🕷️ Crawler Inspector


Like many people, I had not had a break from work since the pandemic began in 2020. And so, I was particularly excited when the Vaccinated Travel Lane (VTL) with the US opened in October 2021. My wife, our 12-year-old boy and I decided to spend two weeks in the US on a self-driving trip. I share our experience below in hopes that it may aid other Singaporeans in deciding and planning for similar trips. ## Preparing for the trip Securing a **return air ticket on a designated VTL flight** was the foremost priority. We could take any flight to the US, but returning on a designated VTL flight was necessary. Once the flight was confirmed, I booked our **pre-departure COVID-19 tests** at a designated clinic, as well as the **on-arrival PCR tests** at Singapore Changi Airport. Different countries may require different pre-departure tests. For the US, a supervised ART at a designated centre was sufficient. Next up was travel insurance. I bought travel insurance that **covered COVID-19-related loss,** such as flight cancellation and additional expenses in the US should our trip be prolonged by a positive pre-departure test. Singaporeans can visit the US without a visa, but there is a new scheme called the **Electronic System for Travel Authorization** (ESTA). It took about ten minutes for online application and approval was granted within three working days. Singaporeans must have ESTA approvals before being allowed to board the plane to the US. I then went to the Automobile Association of Singapore to apply for the **International Driving Permit** (IDP). One must bring their Singapore driving licence along with the IDP to be allowed to drive in the US. I also printed out our **COVID-19 vaccination certificates** via the HealthHub app. The airport checkpoints in both Singapore and the US would need to see proof of vaccination before we were allowed to board the plane. We arrived at Changi Airport three hours before departure, to ensure that we had sufficient time for all the extra procedures. Indeed, the check-in staff took much time to verify our ESTA approvals, vaccination certificates and pre-departure ART results. The plane was less than a quarter filled, and had been sanitised before we boarded. Extra alcohol swabs were provided to clean the seats and tables on board. Mask-wearing was also compulsory, except during mealtimes. Only two meals were served during our 15-hour flight, apparently to reduce mask-down time during the flight. The airline crew wore both goggles and N95 masks. When we arrived at the Los Angeles International Airport (LAX), we cleared immigration smoothly, and on-arrival COVID-19 tests were not required. ## The return trip A negative **pre-departure COVID-19 test result** within 48 hours of departure was required to board the VTL return flight. The Singapore Airlines website provides a list of approved COVID-19 test centres in LA, but details like pricing, queueing systems, booking of appointments and turnaround times were not available. We had our pre-departure tests done at LAX, as the results would be available just three hours after via email. The price was reasonable at US\$125 (S\$169) per person. We made an online booking for the tests a day before, and travelled all the way to the airport for swabbing. The staff at the swabbing station were professional and efficient. There was no queue at all and the whole process was completed within 15 minutes. Our PCR results were emailed to us and fortunately, all of us tested negative. On the day of departure, we arrived at LAX four hours before departure time. The check-in process was longer than usual, as the staff had to check our vaccination certificates and pre-departure test results. The staff recognised our vaccination status displayed on our **TraceTogether app.** We also had to submit an **Electronic Health Declaration** before we boarded the return flight. In it, we declared that we stayed within the VTL country during the trip, and had no contact with COVID-19 patients, nor had any symptoms of COVID-19 infection. We were advised **NOT to patronise the shops or restaurants at the arrival hall** after disembarking from the plane. At the Singapore immigration counter, we showed our **boarding pass,** which confirmed we returned on a VTL flight, to the officer and were each given **a green sticker** after clearance. The sticker was important as without it, we would not be allowed to leave the arrival hall. After collecting our luggage, we were escorted to the swab centre outside the arrival hall to have our **on-arrival COVID-19 swabs** done. This was the worst swab test I have ever had, as we were swabbed in our throat and both nostrils. We were given strict instruction to return home immediately after the swabs. Results would be available about six hours later, and we had to isolate at home until our test results returned negative. We took a nap once we arrived home, but I was woken up by a call from **the Immigration and Checkpoints Authority (ICA).