for all your testing needs. And if you have event goers headed to China, a health station will hugely reduce travel hassles of securing required RT-PCR tests.
No one should have to choose between keeping family members safe and attending a corporate event. You can help your employees, protect event attendees, and maintain business productivity and continuity by providing better testing options.