Extending your vacation as you wait for negative test results — it’s a luxurious thought. But the reality can be expensive and stressful. Here’s what you need to know.As coronavirus travel restrictions ease across many parts of the world and countries report cases of less severe illness, international trips are top of mind for U.S. travelers, many of whom have started to book overseas journeys for the spring and summer.But the requirement for air travelers — vaccinated or not — to present a negative coronavirus test for entry into the United States has many people concerned about the prospect of testing positive and finding themselves stuck in a foreign country, unable to return home.Deborah Haines, 47, a chiropractor from Seattle, was forced to extend her vacation in the Netherlands by 22 days last month because she kept testing positive even after her coronavirus symptoms had subsided. The stress of determining the appropriate documentation for re-entry, and having to cancel work appointments back home, made her feel sicker than the coronavirus itself, she said.“When I thought about the possibility of getting stuck with Covid in Amsterdam, I thought it would mean a few extra days and then I could get a negative test and go home,” she said. “Boy, was that a miscalculation. I kept testing positive and it was so hard to get any clear guidance for what I should do.”For months, the travel industry has been lobbying Washington to drop pandemic measures like mask mandates and testing requirements for travelers. A federal judge in Florida struck down the mask mandate on public transportation in April, allowing airlines and other transit authorities to set their own mask policies. The Biden administration has appealed. But it has not commented recently on the status of pre-departure testing, with the White House coronavirus response coordinator, Jeff Zients, announcing on April 5 that there were “no plans to change international travel requirements at this point.”The uncertainty over the travel rules is making it difficult for travelers to book international trips with confidence. Here’s how to navigate some of the challenges you might face if you test positive abroad.Time to head home. Remind me of the test requirements?To enter the United States, all air passengers age 2 and older must have a negative coronavirus test taken within one day of departure, regardless of their vaccination status.The accepted PCR and viral tests are available at many hotels, airports, health clinics and local pharmacies overseas. Certain antigen or nucleic acid amplification self-tests like BinaxNOW and Ellume that have been approved for emergency use by the Food and Drug Administration are also accepted. These require you to connect to a telehealth service by video, so that you can be supervised by a medical practitioner while you take the test; make sure you have a good internet connection.There are no testing requirements for travelers entering the United States through land or ferry ports of entry.I’m positive! Do I need to self-isolate or quarantine?If you test positive, the Centers for Disease Control and Prevention recommends you should isolate and delay travel for 10 days, regardless of symptoms or a negative test taken within the isolation period. The country where you are staying may have its own rules for quarantine and isolation. The rules differ from country to country and isolation periods may be longer than the 10 days recommended by the C.D.C. Across Europe, many countries follow guidance from the European Center for Disease Prevention and Control, which recommends that fully vaccinated people should self-isolate after testing positive. If their symptoms improve and they feel better for at least 24 hours and they test negative for the virus twice within a 24-hour period, they can stop isolating. Or, if after six days they test negative once, they can stop isolating. Unvaccinated people are advised to self-isolate for 10 days, but can leave isolation if they meet the same requirements for negative tests. Some other destinations, particularly in Asia, may require mandatory quarantine or isolation in a government facility or designated hotel for 14 days or more.Am I required to tell government officials that I’m positive?This will depend on the regulations in the country you are visiting, so be sure to check what they say on local health ministry websites. In most places, tourists are not required to officially report a positive test result to the government, although if you took your test in person at a local health facility, the results are often sent to the regional or national health authority.Where can I stay if I have to isolate?Most countries, including popular European destinations like Greece, Italy and France, allow visitors testing positive to choose their own accommodation for the recommended period of self-isolation. You can find this information on U.S. embassy websites. If you have booked a hotel or Airbnb for your trip, it is worth calling ahead of time and seeing what their policy is for isolation and whether they have availability should you need to extend your stay.Some lodging facilities will require you to isolate alone in a separate room, even if your family members or travel companions test negative. You should also ask about access to food and medical facilities, particularly if you are staying in a remote area.It’s useful to have a plan B in place in case your hotel or rental cannot accommodate you, or to have a cheaper option available if you do have to self-isolate for 10 days. Many countries have designated “quarantine hotels” or apartments and some resorts in popular tourist destinations like Spain, Portugal and Mexico allow guests to quarantine at a discounted rate.Feeling fine, yet still positive. What now?While most people are likely to test negative within 10 days of a positive coronavirus test, for some it can take weeks or even months, according to the global health partnership Gavi, the Vaccine Alliance. If you find yourself in that position, and feel well enough to travel, you can return to the United States but will need to obtain “documentation of recovery.”For this documentation, there are six pieces of information you must provide:The type of coronavirus test you took.Evidence of positive results (“invalid” or “inconclusive” results are not accepted).Your name on the test results, which must match your identification.Where the test was taken, such as the name of the clinic or laboratory. If you self-tested, you can supply the brand name.The date the test was taken, which must be within the last 90 days.The test result must be accompanied by a letter signed by a licensed health care provider or a public health official stating that you have recovered and have been cleared to travel. This can be your health care provider in the United States.More information can be found on the C.D.C.’s airline checklist.Some American doctors are not authorized to provide the documentation outside of the United States or are unable to issue it to you because they need to see you in person. In those cases, Americans have been using telemedicine services like Quick MD, which involves a video or telephone consultation with a doctor, to obtain the documents, or they have booked in-person consultations with a local medical practitioner. Expect to pay $75 for QuickMD, and between $50 and $250 for a local doctor.Ms. Haines, the chiropractor who got stuck in the Netherlands, tested positive for the virus a day before she was scheduled to fly home in March. She immediately extended her apartment booking in Amsterdam for 11 days, but in a frenzy to rearrange her work commitments, she forgot to reschedule her flight.