[Editor’s note: This is an updated version of an earlier article that originally ran on January 28 with multiple updates since then.]
Seven countries, including the U.S., have approved the Pfizer/BioNTech vaccine to date and the E.U. is expected to issue its approval on December 23. The FDA approved the Moderna vaccine on December 15 and the CDC is expected to give its approval on December 18. While clinical trials show the vaccines are very effective at preventing illness, it’s not yet known if they prevent the spread of the virus, a key factor for allowing normal life to resume. Health experts warn that COVID protection measures like masks and distancing will be needed for most of 2021, if not longer, until herd immunity around the world is achieved through mass immunization. Experts continue to caution people to avoid travel and social interactions, including visiting other households over the holiday season. Exceptions include New Zealand, Taiwan, Vietnam, Thailand, and the handful of other countries that conquered their outbreaks and therefore enabled their social and economic lives to return to almost normal.
The CDC reminded that half of all COVID cases are spread by people without symptoms and experts caution that one negative COVID test provides no guarantee that you’re COVID-free and not contagious. The first airline—Qantas—announced that it will require COVID vaccination for its international passengers. Travel—and not obeying health rules—is still seen as a major contributor to the spread of COVID-19. Those who choose to travel need to ensure they are not further contributing to the spread of the disease, difficult to do given limitations in the accuracy of testing and how easily the virus is transmitted. Until the pandemic is over (and it’s far from over), keep asking: Yes, you CAN travel, but SHOULD you travel?
Confusion remains about who can travel where, which destinations are considered “safe” and by whom, and the ever-changing requirements of each jurisdiction. We’ve outlined the rules for 52 of the countries currently allowing Americans to enter their borders. Many question whether it’s ethical to travel at all, particularly for tourism. About 75 countries are open to U.S. travelers, a few requiring only a fever check at the airport, some with mandatory quarantine periods, and most needing proof of a negative COVID test taken between 48 hours and seven days prior to travel. Physical distancing and mask-wearing are strongly encouraged when in public and, increasingly, are mandatory, sometimes enforced via fines for non-compliance. Everyone is worried about revitalizing economies that are in deep recession and many countries are reopening their economies before their peak of cases has passed.
Due to the high case numbers in the U.S. and several abrupt changes in advice from the CDC, Americans continue to face more travel restrictions than residents of most other countries. Many countries continue to recommend their citizens not travel at all, internationally, or even outside of their state or province. For those who must travel during the pandemic, we’ve created a free guidebook: Fodor’s Guide to Safe and Healthy Travel.
We outline what you need to know, but remind you that the World Health Organization (WHO) is the expert source for health advice.
The Latest Statistics
On December 9, the world crossed the 70 million case mark, after reaching 60 million cases on November 25, 50 million cases on November 8, and 40 million cases on October 19. Worldwide, the one millionth COVID death was recorded on September 28. According to Worldometers, as of December 16, there are 74,013,450 cases of COVID-19 and at least 1,645,908 people have died. At least 51,986,276 people around the world have recovered. Fifteen countries have more than one million COVID cases and eight countries have more than 50,000 deaths. The U.S. crossed the 300,000 deaths threshold on December 14, the same day the first doses of the vaccine started being administered.
As of December 16, the top 10 nations with high incidences are the U.S. (17,159,794 cases, 311,316 deaths), India (9,933,997 cases, 144,144 deaths), Brazil (6,974,258 cases, 182,854 deaths), Russia (2,734,454 cases, 48,564 deaths), France (2,391,447 cases, 59,072 deaths), Turkey 1,898,447 (cases, 16,881 deaths), the U.K. (1,888,116 cases, 64,908 deaths), Italy (1,870,576 cases, 65,857 deaths), Spain (1,771,488 cases, 48,401 deaths), and Argentina (1,510,203 cases, 41,204 deaths). China, the first country to identify the disease, has reported 86,770 cases and 4,634 deaths—almost 80 countries now have more cases than China. Note that China doesn’t include asymptomatic cases in their official case count, as most countries do.
COVID-19 is in 218 countries and territories, using the United Nations’ geoscheme definitions. Samoa and Vanuatu are the latest countries to record their first cases. The Marshall Islands recorded its first two cases on October 28, via passengers on a U.S. military flight. Prior to that, the Territory of the Wallis and Futuna Islands—French-administered islands in the South Pacific—confirmed a COVID case on October 16. The Solomon Islands had its first case on October 3. While North Korea reported a suspected COVID case on July 26, those results were deemed inconclusive on August 5, The Guardian reported. Prior to this, Lesotho was the most recent country to report its first COVID case, on May 13.
On August 22, Business Insider listed fourteen countries that then had zero COVID cases. On November 2, The Guardian updated the remaining nations and territories then believed to be COVID-free: American Samoa, the Cook Islands, Kiribati, Micronesia, Nauru, Niue, Norfolk Island, Palau, Pitcairn Island, Samoa, Tokelau, Tonga, Tuvalu, and Vanuatu.
The Latest News
With vaccine distribution beginning in several countries, health experts are trying to increase the public’s understanding that masks, physical distancing, and other COVID protection measures will still be needed until herd immunity is achieved. Enough people in some western countries may be vaccinated by autumn, but it’s doubtful it can be achieved for the entire world until later, with some estimating by 2024. People who have been vaccinated will also need to take precautions because we don’t know yet if the vaccines prevent virus transmission in addition to preventing vaccinated people from getting sick. We also don’t yet know how long immunity will last and if regular vaccinations, as with the flu, will be needed.
Dr. Anthony Fauci said all Americans who want a vaccine are likely to receive it by the end of the summer, and that would mean life could start to get back to normal by the end of 2021. Canada is on a similar timeline. U.K. officials said vaccinating their entire population might take until late autumn or early winter 2021. The U.K. plans for 1,000 vaccination centers and if they operate five days a week and each vaccinates 500 people daily, The Guardian reported that it would take almost a year to provide two doses to everyone in the U.K., which has a population of about 68 million. Officials estimate 20% of the population won’t be able to be vaccinated or will choose not to.
For normal life to resume everywhere (including international travel), herd immunity—about 70 to 80% of the population vaccinated—is needed around the entire world. Humanitarian organizations warn that as it stands now, only 10 percent of the populations of 67 developing countries are on track to be vaccinated by the end of 2021. A December 15 report from John Hopkins Bloomberg School of Public Health said that 25% of people globally might need to wait until 2022 to get the vaccine and called for rich countries “to share in an equitable distribution of COVID-19 vaccines across the world.” Some reports say the world won’t be vaccinated until 2024. Initiatives like the WHO’s COVAX vaccine sharing initiative still need billions in funding (the U.S. has yet to sign on) and rich countries need to communicate how they plan to share their excess supply of vaccines.
There appears to be a new strain of the COVID-19 virus spreading in southern England with some indication that it may be more contagious, but not more deadly, than other strains. Prominent U.K. medical journals called for a reversal of the decision to allow three U.K. households to mix indoors at Christmas, predicting it will cause a significant rise in COVID cases and deaths. Prime Minister Boris Johnson said on December 16 that there is “unanimous agreement” about the U.K.’s rules for holiday gatherings, but The Guardian reported that Scotland and Wales announced more conservative rules than the rest of the U.K.
There’s a mix of countries allowing limited domestic travel and social gatherings over the festive period and others asking their citizens to stay in their homes over the holidays. Poland is an example of the latter, with the health minister saying December 15 that efficient vaccinating of Polish residents might be jeopardized if infection rates rise further. The WHO in Europe recommends families who do choose to get together not to “underestimate the importance of your decisions,” to wear face masks and be vigilant about physical distancing because of the “high risk of further resurgence in the first weeks and months of 2021.”
Italy also linked rising infection rates with difficulties in vaccinating people in the new year. Due to large crowds of shoppers in Rome on the December 11-13 weekend, officials gave new warnings to avoid contact with others and blocked access to popular sites like the Trevi Fountain. Announcements about new domestic travel and gathering rules over the holidays are expected.
Ireland will allow domestic travel as of December 18 including limited mixing of households until January 6. The country closed bars, restaurants, and nonessential stores in October and has the E.U.’s lowest COVID infection rate. However, officials warned that new restrictions could come in January if infection rates rise due to Christmas gatherings.
Germany strengthened its “lockdown light” and is under stronger restrictions as of December 16. Essential stores and banks are amongst the few services allowed to remain open; schools are closed and businesses are asked to have employees work from home or close altogether. Between December 24 and 26, a household is allowed to invite no more than four close family members to their home, otherwise a maximum of five people from two households are allowed to gather. Germany announced a record high of daily COVID deaths on December 15.
December 15 ended France’s stay-at-home order but was the start of the 8 p.m. to 6 a.m. curfew. As of December 16, London is at the highest tier-three restrictions, meaning nonessential stores must close, restaurants can offer only take-out food, indoor socializing is restricted to one’s own household or support bubble, although six people are allowed to meet outdoors.
The Netherlands began a five-week lockdown on December 14, which includes closing nonessential stores and museums until January 19. On December 15, the country had a new record high of daily new infections. Denmark is also extending its lockdown throughout the country.
Turkey continues its restrictions and will have a stay-at-home lockdown from December 31 to January 4. Turkey continues to reach record highs of daily COVID deaths and has the world’s third highest number of daily deaths after the U.S. and Brazil. Turkey’s COVID numbers increased dramatically over recent weeks as the country previously did not include asymptomatic cases or milder cases not requiring hospitalization in its total case numbers. This added 800,000 cases to Turkey’s total on December 13 alone.
South Africa is reimposing some COVID restrictions between December 16 and January 3, including closing beaches and parks where case incidences are high. The move follows spikes in infection rates in early December which the president attributed to travel and gatherings of people. The national curfew will begin one hour earlier at 11 p.m., with restaurants and bars closing by 10 p.m. Festivals and live performances are also banned.
South Korea is implementing new restrictions—and warning that more will come if infection rates don’t drop—given its record highs of new daily infections. Japan suspended its Go To Travel domestic tourism program between December 28 and January 11, given Japan’s rising infection rates and complaints from the Japanese that the subsidized travel program caused unnecessary transmission of the virus. Travel to Osaka and Sapporo was already paused, and Nagoya and Tokyo will pause as of this week. Japan, for the first time, recorded more than 3,000 new infections in one day on December 12 and Tokyo has record highs of new daily cases.
Starting in mid-January, Singapore will reopen for business travel from all countries. Numbers of visitors will be limited through this “travel lane” and stays will be allowed for a maximum of 14 days. COVID tests will be required prior to departure to Singapore, on arrival, and at intervals throughout the stay. Protection measures will include floor-to-ceiling plexiglass dividers when meeting with Singaporeans and requirements to stay within designated facilities. Singapore approved the Pfizer/BioNTech vaccine on December 14.
There was a false COVID alarm on the four-day Royal Caribbean “cruise to nowhere” out of Singapore that ended a day early. A passenger tested positive onboard in a routine test, but then tested negative three times on shore. The cruises are only open to Singapore residents, which has about a dozen new cases daily. Ships operate at 50% capacity to allow for distancing and standard protocols include a COVID test prior to boarding and disembarking, as well as an onboard test if a passenger seeks medical attention for any reason. The false-positive case was seen as an effective test of new COVID protocols.
New Zealand and Australia announced a trans-Tasman travel bubble will open during the first quarter of 2021, subject to no significant changes in infection rates in either country. Both countries have a system of managed quarantine within a limited number of designated hotels, which would be eliminated for travel between the two neighbors. However, both countries are preparing for the possibility of a new outbreak and how they would manage potentially-infected returning travelers and aircrews. Several Australian states have already agreed to allow travelers from New Zealand to skip quarantine. New Zealand and the Cook Islands also announced a quarantine-free travel bubble, which should begin by March 2021.
In Spain, Barcelona hosted a study on COVID testing in order to attend a live music concert on December 12. Volunteers received a same-day antigen screening, and then 500 were randomly selected to attend the concert, and 500 sent home as the control group.
The most recent change to England’s “green list” of destinations exempt from quarantine went into effect on December 12 when Botswana and Saudi Arabia were added to the exempt list and Spain’s Canary Islands were removed. As of December 15, required quarantine in England can be reduced to five days if the passenger tests negative for COVID on day five after arrival. As of December 14, the normal length of mandatory quarantine throughout the U.K was reduced from 14 days to ten. See our latest Europe update for details on how England’s list has changed over time and what applies to Northern Ireland, Scotland, and Wales.
The E.U. ‘s green list, originally with 14 countries when first released June 30, was last updated on October 22. Singapore was added and three countries—Canada, Tunisia, and Georgia—were removed. E.U. member states are not required to abide by these guidelines, and individual European countries continue to set their own rules. The E.U. president’s proposal for consistent color-coded measures and restrictions according to each E.U. country’s epidemiological situation was approved on October 13: A Common Approach on COVID-19 Travel Measures.
