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

The CEO of the real estate investment company flew to both places privately – he is also vaccinated.

“I thought there was no way I was going to get it,” he told CNBC.

His fiancée, Danille Underwood, wasn’t that confident, McElroy said.

After 10 days in Belize, the couple took Covid tests the day before their flight back to Arizona. Although he felt tired and she coughed, they were both surprised when their tests were positive.

“We were out of our room within an hour,” said McElroy. “At that point, it got pretty real.”

With the help of people in protective suits, the couple were quarantined in a different part of the hotel, he said.

“We weren’t sure what was going to happen … whether they’d split us up or take us to a hospital,” McElroy said. “I didn’t know if I would need a ventilator.”

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

“Then Delta appeared”

Before leaving, Underwood bought memberships from Covac Global, a medical evacuation company founded by the crisis response firm HRI in early 2020. This meant the couple didn’t pay a dime for their repatriation, McElroy said.

Commercial airlines and private jets cannot fly travelers home with Covid-19, but certified ambulances with medical teams can.

Covid started to be more in the rearview mirror, but then Delta showed up.

Ross Thompson

CEO, Covac Global

While some companies are evacuating travelers in need of hospitalization, Covac Global is bringing back travelers who have tested positive for Covid-19 and have a self-reported symptom. About 85% of the evacuees will be returned home while the rest will need hospital treatment, said CEO Ross Thompson.

When CNBC first spoke to the company in March, it carried out about two to three medical evacuations every month. Now that number has risen to around 12 to 20.

“Unfortunately, business is booming,” said Thompson. “Covid was more and more in the rearview mirror, but then Delta showed up – and it threw everyone on one lap.”

Covac Global memberships have increased 500% this year, up 250% in the last month alone, he said.

So-called “breakthrough infections” caused by the highly contagious Delta variant lead to people who have been vaccinated being sick or stuck far away from home. About 60% of the current evacuees are vaccinated, Thompson said, because “they are now most comfortable traveling”.

Ken McElroy and Danille Underwood board a helicopter to fly to Belize City.

Courtesy Ken McElroy

Many countries require negative tests to return home, which shows 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 by the end of their trip,” said Thompson. “We see it also in the unvaccinated younger children of vaccinated travelers.”

Another medical evacuation company, Medjet, reports a record summer, announcing that sales of MedjetHorizon memberships – its highest level of coverage – hit an all-time high in July. The company was just seeing its highest net monthly gain in more than a decade, it said.

The calls for help are above pre-pandemic levels, said Medjet CEO John Gobbels, although not all of them are related to the pandemic.

“Some are for Covid, but the majority are still the same old things that never went away,” he said.

“Literally from door to door”

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

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

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

Medical evacuation flights, like the one McElroy and Underwood flew home on, are like a private jet and a hospital emergency room rolled into one, Ross Thompson said.

Courtesy Ken McElroy

Otherwise, situations arise where non-members ask to be evacuated to the closest city in their country so they can drive to their homes to save money, he said. Instead of driving, they can get on a commercial flight, which Thompson calls “a big no-no”.

McElroy called his fiancée “the hero of history” because she pushed for her evacuation policy and eventually bought her.

“Astronomically expensive”

Other travelers are less fortunate.

CNBC spoke to a 43-year-old Singapore man who tried to move back to Singapore from India last April to start a new job. The trip – which can only be a six-hour flight – turned into a six-week saga. The man asked for anonymity for this report.

Singapore restricted travelers from India, so the man and his family planned a two-week trip to Nepal from which they could fly direct to Singapore. There the Delta variant exploded in the region and all flights from Nepal to Singapore were canceled.

Within a few days, the man, his wife, three children and his 85-year-old mother all tested positive for Covid, he said. At the time, Nepal had imposed a strict lockdown – gas stations and public transport were closed and the family struggled to find food and medicine.

For reasons of space, Covid-19 patients flock to the hallways of a hospital in Kathmandu, Nepal on May 11, 2021.

Prabin Ranabhat | SOPA pictures | LightRakete | Getty Images

“We didn’t know anyone,” he said. “We didn’t know about the medical system, and people die, left, right, and in the middle with no beds and no oxygen.”

The family was evicted from their sheltered home when management learned of their health, he said. Weeks passed and the family made a full recovery, but they were prevented from taking the weekly flight back to Delhi because they continued to test positive for Covid-19.

“The RT-PCR [test] basically looking for the virus’ DNA, it doesn’t differentiate between dead and living cells, “he said.

He was investigating medical evacuations, but a friend who was also stuck in the Philippines told him that such flights were “astronomically expensive”.

Eventually the family tested negative and returned to Delhi. In the 20 days after his recovery, the man told CNBC that he slept in 12 different locations. He is now in Singapore, but some of his family members remain in India.

Members vs. non-members

Medical evacuations are expensive. Thompson said evacuations from Singapore to New York could cost up to $ 300,000. Still, 70% of Covac Global evacuations are non-members who pay out of pocket to be flown home from places like the Bahamas, Mexico, South Africa and Dubai.

Since membership opened to all nationalities on July 15, the company has been evacuating more people across Europe, particularly from Spain to the UK.

Comparison of Covid evacuation memberships

Medjet assistant Global salvation Covac Global
deduction Hospitalized 150+ miles from home Hospital more than 100 miles from home Positive PCR test + 1 symptom
Returned Hospital of choice Hospital of choice Home or hospital
Covers other medical problems Yes sir Yes sir Optional add-on
Availability Residents of the United States, Mexico, and Canada All nationalities All nationalities
Cruise coverage Yes sir Yes sir no
Starting prices $ 99 $ 119 $ 675
Source: Medjet, Global Rescue and Covac Global

So far, Thompson said, no foreign government has refused his company’s request to evacuate a Covid-positive traveler from its territory. Usually they like to let her go, he said.

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

The only timing problems can occur when a hospital has already started treatment. “From that point on, governments get really a little weird,” he said.

The cruise riddle

Memberships with companies like Medjet and Global Rescue cover cruise passengers, but Covac Global does not.

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

Covac Global has evacuated Covid-positive travelers who are not members of cruises, although these cases are not making headlines, he said.

Thompson said service is not expensive for budget cruisers.

“The shipping companies,” he said, “are only tacitly paying for it out of their own pocket.”