“I had thought about the possibility that I might test positive before I booked my trip, but didn’t think it would actually happen and that’s why I didn’t have a thought-out plan,” she said. “It was very high stress trying to figure everything and eventually I got Covid symptoms, which were pretty rough.”Ms. Haines kept testing positive for the virus, even after her 10-day isolation period. After 17 days, with help from her husband back home, she managed to get a certificate of recovery through a U.S. telemedicine service that she found online. She waited a few more days to fly home because she had to purchase a new flight and went for the cheapest option.“That process was pretty straightforward in the end,” she said. “But before that, we hit so many obstacles and dead ends and felt really stuck.”Will my airline accept my document of recovery?Most airlines flying to the United States accept paperwork that meets the C.D.C.’s requirements for documentation of recovery. If you are traveling through a third country and plan to leave the airport, however, check the local guidance as some governments may require a longer period of isolation or have other restrictions.“Understand the rules for the country you’re departing from and understand that those rules may change,” said Erika Richter, the senior communications director of the American Society of Travel Advisors, a trade organization. “Travelers should plan to bring with them printed copies of all their paperwork so they can present it to the gate agency,” she said. “You’re really at the mercy of the gate agent upon check-in, so keep that in mind.”Some travelers have also found it useful to print out the C.D.C. guidelines for certificates of recovery to present to the gate agent, she added.Will travel insurance cover additional costs if I test positive?It depends on the type of insurance. The U.S. Travel Insurance Association recommends that travelers concerned about the potential disruption to their plans after testing positive should investigate policies that include sickness and quarantine coverage, and also determine if there are any limits to those benefits.Some policies will cover lodging costs beyond your scheduled return date but may not cover the full 10 days you are required to isolate (you can compare policies on review sites like Covertrip). If you are worried that you could get stuck for even longer as you try to obtain a certificate of recovery, then you might want to opt for a higher level of coverage.Many travel insurance plans cover the costs to see a physician in order to obtain the documentation of recovery under medical expense, trip interruption or travel delay, according to the Travel Insurance Association. Under most policies, trip interruption coverage also covers charges for flight change fees.But travelers should understand that plans often have a daily maximum trip delay limit, and the policy may not cover all costs associated with an extended stay, according to the association.52 Places for a Changed WorldThe 2022 list highlights places around the globe where travelers can be part of the solution.Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places for a Changed World for 2022.

One day after the C.D.C. advised against all travel on cruise ships, thousands of cruisers partied like it was 2019. But worries about onboard policies — and frustration over quarantines — is rising.On the fourth day of a seven-day Mexican Riviera cruise, Jesse Suphan and other passengers onboard the Carnival Cruise Line’s Panorama were denied entry at the port of Puerto Vallarta, because of the number of onboard coronavirus cases. That was the first Mr. Suphan heard about the virus spreading on the ship.“The captain announced that five people had tested positive for Covid and were quarantining,” Mr. Suphan, a 39-year-old revenue cycle manager, recalled in a telephone interview. “But, then, talking to the crew, they told me there were between 100 and 150 crew members who also tested positive, but the captain didn’t mention that.”Two days later, the Centers for Disease Control and Prevention told Americans to avoid travel on cruise ships, regardless of their vaccination status. The advisory, the agency’s highest coronavirus warning, came in response to a surge in cases in recent weeks, caused by the spread of the contagious Omicron variant.But even as case numbers rise, and criticism mounts about the safety of cruising and over cruise line protocols in reporting cases to passengers, ships keep sailing and guests keep embarking, adamant that the onboard environment is safe because of stringent health and safety requirements, including pre-departure testing and vaccine mandates.The German cruise ship AIDAnova, docked in Lisbon, celebrated New Year’s Eve with fireworks.Armando Franca/Associated PressConsider the New Year’s Eve festivities held on ships around the world. One day after the C.D.C. announcement, as dozens of crew members and other passengers were confined to small cabins, infected and quarantined, thousands of revelers packed into ship bars, casinos and deck venues, partying like it was 2019.Harvey Freid, 56, recently returned from a 17-day sailing to Antarctica, during which one positive case was reported. But Mr. Freid, an avid cruiser, is undeterred and is scheduled to go on a Caribbean cruise in late January.“The cruise ships do a very good job of handling Covid, and I think it’s safer than my building in Miami and most places that I go on land, because people are vaccinated and cases are quickly identified and isolated,” he said.The cruise industry’s trade group, Cruise Lines International Association, called the C.D.C.’s warning “perplexing,” and said that cases identified on ships “consistently make up a slim minority of the total population on board — far fewer than on land.”