To help encourage air travel, most U.S. airlines are eliminating change fees for international flights. Some reports say that the fees will be permanently gone. However, it will depend on the fare class purchased and the least expensive tickets are likely to remain unchangeable and nonrefundable. Travelers will also need to pay the difference if rebooked flights have a higher cost.
As travel looks to increase in 2021, experts warned airlines on December 14 to be cautious as they return aircraft to service from extended storage. As examples, they said insects may have affected plane censors and that both pilots and maintenance workers may be rusty in their skills. Reuters reported that the International Air Transport Association (IATA)’s data shows that the number of “unstabilized” or poorly-handled approaches has increased and IATA encouraged airlines to have pilots do more training focussed on landings.
As you plan and prepare for travel in 2021, there are several new products to make travel easier and safer. Another for travelers to consider is the Bond Sanitizer container. You fill it with the sanitizer of your choice (more than 60 percent alcohol to kill viruses) and it clips to a belt or bag. It’s easy to use one-handed as it doesn’t require you to take the cap off to squeeze sanitizer into your hand.
We’ve integrated previous news into the sections below.
Earlier News and Changing Travel Restrictions
In early December, the head of the WHO, Tedros Adhanom Ghebreyesus, expressed concern about countries “where science is drowned out by conspiracy theories, where solidarity is undermined by division, [and] where sacrifice is substituted with self interest” saying that these are the conditions where the virus thrives and spreads.
Tedros also made the case for a “radical rethink” of how the world invests in public health and health care. He reiterated his earlier calls for an urgent $4.3 billion investment and for a further $23.9 billion in 2021 for the WHO’s ACT-Accelerator / COVAX vaccine mechanism, which aims to get vaccines distributed equitably around the world regardless of nations’ wealth. Tedros said December 4 that vaccines “must be shared equally as global public goods, not as private commodities that widen inequalities and become yet another reason some people are left behind.”
Through COVAX, the WHO aims to distribute half a billion doses of vaccine during the first three months of 2021 and two billion by the end of 2021. The goal is for the 20% most vulnerable people in the 189 countries that have signed on to COVAX to be vaccinated first. The WHO’s chief scientist said that with two billion doses distributed—that means vaccinating one billion of the world’s 7.8 billion people—the acute phase of the pandemic would be over. Most of the richer nations that signed on to COVAX have secured additional vaccine supply agreements.
The People’s Vaccine Alliance—made up of organizations like Amnesty International, Oxfam, and Global Justice Now—is accusing rich countries of hoarding vaccines. Though they have only 14% of the world’s population, these nations have secured 54% of the most-promising vaccine candidates. The Alliance predicts that unless something changes, only 10% of people in 69 low-income countries are likely to be vaccinated in 2021. Canada is the country with the largest number of vaccines secured by contracts—if all vaccines are approved, Canada would have about ten doses per person. However, Canada has approved only one vaccine, Pfizer/BioNTech’s on December 9. Canada is a member of COVAX and has committed to sharing unneeded doses with other countries.
Discussions are underway for what a post-vaccine world will look like. The WHO said they do not foresee countries making vaccination mandatory, although do anticipate that some jobs, such as those in the healthcare field, will require it. Private companies may also require their customers to be vaccinated. Qantas was the first airline to say international passengers will require vaccination and Live Nation/TicketMaster’s new policy is that vaccination or negative COVID test certification will be needed to enter its event venues. Cyprus announced on December 4 that, as of March 1, 2021, travelers who have proof of vaccination will be exempt from showing a negative PCR certificate upon arrival.
As the festive holiday period nears, the head of the WHO called for “extreme caution” saying that “we all need to consider whose life we might be gambling with in the decisions we make” when gathering in person with family and friends. While the end of November saw the first decline in worldwide cases since September, Tedros reminded that “gains can easily be lost” and that “this is no time for complacency.”
The WHO warned on November 30 that future pandemics are a risk if the world chooses not to learn from COVID-19. Mike Ryan said “I have seen the amnesia that seems to descend upon the world after a traumatic event,” mentioning the SARS, H5N1, and H1N1 crises. He also called out developed nations in the northern hemisphere who run their health care systems “like low-cost airlines” without necessary surge capacity, and that this decision costs lives and drags back the economy.
German Chancellor Angela Merkel said December 1 that COVID is causing the global balance of power to shift even further to Asia’s favor, especially to countries that have controlled the virus and where mask-wearing is accepted and there are minimal, if any, protests against measures to protect public health. “I believe this will lead again to another reordering of the regions,” Merkel said. Countries that have COVID under control have been able to almost fully restart their economies, showing that prioritizing public health benefits both people’s health and their economic lives.
At a November 30 tourism conference, the UN’s World Tourism Organization and the World Travel & Tourism Council made the case for countries to follow similar international COVID protocols for testing and, eventually, vaccination to facilitate ease of travel. They also called for travel corridor agreements between destinations with similar epidemiological situations.
The WHO said on November 23 that avoiding family gatherings over the holiday period is the “safest bet,” while the CDC recommended that Americans not travel for the Thanksgiving long weekend. The CDC also updated its COVID guidelines saying that half of all cases are spread by people who do not have symptoms, almost a quarter of whom never develop symptoms at all. Experts remind that a negative COVID test does not guarantee that you are virus-free and should not be interpreted as a green light to ignore COVID precautions (these articles by Nature, The Los Angeles Times, and The Washington Post should be read by anyone considering getting a COVID test in order to travel).
More vaccine candidates are showing promise in both efficacy and safety—including a few that can be stored at normal refrigerator temperatures and therefore possible to distribute in the developing world. However, experts remind that it will still take many months for vaccines to finish their clinical trials, be approved, manufactured, and distributed around the world, and for individuals receiving the vaccines to build antibodies. Until then, governments and individuals need to continue doing everything they can to minimize disease transmission. The New Scientist explains the complex chain of events that need to work almost perfectly in order for the world to get vaccinated. Germany called on companies that have profited from the pandemic, including Amazon, to contribute to ensuring fair vaccine distribution around the world.
Qantas is the first airline to announce that, once vaccines are available, air passengers will be required to have had a COVID vaccine in order to fly internationally with the airline. The International Air Transport Association (IATA) plans to create an app to facilitate proof of vaccination. However, CommonPass—created by the World Economic Forum and The Commons Project Foundation— is already being successfully piloted internationally (currently for COVID test status, and eventually for vaccination status). CommonPass announced on November 24 that the Airport Council International (ACI) joins airlines such as Lufthansa and United as members of the CommonTrust Network. In a November 24 briefing, IATA also announced that airline revenues are down 60% for 2020 and estimated losses are $118.5 billion, which threaten the industry’s continued survival.
Countries with the strongest recovery of their travel industry compared to the rest of the world are Thailand, Taiwan, and Vietnam The Guardian reported, due to their success in controlling COVID-19. In New Zealand—known as the country which has most successfully dealt with COVID—domestic travel and other activities are almost at normal levels. Singapore has also successfully fought the virus and has not had any local cases for two weeks, though it once had Asia’s highest infection rate.
The world hit new global records of daily new COVID infections on both November 13 and 14 with 645,410 and 660,905 new cases, surpassing the previous record of 614,013 set on November 7, according to AFP. The WHO’s director general reminded that fighting COVID-19 does not mean the choice between lives and livelihoods, but that “the quickest way to open up economies is to defeat the virus.” He also expressed concern that “particularly in Europe and the Americas, health workers and health systems are being pushed to the breaking point.” Leaders of the G20 countries meet on November 21 to discuss the global economy and the COVAX vaccine initiative.
If you’re interested in how COVID testing can—or can not—aid increased movement, read two articles in the news this week. Calling out Elon Musk (and calling him Space Karen) for falling for conspiracy theories and not understanding how rapid antigen tests work, bioinformatics Ph.D. Emma Bell explained high false negative rates for rapid tests and shared Nature’s Fast coronavirus tests: what they can and can’t do. Also worth reading is a Los Angeles Times piece about COVID tests: Some in L.A. are getting COVID-19 tests so they can party, socialize. Officials call this a disaster. The same logic applies to travel.
Linked, Reuters reports November 18 that the E.U. is recommending that rapid antigen tests should be used for people who show COVID symptoms, since they are less accurate than PCR tests, and called for Europe to develop a common set of testing standards.
According to Reuters, October was, so far, the worst month of the pandemic—one-quarter of the world’s total cases were diagnosed in the 30-day period and it took just three weeks for the world to go from 40 to 50 million cases. The head of the WHO, Dr. Tedros Adhanom Ghebreyesus, said on November 9 “we might be tired of COVID-19. But it is not tired of us.” He added the virus “preys on those in weaker health, but it preys on other weaknesses too: inequality, division, denial, wishful thinking, and willful ignorance” and that “our only hope is science, solutions, and solidarity.”
The WHO and world leaders welcomed news of Pfizer/BioNTech’s interim results of 90% effectiveness of one of their vaccine candidates. However, most noted that March 2021 would likely be the timeframe for vaccinating countries’ most vulnerable populations, assuming further tests show the vaccine is effective and safe. It will likely take longer for widespread vaccination. England’s health service is already saying that it will need to reduce medical services in order to focus medical staff on giving immunizations, once a vaccine is ready.
However, this particular vaccine requires two doses and needs to be stored at about -94 Fahrenheit. Only about 25 countries have adequate infrastructure to store and distribute it. It will therefore be difficult to reach two-thirds of the world’s population and other vaccines will be needed for those populations. How long the Pfizer/BioNTech vaccine protects is also a question that remains to be answered. Until the majority of the world’s population can be vaccinated, wearing masks, keeping at least six feet of distance, and other measures remain essential to minimize COVID transmission.
On November 3 Tedros called for world solidarity and reminded that “the need for a COVID-19 vaccine is very real. But it will not fix the vexing vulnerabilities afflicting us all. There’s no vaccine for poverty, hunger, inequality, climate change, or misguided nationalism. Global commitment to end these scourges is urgently needed.”
He also said “COVID-19 is a reminder that for everything that makes us different, we are one humanity, we share the same DNA, the same hopes and dreams, and the same planet. There’s no other option but to work together.” This comes amidst a Duke University study that reports that rich nations are securing the vast majority of a potential vaccine, which could result in poorer countries not having access to enough vaccine until 2024. Many of these nations were, pre-pandemic, favored by travelers. Lack of immunization could mean limits to travelers, the ruin of tourism economies, the perpetuation of poverty, and increases in long-term illnesses and lives lost.
Dr. Soumya Swaminathan, WHO’s chief scientist, has said that healthy, young people might not have access to a COVID vaccine until 2022. Healthcare workers will be the first to receive the vaccine when it becomes available, likely followed by the highest-risk frontline workers and the elderly. More than 170 countries—including, most recently, China—have signed on to the WHO’s Covax initiative. It guarantees an even distribution of available vaccine by population to participating countries.
At the end of October, a few countries started reinstating domestic travel bans, including Spain and Iran; it’s under discussion for Italy. In other countries, domestic travel is strongly discouraged. For example, in England hotels are meant to be used only for business travel and England residents are requested not to travel to Wales in attempts to avoid the new lockdown. In Germany, hotels are not allowed to host tourists. The Italian government asked residents not to leave the city where they live unless for essential purposes and warned people not to travel to other European countries in case travel bans become necessary affecting their ability to return home. The Netherlands is recommending that people avoid international vacations over the Christmas and New Year holidays.
COVID cases continue to reach record highs in many countries. Several are recording new highs in deaths, such as France which had 523 COVID deaths on October 27. Reuters reported on October 27 that a half million people in the U.S. were infected with COVID-19 during the last seven days. More than 41,000 Americans are hospitalized with COVID, more than 8,000 of those in ICUs. The Guardian reports that the average number of U.S. deaths per day has climbed 10% compared to two weeks ago, with almost 800 Americans dying per day of COVID. The U.S. had a record number of new daily COVID cases on October 22—71,671 cases, with the previous record in July. The Guardian reported on October 14 that about 5,000 people die each day around the world from COVID-19, down from a high of 7,500 in April. The WHO’s chief scientist warned about rising infection and ICU hospitalization rates—100,000 new cases daily in Europe alone: “Mortality increases always lag behind increasing cases by a couple of weeks,” said Swaminathan.
The WHO reported that self-isolation and quarantine failures are one of the causes for rising COVID rates in the northern hemisphere—meaning individuals who refused to follow the rules and jurisdictions that failed to enforce measures consistently. The WHO’s emergencies director said virus transmission could be curtailed if “every contact of a confirmed case is in quarantine for the appropriate period.”
