How are people coping with 24-hour PCR test requirements vs travel reservations?

Many people plan these trips taking into account the chance the whole trip might be cancelled if they test positive. For example, choosing airlines that allow a refund for this reason, booking hotels but not prepaying, and so on. And they tell the people they are visiting there is a chance they might cancel on the day of travel. Some places also sell insurance to help cover costs in these instances.

Yes, some people will not be willing to travel on these terms. Travel is still way down from pre-pandemic levels. But some people will, especially if the trip is important. I've travelled once on urgent family business (and put up with two-week quarantines on both ends of the trip) and just a few weeks ago on normal business, and yes, I knew it might all go sideways on the day of travel and I just had to live with it. I will say that for the normal business trip, one of the reasons I was willing to go was that neither my destination nor my home demanded these tests any more.

As for your chances of testing positive, it depends on how many times you've had it already, how many vaccine doses you've had, the prevalence of the virus in your area, and your lifestyle (for example, I'm still masking and not going to restaurants or really anything with strangers other than essential shopping.) The math will be different for each person. For you, it leads to "no way, I'm not going." To me, it has led that way for most trips, but there are two I have done.

Obviously this is an unacceptable risk for many people including myself.

Than you cannot travel. That's the rules and if you don't like them you have to stay home.

I'm currently travelling with a test I did yesterday. It can be done and many people do it.

I once failed a test while travelling: you just need to figure it out. Hotels can be rebooked, flights can be changed, meetings can be re-scheduled or virtualized, rental cars can be extended, etc. It's a hassle but it can be done and it wasn't outrageously expensive either.

There may be something big I'm missing here, because I cannot see it in the other answers, but you wouldn't incur costs if you bought insurance that covered them. I can see that such policies exist; https://www.smartraveller.gov.au/CHOICE-travel-insurance-guide-COVID-19 I'm not recomending one in particular, because that's likely out of scope for this site. Just highlighting that they are available.

I've actually never bought them, because I tend to travel cheaply (like sleep-on-the-coach cheaply), so the cost of insurance would likely be more than the cost of cancellations. But it would make a lot more sense to buy it if you had spent a lot on reservations.

As for not being able to make appointments if you test positive; one might say "that is a feature, not a bug" (though you would in fact have a bug in that case...). If it turns out a person is sick with this particular pathogen, we would rather they didn't use public transport/aeroplanes or travel too far. We would also rather then didn't meet other people in person, so no appointments. Frustrating, but it is the point of the test.

As mentioned in the other answers, if do your best to avoid infection in the weeks before your trip, you can greatly reduce the chances of a positive test to start with. Best of luck, I hope it all goes well.

Just a supplementary answer: If a trip is very important to you, you can minimize the risk of a positive test by quarantining 7-10 days before your test (if your work and circumstances allow this). And if you are afraid of a false positive or another test failure/delay you could arrange tests with two (or more) independent test providers.

There are ways to avoid getting a Covid test these days or at least minimize the risks of a late test:

• If you’re vaccinated or boosted, many nations waive the test requirement.
• Covid recovery certificates are sometimes accepted instead, so if you already tested positive in the last 90 days you can avoid getting a new one for traveling
• Rules are often different at land borders. I.e. in the case of the US, you can avoid getting tested by flying to Mexico or Canada and then crossing overland, as the US does not require Covid tests to go through the land border.
• There are now plenty of “remote” antigen Covid tests that let you run the test while supervised by a remote nurse, which allows you to get an official test certificate without having to rely on a test center.

Overall Covid restrictions are currently being dropped all over the world so it’s unlikely that any nations other than China will require pre travel testing by the end of the year. So if you’re extremely stressed by the current rules, choose a test-free destination for now and schedule the other trip for later.

can afford to make all their reservations, take vacation from work, and then are fine with having everything cancelled because of a test failure

If you can afford to pay for all reservations and go on vacation, you can also afford to pay for all reservations and not go on vacation¹. Vacation is a luxury. Of course, it's a pity if you have to cancel and are out of money and out of vacation, but that risk already existed before the pandemic (you could have a car accident on your way to the airport or train station, for example). The PCR testing requirement has zero impact on the affordability of travel.

If this is business travel, then it is up to your employer to carry the risk of you being unable to travel. Depending on the business, a cancelled business trip may have high costs for the employer. It is up to them to send someone in your place if you are unable to travel, or to organise alternate arrangements.

