How do I get home if I test positive for Covid while traveling?

When Ken McElroy decided to go to Belize after a business trip to Miami last June, he was not worried about hiring Covid-19, he said.

The CEO of the real estate investment company was flying privately to both locations, in addition to being vaccinated.

“I was like, there’s no way to get it,” he told CNBC.

His fiancée, Danille Underwood, was not so sure, McElroy said.

After 10 days in Belize, the couple tested Covid the day before his return to Arizona. Although he felt tired and she had a cough, they were both surprised when their tests came back positive.

“In an hour, we were out of our room,” McElroy said. “Things became pretty real right now.”

The couple, aided by people dressed in Hazmat suits, were quarantined elsewhere in the hotel, he said.

“We weren’t sure what would happen … if they separated us or put us in a hospital,” McElroy said. “I didn’t know if I would need a respirator.”

None of this happened. Within 72 hours, the couple was on a Learjet back in Arizona.

Before leaving, Underwood acquired members of Covac Global, a medical evacuation company launched by the HRI crisis response company in the spring of 2020. This meant that the couple did not pay a penny for their repatriation, said McElroy.

Commercial airlines and private jets cannot fly passengers with the Covid-19 home, but certified air ambulances with medical equipment can.

While some companies evacuate travelers in need of hospitalization, Covac Global recovers travelers who test positive for Covid-19 and have a self-report symptom. About 85 percent of evacuees are returned home, while the rest need hospital care, CEO Ross Thompson said.

When CNBC first spoke with the company in March, it performed approximately two or three medical evacuations each month. Now, that number has risen to about 12 to 20.

“Unfortunately, business is booming,” Thompson said. “Covid was starting to be more in the rearview mirror, but then the delta appeared, and it caused everyone a loop.”

Affiliations to Covac Global have increased 500% this year, with a 250% increase just last month, he said.

The so-called “advanced infections” caused by the highly contagious delta variant mean that vaccinated people can also be found sick or trapped away from home. About 60 percent of current evacuees are vaccinated, Thompson said, because “they’re the ones who feel most comfortable traveling now.”

Many countries require negative tests to return home, which detects mild cases of Covid-19 in travelers who did not know they were infected.

“We find that between 30% and 40% of members test positive at the end of their trip,” Thompson said. “We also see it with the unvaccinated younger children of vaccinated travelers.”

Medjet, another medical evacuation company, reports a record summer, announcing that sales of affiliations to MedjetHorizon – its highest level of coverage – reached an all-time high in July. The company has just posted its highest month-over-month net earnings in members in more than a decade, he said.

Assistance calls are above pre-pandemic levels, said John Gobbels, CEO of Medjet, though not all of them are related to the pandemic.

“Some are for Covid, but most are still the same old things that have never gone away,” he said.

After flying by helicopter to the Belize mainland and moving to a Learjet (“we didn’t have to get into the terminal”), McElroy and Underwood flew to Phoenix where a limousine bus was waiting on the tarmac.

The service “was literally door to door,” McElroy said.

It’s not, however, a five-star service, Thompson said. Certified air ambulances are required to take Covid-positive patients to hospitals or in the case of Covac Global, to their homes, he said.

Otherwise, there are situations where non-members ask to be evacuated to the nearest city in their country so that they can drive home to save money, he said. Instead of driving, they can jump on a commercial flight, which Thompson said is “a big no-no.”

McElroy called her fiancée “the hero of the story,” as she had driven and eventually bought out her evacuation policies.

Other travelers are not so lucky.

CNBC spoke with a 43-year-old Singapore man who tried to return from India to Singapore last April to start a new job. The journey, which can be a mere six-hour flight, became a six-week saga. The man requested the anonymity of this report.

Singapore limited travelers from India, so the man and his family scheduled a two-week trip to Nepal, after which they could fly directly to Singapore. While there, the delta variant exploded in the region and all flights from Nepal to Singapore were canceled.

Within days, the man, his wife, three children and his 85-year-old mother tested positive for Covid, he said. At the time, Nepal had imposed a strict closure: gas stations and public transportation had closed, he said, and the family was struggling to find food and medicine.

“We didn’t know anyone,” he said. “We didn’t know anything about the medical system and people are dying, left, right and center without beds and without oxygen.”

The family was evicted from their serviced apartment when management learned of their health conditions, he said. Weeks passed and the family recovered completely, but they were prevented from taking the weekly flight back to Delhi because they continued to test positive on Covid-19.

“RT-PCR [test] it basically looks for the DNA of the virus, it doesn’t distinguish between dead and living cells, ”he said.

He examined medical evacuations, but a friend who was equally trapped in the Philippines told him those flights are “astronomically expensive.”

Eventually, the family turned negative and returned to Delhi. In the 20 days following his recovery, the man told CNBC he was sleeping in 12 different places. He is now in Singapore, but some of his relatives remain in India.

Medical evacuations are expensive. Thompson said Singapore’s evacuations to New York could cost more than $ 300,000. Still, 70% of Covac Global’s evacuations are non-member paying out-of-pocket to return home from places like the Bahamas, Mexico, South Africa and Dubai.

Since members opened to all nationalities on July 15, the company has evacuated more people to Europe, especially from Spain to the UK.

So far, Thompson said, no foreign government has rejected his company’s request to evacuate a positive traveler to Covid from its territory. They tend to be happy to let them go, he said.

“They don’t want news of some foreigners dying delta in their hospitals,” he said, nor do they “want to lose one of their beds to a foreigner.”

The only time problems can occur is when a hospital has already started treatment. “That’s when governments really start to get a little weird about it,” he said.

Affiliations to companies like Medjet and Global Rescue cover cruise passengers, but Covac Global does not.

“Cruises go very well with their protocols and policies,” Thompson said. “But the problem is that … every time it is reported or not, there are sick people.”

Covac Global has evacuated non-member Covid-positioned passengers from cruises, although such cases are not news, he said.

Thompson said the service is not expensive for price-conscious cruisers.

“Cruise lines,” he said, “pay for it quietly out of your own pocket.”