Scientists continue to make the case that “herd immunity” without a vaccine is both unethical and impossible, and would result in countless unnecessary deaths and long term disabilities. A report from the CDC says that so far this year, the U.S. has had 300,000 more deaths than it normally would have, an increase of almost 15%. The “excess death” rate of 25- to 44-years olds is 26.5% higher than in previous years, reported to be the largest change of any age group. The CDC also said the pandemic has taken a “disproportionate toll” on the Black and Latinx communities.
CommonPass—the new digital health pass under development by the World Economic Forum and Common Project Foundation—may be a key way for governments to use COVID testing in ways that better protect their own citizens and travelers to their countries, and therefore improve confidence in travel. CommonPass aims to establish standards for lab certification and testing (and, eventually, vaccination) status. This will allow airlines and border officials to verify travelers’ COVID status, for example by ensuring the test result is from a valid lab and the traveler is the same person who took the test. In October, CommonPass trials are being expanded to international flights starting with United and Cathay Pacific between New York, London, Hong Kong, and Singapore.
Governments are trying to re-engage their citizens to do their part, despite pandemic fatigue, while trying to find the elusive balance of the right level of restrictions to control new outbreaks but not hamper economic recovery or personal freedoms. Mask use is an essential part of this and is becoming mandatory in more and more places. Many countries continue to open their borders, fully or to an increased degree. While COVID tests are seen as a key element of increasing international travel, the rise of infections in the White House is a prominent example of how tests need to be used properly and in conjunction with other measures to minimize virus transmission.
Concern remains about information coming out of the U.S.’s CDC. The New York Times broke the news on September 17 that late-August changes to the CDC’s COVID testing guidelines were made over the objections of CDC scientists. Reportedly, the Department of Health and Human Services and White House COVID task force changed the CDC’s advice to recommend that people with known contact with a COVID carrier did not need to get tested if they had no symptoms. The advice was changed again, with the CDC again recommending that everyone who has suspected COVID contact should get tested, as is consistent with the advice of the WHO and other countries.
On September 21, the CDC removed information that COVID could be spread through aerosolized droplets that had been posted on their site a few days earlier. The CDC said the information was in draft and posted in error. On October 5, the CDC again updated its guidelines that “COVID-19 can sometimes be spread by airborne transmission” and “there is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than six feet away.” In a separate article, U.S. scientists said “The reality is airborne transmission is the main way that transmission happens at close range with prolonged contact,” and that aerosolized droplets can remain in the air for hours. Also on October 5, The New York Times reported that the White House is blocking the FDA from releasing vaccine guidelines, said to be because this would eliminate the possibility of a vaccine being approved prior to the November presidential election
Virtually all airlines have a mask policy, with several countries enacting regulations at a national level. After mixed reports of enforcement of mask rules, the International Air Transport Association (IATA) appealed for “common sense and responsibility” from the small minority of people refusing to wear masks and called for them to comply with the rules and protect their fellow passengers and crew aboard flights. National Geographic published “How clean is the air on planes?” making the case for the importance of mask use.
United Airlines launched a digital map tool, Destination Travel Guide, showing the status of U.S. states as fully or partially open or closed, and detailing COVID requirements like testing and quarantine rules. A group of engineers from MIT created a new website, Covid.Control.com, to help reduce confusion over restrictions and rules within each country. An interactive map provides, by country, details on the epidemiological situation, current restrictions, and the infrastructure of interest to travelers that’s open and closed. The International Air Transport Association launched a world map detailing travel requirements.
Governments, health authorities, airlines, and those who work in travel around the world continue to grapple with how to reopen tourism while keeping travelers and, especially, populations at destinations safe from COVID. One initiative to help is CommonPass, under development by the World Economic Forum and the Commons Project. Via CommonPass, governments and airlines will be able to validate travelers’ COVID testing and—once it’s developed—vaccination status in order to facilitate international travel and help improve consistency in testing requirements. CNN published an article explaining the differences between various types of COVID tests and how they apply to travel.
In late September, Nature reported that some health care workers are being reinfected by COVID and that the virus is mutating. The CBC described new research that the dominant strain of the COVID virus found in North America and Europe is a more infectious mutation.
In late September, The New York Times reported that COVID cases are surging in at least 73 countries including the U.S., Canada, India, and much of western Europe. Cases were already expected to rise because of students returning to school and colder weather in the northern hemisphere making safer outdoor interactions more difficult. In many countries, cases began resurging in mid-July or August and efforts were not significant enough to bring them down to more manageable levels prior to the start of school. Initially, hospitalization and death rates did not rise at the same rate as new cases, but that is changing. In the U.S. alone 800 people die every day from COVID-19, says the Times. More than 20% of the world’s COVID deaths—over 200,000 people—are in the U.S.
The head of the International Monetary Fund called for urgent action to prevent the gap between rich and poor countries from widening further due to COVID, saying that decades of efforts to improve poverty levels will otherwise be lost and result in increased social and economic upheaval around the world. She said that a billion people in 70 countries face “unprecedented human and economic devastation” and that 90 million people are at risk of extreme poverty. The United Nations said that 2021 is a “make or break year” for humanitarian aid, preventing famines that could “sweep the globe” and minimizing children dying from lack of routine vaccinations.
It’s not just developing countries that are at risk—a report by the European Court of Auditors said that 23 million kids (one in four) in the E.U. are at risk of poverty or social exclusion. As far as COVID cases go, the American Academy of Pediatrics reported September 29 that in the U.S., children and teens now make up 10% of all COVID cases when it was only two percent in April. The extent that school is being disrupted due to COVID—and the long-term consequences—has not been calculated.
The WHO is rolling out new rapid low-cost antigen tests to low- and middle-income countries. The tests do not require labs or highly-trained health workers to process and provide results in about 15 to 30 minutes; however, they are not as accurate as laboratory PCR tests. The new tests are seen as a major enabler to provide testing in remote locations and to quickly assess clusters of cases to aid with contact tracing and quarantine.
A report by the Air Transport Action Group released September 30 projected that 46 million jobs around the world are at risk due to COVID-caused travel slowdown, half the 88 million jobs that directly or indirectly support the travel industry. A high-profile example is Disney, which announced on September 29 that 28,000 theme park jobs are being cut. Disney has reopened its parks, with limited capacity, in all locations (i.e. Orlando, Hong Kong, Paris, Shanghai, and Tokyo) except California.
On September 13, the WHO reported the highest ever single-day number of new COVID cases: 307,930 new infections in 24 hours. A COVID-19 envoy from the WHO said September 15 that “This is really serious—we’re not even in the middle of it yet. We’re still at the beginning of it,” and said cases surging in Europe appear to be “getting nastier.” He expressed concern about the rates of illness and deaths and the dire economic situation around the world, predicting consequences like “double the number of poor people” and of malnourished people and “hundreds of millions of small businesses going bankrupt.” Previous goals of ending world poverty, hunger, and gender inequality by 2030 have been “kicked backwards,” says a report from the Bill & Melinda Gates Foundation.
The director of UNICEF expressed concern on September 15 that half of the world’s schoolchildren have not returned to the classroom. She said that 872 million children are not allowed to attend classes in person and half of those aren’t able to study remotely. These children are now more at risk of child labor, abuse of all kinds, and less able to break the cycle of poverty. UNICEF projects that at least 24 million children are likely to drop out of school because of the pandemic.
In September, at the six-month mark following the declaration of the worldwide pandemic, the head of the WHO said his greatest worry is the lack of solidarity to address COVID-19. He called for global leadership, particularly from world powers, and for the world to work together to fight the disease. At the same time, the head of the United Nations expressed concern over the lack of funding for the development of vaccines and other treatments. Calling COVID-19 “the number one global security threat,” he said $35 billion is needed, including $15 billion over the next three months. This is on top of the $3 billion that many countries already contributed to the Access to COVID-19 Tools (ACT) Accelerator program.
The CEO of the world’s largest producer of vaccines, The Serum Institute of India, said on September 13 that vaccine producers are not increasing their production capacity enough to be able to provide the world’s population with enough COVID vaccine, should a safe and effective one be discovered. At the current rate of production, he predicted the end of 2024 as the earliest point that the expected 15 million doses (two doses per person) could be ready. The Financial Times describes how other experts predict that perhaps 75 percent of the world’s population might be able to be vaccinated by mid-2023 and that this may be enough to stall the transmission of COVID.
In a 2015-19 worldwide study about trust in vaccines, The Lancet medical journal concluded that public trust in vaccines is growing in Europe, but falling in many other parts of the world. The study showed that political instability, misinformation, and religious extremism are linked with a lack of trust in the safety of vaccines. In mid-September, Bill Gates expressed concerns about the politicization of the CDC and FDA—regulators responsible for vaccine safety and effectiveness—about inequality in populations affected by COVID-19 and, potentially, in vaccine distribution. Bill and Melinda Gates are funding vaccine development through their foundation.
There are renewed calls for the world to tackle COVID-19 together. The head of the International Air Transport Association (IATA) said that fighting a global pandemic in isolation and the closing of individual borders isn’t working. He called for greater cooperation to restart aviation and to take a risk-management approach to quarantine and opening borders, as reported by Travelweek.
The U.S. decided not to participate in the WHO’s Vaccines Global Access Facility (COVAX) program, where 150 countries are working together to develop and fairly distribute a portfolio of vaccines to combat COVID-19. ABC News reported that the North American director of the U2-founded advocacy organization The ONE Campaign said, “Not only does this move put the lives of millions around the world at risk, it could completely isolate Americans from an effective vaccine against COVID-19.”
Reports of a few patients getting infected twice with COVID-19 continue, with a 25-year-old Nevada man the latest to have gotten sick from two different strains of the virus (the second time requiring hospitalization). There is concern that if infection doesn’t bring immunity, “immunity passports” will be impossible and the long-term effectiveness of vaccination questionable. Previously, doctors confirmed that a patient in Hong Kong, one in Belgium, and one in the Netherlands have all been reinfected twice.
Several airlines are stepping up their enforcement to encourage compliance with COVID protection rules. Lufthansa, as of September 1, requires a medical certificate as well as a negative COVID test less than 48 hours old in order to be exempt from the airline’s mask rules. Also as of September 1, Canada’s WestJet announced a zero-tolerance policy and that if passengers “choose to not wear a mask, they are choosing not to fly our airlines.” A consequence of ignoring the Transport Canada mask requirement includes being placed on WestJet’s no-fly list for 12 months. Medical exemptions require a doctor’s letter.
The United Nations gave a policy briefing on the tourism sector on August 25. The UN Secretary General said that, due to the pandemic, international tourist arrivals are down by more than half during the first five months of 2020. More than $320 billion in exports has been lost (this is three times the loss in 2009, the year of the last global financial crisis) and more than 120 million jobs are at risk (as are 144 million related jobs in associated sectors like food service). The crisis is affecting all nations, although islands, African countries, and developing countries are the worst affected, said the Secretary General. He also discussed how important tourism is for small businesses and for the conservation of cultural and natural heritage. He used wildlife tourism as a specific example, saying that reductions in tourism revenue have resulted in habitat destruction and increased poaching (7% of world tourism is linked to wildlife, and this segment of tourism was growing at a rate of 3% annually). The UN called for tourism to be rebuilt equitably and with the climate in mind, and in ways that are safe for travelers, workers, and host communities.
Transportation-wise, Delta announced August 20 that the airline will continue to block middle seats into January 2021. The EPA has approved a new cleaning agent that kills viruses—including the one that causes COVID-19—for seven days. The product reduces virus concentration by more than 90% after 10 minutes of contact and by more than 99.9% after two hours. The product is called Surfacewise 2 and is made by Allied BioScience; American Airlines is the first airline to test it. Several airlines are announcing staff layoffs, and American Airlines has temporarily cut service to some small cities, including New Haven, Connecticut, and Roswell, New Mexico.
The WHO said on August 18 that it is primarily people in their 20s, 30s, and 40s who are transmitting COVID-19 to others, often without realizing they are carrying the virus. While some younger people have no or mild symptoms, the Guardian quoted Maria Van Kerkhove, a WHO epidemiologist, who said “we are seeing young people who are ending up in [the] ICU. Young people are dying from this virus.” Countries around the world are appealing to their younger populations to do their part to protect their family members, fellow citizens, and healthcare systems.
The WHO also launched a new shared vaccine appeal on August 18 for countries to join the WHO’s global shared vaccine program. The WHO outlined a worldwide plan to distribute an eventual vaccine fairly and to first vaccinate the planet’s most vulnerable populations, making the case that this is a key initiative to reopen and rebuild the world’s economy. The WHO said the first people to receive the vaccine should be “the most-exposed 20 percent of each country’s population” which would include front-line health workers and people over the age of 65 who have pre-existing conditions. Warnings are coming from many sources, including the pope, that vaccine nationalism and vaccines going first to rich countries or rich people would make the pandemic worse.