If you want to get some money back if you can't travel, you may consider travel insurance. Some travel insurance policies may refund (part of your) trip if you cannot travel due to illness. Check their policy if asymptomatic infection with SARS?CoV?2 is covered.

¹Unless you spent every last cent on an all-inclusive holiday, including food, and will not have money for necessities in case of a cancellation. Don't do that.

The tests add an extra layer of stress and logistics to travel, but for many destinations it's not insurmountable. After all, you could break your leg or a family member could suffer a mishap or get ill just before a trip too.

On a recent trip to Europe and North Africa I needed a full PCR test before departure (due to the North African destination's requirements), which required booking and waiting some 20 hours before the results were ready. The requirement was that the test be administered no more than 48 hours before boarding, which allowed the cheapest PCR test (still rather pricey, around $150 USD). Upon arrival they administered another test (this one free) and required contact information but released passengers immediately. Then upon return, antigen tests at the two departure points were required, which were relatively cheap ($30-ish) and results were almost immediate (45 minutes to a couple hours). In fact the European one was done at the airport just before boarding. Obviously if you test positive under those conditions you're in for additional costs and inconvenience so you need to be able to deal with that. I had a smaller laptop and over 150 books to read in epub form so a week or so would not be too irritating.

Personally, I was willing to take the risk of paying for extra accommodation, and booked (mostly) cancelable things in case departure had to be canceled due to failing the test, other illness, serious illness or death in the inner circle etc., so the total risk was acceptable to me even without insurance (have medical insurance, of course). I made a spreadsheet with items and the latest cancellation dates. There was some logistics involved in the return testing because of language barriers and opening hours allowed only a narrow window for testing. Usually you can trade money for convenience in getting faster test results.

Most destinations that I've looked at allow PCR tests to be administered 48 to 96 hours in advance, but rapid antigen tests have a much shorter window (like 24h), which is fine because the results of the former can take more than 24 hours (unless you shell out USD $300 or so) but the antigen tests are almost immediate. It's particularly confusing (and sometimes alarming) because "PCR" has become a bit genericized in some locations and even officials sometimes refer to 'PCR test results' to mean COVID-19 test results, when the cheap and fast (but less reliable) rapid antigen tests are perfectly acceptable.

Unfortunately, where I really want/need to go (mainland China) is still quite impractical- basically special permission (new visa issued with more documentation since the old visas are suspended), self-quarantine for some time before travel with multiple tests of different types, few flights (which must be direct) and then likely 21 days of supervised quarantine with many tests at the other side, something of the order of $10,000 USD in expense and a month's lost time for something that used to be $1000-ish and a day's time. Hopefully that can change in a few months but I'm not especially optimistic for 2022 as they've actually been tightening requirements even before the latest outbreaks.

So: TL;DR Review all cancellation rules before booking (some accommodation sites allow you to filter) to know and limit risk. Research what requirements are in the unlikely event that you fail a required test before leaving for home or between destinations and, at least roughly, what the costs might be. Research test locations, costs, and opening times and add those to your itinerary, and have a plan 'B' in case they are, for some reason, unavailable or you are delayed in reaching your departure city. Review insurance coverage to see exactly what you are covered for and arrange supplemental insurance if deemed worthwhile. If, after all that, the costs or risks are too high, you can always stay at home. Or go with the peace of mind that most eventualities, even unlikely ones, are covered.

If test failure = test result not within 24h:

Antigen rapid tests, as your quote offers as alternative to PCR, just take a few minutes to get the results, and are therefore straightforward to get the same day. Some airports such as MEX even offer it before check-in. It's very uncommon to require a 24h PCR test while not accepting antigen tests, but still feasible in many places if willing to pay for it.

Note that your quote says the day before, not 24h, which gives your more time if not taking an early flight.

If test failure = positive test, see jcaron's comment + getting a positive test has a very low probability, typically much lower than 0.1 % unless if currently in a covid hotspot. That's one of these low-probability events than one has to live with when traveling (delayed plane, lost passport, visa issue, immigration non-sense, custom trouble, airport security headache, etc.). It can be partly insured against, e.g. for this flight from Seattle to San Francisco:

Some places explicitly exclude COVID-related cancellation from their policies, e.g. Airbnb:

Also, see this list of airline policies on COVID-related fare flexibility.