** The caller checked my NRIC number and requested that I showed him my surroundings via a WhatsApp video call. I suppose they wanted to be sure that I was at home, as required by law. We received our on-arrival test results through both the **TraceTogether and HealthHub apps** about seven hours later. We heaved sighs of relief when our swab results turned out negative. The isolation process was over and we were free to roam around. ## Travel costs Cars, hotel stays and even meals in the US were affordable. Most of my hotel rooms for my family of three cost between US\$100 and \$200. Some only charged US\$80 per night. My seven-seater rental car cost about US\$120 per day. The cost of petrol was about US\$4 per gallon, which is cheaper than Singapore. Travelling in pandemic times did impose additional costs. **Prices of VTL return flights** are high and continually rising; thus, booking the tickets early is important. I booked my VTL return flight two weeks before my trip. I paid S\$2,400 for a seat in Premium Economy Class. The price increased to S\$3,400 just two days later. The price of the pre-departure COVID-19 ART at the designated clinic was SS\$30 per person. Pre-departure COVID-19 tests in LA and Singapore were US\$125 and S\$160, respectively. The price of an ESTA application was US\$14 per person. The total additional fixed cost was about S\$350 per person per trip. As the cost of COVID-19 testing was fixed regardless of how long the holiday was, it made more sense to have a long trip. Hence, I chose to go on a 14-day holiday. ## Managing risks The risk of contracting COVID-19 on a plane was low, as most passengers were vaccinated and had a negative pre-departure test. But **children below 12 years of age** were not vaccinated, and children below three years of age did not need a pre-departure test. Most COVID-19 infections in children are mild and/or asymptomatic, which may not be picked up via symptom questionnaires or temperature checks. I guess children could possibly be a concern, as they could contract and spread the virus on board. There was no monitoring app like TraceTogether in the US, so entering and leaving any premises was easy. The US Centers for Disease Control and Prevention recommended mandatory mask-wearing in indoor places. We did not need to wear masks in open spaces. Hotels, restaurants and shops would request customers to wear a mask. But from what we saw, the **adherence rate of this rule was not 100%, and the vaccination rate in California was only about 62%.** We were still mindful of contracting the virus in enclosed indoor places, so we travelled in our own vehicle and visited mainly outdoor attractions. We wore masks whenever we entered any enclosed spaces. We were also mindful that should a pre-departure test return positive, we would not be allowed to board the plane and would have to extend our stay for an additional 14 days. Sometimes, **test results could be equivocal** (ie, neither positive nor negative). A retest would then be done. It is better to have any pre-departure test done early in case extra time is needed for any additional tests. If a Singaporean is admitted to a hospital in the US for COVID-19, **medical costs would be substantial.** One US study estimates medical costs to be approximately US\$42,200 per person. Lastly, **rules change all the time** so travellers must accept such uncertainties. One example is when Denmark imposed a minimum four-day quarantine and an additional COVID-19 PCR test for all arrivals from Singapore on 9 November 2021, despite VTLs. ## Final thoughts Most of us want an overseas break. But travelling during a pandemic does impose extra costs and procedures, and it comes with much uncertainties. The risks of contracting the virus while on a plane or overseas, though low, are real with serious consequences. It is important that we continue to follow safe management measures while overseas, and make our own risk assessments. Despite all this, my family and I had a great time on our much-needed overseas break. We had a wonderful time in California and Arizona, visiting places like the Grand Canyon, Antelope Canyon, Lake Powell, Monument Valley, and the great beaches along the Pacific Coast Highway. The canyons were beautiful, and I particularly feel refreshed after the trip. To me, the benefits outweighed the costs and the risks. *Information accurate as at time of writing.* [](https://www.sma.org.sg/news/author/Desmond-Wai) is a gastroenterologist in private practice. He enjoys writing about life as a doctor. He strongly believes that doctors must share their experience and knowledge with one another to raise the standard of the medical profession. Tag ***