Reuters reported on August 19 that Germany and France are seeking consensus “from Washington to Beijing” on a proposal to reform the WHO. They want to give the health agency more power and funding so that its mandate of preventing pandemics and helping governments fight them has sufficient legal authority and financial resources. Examples of reforms are to empower the WHO to be more critical of countries that don’t respect transparency and to reduce excessive external influences.
Though tourism is reopening, the economic and health situation is still grim. On June 10, the OECD reported that all its 37 member countries are in a recession, global GDP is in the sharpest decline since the creation of the OECD in 1961, and the world is on track for the most severe peacetime recession in a century. On June 24, the International Monetary Fund projected the world’s economy will shrink by 4.9% in 2020, worse than its April prediction. Some countries will fare worse; South Africa predicts its economy will shrink by 7.2%. Poverty and starvation will follow in many countries. In mid-June the UN raised concerns about food security in Latin America, saying 40 million people are at risk of hunger. The World Wildlife Fund published a report on June 17 making the case that the COVID pandemic—as well as likely future pandemics—is due to humans’ “destruction of nature” through agriculture, deforestation, and the trade-in wildlife. The WWF issued a comprehensive call to action for governments, industry, civil organizations, and members of the public to “mend our broken relationship with nature.”
The United Nations World Tourism Organization announced on June 4 that “the time has come to restart tourism” (this followed their May 31 announcement 31 that 100% of the world’s destinations had travel restrictions in place, 75% had borders closed completely to international tourists, and 3% of destinations had started easing restrictions in some way).
Several airlines announced they’ll no longer block middle seats on flights, given the International Air Transport Association’s advice that HEPA filters and mask-wearing are sufficient. Delta Air Lines is an exception, Delta plans to continue to block middle seats until early 2021.
Delta is placing people on their no-fly list (over 100 so far) because the passengers refused to wear a mask, which has been required since May. Pilots returned to the gate on several occasions because passengers refused to wear their masks onboard. Both Delta and United are closing loopholes that passengers had been taking advantage of, but are providing mechanisms for passengers with documented medical exemptions to fly. American and Southwest announced the only allowable exemptions to wearing masks onboard are children under two years old. However, reports continue of small numbers of passengers who refuse to comply with mask rules, despite the requests of crew.
The Guardian reported that it will likely be 2024 until air travel recovers to pre-pandemic levels, according to an airline trade association. To help boost travel, Emirates is providing passengers with free COVID insurance. Emirates passengers will have any COVID-related expenses covered up to 150,000 euros if they’re diagnosed with the virus during travel. It affects passengers flying up to October 31 and is valid for 31 days after the beginning of their trip.
Portugal is the latest country offering insurance for COVID-19, reports Travelweek. Spain’s Canary Islands are also offering to cover COVID medical expenses. Uzbekistan is luring back tourists with a promise of $3,000—the equivalent of a hospital stay—if they contract COVID-19 there, as we describe in This Country Offered Tourists $3,000 to Lure Them Back–Did It Work? Cyprus, reports CNBC, will cover accommodations, food, and medications for tourists who contract the virus there.
Some hotel groups are now implementing insurance initiatives. Palladium Hotel Group is offering free COVID health insurance for guests at its hotels in the Americas and Spain. Any incidents that are directly related to COVID-19 during guests’ stays will be covered. Palladium’s properties include Grand Palladium resorts and TRS hotels in Mexico, Jamaica, Dominican Republic, and Spain.
For planning travel, we outline considerations to keep in mind: Will It Be Safe to Travel Again When This Is All Over? Will We Even Know?
See details in our weekly Europe update. Bloomberg Opinion published Did Europe Make a Mistake Reopening Its Borders on August 22, saying that “the experiment has backfired” since many of the new cases are traceable to travelers.
Outbreaks started climbing again in Europe in mid-July. In early August, The Guardian reported that several western European countries are facing significant rises in infection and that French authorities said the country “could lose control of COVID-19 at any time.” October and November saw record highs of cases, hospitalizations, and deaths in many European countries, with resulting lockdowns. In early December, rising cases started to slow in western Europe and restrictions began lifting. Restrictions will be in place to some extent over the Christmas holiday period with fears that gatherings of family and friends will spark new cases.
On July 3, the U.K. released a list of “travel corridor” countries and territories allowed into England without the mandatory quarantine in place for the U.K. since June 8. England’s green list is updated almost weekly. Wales and Scotland have separate lists and Northern Ireland uses the same list as applies to England. England announced a major change to its international travel requirements on November 24. Starting December 15, travelers who test negative for COVID on the fifth day after arriving in the country can skip the rest of the quarantine required for all travelers except those on the current green travel corridor list. As of December 14, the U.K.’s quarantine period was reduced to 10 days from 14. The E.U.’s “green list” is updated less frequently, and E.U. nations are able to set different border rules if they wish.
See our Coronavirus Outbreak: Should You Cancel a Trip to Europe? for details.
Japan, which currently allows some international travelers with a mandatory 14-day quarantine, is considering expanding travel in the spring. In anticipation of the Olympics, Japan is likely to first allow small tour groups from Asian countries that have COVID under control, Reuters reported. Travelers would be required to show a negative COVID test and submit an itinerary in advance, use a contact-tracing and symptom-monitoring app, keep separate from others at hotels and sites, and travel only by charter bus. Japan’s domestic Go To Travel campaign—aimed at encouraging Japanese citizens to explore their own country and to support regional economies—is at risk given new polls showing 48 to 57% of respondents want the program paused due to infection surges in several of Japan’s major cities. A majority of respondents also said the Olympics, already rescheduled to July 2021, should be changed, postponed, or canceled altogether.
Following the first domestic transmission of COVID in 89 days, Vietnam suspended most inbound commercial flights in early December. Repatriation flights are still allowed, but anyone entering Vietnam needs to quarantine for 14 days. The outbreak is said to be caused by someone who violated quarantine rules.
Hong Kong is officially experiencing its fourth COVID wave, with the latest set of restrictions in place in mid-December. The Hong Kong-Singapore quarantine-free travel bubble was delayed the day before it was to start, November 22. It won’t start until January 2021 at the earliest. JSingapore already has travel bubbles with Brunei and New Zealand, as well as business travel agreements with countries such as Indonesia, Malaysia, and South Korea.
Another example of how quickly the travel situation can change was at Pudong airport in Shanghai, China. On November 22, hundreds of flights were canceled and thousands of passengers and staff were subjected to last-minute COVID testing in an attempt to prevent two detected cases from spreading further. Videos posted online show crowds pushing through the linked arms of officials in hazmat suits.
Japan is putting restrictions on its Go To Travel domestic travel campaigns, first for Osaka and Sapporo, until at least December 15. The changes are in response to record highs in infection rates and concerns about healthcare capacity. Restrictions include no travel to either city, and there are calls that residents of those cities should also not be allowed to travel as they could potentially bring the virus with them. Japan also has “business bubble” agreements allowing quarantine-free business travel, with a negative COVID test, newly with China, in addition to Singapore, South Korea, and Vietnam.
Taiwan set new rules for travelers (including Taiwanese citizens, previously exempted) arriving on the island as of December 1, including a mandatory negative COVID test taken within three days of departure. Taiwan has not had any domestic COVID cases for 200 plus days, however, several travelers are arriving with COVID—including eight on November 13—the largest number since April, according to Reuters. Taiwan is also discussing travel bubbles, for example, with Singapore and Australia.
China reimposed some travel bans. On November 5, several Chinese embassies around the world posted notices on their websites that non-Chinese nationals from those countries, including people with permanent residency permits, are “temporarily suspended” from entering China. The affected countries include Bangladesh, Belgium, Ethiopia, France, India, Italy, the Philippines, Russia, and the U.K. New testing requirements are in place for several other countries. Travelers coming from Australia, the Czech Republic, Denmark, Germany, Japan, Singapore, and the U.S. must now provide two tests to enter China—both a negative PCR test no older than 48 hours and a positive antibody test. Travelers needing to go to China should check rules carefully, as requirements are changing frequently.
In mid-November, Cambodia ordered entertainment venues including beer gardens closed. Malaysia has new conditional movement rules in place for most parts of the country and is extending the partial lockdown in place in Kuala Lumpur.
Individual tourist attractions in Asia started reopening in the fall. For example, Japan reopened the observation deck for the tuna auction at the Toyosu Market. Before the pandemic, 120 people used to watch and photograph the 30-minute rapid sale of the popular sushi fish. The reopened observation deck will allow a maximum of 27 observers, chosen by lottery and requiring temperature checks, masks, and the provision of contact-tracing information. Given its success in controlling domestic COVID transmission—though travelers continue to bring new cases—Hong Kong is lifting further restrictions including reopening beaches.
The Maldives which began reopening its borders in July, introduced a loyalty program and insurance program to encourage tourism to its 1,192 tropical islands. The Maldives Border Miles program, the world’s first, allows travelers to earn points for the number of visits and length of stay in the Maldives, with bonuses for special occasion visits. The full list of reopened resorts and information on COVID protocols is available for travelers. After a spike in cases brought by travelers to resorts, the Maldives announced on September 2 that visitors will now need to provide confirmation of a negative COVID test on arrival at the airport.
Japan announced it will reallow travel to 12 countries including Australia, China, Malaysia, New Zealand, Singapore, South Korea, Taiwan, and Vietnam in November, however, it will continue to recommend only essential travel. Japan and South Korea are opening a business travel bubble between the two countries as of October 8. To enter Japan, travelers need a negative COVID test, a 14-day quarantine, and a guarantor who will ensure they follow the rules. Japan is also determining requirements for travelers coming for the Olympics, which will now begin July 23, 2021.
Papua New Guinea expanded its border reopening—flights are now allowed from Japan, Hong Kong, Singapore, and the Solomon Islands, in addition to Australia and New Zealand. Most travelers need a negative test taken within a week of their flight, advance approval from the PNG’s pandemic response coordinator, and may need to self-isolate for seven to 14 days depending on where they’re traveling from.
The Chinese city of Wuhan reopened to international flights on September 18, after eight months and as of September 28, foreigners with Chinese residency permits are again allowed in the country. Singapore announced a new travel pass aimed at frequent business travelers on September 23 and easing of restrictions for travel between countries with low infection rates is expected in October. Japan is set to increase the number of foreigners into the country beginning in October, but the change is expected to be only for students and business travelers, not for tourists.
Thailand is expected to start reopening to tourism in October. Already allowed into Thailand since July are business travelers, people with Thai families, those seeking Thai health care services, and some migrant workers. Details are still to be confirmed, but travelers from countries with low infection rates are likely to be first welcomed. A 14-day quarantine, with a GPS wristband, is likely. A new tourist visa, allowing 90-day stays is also in the works, which can be extended up to 270 days. However, the number of such visas may be limited to 1,200 per month.
In mid-September, Indonesia’s island of Bali postponed its reopening plans to international visitors from September to 2021. Malaysia’s tourism minister said foreign visitors might be banned until the second quarter of 2021.
Regarding major attractions and events in Asia, the Taj Mahal, closed since March, reopened September 21, with a daily cap on visitors of 5,000. Hong Kong Disney reopened on September 25 with reduced capacity. The International Olympic Committee announced on September 7 that the Tokyo Olympics, postponed to summer 2021, will go ahead regardless of the state of the pandemic.
Singapore announced that as of September 1, visitors from Brunei and New Zealand will be allowed into the city-state without a 14-day quarantine, reported Business Traveller. General requirements for visitors to enter Singapore include applying (seven to 30 days in advance) for an Air Travel Pass (ATP) and getting a COVID test on arrival. Singapore also reduced the time required to self-isolate from 14 to seven days for travelers from low-risk countries, which began with Australia (excluding the state of Victoria), China, Macao, Malaysia, Taiwan, and Vietnam. Travelers from other locations must quarantine for 14 days at a designated facility. Information is on Singapore’s Safe Travel website.
Vietnam provides an example of how quickly a small number of cases can grow. On July 26, three COVID cases were reported in the popular tourist area of Da Nang, open only to domestic travelers for now. As of August 5, the country had 713 cases and eight deaths; as of August 11, it had 863 cases and 16 deaths. Vietnam earned a reputation for handling COVID-19 better than almost every other country—it had previously reported no COVID deaths—and hadn’t had any new cases since April. Domestic travel and other restrictions gradually lifted. At the end of July, Reuters reported that 80,000 domestic travelers needed evacuation from Da Nang. Flights, trains, and buses to and from Da Nang were suspended July 28 for at least 15 days and the city of 1.1 million is under lockdown, said CBC. On July 29, Vietnam closed bars and pubs in Hanoi and the 21,000 travelers returning from Da Nang to Hanoi received rapid COVID tests.
Cambodia has some of the most extreme border control measures in the world. As described on the Cambodia Airports’ website, travelers need to pay a deposit of 3,000 USD to cover the costs of a COVID test, accommodations while awaiting the test results, and other costs should the test be positive. Adequate health insurance is also required for entering the country famous for the Angkor archeological site.
