United States: CDC Issues Guidance on New COVID Test Requirement for Travel from China

Under this new policy, air passengers two years of age and older originating from the People’s Republic of China (PRC) and the Special Administrative Regions of Hong Kong and Macau, and passengers traveling from certain designated transit hubs outside China who have been in mainland China, Hong Kong, or Macau within 10 days prior to departure, will be required to undergo a COVID-19 test no more than two days before their departure and show a negative test result to the airline at the time of departure. Alternatively, passengers who have tested positive for COVID-19 within 90 days of departure can provide certain specified documentation of recovery in lieu of a negative test result.

Airlines must confirm the negative COVID-19 test result or documentation of recovery for all passengers before boarding. If the passenger fails to comply with the requirement, the airline must deny boarding to the passenger.

The new requirement applies to flights departing at or after 12:01 am EST (5:01 am GMT) on January 5, 2023, and will remain in effect until modified or rescinded by the CDC.

The requirement applies to the following two classes of air travelers aged two years and older traveling to or through the United States:

• Those traveling from mainland China, Hong Kong, or Macau; and
• Those traveling from South Korea’s Incheon International Airport, Toronto Pearson International Airport, or Vancouver International Airport who have been in mainland China, Hong Kong, or Macau within ten days prior to their departure to the United States. (The CDC notes that it will continue to monitor travel patterns from China and may subject other foreign transit hubs to the requirement in the future.)

The requirement will apply both to direct flights and to indirect flights via third-country transit, as well as to passengers transiting through the United States to other destinations.

The requirement will apply to all subject travelers regardless of nationality or vaccination status – including U.S. citizens and lawful permanent residents (LPRs). There is no exemption for diplomatic travel.

According to the initial CDC announcement, passengers may meet the testing requirement through a PCR test or an antigen self-test administered by a telehealth service or a licensed provider and authorized by the Food and Drug Administration (FDA) or the relevant national authority. Self-tests are only acceptable if they are performed through a telehealth service that provides real-time test supervision remotely, and the telehealth provider must confirm the traveler’s identity, observe the sample collection and testing procedures, confirm the test result, and issue a report meeting the technical requirements of the CDC order. The subsequent CDC guidance provides additional detail regarding specific forms of testing that will be considered acceptable, including NEAR, TMA, LAMP, HDA, CRISPR, and SDA testing.

Test results must identify the traveler, specify the specimen collection date, type of test administered, and test result, and identify the testing entity.

In lieu of a negative COVID-19 test, a traveler may show recovery from COVID within the past 90 days, in one of two ways:

• A positive COVID test taken more than 10 days and less than 91 days before departure; or
• A positive COVID test taken within 10 days before departure, along with a letter from a licensed healthcare provider or public health official stating that the passenger’s COVID-19 symptoms began more than 10 days before the date of departure.

Travelers must present the required documentation of a negative test or recovery from COVID to airline personnel prior to boarding, and they must carry this documentation while traveling in the event the documentation is requested by U.S. government personnel or state or local health authorities. In addition, travelers must complete a required attestation, which must be retained by the airline.

If the flight delay is 24 hours or less past the two-day limit for testing, the negative test remains acceptable. If the delay is beyond that, the traveler would need to undergo a new test.

The following travelers are exempt from the requirement of a negative COVID test or proof of recovery from COVID:

• Passengers transiting mainland China, Hong Kong, or Macau (if for a period of 24 hours or less);
• Passengers who have been in mainland China, Hong Kong, or Macau for less than 24 hours;
• Airline crew members, and U.S. federal law enforcement personnel and U.S. military personnel traveling on official orders, subject to certain health and safety requirements; and
• Individuals for whom the CDC has approved a humanitarian exception, where emergency travel is required for health and safety (e.g., emergency medical evacuations) and there is insufficient time for pre-departure testing. The CDC guidance makes clear that humanitarian exceptions will be granted only in very limited circumstances, and on an extremely limited basis.

The new CDC requirement will require travelers from China to engage in additional advance planning in order to ensure they are permitted to board an aircraft for travel to the United States.

The CDC is continuing to monitor the progress of the pandemic and travel patterns relating to China and may adjust the scope of the requirements as needed.

Fragomen is closely monitoring the situation and will provide updates as developments occur.