Last summer I wrote about the challenges of air travel due to the impact of COVID. I had just flown from Italy to the US on one of the first post COVID-lockdown summer flights out of Italy. A month after that post I flew back to Italy, my permesso di soggiorno / residency permit making my return not only possible but smooth. I quarantined for two weeks on each end of that trip, which for me was the most difficult aspect of travel. Now, almost one year later, I have just made another international trip, returning to the United States from Italy for a family visit. COVID is still having a major impact on travel, but some things have changed over the past year and so it seems a good time for an update.

In some ways travel is even more complicated than a year ago, mostly because the rules seem to change on a weekly (daily?) basis and because different countries, even within the EU, have different requirements related to entry and testing. The complications mean this will be a pretty long post !

So, what’s new this year for those who want to travel to (or from) Italy? At this point, there may be more questions than answers.

Question #1 Has Italy reopened to tourists?

The answer here is yes, but…. it depends on where (ie, what country) the tourist is coming from. Residents of EU and Schengen Zone countries, along with just a few other places, can fly into Italy with a negative COVID test 48 hours prior to arrival. No quarantine required.

Visitors coming from the United States (along with Canada, Japan and the United Arab Emirates) are welcome, but the rules vary depending on the type of flight on which they arrive. Those arriving on flights designated as “COVID tested” (offered by Delta, American, and Alitalia) do not have to quarantine on arrival in Italy. These flights arrive to select airports in Italy (Rome, Milan, Venice and Naples) and operate on limited schedules. They require PCR testing before flying with proof submitted to the airline and an antigen (rapid) test at the airport on arrival in Italy. Passengers must also fill out a “self-declaration form”. These travelers do not have to quarantine on arrival, a definite plus for short term visitors.

The rules are different if arriving on a flight that is not designated as “COVID tested”. In this case, a test 72 hours prior to arrival is required and a 10 day quarantine is a must. The “self-declaration” form must also be submitted on arrival, with contact information about where the quarantine will take place (the traveler may be contacted by Italian authorities during the quarantine period). A repeat COVID test at the end of the quarantine is also required. It is tempting to think that additional testing on arrival, arranged by individual travelers, is equivalent to the testing done on those “COVID tested” flights but it is not and can not be used as a substitute for arrival via one of the specifically designed “COVID tested” flights.

Question #2 Does vaccine status matter?

Well, of course it matters and it is highly recommended that all travelers are fully immunized before heading to Italy, but at this moment vaccine status is not a factor in who can enter Italy or who has to quarantine. This is an evolving issue - the EU is working on a standardized electronic system for proving vaccine status (with information uploaded directly from the agency administering the vaccine) and it is likely that fully vaccinated EU citizens will be able to skip COVID testing prior to travel in the near future (perhaps as early as this week). It is not clear how this will work for those vaccinated outside of the EU. The United States, for example, does not have a national registry of vaccinations and the many different systems for administration (pharmacies, grocery stores, mass vaccination events, etc) do not contribute identifying information to a centralized data base. That makes proving vaccination status a bit tricky. Will my CDC card, which shows my name and birthdate, along with the manufacturer, lot number, and dates of my vaccines, be sufficient? Fingers crossed! It may well be another month or so before this is sorted out.

Question #3 What about travel from Italy to the US?

The first challenge is finding flights, as flight schedules are still not back to normal. Flying directly from Italy (Rome, Milan) to a major US airport, especially on the east coast, is quite easy but getting to smaller cities can be a challenge. When I traveled in April my choice was to either get a flight out of Rome or wait until the airport in Florence reopened (it was completely closed for months). I waited for Florence. My preferred route appeared available when I booked, but by the next day all those flights had been changed (did they ever really exist?) and the new ones required 2 days, 4 flights, and an overnight stay in Washington, D.C. to get from Italy to New Mexico. Staying flexible, and anticipating that these changes would occur, kept me relatively sane throughout the process. Luckily, flights are expected to increase this summer so routes and schedules should improve.

Question # 4 What about testing and quarantine to enter the United States?

