Mandatory testing for US air travelers from China

As of January 5, 2023, new travel regulations are in effect for entry into the United States. Air travelers, regardless of citizenship or vaccination status, traveling to the US from China, Hong Kong, or Macau must provide the airline with a negative COVID-19 test result prior to departure for the US. However, it is not only people traveling directly to the US from these regions who are affected.

The Centers for Disease Control and Prevention (CDC) announced in late December 2022 that a negative COVID-19 test or proof of recovery will be required for passengers from the People's Republic of China and the Hong Kong and Macau Special Administrative Regions entering the United States.

CDC justified this step as a result of the sharp increase in corona cases in China and aims to prevent further spread in the United States. Currently, no reliable transparent epidemiologic data are provided from China by which to monitor introduction of new COVID-19 variants.

Huge increase in corona cases in China

Due to strict measures as well as mass testing regimes, corona cases in China had been contained within the last few years. After almost three years of lockdown, quarantines and strict contact tracing, China has now very abruptly lifted its "zero covid policy" on December 7 - after nationwide protests. The decision was justified by the rather harmless infection course of the Omikron variants. Furthermore, it was announced that China would reopen its borders to tourism on January 8 and that quarantine for entrants would no longer be required.

These measures had not only triggered a travel rush among the Chinese, but also a huge increase in COVID-19 infections. Within the last 3 weeks, an estimated 248 million people have been infected with the viral variant in China, the highest global increase in infections since the pandemic was announced in the spring of 2020.

Notably, the end of mandatory testing has made it impossible for Chinese authorities to provide realistic infection numbers. The Chinese government reacted soberly to the rise in infection, saying they believe international concerns are unfounded.

Containment of the virus

New SARS-CoV-2 variants continued to emerge worldwide within the last 2 years. Only through transparent disclosure and collaboration among public health agencies can new variants be identified, understood, and the further spread of the virus slowed. Testing efforts over the past two years have reduced the number of infected airplane passengers on board and contained the spread of the virus.

The World Health Organization (WHO) had asked China for more transparent communication related to the rising Corona situation and offered its support in the fight against the virus.

Global concern for transmission of the virus as well as new variants is on the rise, which is why the US has now joined Italy, Japan and India in calling for mandatory testing for travelers from China. Germany has also followed suit and introduced mandatory testing.

Mandatory testing before entering the USA

In order to prevent the spread of the COVID-19 virus, since January 5, 2023, all air travelers aged two years and older entering the US from China, Hong Kong or Macau, either directly or with stopovers, must present a negative COVID-19 test.

Negative PCR and antigen tests, no more than 2 days old at departure, from government-licensed providers are accepted and must be presented to the airline prior to departure (usually at check-in).

The Food and Drug Administration provides a list of approved COVID-19 tests on its site.

The requirements apply to passengers regardless of nationality or vaccination status. This includes US citizens and green card holders, as well as individuals who wish to enter the US on a US visa or under the Visa Waiver Program (VWP/ESTA). Passengers who have a transit stay in the USA are also included in the testing obligation.

In addition to direct flights from China, the testing requirement also applies to flights that have flown to Incheon International Airport (Seoul/South Korea), Toronto Pearson International Airport and Vancouver International Airport in Canada on their way to the US and carry passengers who have had a layover in China in the last 10 days prior to departure.

This test requirement does not apply to air travelers who passed through an airport in China, Hong Kong, or Macau en route from another country to the United States or if they have been in China, Hong Kong, or Macau for less than 24 hours. Also, individuals seeking to enter the US by sea or land who have been in those regions for 10 days previously are not subject to the testing requirement. For individuals who tested COVID-19 positive more than 10 days prior to flying to the US, the following alternative documents may be provided (in lieu of a negative test):

  • Positive COVID-19 test result from a specimen collected more than 10 days but less than 91 days before the flight; or
  • A positive COVID-19 test result from a specimen collected 10 or fewer days before the flight PLUS a letter from a licensed health care provider or health authority stating that COVID-19 symptoms began more than 10 days before the flight.

The CDC provides detailed information on its website regarding the testing requirement for travelers to China.

Please note that only persons fully vaccinated against COVID-19 will still be allowed to enter the United States.

COVID-19 early warning system TGS expanded.

In addition to the increased testing measures, CDC also announced an expansion of the TGS program (Traveler-based Genomic Surveillance Program), an early warning system designed to detect and characterize new COVID-19 variants.

This involves anonymously performing and collecting nasal swabs from international travelers upon arrival at major airports in the United States to identify variants of the virus. Currently, 7 US airports are participating in the program, with approximately 500 flights arriving daily from about 30 countries - about 290 flights weekly from Chinese regions.

Because of the different specifications in each case for regional corona testing, the TGS has been able to demonstrate gaps in global surveillance for SARS-CoV-2 variants. As a result, omicron variants were deposited in the global database early, before they were reported from other countries.

In addition to working with WHO and other countries, the TGS program aims to help limit the spread of corona at the airport, on airplanes, and in their respective destinations, making travel safer again.





Updated on 9.1.2023

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