The Middle East
In Palestine, Bethlehem’s mayor announced that Christmas would not be canceled this year, although most hotels remain closed.
Oman, which restarted international flights on October 1, announced on November 30 that it is resuming issuing tourist visas, although initially only for travelers on trips arranged by tour companies and hotels. Oman announced December 9 that 103 countries have an exemption from needing a visa for ten-day visits to Oman.
Lebanon announced a new lockdown on November 10. In mid-November, Iran—with the region’s highest number of COVID deaths—began a 6 p.m. curfew for restaurants and nonessential businesses in most cities.
Israel was the first country to impose a second nationwide lockdown to deal with its rising cases; the three-week lockdown began September 18 during the Jewish new year.
Travel to Saudi Arabia is expected to resume in early 2021 when tourist visas are reinstated. Saudi Arabia closed to all international travelers in March.
Popular tourist destination Jordan, after suspending flights for almost six months, resumed regular international flights on September 8 (Jordan delayed this from August 12). To start, the country’s main airport is allowing just six international flights per day. To enter Jordan, travelers need to complete a health declaration form in advance, which includes a negative COVID test. Air passengers also receive a test on arrival at a cost of about $56 US. A self-isolation or quarantine period is required, dependent on the state of the pandemic in the destination where the traveler is coming from.
Dubai reopened on July 7 and requires travelers to complete a health declaration card and register on an app. Testing on arrival or proof of a negative COVID test is also needed. Unusually, both masks and gloves are required in Dubai’s airport. In the city, masks are required indoors and outdoors when near other people.
There’s another indicator for destinations that have implemented COVID-protection standards. Joining the already-popular World Travel and Tourism Council (WTTC)’s Safe Travels Stamp is Bureau Veritas’ SafeGuard Assurance Program, which also includes audits. The first city to receive both certifications is Ras Al Khaimah, in the United Arab Emirates. Ras Al Khaimah, known as RAK, is the most northern of the seven Emirates and features 64 kilometers of beaches and mangroves as well as the UAE’s highest mountain.
Nigeria is imposing strict penalties on anyone who doesn’t follow their COVID rules, including banning anyone from travel for six months if they fail to get the COVID test required seven days after arrival. This is in response to 60% of passengers who did not show up for the pre-paid test, reported The Guardian.
Botswana’s main airports reopened on November 9 and Botswana’s borders open to international travelers on December 1. A negative PCR test taken a maximum of 72 hours prior to departure is needed to enter Botswana. Kenya and South Africa are also open to international travel. Cape Verde reopened its air and sea borders as of October 12. To enter Cape Verde’s ten islands, travelers need a negative PCR test.
Uganda reopened its borders on October 1, with special measures to protect its mountain gorillas and chimpanzees from COVID. To enter and depart from Uganda, a negative PCR test is needed. South Africa also reopened to some international travel on October 1, with an initial red list of 50 countries (including the U.S. and U.K.) not yet allowed entry. The list will be updated every two weeks.
Namibia—popular for safaris to view rare desert elephants and to see the world’s largest sand dunes—relaxed COVID restrictions for international tourists in early September. Reuters reported that, initially, tourists were required to quarantine for seven days, but may now participate in activities and receive a COVID test on day five of their visit.
As of September 1, Egypt reopened its archeological and cultural tourism sites. A negative COVID test is required for entry into Egypt and travelers can now access more areas of the country than the coastal areas which reopened in July. Hotels, restaurants, and other facilities must get a health safety certificate from the Ministry of Tourism and Antiquities. Egypt reopened to international tourists as of July 1, initially restricted to one of three resort areas on the Red Sea and the Mediterranean.
After first announcing it would open its border fully as of June 27, Tunisia revised its reopening rules. Instead, Tunisia has both a “green list” and an “orange list” of countries. Passengers arriving from green list countries are only required to fill in an online health declaration. Passengers from orange list countries need to provide a negative PCR test taken within 72 hours of departure. Countries that are on neither list are not permitted tourist entry to Tunisia, and that includes the United States.
African countries open to tourism include Rwanda (with discounts on gorilla trekking permits). and Tanzania. South Africa is another country approaching reopening carefully, with plans to reopen domestic tourism later in 2020 and international tourism only by February 2021.
Oceania and the South Pacific
Things are returning to normal in Australia, where domestic border restrictions are lifted between the states of Victoria and New South Wales and between Queensland and New South Wales, including those that remain in place for residents of Sydney. In South Australia, the strict six-day circuit-breaker lockdown was lifted after contact tracers discovered someone lied to them. The news changed officials’ earlier interpretation that they were dealing with a strain of COVID-19 that became infectious just 24 hours after exposure. Victoria’s premier announced on November 21 that the Australian Open tennis tournament, scheduled for January 18 to 31, 2021, is likely to go ahead in early 2021 although perhaps not at the originally scheduled dates.
In early December, Melbourne received its first international passenger flights since late June after flights were halted due to outbreaks in two Melbourne quarantine hotels. This increases the number of Australians allowed in the country—there are thousands still abroad who want to return home. Australia restricts the number of returnees due to its policy of hotel-based quarantine in the city of arrival and availability of rooms; the number allowed to return via Melbourne is now 160 per day. Health officials are monitoring the situation closely, as the state of Victoria had zero COVID cases for over a month. On December 5 two passengers from Germany bypassed the quarantine system and traveled from Sydney to Melbourne without first quarantining, but then quarantined in Melbourne without any known resulting infections.
Like the U.K. and Finland, Australia is also training dogs to sniff out COVID at its airports. In trials, the dogs are able to smell a particular odor in people’s sweat, including in asymptomatic people who initially test negative with a PCR test but later test positive.
New Zealand and the Cook Islands aim to open a travel bubble before Christmas. Cook Islanders are also New Zealand citizens, though the Islands are a “self-governing associated state” with their own prime minister. The Cook Islands have not had any COVD cases and New Zealand has been one of the world’s most successful countries at controlling their outbreaks.
On November 8, Melbourne lifted its “ring of steel,” the rules that protected the rest of Victoria state from what had been Australia’s COVID epicenter. Melburnians are now able to travel beyond the 15-mile limit. Australia also plans to create a “healthcare worker wellbeing center” to provide training and advice about best practices in stress management, fatigue, and burnout of medical staff.
At the end of October, officials warned New Zealanders hoping to return home for Christmas that it may be too late to confirm their plans. New Zealand requires arrivals (only essential travel is allowed) to quarantine for 14 days at designated hotels rather than at home. As of November 3, travelers to New Zealand need to have a voucher showing proof they have a reservation at one of the quarantine hotels before they’re allowed to board their flight to New Zealand. The limited supply of these “managed isolation facilities” was almost fully booked by the end of October.
Australia is expanding the number of Australians allowed to return home, with Tasmania now able to welcome returning travelers. As with New Zealand, only essential travel is allowed to Australia and anyone arriving is required to quarantine at a designated hotel. Tasmania is adding 450 rooms to the country’s 6,315 quarantine spaces. For the first time in more than 20 years, flights between Tasmania and New Zealand will resume, likely in January 2021, with a planned quarantine-free travel bubble between the islands.
Australia is increasing the number of Australian citizens and permanent residents abroad allowed to return to 5,865 people per week. About 26,000 Australians have advised their government they still intend to return home. Beginning in July, Australia put a weekly cap on the number allowed to return each week, due to concern of contagion since Australia requires a 14-day hotel quarantine for all travelers (except those from New Zealand). Australia is looking at other options in lieu of hotel quarantine, including wearable surveillance devices and smartphone apps to allow quarantine at home.
The Islands of Tahiti and French Polynesia reopened to tourism as of July 15 and recently extended generous change and cancelation policies past the original September 30 end date: for reservations made between May 1, 2020, and March 31, 2021, change and cancelation fees will be waived if there’s a lockdown in French Polynesia or the traveler’s country of residence, if border closures affect transit to the islands, or if the traveler has a positive COVID test affecting their travel. Many travel businesses also committed to not implementing price increases until March 31, 2022. To enter French Polynesia, travelers need to register in advance and complete an online health commitment form, provide a negative COVID test no more than three days old, and self-administer a COVID test four days after arrival (the kit is provided free of charge upon arrival). Masks are mandatory, indoors and outdoors, when physical distancing is difficult.
New Zealand and Australia hope to reopen the travel bubble between the two countries by Christmas, according to a late September statement by New Zealand prime minister Jacinda Arden. After conquering COVID and declaring itself COVID-free, New Zealand had a small resurgence in cases starting in mid-August, which it again brought under control in September. Progress to reopening borders was delayed due to the resurgence of cases in Australia’s Victoria state and the resulting lockdown which began in early July.
Australia is limiting the number of Australian citizens and permanent residents that can return home from abroad—an unusual move given most democracies allow an unconditional right of return to their citizens. Initially, only 4,000 Australians were allowed back into the country per week though, in September, those numbers increased. Al Jazeera also reports that returning Australians will now need to fund their mandatory two-week quarantine period.
The Islands of Tahiti reopened to tourism as of July 15. To enter French Polynesia, travelers need to register in advance on the Etis.pf platform (Electronic Travel Information System), provide a negative COVID test no more than three days old, and self-administer a COVID test four days after arrival (the kit is provided free of charge upon arrival). Masks are mandatory, indoors and outdoors, when physical distancing is difficult. The Islands of Tahiti and French Polynesia have a generous change and cancelation policy in effect, recently extended past its original September 30 end date. For reservations made between May 1, 2020, and March 31, 2021, change and cancelation fees will be waived if there’s a lockdown in French Polynesia or the traveler’s country of residence, if border closures affect transit to the islands, or if the traveler has a positive COVID test affecting their travel. Many travel businesses also committed to not implementing price increases until March 31, 2022.
Bloomberg reported that the Caribbean is facing a once-in-a-century tourism shock with a best-case scenario of losing 50% of its 2020 tourism revenue. Several islands opened in June with more in July and August, including to U.S. passport holders. Starting in mid-July, several islands began reinstituting some restrictions in response to new cases amongst travelers. Many Caribbean destinations are open to tourists, but be sure to check and recheck requirements as they change quickly.
The Federation of St. Kitts and Nevis updated its COVID entry rules, which we detail in the Caribbean section below. International travelers need to submit a negative PCR test taken within 72 hours, complete an application form, and download a contact tracing app for use during the first 14 days of stay. Travelers staying seven days or less need to remain within their resort and are required to confirm a negative PCR test 72 hours prior to departure.
As of December 1, the three-island Caribbean nation of Grenada, Carriacou, and Petite Martinique simplified entry protocols (previously, travelers from green-listed low-risk countries had different rules). Details are on Pure Grenada’s and Grenada’s Ministry of Health websites. A minimum of 48 hours before travel, apply online for a Pure Safe Travel Certificate. You’ll answer some health questions, show proof of payment for a minimum five-day stay at approved accommodations, and upload a negative PCR test taken at least 72 hours prior to travel. Once approved, you’ll get a travel authorization and then need to show it and your negative test certificate to board your flight. Grenada’s COVID protocols allow you to stay on your resort or, if you wish to tour the island, confirm a negative test on day four of your stay. You’re asked to monitor your symptoms via the Ronatrac app. JetBlue resumed flights to Grenada on October 3 and American Airlines restarted flights on October 8. Sandals Grenada, on Pink Gin Beach, reopened on October 1. Grenada delayed its originally-announced reopening date of July 1 to August 1.
Jamaica announced what’s being called a first-of-its-kind COVID protection program. The Jamaica Cares program will launch in November. All foreign visitors to Jamaica will be required to pay a $40 US fee which will provide health insurance to visitors and fund an “all-hazards program” for medical emergencies including COVID-19.
St. Kitts and Nevis reopened October 31, one of the last Caribbean nations to reopen, and updated its entry rules in November. International travelers arriving by air need to complete a Travel Authorization Form, submit a negative RT-PCR Test from an approved lab taken within 72 hours of travel and download a contact tracing app for use within the first 14 days on the island. COVID testing requirements differ depending on the length of stay in the federation. Travelers staying seven days or less need to take a PCR test 72 hours prior to departure, which is arranged through hotels. Visitors need to stay within their resort for the first seven days in the federation. On day seven, they need to take a PCR test (cost of $150 US). If they receive a negative result, they’re allowed to book specific tours and go to specific destinations. Visitors staying longer are required to take another test on day 14, and then can explore the islands fully.
Cuba reopened further, with 13 of its 16 provinces now open to tourists. However, Havana is not yet open due to a second wave of cases there. The popular tourist peninsula of Varadero reopened as of October 15 with only those approved able to cross the new tourist zone perimeter, reported Travelweek. Travelers take a free PCR test upon arrival at the airport and must have COVID-19 insurance (or buy Cuban medical insurance coverage upon arrival).
