Pre-pandemic, our work schedules in public institutions were peppered with overseas conferences and teaching engagements. In addition, my family often travelled during the school holidays. These past two years of COVID-19 have certainly led to nonstop work, particularly since we had to cope with an immense backlog of elective surgeries from the initial circuit breaker period, as well as the periodic mandated cessation of elective surgeries.
A chance to head overseas
In mid-2021, I had the opportunity to visit a fellow spine surgeon in the US to familiarise myself with a new surgical navigation system. With the worldwide rollout of this system, Singapore would likely be the first country in Asia to obtain this technology. I was keen to learn the workflow and technique so that we could readily apply this to our patient population. With the Vaccinated Travel Lanes (VTL) that began in November 2021, I felt it would be an opportune time to proceed with the visit, as it would be a good platform to share ideas and find new surgical pearls by observing fellow spine surgeons in the US. Additionally, I felt a short break would be great to recharge mentally and physically. All this was made possible with VTL, without having to quarantine upon return to Singapore.
I had to do quite a fair bit of preparatory work for the VTL travel to the US. For starters, US travel for Singaporeans still required an Electronic System for Travel Authorization approval.1 As I was going on a VTL return flight, there were a few critical details required:
- Notarised vaccination certificate2
- Pre-departure PCR testing3
- Knowledge of the location of test centres in the US within 48 hours of departure (this can be tricky especially if travelling out of state)
I had initially aimed to have my pre-departure PCR done on a Friday. However, the pent-up demand for travel had led to many clinics being booked solid.
My packing list included some N95 masks and ART kits. My trip would take me into New York (NY) with business meetings in New Jersey (NJ) and North Carolina (NC). The day of my departure came and having not travelled for around two years, it felt so surreal as the car rolled past the bougainvillea bushes and I glimpsed the control tower of Changi Airport.
Starting the trip proper
I travelled by Singapore Airlines (SIA) and much of the check-in process was already available on the SingaporeAir mobile app. I would just need to drop my bags and show my vaccination status and PCR results to the counter staff, which went quickly. Travelling one month into the start of VTLs, I suspect many teething problems were already ironed out, and I completed the check-in process within 20 minutes. Boarding was on time and as I entered the air bridge, I suddenly felt a little apprehensive – it was going to be a 17-hour flight and I would be sleeping and working with a mask on for most of the trip.
The cabin crew was cheerful as usual. One could almost see their smiles from behind their masks as they greeted boarding passengers. Upon reaching my seat, I found a COVID-19 care pack with two masks, a hand sanitiser and some disinfecting wipes. I proceeded to wipe down my seat and plugged in my personal headphones. Looking around, I could see that the flight was full, with many returning Americans as it was the Thanksgiving weekend. As a tip, those who like to read should bring your own reading materials as SIA no longer provides them on the flight. Passengers can also opt to download magazines via the SingaporeAir app.
The flight time passed quickly. I used the time to catch a movie, sleep, eat a little and update my slide decks for the two presentations that I would be doing in NJ and NC. Before long, I saw the outlines of NY. Landing in the John F Kennedy International Airport (JFK), the arrival procedures were straightforward and as it was an early morning flight, I was able to clear security within the hour. I noticed that all transportation in NY, including Uber and taxis, had a mask-on rule for passengers. These were certainly important rules to stick to if I wanted to stay COVID-19-free.
This being my first visit to NY, I had made a list of places to see. Times Square, Central Park and the Statue of Liberty, along with a few meals at popular haunts would certainly be all I could squeeze in. Reassuringly, many restaurants and department stores had notices requiring all patrons to don a mask and to also show vaccination certificates before granting entry. This certainly contributed to travel safety for the trip. Walking around the city, I estimated around 80% to 90% of New Yorkers kept their masks on and would only remove them during mealtimes.
Concluding the overseas drought
I completed my meetings in NJ the next day and flew to NC for a surgeon visit and research meeting. Landing at NC, I immediately noted that each US state had differing practices; mask-wearing was neither mandatory nor enforced in many of the establishments there. Many had signs encouraging mask-wearing but left it up to the individual's comfort.
I had a fruitful meeting in New Hanover Hospital, NC and observed four cases, noting how workflow could be improved in my own operating theatre. I came away with new thoughts and surgical pearls for anterior minimally invasive spine surgery.
My flight back from NC to La Guardia Airport in NY brought me to the tail end of my trip. After a quick shopping trip around the corner for some fresh bagels to bring home for my children, I was off to JFK. The SIA desk in JFK was busy. Many Americans were using SIA to transit to Thailand and Australia as the VTL would save them much travel time. With a mere hour to spare, I cleared airport security and waited patiently for boarding.
Concluding three locations within five days was tiring and I slept most of the fight back home. Upon reaching Singapore, all passengers were herded straight for a PCR test. The process was quick, and an hour after landing, I was on my way home in a taxi. My COVID-19 test results were released five hours post-testing. Phew, I was negative! During my absence, America had seen its first Omicron case and looking back, I was fortunate to have just missed the Omicron wave there. A supervised ART on days three and seven concluded my travel journey. I must say that the travel process was slightly stressful and certainly expensive given the testing requirements but overall, I found the trip refreshing and found myself recharged for a new year of challenges!
Update: The process of VTL has been further simplified since my travels in December 2021. SIA now only requires passengers to be fully vaccinated for air travel out and into Singapore.3