The US requires a negative COVID test 72 hours before entry, including for passengers holding American citizenship and returning from vacation travel. Both PCR and antigen (rapid) tests are acceptable; even travelers who are fully vaccinated must be tested. For my recent trip to the US, I had a rapid test at a pharmacy in Italy with results available in 20 minutes. I was able to upload the results to my airline (United) 72 hours before travel. The airline approved this test for entry into the US. So far so good. But … not so fast. My route took me though Germany where the testing requirement was changed a week before I traveled to require a test 48 hours (not 72) before boarding, and was expanded to include passengers just transiting to a connecting flight. To further complicate things, Germany would not accept results written in Italian. Really, wouldn’t you think that a big NEGATIVO was clear? Or that results in any of the EU country languages would be ok? Nope. To get results in English I had to schedule another test at a different lab (cost about $150, which included same day results in English). In Munich, I encountered people who had been refused boarding because their results were more than 48 hours old or not in an acceptable language. These were not suggestions but absolute rules, as was clear when arriving in Germany to a checkpoint staffed with police who carefully checked the COVID results and wanted to see that I had a boarding pass for my connecting flight. (It ooks like the EU has since agreed to accept test results in any of the EU languages, along with English, but it’s not clear if that agreement is being implemented yet). A direct flight from Italy into the US simplifies things immensely - the fewer countries to pass through the better because travelers must meet the requirements of every country through which they transit!
Current CDC guidelines do not require quarantine on return to the US for fully vaccinated persons (ie, more than 2 weeks after the second dose) but do recommend repeat testing 3-5 days after arrival in the US. Persons not fully vaccinated should retest and quarantine for 7 days. Individual states may have different guidelines. The US does not seem to track returning travelers as carefully as does Italy.

Question # 5 The biggest question of all is whether to travel now or wait until things become more clear. That is a question everyone must answer for themselves. It depends a lot on one’s tolerance for risk and ambiguity along with just how desperately in need of Italy they are! Travel insurance, to cover costs of transportation, hotels, activities and illness is always a good idea (but check the fine print to be sure they cover COVID-related issues).

For those who decide to go ahead, I have a few tips :

First, It is essential to check the requirements for every airline and every country that is part of one’s travel itinerary. Information can be found on airline and airport websites as well as government web pages. The US State Department website has up to date US information. The rules change quite frequently, so keep checking! When I looked this week, Germany’s rules were already different from when I traveled a month ago. And Italy’s rules were not the same as Germany’s.

Next, be sure to know what types of COVID tests are acceptable. PCR tests are always good, some countries accept antigen (rapid) tests but may be specific about which brands of test are ok. Very few countries accept self-administered tests (though the US does for returning travelers if the test is video monitored). United Airlines has advertised that they will provide international travelers with self-administered tests to use when returning to the US, but those may not be sufficient to transit through other countries.
Also consider when results will be available from the lab. Many PCR test results take 48 -72 hours to be reported, so coordination with flight times can be a challenge. I was able to get same day PCR results on a Saturday, critical timing since the lab was closed on Sunday and I needed results before they reopened on Monday morning to meet the 48 hour before travel requirement. I was certainly holding my breath until those results arrived late in the day. If I were doing this again I would not fly on a Monday or Tuesday. Scheduling flights later in the week avoids needing to test on a weekend and weekend delays in getting results. Also be aware if results are needed 48 - 72 hours before departure or before arrival. With flight times of 10+ hours this can make a big difference.

A COVID-tested flight or a negative test before travel is not a guarantee against contracting the virus during travel or spreading it during a trip. Being a good guest in Italy means doing everything possible to avoid this by being fully immunized and testing negative before arrival plus using precautions while in Italy (masks, avoiding crowds, quarantine if required and using common sense). It goes without saying that, even with negative test results, anyone who develops last minute symptoms of illness absolutely must not fly.

What’s next ? Much depends on the trends in COVID infections and vaccine rates over the coming weeks and months. If COVID rates go up, restrictions may return. It looks like some combination of vaccine status and/or COVID testing or documentation of recovery from COVID infection will be required to skip the need for quarantine on arrival in Italy as well as other EU countries. The systems for documenting vaccine status are still in development for non-EU citizens. It’s impossible to know exactly what will be required as proof of vaccination - stay tuned!

A good source of info for Italy is the website esteri.it This is the Ministry for Foreign Affairs site, with info in Italian and in English. It has the most current information on travel restrictions and a downloadable copy of the self-declaration form. I will be checking that site carefully before my return flight to Italy in August.