In The Bahamas, the 14-day “Vacation in Place” requirement to stay within the hotel’s premises for the duration of stay ends October 31. As of November 1, a negative PCR test taken within seven days of travel is required, as is a rapid antigen test on arrival and on day five of the stay. Antigen test costs are covered by the Bahamas Health Travel Visa fee, which visitors need to apply for in advance. The cost varies by length of stay. Masks are required in the Bahamas. The Bahamas changed their COVID protection measures several times, largely in response to a significant rise in COVID cases since the country reopened to tourism July 1—rising from about 50 on July 1 to cases 715 as of August 4.
The Dominican Republic changed its COVID arrival rules as of September 15. New measures include the end of the requirement for a proof of a negative PCR test; instead, some passengers will be randomly selected for a rapid breath test on arrival. Until at least December 31, foreigners who stay at a Dominican Republic hotel will also receive, at no cost, COVID insurance for “emergency coverage, telemedicine services, long-stay accommodation, and flight change costs.”
The U.S. Virgin Islands reclosed its borders for tourism on August 19 and the islands’ accommodations are not allowed to check-in guests or accept new reservations for a 30-day period. Business travelers, government workers, emergency staff, and air crews are exempt from the new rules. Nonessential businesses closed on August 17 and everyone is encouraged to stay at home for two weeks.
Bermuda updated its entry protocols and now requires a negative COVID test within 48 hours of departure as well as three in-country tests after arrival, on day four, eight, and 14 of stay. A mandatory $75 US arrival fee covers the cost of testing. A Bermuda Travel Authorization must be completed within 48 hours of departure to Bermuda. As well, Bermuda is joining Barbados and Chile in offering year-long visas to some visitors. Bermuda’s One Year Residential Certificate Policy allows work, research, or study on a 12-month temporary basis, ideal for nationals from other countries who can work from home and want to substitute their digital Zoom background for the real thing. The application will be on the government’s website.
Turks and Caicos reopened July 22. COVID rules are detailed on VisitTCI.com and include completing a travel authorization request via the TCI Assured portal. A negative PCR test taken within five days of travel and travel health insurance are needed. Face masks are required in public until at least December 31. Details are at TCI Assured and the tourist board’s website. The Nature Island, Dominica, is reopening to international travel on August 7 and will require an advanced online health questionnaire and a negative PCR test 24 to 48 hours prior to arrival as well as screening upon arrival.
Strengthened COVID protection measures include in Jamaica, which now specifically requires a negative COVID test for travelers from high-risk locations. As of July 10, those locations are listed as Arizona, Florida, New York, and Texas. All travelers to Jamaica will now be screened upon arrival to determine if further testing or quarantine will be required. Further details are online, including the portal to apply for the required travel authorization. The Jamaican government plans to update the entry rules every two weeks or as required.
Aruba opened to U.S. travelers on July 10 but now says that travelers from 24 high-risk U.S. states listed on its website must provide certification of a negative COVID test taken within 72 hours of departure. Other travelers can take a test on arrival (at passenger expense). TravelWeek reports that Sint Maarten changed the date it reopens to travelers from the U.S. to August 1 from July 15 (the earlier date was maintained for other travelers, such as those from Canada).
To enter Antigua and Barbuda, travelers now need a negative COVID test no more than 48 hours old. This follows reports of several Americans threatening to sue the government of Antigua and Barbuda because they (erroneously) believed a COVID test on arrival was a violation of their rights and because of some Americans who refused to obey quarantine orders after testing positive for COVID-19, as reported by TravelPulse.Antigua and Barbuda updated its rules on July 2. The country requires, as of July 9, a negative COVID test within 7 days of arrival, a health declaration form, and visitors may be monitored and tested for 14 days after arrival.
Saint Lucia, reopened as of June 4, also updated its entry rules. A negative COVID PCR test within seven days of travel is required as of July 9 (arrivals from “travel bubble” countries in the Caribbean are excluded from this new requirement). Details are at StLucia.org.
Also reopening, but slowly, is Barbados. Barbados will first welcome flights from Canada, as of July 12. Requirements include advance online approval via a new Embarkation/Disembarkation card, wearing face masks onboard flights, and temperature checks on arrival. Rules for advanced COVID testing depend on the epidemiological situation in the country of departure; testing on arrival is available with required quarantine until negative results are confirmed. Information is on Barbados’s website.
The first Caribbean countries to reopen included Antigua and Barbuda (June 4), Saint Lucia (June 4), the U.S. Virgin Islands (June 4), Jamaica (June 15, advance application for the Jamaican COVID travel authorization is needed), and Saint Barth (June 22). Newly reopened as of July 1 are Bermuda; Cuba; the Dominican Republic; and the French-Dutch “Friendly Island” of Saint Martin and Sint Maarten. The Bahamas reopened July 7 with an apply-in-advance travel health card. As of July 1, Aruba will welcome visitors from many Caribbean neighbors and Europe and Canada. Visitors from the U.S. were welcomed as of July 10. The “Spice Islands” of Grenada, Carriacou, and Petite Martinique delayed their reopening, deciding that only charter, rather than commercial, flights will be allowed until further notice.
Earlier, Club Med announced reopening plans for several resorts with new health and safety protocols. Club Med Sandpiper Bay was the earliest to reopen, on June 12, with most resorts reopening later this year. Club Med Cancún and Club Med Turkoise (in Turks and Caicos) will open on October 17 and September 5, respectively. Most Sandals Resorts, with their new Platinum Protocols of Cleanliness, opened June 4 where border restrictions allowed.
The Institute for Health Metrics and Evaluation said that as of December 4, “COVID-19 is the leading cause of death in the U.S., surpassing ischemic heart disease and lung cancer.” The Institute predicted that 66,000 fewer people will die between now and April 1, 2021, if Americans wore masks consistently. An average of 2,200 people die from COVID daily in the U.S. and the country records an average of 200,000 cases per day.
Donald Trump signed an executive order on December 8 with the goal of getting the U.S. priority access to vaccines. As ABC News reported, it’s unclear whether the executive order would affect U.S.-headquartered multinationals like Pfizer and their existing vaccine contracts with other countries. However, the initiative echoed the “PPE piracy” accusations against the U.S. from many countries earlier in the pandemic.
The U.S. recorded more than 100,000 new COVID cases every day in November, six new cases every second, and one COVID death per minute, several times more deadly than car accidents, gun deaths, and the flu. November 24 had 2,157 deaths—one person every 40 seconds—and was then COVID’s deadliest day in the U.S. since April 14, Reuters reported.
Infection rates are expected to increase after the Thanksgiving long weekend, what’s called a potential “surge upon a surge.” The TSA reported that on November 29 alone, they screened 1.18 million passengers in U.S. airports, the highest traffic day since March. The CDC reported that only one in every eight COVID cases is caught, estimating that the actual COVID infection rate in the U.S. is eight times higher than what is currently reported.
The New York Times reported that half of U.S. states have restrictions in place, such as quarantine and certification of a negative COVID test. The CBC and Reuters reported November 17 that 41 states had record highs in daily new COVID cases, 20 had record numbers of deaths, 26 had record levels of hospitalizations, and that test positivity rates in 25 states were at 10% or higher (the WHO deems 5% concerning, and 4% is the threshold in the European Union). Three weeks after the U.S. election, on November 24 the Trump administration finally agreed to share COVID information with President-elect Biden’s team. This followed appeals from healthcare workers and medical associations, including an open letter published November 17.
President-elect Biden announced members of his COVID task force on November 9 and said “dealing with the coronavirus pandemic is one of the most important battles our administration will face and I will be informed by science and by experts.” An October University of Washington modeling study predicted that more than 500,000 Americans could die from COVID by February 2021, up by another 300,000. The study said that number could drop by 130,000 if everyone wears masks in public. If states continue to lift COVID protection measures, the study said the U.S. death toll could reach one million.
An October study by a Harvard professor said that in the U.S. alone the pandemic has taken 2.5 million person-years of life and “productive, active, and happy existence.” Contradicting misperceptions that COVID mostly kills elderly people, Stephen Elledge’s report said that, on average, men’s lives were cut short by 13.93 years and women’s by 12.45 years.
The CDC changed its cruise travel notice on November 24. At a Level 3 advisory since March 2020, traveling by cruise anywhere in the world is now at Level 4, the CDC’s highest level. The CDC also recommended that U.S. travelers who go on an ocean or river cruise get a COVID test three to five days after their trip, quarantine for a full seven-day period if they test negative, and quarantine for 14 days if they do not get a COVID test.
In place since March 14, the CDC allowed its No Sail order to expire on October 31. Instead, a Conditional Sailing Order for Cruise Ships is in place as of November 1. The CDC has a framework that outlines various phases to, eventually, reinstate cruises. In response, at least six cruise lines extended their hiatus until January. Cruise lines will need to meet extensive new conditions—including successfully completing simulated voyages—and apply for a Conditional Sailing Certificate 60 days in advance of resuming their operations. Cruise Critic analyzed the CDC’s new framework and explains what it means and questions remain to be answered.
Variety reported news about the reopening of California’s theme parks. Government officials announced on October 20 that large theme parks like Disneyland and Universal Studios Hollywood cannot reopen until their county’s COVID risk drops to the yellow or minimal level (i.e. less than one new case per 100,000 in the population and positive testing under 2%). Orange County, home to Disneyland, is currently at the red level, with new daily cases between 4 and 7 per 100,000 and positive testing between 4% and 7%. Los Angeles County, home to Universal Studios Hollywood and Six Flags Magic Mountain, is at the highest level, purple.
There’s concern over the CDC reversing its COVID testing guidelines. In late August, the CDC said it no longer recommends that asymptomatic people exposed to the virus get a test—even though about 40% of COVID-19 cases are asymptomatic. The governors of New York, California, Florida, Texas, and other states announced they plan to ignore the CDC’s advice and continue to recommend testing for everyone who has had contact with someone with COVD-19, regardless of whether they have symptoms. The governor of New York called the CDC’s decision “indefensible,” “reckless,” and not based on science. The CDC’s decision may affect where Americans can travel, and the CDC’s decision to drop the recommendation for returning travelers to self-quarantine for 14 days may cause new outbreaks in the U.S. There’s also concern that notifications for health authorities to get ready to distribute vaccine before the November presidential election will mean unproven vaccines are administered.
In the U.S., the Department of State lifted the Global Level 4—Do Not Travel Health Advisory on August 6. It had been in place since March 19. This is a return to the State Department’s pre-pandemic practice of designating individual countries with a specific travel advisory on a scale of one to four. Many countries remain at Level 4, but most of the world is classified at Level Three—Reconsider Travel. There are a few exceptions, such as Thailand, New Zealand, French Polynesia, and Fiji which are at Level Two—Exercise Increased Caution. Taiwan and Macau are at Level One—Exercise Normal Precautions. Most countries have not yet removed border restrictions allowing Americans to enter, particularly for tourism purposes.
The New York Times reported in August that the U.S. government is considering banning U.S. citizens from entering the county if an official “reasonably believes that the individual either may have been exposed to or is infected” with COVID. The draft regulation obtained by the Times does not specify how long citizens would not be allowed re-entry. Legal experts have said blocking citizens from entry into their own country is not constitutional, even if temporary, reports the Times.
The TSA announced a few new measures in August, including that passengers will now scan their own boarding pass on the electronic reader. However, there’s not yet news about whether that also applies to identity documents or news about factors like sanitizing security bins, opening passengers’ bags for inspection, or pat-downs. While a few airlines and some businesses are screening for fever, new evidence shows that this may not be effective for preventing COVID exposure, as reported by Healthline. At the end of June, many airlines announced they will no longer block middle seats on flights, following the advice of the International Air Transport Association (IATA) which cites HEPA filters and mask-wearing as combatting the lack of physical distancing. Delta Air Lines is one of the exceptions; it extended blocking middle seats and restricting the number of passengers first until September 30 and then to January 2021.
Aimed first at domestic travelers, many U.S. tourist sites, such as theme parks, continue reopening. We detail whether visiting theme parks will ever be the same. Orlando continues to open, with businesses required to follow safety guidelines and encouraged to, as Orlando’s mayor described, “lead by example, hold ourselves accountable and positively reinforce those who are doing it right” via Orlando’s “Safer, Stronger, Together” program and “DoYourPartORL.” Universal CityWalk began reopening May 14 and Disney Springs began May 20. Universal Orlando Resort’s three theme parks opened to the public June 5. Disney’s Orlando parks are open, by reservation only, as follows: Animal Kingdom and Magic Kingdom as of July 11, and EPCOT and Hollywood Studios as of July 15. Legoland opened June 1 and the three SeaWorld Parks opened June 11 Guests at all Orlando theme parks have their temperature checked for fever upon arrival and are required to wear masks. Parks have reduced capacity, frequent cleaning of high-touch surfaces, hand sanitizer available, and mechanisms to enhance physical distancing in attraction lineups. See the latest on Visit Orlando’s Healthy Traveler Information page. Disney delayed the reopening of its two California parks, originally planned to reopen on July 17.