“No setting can be immune from this virus — however, it is also the case that cruises provide one of the highest levels of demonstrated mitigation against the virus,” the group said in a statement.But some passengers are starting to question the effectiveness of health and safety protocols, and say they aren’t being informed of the full extent of coronavirus cases on board. They say they learn of the positive cases only after returning home and would have been able to make more informed decisions about their behavior and participation in activities, if they had been made more aware.When Mr. Suphan booked his vacation, he felt confident that Carnival had good protocols in place, which included pre-departure testing and requiring vaccines for all crew and most passengers. But as the ship sailed, Mr. Suphan was surprised by the number of people he met who said they had been exempted from the vaccine mandate. He said there were not enough crew members to enforce indoor mask rules for more than 3,000 passengers on board.Carnival said only a small number of passengers had been exempted from the vaccination requirement, but did not specify how many.Mr. Suphan was also struck, he said, when a crew member told him that several infected crew were isolating on board when the ship departed from Long Beach.“The fact that they had infected staff on board when the cruise left Long Beach means that they knew there was the possibility of more cases coming up after we left,” Mr. Suphan said. “But they still continued with the cruise so they could take everyone’s money. It feels like a cash grab to maintain payments.”Carnival said four asymptomatic crew members were in quarantine when the cruise departed, while others had been taken off the ship.Reporting positive casesMost major cruise lines do not publicly announce the number of coronavirus cases on board their ships, but they are required to submit daily figures to the C.D.C. Currently, the agency is monitoring more than 90 cruise ships, because of reported cases that have reached the agency’s threshold for an investigation. (An investigation is undertaken when a certain number of cases is reported among a percentage of passengers.)Carnival has denied that the number of infected crew was as high as 100 on Mr. Suphan’s sailing, but has not disclosed the total number of people who tested positive. On Dec. 28, when the cruise was denied entry to port, the Jalisco state health ministry said 69 cases had been detected among the ship’s 1,450 crew members. That day, Christine Duffy, the Carnival president, called into the ship and briefed guests on the situation. Passengers said she did not give updated figures for positive cases, which many found concerning.Chris Chiames, chief communication officer for Carnival, said the company takes its responsibility for public health “very seriously” and has implemented protocols that exceed C.D.C. guidance since restarting operations in the United States in June.“The extreme majority of the crew who test positive are asymptomatic and detected through the random testing protocol, and they and their close contacts are put into isolation or quarantine,” Mr. Chiames said. “None have required escalated medical attention or hospitalization, and we have also moved most crew off the ship to complete their isolation or quarantine.”Carnival declined to comment on its policies for reporting daily cases to passengers onboard its ships, but Mr. Chiames said, “the additional complications caused by the fast-spreading Omicron variant will require us to evaluate how to communicate moving forward.”Testing positiveFor many, the idea of testing positive for the coronavirus on a cruise ship conjures up the horrors of the major outbreaks in the early stages of the pandemic, when thousands of people were confined to their rooms for endless days while the pandemic.The health and safety protocols that allowed U.S. cruise ships to restart operations in June have helped cruise lines contain the virus and avoid large outbreaks, and until now, many of the small percentage of guests who tested positive during sailings have been satisfied with the handling of their cases. Some even received complimentary food and champagne to their rooms and were flown home by charter plane.But since more contagious variants like Delta and Omicron have emerged, causing cases to increase among passengers and crew, guests have started to complain about quarantine conditions.Breakfast served to Richard Lewis during his quarantine on board the Celebrity Apex.Richard LewisRichard Lewis, the chairman and chief executive of Savile Row Travel group, recently caught the coronavirus during two back-to-back Caribbean cruises with his family on board Celebrity Apex. It was his first cruise during the pandemic and initially, the protocols met his expectations and the experience felt relatively normal.The Coronavirus Pandemic: Key Things to KnowCard 1 of 6The global surge.

Many lines are adjusting their masking, testing and vaccine rules, while criticism is mounting about the lack of transparency in reporting positive cases to passengers and crew members.By the time the Norwegian Breakaway cruise ship docked in New Orleans on Dec. 4, after a weeklong cruise that included stops in Belize, Honduras and Mexico, 17 coronavirus cases had been identified on the ship, including a case of the new Omicron variant. The local and federal health authorities were notified — but not all the disembarking passengers.“I only found out after I got home and saw it on the news,” said Betsy Rodriguez, a retired veterinarian who took the Caribbean cruise with her daughter. “We felt pretty safe knowing everyone on the ship was vaccinated, but I guess it would have been good to know people tested positive so we could have been more careful.”Since the cruise industry restarted operations in the United States this June, its efforts to keep the coronavirus at bay — or at least contained, unlike the major outbreaks experienced in 2020 — have been largely successful. Most cruise companies mandate full vaccinations for crew and most passengers, and have implemented strict health and safety protocols to swiftly identify coronavirus cases onboard and reduce their spread.But in recent months, as new and highly contagious variants have emerged and case numbers steadily increase worldwide, these measures are being put to the test. Many lines are adjusting their masking, testing and vaccine rules, while criticism is mounting about the lack of transparency in reporting positive cases to passengers and crew members during sailings.A crew member on the Breakaway, who spoke on the condition of anonymity because he was not permitted to speak to the news media, said he first heard about the outbreak from a friend and fellow employee. When he contacted management, they neither shared the number of positive cases nor identified who was infected.