Amy and her daughter began their evacuation on Feb. 9 in PPE with a 45-minute speedboat ride from the resort to the airport near Male, the capital. They boarded a twin-engine Hawker 800XP jet, which had the stretcher, medical equipment, lavatory and seating for seven. Along with them were two nurses and two pilots who could switch out during the 16 hours it took to get from the Maldives to Ireland with refueling stops in the United Arab Emirates and Greece.

From Ireland, a second air ambulance and a third crew flew them to Canada, and finally to the United States. They arrived Feb. 10, three days after their originally scheduled return date. Amy tested negative throughout the trip, and her daughter tested negative before boarding the air ambulance and again upon returning to her home.

The extra resort stay, plus phone calls and the cost of shipping back their luggage since the plane was too small to carry it cost Amy about $11,000. Had she not purchased Covac’s coverage, the repatriation would have cost about $200,000, said Mr. Thompson, whose company also does fee-for-service evacuations.

The Centers for Disease Control and Prevention referred questions about the frequency of repatriation of Covid-19 positive people to the State Department, where a spokeswoman said those statistics aren’t collected. She did say that those who test positive for the virus while abroad “should prepare to remain overseas for an extended period and seek medical attention locally.”

When a person gets ill far from home, even if they speak the language, knowing what to do in the midst of a developing crisis is daunting. “If you do decide to take the risk of going, especially taking a trip to a foreign place where you have nobody you know, have a plan just in case,” said Christian Arellano. “The thing that affected us the most was scrambling. To find where to go, who to talk to, where we could get the medicine, where we could stay,” he said.

When the Arellanos first started feeling sick, they visited a medical clinic, where a doctor said they had asthma. A second physician eventually diagnosed Covid-19. Christian Arellano said that despite his mother’s illness, she “ran all over town getting all the medicine, thousands of dollars in just medicine.”

As the situation worsened, the couple called the U.S. Consular Agency in Oaxaca, which said no area hospital beds were available. They suggested an oxygen tank. With Mr. Arellano’s condition deteriorating, the couple spent $25,000 for a Mexican air ambulance to take him to the Naval Medical Center in La Jolla, Calif.

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When Your Covid-19 Test Comes Back Positive While Traveling

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