Announced November 29, Canada extended its 14-day mandatory quarantine rule and border closure. The border remains closed to nonessential international travel until at least January 21, 2021, and until at least December 21, 2020, for travelers from the U.S. Pilot projects are underway to test the effectiveness of multiple COVID tests in lieu of the 14-day quarantine.
Canada’s cases continue to rise. New restrictions are in place in many parts of the country, and many Canadians are calling on their provincial premiers—who have jurisdiction over most rules—to implement more measures to reduce infection rates. Measures in place include advisories to postpone nonessential domestic travel, even within provinces. As well, the “Atlantic bubble”—allowing quarantine-free travel between Canada’s four Atlantic provinces—popped. All Atlantic provinces except Nova Scotia now require a 14-day quarantine for anyone entering their borders.Canada extended its ban on cruise ships until at least February. A November 2 announcement of new requirements for travelers arriving in Canada hints at a possible future opening of the border.
As of November 21, travelers flying to Canada are required to submit information electronically in advance of travel via the ArriveCan app or website, and travelers arriving by land and sea are encouraged to do so to speed entry. Rules requiring travelers to submit a quarantine plan remain in place—almost everyone entering Canada must self-isolate for 14 days (exceptions include essential workers and those participating in a new pilot project which uses COVID testing in lieu of the full self-isolation period). As of November 21, travelers need to confirm they’re at their quarantine location within 48 hours of entering Canada and report their COVID symptoms daily.
Restrictions about who is eligible to enter Canada are slowly being lessened. including these exemptions allowed into Canada as of October 8. Extended family members—including couples in long-term dating relationships—of Canadian permanent residents and Canadian citizens are now allowed entry (documentation is required to prove the relationship under some circumstances). Exemptions for compassionate reasons, such as a life-threatening illness of a close friend, are also allowed. International students, with pre-approval, are also allowed into Canada again as of October 20. Details are at Canada.ca.
CBC reported lobbying by U.S. members of Congress for a phased reopening out of concern that the border closure is “creating tension and uncertainty.” Several U.S. travelers in Canada have been fined for not obeying Canada’s mandatory two-week quarantine period and for stopping to sightsee en route to Alaska (driving to a residence in Alaska is, currently, allowable). Spot checks have been increased. CTV News reports that more than 10,000 U.S. citizens and 1,500 other nationals were turned away from the Canadian border between March 22, after the border was closed, to July 12.
The Mexican land border remains closed to nonessential travel, although Mexico is welcoming air passengers. In mid-November, Mexico increased the risk designation of several northern states including Chihuahua and Durango to red, though most of the country remains at the orange and yellow levels. Several tourist areas opened in June including the Mexican Caribbean(Quintana Roo and the Cancun area), Jalisco and the Riviera Nayarit, as well as Baja California Sur which includes Los Cabos, La Paz, and Loreto on the Sea of Cortez. Several Mexican destinations have received the World Travel and Tourism Council’s Safe Travels Global Safety & Hygiene Stamp—Quintana Roo was the first destination in the Americas to receive it.
Colombia announced on November 30 that its sea borders would open December 1 but that its land and river borders would remain closed until January 16.
Costa Rica announced a further reopening of its borders on October 2. As of November 1, residents of all U.S. states will be eligible to enter Costa Rica (and state identification showing state residency will no longer be required). Residents of Florida, Georgia, and Texas are allowed as of October 15, and residents of several other states and countries were permitted earlier. Requirements to enter Costa Rica are detailed on the Visit Costa Rica website and include travel medical insurance, a negative PCR test within 72 hours of departure, and filling out Costa Rica’s Health Pass form. Approximately 45 countries are on Costa Rica’s green list, with travelers eligible to enter Costa Rica.
Panama reopened to international travelers as of October 12, see details on the Visit Panama website. Travelers to Panama need to provide proof of a negative COVID test no more than 48 hours old or must take a test on arrival at a cost of about $30 (the U.S. dollar is used in Panama). If travelers test positive, they are subject to a seven-day mandatory quarantine (at no cost to the traveler) before being retested. Travelers must also sign an affidavit that they will comply with all COVID measures. Face masks are required in public in Panama, and measures to facilitate safer travel—such as hand sanitizing stations and contactless restaurant ordering and payment—are being implemented throughout the country.
Belize, which had planned to reopen on August 15, delayed its reopening to October 1. Updated information is posted at TravelBelize.org. To enhance the country’s health and safety standards, Belize implemented the Belize Health App and a nine-point Tourism Gold Standard program To enter Belize, COVID protocols include registration on the health app and, if possible, a negative PCR test within 72 hours of travel; testing on arrival is available for those unable to get a test in advance at a cost of $50 US. A positive test means 14 days quarantine at passenger expense. The health app requires a daily check-in and reporting of symptoms. International travelers are restricted to approved hotels and transportation.
Guatemala reopened its land, sea, and air borders as of September 18 and began lifting restrictions on domestic travel. El Salvador reopened to international flights as of September 19; a negative PCR test is required for all travelers.
In October, the world’s COVID epicenter shifted from Latin America back to Europe. South America’s hardest hit countries ate Argentina, Colombia, and Peru.,
On October 5 Peru restarted international flights from neighboring countries from as far south as Uruguay and as far north as Panama. Just beginning phase four of its reopening, bars and casinos remain closed in Peru but restaurants and shops are open with reduced capacity. Machu Picchu reopened on November 1 with an Incan ritual to thank the gods. Capacity is at 30% of pre-pandemic levels, with 675 tourists allowed to explore the site per day. The reduced capacity is especially important given access to Machu Picchu is by train from Ollantaytambo and then by bus (or a very long hike) from the town of Aguas Calientes. The site opened in October for a single Japanese tourist who had been waiting for seven months to see the ruins but wasn’t able to leave the country nor visit the closed UNESCO site because of pandemic restrictions. In mid-September, Brazil’s tourism agency said that without a COVID vaccine, large events like Carnival could not take place and canceled the February 2021 Carnival parade in Rio. The parade has taken place annually for 100 years.
The White House’s travel ban for Brazil began at midnight on May 27. People are no longer able to enter the U.S. if they have been in Brazil during the preceding 14 days. The restriction does not apply to U.S. citizens or green card holders, though it will be more difficult for them to get home as flights are usually curtailed in response to these types of bans. The Washington Post describes how flights between the two countries were already limited because of travel restrictions Brazil imposed in March against all foreigners. At the time, the United States had about four times as many COVID cases as Brazil and almost three times as many cases per capita. CTV News points out that the U.S. has not issued a travel ban against Russia, the country with the third-highest reported cases.
We’ve integrated other key events from earlier this spring into the information below.
The Evolving Spread of COVID-19
Reports of a rapid spread of COVID-19 outside of Asia began late in the week of February 17. When March began, cases were climbing in China, Italy, Iran, and South Korea. By mid-March, Western Europe and the U.S. had high numbers, and COVID was in 125 countries. Europe became the epicenter of the disease, but by the end of March it had shifted to the U.S.
For more on what’s happening in Europe, check out
Coronavirus Outbreak: Should You Cancel Your Trip to Europe?
Read more about U.S. travel below and in our
Coronavirus Outbreak: Should You Change or Cancel U.S. Travel Plans?
Many experts say that cases of COVID-19 have been circulating within many countries long before confirmed cases started to be counted. A new study indicates that a man in France may have had COVID-19 in late December 2019, Dr. William Spangler, Global Medical Director with AIG Travel, says, “There could be large segments of the population who contract it and never know it.” It’s assumed that the total number of cases is much higher than what’s being reported because many people experience mild or no symptoms and because most countries are not able to test everyone with symptoms. This means that the mortality rate is also unknown, as explained in this Economist article. Case numbers rose dramatically throughout March and even more so in April. Dr. Faheem Younus, Chief of Infectious Diseases at the University of Maryland, says it took 66 days for the case count to go from 100,000 to 200,000; 12 days to go to 300,000; four days to go to 400,000; two days to go to 500,000; and less than two days to go to 600,000. It then took one day to go to 700,000 cases. In April the number of cases rose from one million to three and by May 20 were at five million.
In March, most countries started to pay a lot more attention to COVID-19, while in China the disease was easing. On March 10, China reported that the country no longer needs 11 of its 14 new temporary COVID-19 hospitals as new domestic cases dropped. However, occasional domestic cases continued to be confirmed and a second wave of cases, brought in by travelers to China, then began. Second waves hit several of the earliest affected countries, including South Korea, Singapore, and Japan, as the BBC reported on March 18.
The United States became the third most-affected country in the world on March 23, rising from the sixth most affected as of March 20. March 26 saw the U.S. case count not only surpass that of Italy but also of China. A White House official said on March 30, “If we do things together well, almost perfectly, we could get in the range of 100,000 to 200,000 fatalities.” New York, as CNN explains, is the U.S. epicenter. On April 11, the state of New York alone surpassed the COVID-19 case count of Spain. The U.S. crossed the 10,000 COVID-19 deaths threshold on April 6 and on April 11 became the country with the highest number of COVID-19 deaths. At the beginning of March, the U.S. had about 100 confirmed cases. Two separate studies tracing the virus genome show that COVID cases in the United States originated not from travelers from China but Europe. The first U.S. case was reported on January 13, well before the White House’s January 31 China travel ban and the March 11 Europe travel ban.
May brought the easing of COVID cases in Europe, although a German study said actual COVID cases there are likely 10 times higher than confirmed cases, and May 10 brought reports that Germany’s case numbers are rising again. Cases in other parts of the world continue climbing, especially in Russia, India, and Brazil. Many countries are beginning to lift their restrictions. Some citizens are protesting that they want additional freedoms while others fear their governments are putting the economy ahead of their health, often in the same jurisdiction.
What Is This New Virus?
In early January 2020, China and the WHO confirmed the identification of a new virus. It stems from several cases of pneumonia identified in Wuhan, a city in the Chinese province of Hubei, on December 31, 2019. The new illness initially had the temporary name 2019-nCoV. On February 11, 2020, the WHO officially named the illness COVID19, pronounced “co-vid 19.” It’s short for coronavirus disease, with the “19” designating 2019, the year it was first identified. The official name of the virus itself is severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.
A Coronavirus—What’s That?
The Centers for Disease Control and Prevention (CDC) describes coronaviruses as a type of virus that causes a fever and symptoms of the upper respiratory system, like a sore throat, coughing, and a runny nose. Sometimes coronaviruses can cause more severe symptoms like difficulty breathing, illnesses of the lower respiratory system like bronchitis and pneumonia, and sometimes death. Other coronaviruses include the common cold, as well as SARS (Severe Acute Respiratory Syndrome), and MERS (Middle East Respiratory Disease). Coronaviruses were first identified in the 1960s and have “corona” in their name because, at the molecular level, they have a crown-like shape.
Cold and flu viruses generally mutate frequently, which is why we keep getting sick from them and why the flu vaccine changes every year. We don’t yet know if people who recover from COVID-19 will have lifelong immunity to it, or if the virus will change.
There was initial hope that the virus would not survive in warm weather and therefore cases would ease off as the northern hemisphere entered summer, but outbreaks in warm countries like Singapore proved that wrong. As Spangler says, “unfortunately, it does not appear this particular virus is susceptible to heat and humidity.” For more detail see Is It Safe to Go to the Beach Right Now?
Coronaviruses can infect both humans and animals. Scientists don’t yet know the origin of SARS-CoV-2. When a virus jumps from an animal to a human, or vice versa, the virus can change rapidly and even become a new virus.
Scientists pay close attention to new viruses because they don’t know how they’ll behave and how dangerous they might be. For example, a virus that’s contagious only when the infected person is clearly sick and that causes only minor symptoms isn’t a big concern. But a virus that transmits rapidly, especially before an infected person even realizes they’re sick, is more dangerous, as is one that causes severe symptoms. Viruses that are transmitted by direct contact, like touching mucus membranes or bodily fluids, are easier to control than smaller viruses (like measles and chickenpox) that are transmitted through the air by floating on dust particles.
On January 30, 2020, the World Health Organization declared COVID-19 a global health emergency. On March 11, the head of the WHO, Tedros Adhanom Ghebreyesus, declared the spread of COVID-19 a pandemic. However, Tedros accompanied that declaration with several important statements:
- “…we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.”
- “Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
- “Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do.”
Linked are Tedros’ statements from March 2, when he said, “We are in unchartered [sic] territory. We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures. If this was an influenza epidemic, we would have expected to see widespread community transmission across the globe by now, and efforts to slow it down or contain it would not be feasible.”