“I would like to know who tested positive because this new variant spreads very quickly and I have a medical condition which means I need to be very careful and protect myself,” he said, voicing concern that if he became sick, he could be sent back to his home country. “I can’t afford that because I need to take care of my family at home.”Most cruise companies do not publicly announce the number of coronavirus cases identified during sailings, but all cruise ships operating to and from U.S. ports must submit daily numbers to the Centers for Disease Control and Prevention, which uses a color-coded system to inform the public whether the number of cases is above or below the agency’s threshold for an investigation. Sharing this data is one of many requirements in the Framework for Conditional Sailing Order, a series of C.D.C. guidelines that cruise companies must follow to operate in U.S. waters.The 17 cases on board the Norwegian Breakaway were first publicly reported by the Louisiana State Department of Health on Dec. 4. All passengers and crew members — more than 3,200 people — onboard were fully vaccinated, following the company’s policy.Norwegian declined to comment on its policies for reporting cases on board its ships or whether any additional Breakaway crew members tested positive after passengers disembarked.“All the identified cases onboard were asymptomatic, ” a company spokesman said in a statement. “We implemented quarantine, isolation and contact tracing procedures for identified cases and tested all individuals on Norwegian Breakaway before disembarkation.” In addition, he said, passengers were given “post-exposure and quarantine public health guidance” as laid out by the C.D.C.Reporting to the C.D.C.The coronavirus wreaked havoc on the cruise industry in the early stages of the pandemic, infecting hundreds of cruise passengers and workers, and requiring the sector to shut down for 18 months. To begin sailing, cruise ships had to agree to the C.D.C.’s Conditional Sailing Order, which is valid until Jan. 15.Among the safety measures the order requires — beyond submitting the daily number of coronavirus cases — is a prevention and control plan for each cruise ship. The plan, said Bari Golin-Blaugrund, a spokeswoman for the Cruise Line International Association trade group, includes “procedures for informing passengers and crew members that a threshold of Covid-19 has been met or exceeded.”“The reporting requirements and practices of the cruise industry are practically unmatched compared to other sectors in the United States, especially within the travel and tourism sector,” she said.In a C.D.C. report of coronavirus data published last month, cruise operators had reported 1,359 positive cases between June 26 and Oct. 21. During that time, 49 hospitalizations, 38 medical evacuations and one death occurred because of coronavirus infections detected onboard cruise ships.The report highlighted several large outbreaks, including one in which a symptomatic passenger who tested positive on a ship in July was linked to 20 additional cases over two sailings. One ship reported 58 positive between July 24 and Aug. 28 and another reported 112 cases over four consecutive voyages, which ended on Sept. 7. Most of the cases were breakthrough infections in fully vaccinated passengers.While the C.D.C. relies on data reported by the cruise companies, the agency also carries out inspections to make sure that cruise ships are in compliance.With the rise of Delta and Omicron variants, and as the virus surges across the world, cruise lines have been adjusting their health and safety protocols, reinstating measures like mask mandates and requiring additional testing from passengers. Starting Jan. 13, Disney Cruise Line will require all children over the age of 5 to be fully vaccinated against the coronavirus.The Coronavirus Pandemic: Key Things to KnowCard 1 of 4Pfizer’s Covid pill.

The prevalence of the Delta variant means many travelers, including those who are vaccinated, are facing sickness, quarantines and delayed returns.April DeMuth and her partner, Warren Watson, had just finished what they described as the perfect vacation in Greece when they took a coronavirus test at the Athens airport. They had spent their days sipping coffee on their hotel balcony overlooking the Venetian windmills in Mykonos; driving buggies across red sand beaches in Santorini; watching the Parthenon turn shades of gold at sunset; and eating gyros at midnight.Every detail of their trip ran seamlessly until they were waiting in line for their flight home to South Carolina on Aug. 3, when Mr. Watson, 51 — who, along with Ms. DeMuth, is fully vaccinated — received an email saying he had tested positive for the coronavirus.“We were in total shock and didn’t know what to do,” Mr. Watson recalled. “Then 10 minutes later we received a call from the Greek authorities telling us they were going to get a van and take us to a quarantine hotel.”When Europe reopened its borders to Americans in June after a 15-month ban, the highly contagious Delta coronavirus variant was not as prevalent as it is today, and breakthrough infections for the fully vaccinated were rare. But now, with the Delta strain making up more than 90 percent of the cases in Europe and the United States, stories of travelers catching the virus abroad — including those who are fully vaccinated — are beginning to surface. Their plans have been upended by mandatory quarantine requirements in different countries.The Times spoke with 11 people who got sick with Covid-19 during recent vacations to Europe and were forced to extend their trips to recover. Among them were adults and children between 12 and 62 years old, who traveled to Britain, France, Italy, Spain, Greece and Cyprus.‘We’re going a little stir-crazy…’In Athens, Ms. DeMuth and Mr. Watson were required to spend a minimum of seven days in a quarantine hotel that was paid for and provided by the Greek government. They were not allowed to leave their room until the seventh day and after they both tested negative for the virus.“It was very well organized, and they were extremely nice to us,” Ms. DeMuth said of the first days of their quarantine. “They brought us three meals a day and anything we ordered on the internet was delivered to our door.”“I mean we’re going a little stir-crazy,” Mr. Watson added during a recent telephone interview from the hotel where they were quarantining. “We aren’t allowed to leave our room and there is a major heat wave and fires in the area, but we can still poke our heads out the window.”The couple suspect they caught the virus in South Carolina in July before they traveled to Greece. Ms. DeMuth had mild coldlike symptoms that passed quickly, and Mr. Watson said he felt some drainage at the back of his throat on the way to the airport, but he assumed it was allergy symptoms, which are common for him around this time of year.“We had our vaccinations cards, we felt healthy, we’re in our 50s, it really didn’t occur to us that we had Covid,” Ms. DeMuth said.Greece does not require fully vaccinated visitors to provide a coronavirus test before entering the country; therefore, Mr. Watson did not realize he was probably carrying the virus until the end of their trip. In hindsight, Ms. DeMuth, who is a travel associate for Valerie Wilson Travel, a FROSCH Company, said that because of the highly transmissible nature of the Delta variant, she would recommend getting a test before departure as an extra precaution, even if it is not required by the destination.“Even if you don’t have any symptoms and don’t feel sick you don’t want to put other communities at risk,” she said.And, of course, there is also the risk that American travelers will get infected at their destination. Although most European countries are open to American travelers, the Centers for Disease Control and Prevention has added several to its list of level 4 or very high risk destinations, including France, Iceland and Britain, because of the high infection rates in those countries.Skylor Bee-Latty and her boyfriend, Alex Camp, outside the Manchester, England, property where they were quarantined. Days into their trip, they received a notification on a government tracing app, asking them to self-isolate for 10 days because of possible exposure to the virus.Andy Haslam for The New York Times‘It all escalated pretty quickly …’When Skylor Bee-Latty, a 28-year-old search engine optimization manager, flew from Washington, D.C., to London in early June to visit her boyfriend, Alex Camp, she had to take four coronavirus tests within 10 days and quarantine for five days before she was free to travel across Britain. Even then, the vaccinated couple proceeded with caution, choosing an isolated location in Wales for their first vacation together in a year.Days into their trip, they received a notification on a government tracing app, asking them to self-isolate for 10 days because of possible exposure to the virus. They cut their trip short and went back to the city of Manchester, where Mr. Camp lives.“We were really surprised when we got the notification because we were already self-isolating in a cottage and only really came into contact with a few people when we went to a pub or restaurant,” she said.After 10 days of isolation at home and multiple negative virus tests, the two were once again free to travel, but this time they decided to stay in Manchester and enjoy the Euro 2020 championship soccer games at pubs. Three weeks later, around July 10, when the Delta variant was surging across Britain, Ms. Bee-Latty and Mr. Camp started to feel unwell.“For the first few days I felt nauseous, but then I woke up one day and my head was completely stuffed up, it was difficult to open my eyes and then my boyfriend started to get a tickle in his throat, and I got aches and pains in my body,” she said. “It all escalated pretty quickly and before we knew it, we tested positive and were back into isolation.”By August, Ms. Bee-Latty had spent more than four weeks of her trip in quarantine and even after she recovered it took a long time to stop feeling so lethargic and foggy-headed.“I’m still not feeling great so I’m just taking it day by day,” she said. “I had plans to go and see my family in Italy, but right now I’m just watching to see how the numbers go because even though I’m traveling and I’ve recently recovered from Covid, I still want to be smart about it.”“My sister had Covid three times, so there’s always a chance I could get it again,” she added.Many travelers who booked their summer vacations to Europe in June said they had not considered the consequences of what would happen if they fell sick while on vacation, including the financial setback of having to pay for additional accommodations, food, flight change fees and taking extra time off work.Most European countries do not cover quarantine accommodations, which can add between seven to 21 extra days to a trip, depending on a country’s quarantine mandate. Last month, Louise Little, a 42-year-old personal trainer, spent $1,800 to extend her Airbnb in Spain after she tested positive for the virus a day before she was scheduled to fly from Barcelona back home to New York.“When I saw the result, I wanted to die,” recalled Ms. Little, who was fully vaccinated. “I had no symptoms and just to think of all the people I had come into contact with in all the places I had been during my 10 days’ vacation. I truly feel awful.”When Ms. Little booked travel insurance for her trip, she assumed it would cover all coronavirus expenses, but when she made a claim for the extension of her accommodations it was rejected on the basis that only medical treatment and hospitalizations were covered.“To be honest, back then I didn’t think to read the small print because I was fully vaccinated and it didn’t occur to me that I would catch the virus,” she said. “I think a lot of people like me who are young, healthy and vaccinated felt invincible at the beginning of summer, but that’s changed now with the Delta. Traveling has become quite risky again.”Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation.

Creating a digital certificate of vaccination against the coronavirus is one of the hottest debates right now. What’s keeping it from happening, and why are some people opposed?With all American adults now eligible for Covid-19 vaccines and businesses and international borders reopening, a fierce debate has kicked off across the United States over whether a digital health certificate (often and somewhat misleadingly called a “vaccine passport”) should be required to prove immunization status.Currently, Americans are issued a white paper card as evidence of their Covid-19 shots, but these can easily be forged, and online scammers are already selling false and stolen vaccine cards.While the federal government has said it will not introduce digital vaccine passports by federal mandate, a growing number of businesses — from cruise lines to sports venues — say they will require proof of vaccinations for entry or services. Hundreds of digital health pass initiatives are scrambling to launch apps that provide a verified electronic record of immunizations and negative Covid-19 test results to streamline the process.The drive has raised privacy and equity concerns and some states like Florida and Texas have banned businesses from requiring vaccination certificates. But developers argue that the digital infrastructure is secure and will help speed up the process of reopening society and reviving travel.Governments, technology companies, airlines and other businesses are testing different versions of the digital health passes and are trying to come up with common standards so that there is compatibility between each system and health records can be pulled in a safe and controlled format.The process comes with great technical challenges, especially because of the sheer number of app initiatives underway. For the certificates to be useful, countries, airlines and businesses must agree on common standards and the infrastructure they use will need to be compatible. In the United States, there is an added complexity of getting individual states to share immunization data with different certificate platforms while maintaining the privacy of residents.Here’s what we know about the current status of digital health passes and some of the roadblocks they are facing in the United States.Can I get a vaccine passport?In March, New York became the first state in the United States to launch a digital health certificate called Excelsior Pass, which verifies a person’s negative coronavirus test result and if they are fully vaccinated.The app and website, which has now had more than one million downloads, is free and voluntary for all New York residents, and provides a QR code that can be scanned or printed out to verify a person’s health data. The pass has been used by thousands of New Yorkers to enter Yankee Stadium, Madison Square Garden and other smaller public venues.Most businesses require people to show their state I.D. along with their Excelsior Pass to prevent potential fraud.In Israel, where more than half the population is fully vaccinated, residents must show an electronic “Green Pass” to attend places such as gyms, concerts, wedding halls and to dine indoors. The European Union has endorsed an electronic vaccine certificate to be recognized from July 1, which a number of European countries have begun using, but each individual member country will be able to set its own rules for travel requirements. Britain has also started testing a Covid-19 certificate system that aims to help businesses reopen safely.Some airlines including Lufthansa, Virgin Atlantic and Jet Blue have started to use the digital health app, Common Pass, to verify passenger Covid-19 test results before they board flights. The International Air Transport Association’s Health Pass is being used by more than 20 airlines and allows passengers to upload health credentials necessary for international travel. Are they legal?It depends on state regulations. The Biden administration has said there will be no federal vaccination system or mandate. Individual states hold primary public health powers in the United States and have the authority to require vaccines..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-1rh1sk1{margin:0 auto;overflow:hidden;}.css-1rh1sk1 strong{font-weight:700;}.css-1rh1sk1 em{font-style:italic;}.css-1rh1sk1 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#ccd9e3;text-decoration-color:#ccd9e3;}.css-1rh1sk1 a:visited{color:#333;-webkit-text-decoration-color:#ccc;text-decoration-color:#ccc;}.css-1rh1sk1 a:hover{-webkit-text-decoration:none;text-decoration:none;}“We expect a vaccine passport, or whatever you want to call it, will be driven by the private sector,” Jen Psaki, the White House press secretary, said at a briefing in March. “There will be no centralized, universal federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential.”In April, Gov. Greg Abbott of Texas issued an executive order banning government agencies, private businesses and institutions that receive state funding from requiring people to show proof that they have been vaccinated against the coronavirus.Ron DeSantis, the Florida governor, issued a similar order, saying that requiring proof of vaccination would “reduce individual freedom” and “harm patient privacy” as well as “create two classes of citizens based on vaccinations.”But those orders may not stick. “The governors are on shaky legal ground,” said Lawrence Gostin, the director of the O’Neill Institute for National and Global Health Law at Georgetown University. “Certainly, the legislature has authority to regulate businesses in the state, and it can also pre-empt counties and local governments from issuing vaccine passports. But a governor, acting on his or her own, has no inherent power to regulate businesses other than through emergency or other health powers that the legislature gives them.”Where will the information come from?In the United States, there is no centralized federal vaccine database. Instead, the states collect that information. All states except New Hampshire have their own immunization registries and some cities, like New York, have their own.Currently states are required to share their registries with the Centers for Disease Control and Prevention, but the data is not public and could be withheld.That means anyone developing a digital vaccine certificate in the United States would have to obtain immunization data from individual states, which could be problematic in states that oppose health pass initiatives.Why are people opposed?One of the issues is with terminology. A passport is issued by a government and certifies personal data including a person’s legal name and date of birth. Many people fear that if they are required to have one related to the coronavirus, they will be handing over personal and sensitive health data to private companies that could be stolen or used for other purposes.“There are a whole lot of valid concerns about how privacy and technology would work with these systems, especially as Silicon Valley does not have a great history delivering technologies that are privacy enhancing,” said Brian Behlendorf, executive director of Linux Foundation Public Health, an open-source, technology-focused organization.“And the concept of privacy here is complicated because you are ultimately trying to prove to somebody that you received something,” he said. “You aren’t keeping a secret, so the challenge is to present and prove something without creating a chain of traceability forever that might be used.”The Linux Foundation is working with a network of technology companies called the Covid-19 Credentials Initiative to develop a set of standards for preserving privacy in the use of vaccine certificates. The main aim of the initiative is to establish a verifiable credential (much like a card in one’s wallet) that contains a set of claims about an individual but is digitally native and cryptographically secure.Some argue that such a credential would intrude on personal freedoms and private health choices.“‘Vaccine passports’ must be stopped,” former Representative Ron Paul of Texas wrote in a tweet last week. “Accepting them means accepting the false idea that government owns your life, body and freedom.”Others worry that an exclusively digital system would leave some communities behind, especially those who do not have access to smartphones or the internet.“Any solutions in this area should be simple, free, open source, accessible to people both digitally and on paper, and designed from the start to protect people’s privacy,” Jeff Zients, the White House coronavirus coordinator, said in a statement.The World Health Organization said in April that it does not back requiring vaccination passports for travel yet because of the uncertainty over whether inoculation prevents transmission of the virus, as well as equity concerns. But the organization is working with a number of agencies, like UNICEF, ITU and the European Commission, to establish the standards and specifications of a possible globally recognized, digital vaccination certificate. Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places list for 2021.

In updated recommendations, the federal health agency said both domestic and international travel was low risk for fully vaccinated Americans. But travel remains far from simple.The Centers for Disease Control and Prevention updated its guidance for fully vaccinated Americans in April, saying that traveling both domestically and internationally was low risk.The long-awaited recommendations were issued by federal health officials after a series of studies found that vaccines administered in the United States were robustly effective in preventing infections in real-life conditions.One is considered fully vaccinated two weeks after receiving the single dose of the Johnson & Johnson vaccine, or two weeks after receiving the second dose of the Pfizer-BioNTech or Moderna shots.If you decide to travel, you might still have some questions. Here are the answers.Will I still need to wear a mask and socially distance while traveling?Yes. Under federal law, masks must be worn at airports in the United States, onboard domestic flights and in all transport hubs. The C.D.C. says that as long as coronavirus measures are taken in these scenarios, including mask wearing, fully vaccinated Americans can travel domestically without having to take a test or quarantine, although the agency warns that some states and territories may keep their local travel restrictions and recommendations in place.For those wishing to travel internationally, a coronavirus test will not be required before departure from the United States unless mandated by the government of their destination. Vaccinated travelers are still required to get tested three days before travel by air into the United States, and are advised to take a test three to five days after their return, but will not need to self-quarantine.Can I go abroad?Yes, but only to countries that will have you. More than half the world’s countries have reopened to tourists from the United States, including some countries in the European Union, which recently reopened their borders to vaccinated travelers in anticipation of the summer tourism season. Other places like Turkey, Croatia and Montenegro have already been welcoming Americans with negative test results. Greece also joined that growing list in May, ahead of most European countries, opening to fully vaccinated tourists and other foreigners with a negative test.Many Caribbean nations have reopened to American tourists, but each has its own coronavirus protocols and entry requirements.Here’s a full list of countries Americans can currently travel to.What about domestic travel? Is it free and clear to cross state borders?If you are fully vaccinated, the C.D.C. says you can travel freely within the United States and that you do not need to get tested, or self-quarantine, before or after traveling. But some states and local governments may choose to keep travel restrictions in place, including testing, quarantine and stay-at-home orders. Hawaii, for instance, still has travel restrictions in place. Before you travel across state lines, check the current rules at your destination. How are they going to check that I’m fully vaccinated?Right now, the best way to prove that you have been vaccinated is to show your vaccine card.Digital vaccine and health certificates showing that people have been vaccinated or tested are in various stages of development around the world and are expected, eventually, to be widely used to speed up travel.The subject of “vaccine passports” is currently one of the most hotly debated topics within the travel industry, with questions over the equity of their use and concerns over health and data privacy.In early April, Gov. Ron DeSantis of Florida issued an executive order that would ban local governments and state businesses from requiring proof of vaccination for services.And in March, the European Union endorsed its own vaccine certificate, but individual European countries are still expected to set their own rules for travel requirements this summer.But what about my kids? What’s the guidance on traveling with unvaccinated people?The C.D.C. advises people against travel unless they have been vaccinated. If you must travel, the agency recommends testing one to three days before a trip and following all coronavirus guidance at your destination.In May, the F.D.A. expanded its emergency use authorization of the Pfizer-BioNTech coronavirus vaccine to include adolescents between 12 and 15 years of age.All air passengers aged two and older coming into the United States, including fully vaccinated people, are required to have a negative Covid-19 test result taken no more than three days before they board their flight.What is my moral obligation to the places I visit where most people are not vaccinated?The United States inoculation rollout has been among the fastest in the world, but there is a stark gap between its rapid rollout and the vaccination programs in different countries. Some nations have yet to report a single dose being administered.Many countries are currently seeing a surge in new cases and are implementing strict coronavirus protocols, including mask mandates in public spaces, capacity limits at restaurants and tourist sites and other lockdown restrictions.It is important to check coronavirus case rates, measures and medical infrastructure before traveling to your destination and not to let your guard down when you get there. Even though you are fully vaccinated, you may still be able to transmit the disease to local communities who have not yet been inoculated.You can track coronavirus vaccination rollouts around the world here.Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation.

Cruise companies and their allies are fighting against rules that have kept U.S. ships from sailing. But experts say controlling the coronavirus onboard is a complex puzzle.In the United States, flights are filling up, hotels are getting booked, vacation rentals are selling out and car rental companies are facing a shortage because of spiking demand.But one sector remains stalled: the cruise industry.Cruise ships sailing out of United States ports have been docked for more than a year following a series of outbreaks of the coronavirus onboard vessels at the start of the pandemic. Now, cruise companies can restart operations only by following rules laid out by the Centers for Disease Control and Prevention in October.Earlier this month, the C.D.C. published a set of technical guidelines to help cruise companies prepare their ships to start sailing again in line with those rules, which were set out in the agency’s Framework for Conditional Sailing Order. But the Cruise Lines International Association (CLIA), the industry’s trade group, called the instructions “so burdensome and ambiguous that no clear path forward or timetable can be discerned.”Cruise companies have asked the agency to revise its guidelines to factor in the speedy rollout of vaccinations and allow for U.S. sailings to restart in July. But the C.D.C. has not yet provided a firm date, and under the current rules, cruise ships must follow a monthslong process that includes simulation voyages to test out their health and safety protocols, followed by a review period.“The cruise industry as a whole is very frustrated,” said Stewart Chiron, a cruise industry analyst and chief executive of the news site cruiseguy.com. “Travel is resuming at a very high level. Airplanes and hotels are packed, and no industry is better suited to restart than cruising. The lines are prepared, safety protocols are in place and now, with the high level of vaccine distribution, they feel it’s a good time to resume operations.”In response to the C.D.C.’s delay of U.S. sailings, some cruise lines are moving their ships abroad to launch summer cruises from foreign ports, including from the Caribbean and Europe, where they are permitted to sail. Many of the voyages require adult passengers and crew members to be vaccinated.Christine Duffy, the president of Carnival Cruise Line (center), at a groundbreaking in January for the company’s new cruise terminal at PortMiami. Lynne Sladky/Associated PressCarnival, the world’s largest cruise company, has warned that it might also look outside the United States if the C.D.C. continues to prevent cruises from sailing domestically.CLIA paints the C.D.C. as targeting the industry unfairly, and points to the global economic impact of the initial suspension of cruise operations from mid-March to September of last year, the latest period for which it has statistics. The group says there was a loss of $50 billion in economic activity, 334,000 jobs and $15 billion in wages.But health experts note the number and severity of outbreaks on ships last year when, for example, more than 700 people became infected with the virus on the Diamond Princess cruise ship in Japan and 14 people died. “The C.D.C. wants to prevent people from getting sick and the cruise lines want to go back to business and start making money,” said Tara Kirk Sell, an assistant professor at the Johns Hopkins Center for Health Security. “So there’s going to be a central disconnect and tension there as we sort our way through this pandemic, which isn’t over yet, and we are still trying to figure out.”Gov. Ron DeSantis of Florida, at a news conference announcing that the state was suing the C.D.C. over its rules for cruise ships. Wilfredo Lee/Associated PressFlorida joins the fightThe state of Florida is home to PortMiami, the world’s busiest cruise port, and it probably has the most to lose if cruise companies shift more sailings to the nearby Caribbean.Earlier this month, Senators Rick Scott and Marco Rubio of Florida (both Republicans), along with Senator Dan Sullivan of Alaska (also Republican), introduced the Cruise Act bill that, if passed, would revoke the agency’s Conditional Sail Order and require it to issue new guidance to restart United States sailings. (Because of a quirk of maritime law, several major cruise lines have canceled all 2021 sailings to Alaska.)“With the way this is going, it seems that the C.D.C. doesn’t want the cruise industry to be in business because they are not setting the rules in a manner that the cruise industry feels they can comply and safely return to work,” Senator Scott said in a telephone interview.“Cruise lines clearly want their passengers and employees to be safe,” he continued. “They have been working all year to prepare their ships, but the C.D.C. has been very difficult to work with and if they don’t want to help then we’ll make sure they do it because we are going to pass this legislation.”The state of Florida has sued the federal government to demand cruise ships be allowed to start sailing immediately.Gov. Ron DeSantis, also a Republican, has maintained that the cruise ban has had a disproportionate impact on the state’s economy; cruises usually generates billions of dollars from the millions of passengers that pass through Florida’s ports each year.“People are going to cruise one way or another. The question is are we going to do it out of Florida, which is the number one place to do it in the world, or are they going to be doing it out of the Bahamas or other locations?” Gov. DeSantis said, speaking at a recent news conference at PortMiami.Ms. Sell said she thinks the C.D.C.’s phased approach, where safety protocols are tested out before passengers are allowed back on onboard, is the right one.“Cruises have for a long time had a potential to super spread diseases that include Covid because people are often in close quarters,” she said. “I’m not saying that you could never do cruises again, but that it just needs to be something where you sort through all the requirements.”Battle over vaccinationsMs. Sell, and other health experts say that requiring everyone onboard to be vaccinated against the coronavirus is one of the best ways to prevent outbreaks. Several cruise lines have made vaccinations a requirement for smaller U.S. river cruises and foreign sailings.But while Gov. DeSantis is arguing for cruises to restart, he has also issued an executive order banning Florida businesses from requiring proof of vaccination from people seeking to use their services. The governor’s office said that the order prohibits all cruise lines from requiring vaccine certificates for their Florida operations.The C.D.C. recommended vaccinations in its latest technical guidance, but stopped short of making them a requirement, avoiding a conflict with Florida.Requiring vaccinations appeals to at least some would-be cruisers. “I’m really excited to get back on a cruise, but I don’t think I could fully relax and enjoy it if everyone on board wasn’t vaccinated,” said Molly Osborne, an avid cruiser based in South Florida. “It would be a great shame if we had to travel to other U.S. ports to get on a ship. Florida is the cruising capital of the world.”Still, Ms. Osborne said she is open to traveling abroad to get on a cruise if the C.D.C. doesn’t lift its ban by the fall. “I haven’t booked anything yet as I’m waiting to see what happens, but if the only way to go this year is from the Caribbean, then I’ll probably do it.”Passengers enjoy the sun on board the MSC Grandiosa in Italian waters. Companies in Europe and other places have restarted sailings. Andrew Medichini/Associated PressWhite House meetingExperts from the C.D.C. and White House staff met with cruise line executives and industry leaders last week to discuss the details of the Conditional Sailing Order.“The objective of the meetings are to mutually review the top priority issues of the cruise industry to work out implementation details of the CSO, including the impact of vaccines and other scientific developments since the CSO was issued in October 2020,” the agency said in a statement. “This goal aligns with the desire for the resumption of passenger operations in the United States by midsummer, expressed by many major cruise ship operators and travelers.”In the meantime, cruise lines are focusing on launching summer sailings abroad in Europe, Asia and the Caribbean. MSC Cruises, the industry’s fourth-largest operator, announced on Thursday that it would be canceling all U.S. cruises through June 30 and instead plans to have at least 10 ships sailing out of Europe and the Mediterranean by August. Royal Caribbean, the second-largest by passenger count, is sailing out of the Bahamas and Bermuda, among other places, and is requiring vaccinations for all crew and passengers.Before vaccines were being widely distributed, cruises lines operating in Europe reported some Covid infections on board, but say that the cases were brought under control using stringent health and safety protocols, which prevented any larger outbreaks.The C.D.C.’s advisory regarding cruise travel remains at a Level 4, the highest, and the agency recommends that all people avoid travel on cruise ships, including river cruises, worldwide.“That’s because the chance of getting Covid-19 on cruise ships is high since the virus appears to spread more easily between people in close quarters aboard ships,” the warning says.Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places list for 2021.