On March 16, Tedros noted that many countries have implemented decisions to enhance social distancing, for example by canceling events and closing schools. However, he said there is not “an urgent enough escalation in testing, isolation and contact tracing” and that these are needed to “extinguish this pandemic.” He added “We have a simple message for all countries: test, test, test. Test every suspected case.”
World Leaders’ Reactions and the WHO’s Advice
Leaders around the world first tried to protect their own countries by closing borders and restricting movement. As the disease spread, many countries realized they could better tackle the pandemic, and the economic consequences of it, by cooperating rather than competing against each other.
The WHO said on July 28 that the world is still in the first wave of the pandemic, and warned against thinking of COVID as a virus that behaves in seasonal waves, as the flu does. “It’s going to be one big wave. It’s going to go up and down a bit. The best thing is to flatten it and turn it into just something lapping at your feet,” said the WHO’s Dr. Margaret Harris. The pandemic has many side effects as well, for example, the United Nations said 10,000 children are dying every month because of COVID-related hunger, with 550,000 children affected by “wasting” malnutrition, the CBC reported. In early August, the United Nations reported that more than a billion students in 160 countries around the world have missed school due to COVID-19. It’s estimated that over 23 million students are at risk of not having access to school or of dropping out this year, which could lead to “a generational catastrophe.”
International meetings addressing health and the economy continue. For example, on May 4 a global alliance of world leaders pledged to raise $8 billion to research vaccines and therapeutics and distribute them equitably once developed. The U.S. did not attend the virtual meeting.
The head of the United Nations drew attention to the rise in anti-foreigner hate and xenophobia around the world. On May 8, the UN Security Council’s vote for a worldwide cessation of conflict zone hostilities was prevented by the U.S., reportedly because the resolution mentioned the World Health Organization, reports Al Jazeera. CNN reports that international health experts warn that diseases like HIV/AIDS, measles, tuberculosis, and malaria could surge because of a shift in health resources toward COVID-19.
In his April 1 remarks, the head of the WHO, Tedros Adhanom Ghebreyesus, urged governments to put social welfare measures in place to protect vulnerable people. He commended India for providing free food rations for 800 million citizens and free cooking gas for 80 million households. Tedros drew attention to the needs of developing countries and echoed the call from the World Bank and International Monetary Fund to provide debt relief. The WHO, with UNICEF and the International Federation of the Red Cross, is releasing new guidance for handwashing aimed at countries where access to clean water is limited.
Authoritarian governments and police forces are exerting their influence. The Guardian reports that a 13-year-old boy in Nairobi, Kenya was shot dead on his balcony by police enforcing curfew. Global News describes how the word “coronavirus” is banned by the Turkmenistan government and that people who say it or wear face masks are being arrested. The BBC reports that the Hungarian parliament passed a bill that gives the government the ability to rule by decree without any time limits. The law also allows significant jail sentences for people deemed to be spreading rumors or breaking quarantine. Journalists are alarmed by the government-sponsored “hate campaign” against independent news.
The E.U. and Germany both called attention to the new Hungarian situation and of the importance of the rule of law, human rights, democracy, and an independent and free media. The Guardian also reports on concern about how the coronavirus is affecting European solidarity. A former Italian prime minister, Enrico Letta, said, “If everyone took the strategy of ‘Italy first,’ ‘Belgium first’ or ‘Germany first,’ we will all sink together.” See more on the situation in Europe in Coronavirus Outbreak: Should You Cancel a Trip to Europe?
On March 31, Donald Trump warned that “We’re going to go through a very tough two weeks” with modeling showing that between 100,000 and 240,000 Americans could die of COVID-19. However, Politico reports that the White House has decided against allowing new Obamacare enrollments for uninsured Americans. On April 22, Donald Trump issued a 60-day suspension on green cards and guest worker programs, as detailed by Deutsche Welle.
Also on April 22, the UN secretary general warned that COVID-19 “is a public health emergency that is fast becoming a human rights crisis.” He warned about the rise in authoritarian governments, hate speech, domestic abuse, and the disproportionate effect of the virus on refugees and migrants. World leaders continue to provide mechanisms to try to ease the economic, social, and health effects of COVID-19. The World Food Program warned that 300,000 people daily could starve to death over the next three months and that there could be famine in more than 30 countries.
On April 16, the White House issued guidelines for reopening the economy. This resulted in, for example, the opening of Florida beaches with reports that they were immediately crowded. USA Today describes some of the new measures. On April 13, Donald Trump claimed that he has “total” authority to order states to reopen. As NPR reported, it is individual state governors, not the U.S. president, that have these powers. Throughout the week, arguments with governors and constitutional experts followed, with Trump tweeting that “a good old-fashioned mutiny every now and then is…exciting and invigorating.” As reported by NBC, some saw tweets to “liberate” Virginia, Michigan, and Minnesota, and describing the 2nd amendment as “under siege,” as a call to arms.
Several international meetings took place in April, including G7 leaders, G20 health ministers, and of the 24 member countries of the Alliance for Multilateralism. Relying on science, supporting the WHO, and the importance of international cooperation were prominent agenda items. However, the planned April 19 statement by G20 health ministers about cooperating to prevent future pandemics and strengthening the WHO’s mandate was not released because the U.S. would not agree to it, as reported by The Guardian. On April 17, the Ministerial Coordination Group on COVID-19 put out a statement endorsing global cooperation to mitigate disruptions to the economy, trade, and travel. Amongst many other things, signing countries agreed to work to extend visas for non-nationals unable to exit countries because of COVID-19 travel restrictions and to offer them essential health care. Thirteen countries signed the statement: Brazil, Canada, France Germany, Indonesia, Italy, Mexico, Morocco, Peru, South Korea, Singapore, Turkey, and the U.K.
Leaders of the G7 met April 16 and, as described by the Globe & Mail, “confronted Donald Trump” about cutting funding to the WHO. The other leaders expressed support for the WHO and the importance of fighting the pandemic through shared information and coordinated science. Supporting funding of the WHO was also discussed at the April 16 meeting of the Alliance for Multilateralism. The goal of the informal network of foreign affairs ministers, founded by France and Germany, is “to renew the global commitment to stabilize the rules-based international order, uphold its principles and adapt it, where necessary.” The Alliance’s April 16 joint statement begins with “The COVID-19 pandemic is a wake-up call for multilateralism” and calls for global cooperation and solidarity. It has 24 signatories from Europe, Africa, Asia, the Caribbean, the Middle East, North, Central, and South America. The United States has not yet participated.
In his April 8 remarks, Tedros Adhanom Ghebreyesus, the head of the WHO, gave an overview of the first 100 days of the COVID-19 crisis. This included that the WHO notified world leaders of the outbreak on January 5 and issued guidance on how to detect, test, and manage cases on January 10. In his April 10 remarks, Tedros outlined six factors for countries to consider in deciding when to start lifting physical distancing and other lockdown conditions. He raised concerns about countries where more than ten percent of health care workers are infected and the need for them to have access to personal protective equipment. He described the UN’s new Supply Chain Task Force to help with procurement and distribution where it’s most needed.
Tedros also drew attention to Africa where the virus is now spreading in rural areas which already lack health capacity. He reported that, after 52 days without any new Ebola cases, an Ebola diagnosis was confirmed in the Democratic Republic of the Congo, which also has 235 COVID-19 cases. As of April 24, Africa has more than 27,600 coronavirus cases in 52 countries. Only two African countries—Comoros and Lesotho—have not yet confirmed any COVID-19 cases.
E.U. finance ministers reached an agreement on April 9 for a financial rescue package worth 500 billion euros. G20 leaders met on March 26 to discuss working together to address the effects of COVID-19 but no specific actions were shared with the media. This followed a March 25 G7 foreign ministers discussion where they were unable to issue a planned joint statement because the U.S. insisted on calling COVID-19 the “Wuhan virus” and the other G7 ministers refused, as reported by the CBC.
On April 5, the head of the United Nations called for governments to enact measures to protect abused women and children who must self-isolate at home with their abusers.
Tedros Adhanom Ghebreyesus, the head of the WHO, reminded G20 leaders that to address COVID-19, “No country can fight alone; we can only fight together.” In his March 27 public remarks, he said “The chronic global shortage of personal protective equipment is now one of the most urgent threats to our collective ability to save lives,” adding that “when health workers are at risk, we’re all at risk.” He announced next steps in the WHO’s SOLIDARITY clinical trial and requested that countries “refrain from using therapeutics that have not been demonstrated to be effective” against COVID-19, saying “We must follow the evidence. There are no short cuts.”
Tedros said the world “squandered the first window of opportunity” to deal with COVID-19 and must “do everything to suppress and control this virus” and not squander the second opportunity. In his March 25 remarks, he said encouraging people to stay in their homes is slowing the spread of COVID-19, but that it will not extinguish it. He called on countries that have implemented lockdowns to use the time to enhance measures so that the virus does not simply resurge when lockdowns are lifted. He outlined six key actions, including refocusing “the whole of government on suppressing and controlling COVID-19.”
Tedros echoed the March 23 call of the United Nations’ Secretary-General for a ceasefire of all armed conflicts, stating “We are all facing a common threat, and the only way to defeat it is by coming together as one humanity because we are one human race.” Tedros continued to press for more testing, isolating, tracing, and quarantining. He discussed the rising number of COVID-19 infections amongst medical staff and recommended that limited protective equipment be prioritized for use by medical teams. He also encouraged countries to work together in the WHO’s SOLIDARITY clinical trial study, saying it will bring faster and more effective results than many smaller observational studies. For individuals, Tedros reminded us that physical distancing does not mean social distancing. He encouraged everyone to reach out to others by phone or electronic means, especially to older people and those who live alone.
In his remarks on March 18, Tedros again pressed countries to enhance COVID-19 measures beyond physical distancing (like canceling events and large group gatherings). Without “isolating, testing, and treating every suspected case” and then tracing contacts of anyone diagnosed, he said transmission chains will continue at low levels and then surge again once physical distancing restrictions are lifted. On March 13, the head of the WHO expressed relief that more and more countries are now acting on the WHO’s advice but repeated that there is much more to be done.
The WHO’s advice to the general public, last updated on March 18, remains taking the usual precautions: wash your hands frequently, avoid touching your face, practice respiratory hygiene, practice physical distancing, and maintain at least a three-foot distance from people. People who show even mild symptoms, like a headache or runny nose, should stay home. Those with more serious symptoms (like a cough, fever, and difficulty breathing) should seek medical care but call for instructions before visiting a medical provider in person. We explain the details of this below.
In a statement on March 16, the WHO advised on how to care for a COVID patient who is quarantined at home to minimize the chance the virus is spread to other family members (a key way COVID-19 spread in China). New guidance is also available for how to care for older people, pregnant women, and children.
The WHO also provides advice on international mass gatherings, defined as events where the number of participants could drain the destination’s health system. The WHO has ruled out blanket cancellations but has provided advice on how assessments should be made including that multiple stakeholders, particularly public health authorities, be involved.
With respect to travel bans, the WHO reiterates that “evidence shows that restricting the movement of people and goods during public health emergencies is ineffective in most situations and may divert resources from other interventions.” The organization says some short-term restrictions, carefully weighed against risk, may be justified at the beginning of an outbreak to allow countries to implement preparedness measures and identifies circumstances where the temporary restriction of movement may be useful “such as in settings with few international connections and limited response capacities.”
In April, bidding wars by countries and institutions for increasingly hard-to-find personal protective equipment was jacking up prices and putting health care workers at risk. Dubbed “mask wars,” blame was focused on the U.S. For example, the U.S. attempted to limit exports of N95 masks made by 3M to Canada and Latin America. Canadian officials made statements about how the pulp used to make N95 masks comes from British Columbia and about the number of Canadian medical staff who work in Detroit hospitals. The U.S. was accused of interfering with European mask purchase agreements, including allegedly redirecting to the U.S. a shipment of 200,000 masks from Bangkok bound for Germany. German officials dubbed it an “act of modern piracy” and called the “behavior of the U.S. president…inhumane and unacceptable” and insisted that “the U.S. comply with international rules.” Barbados accused the U.S. of blocking the shipment of 20 donated ventilators. Experts say this kind of individualism will likely increase virus transmission and put everyone at greater risk.
On April 3, the CDC advised Americans to wear face coverings in public to help prevent people without symptoms from inadvertently spreading COVID-19. The CDC provided instructions for making them. Medical experts warned about a false sense of security with a mask, saying that staying home and, when out, keeping physical distance from others is still the most effective way to prevent COVID transmission. People can also easily infect themselves by not using masks properly (we provide more details toward the end of this article). Officials also reminded of the shortage of masks for medical professionals and that everyone is less safe if health care workers become sick.
Cancelations, Domestic Restrictions, and Lockdowns
In most countries, the initial response to COVID-19 was to cancel major events like international conferences and to have sports matches played without audiences in stadiums. Restrictions grew in most countries, first in Asia and then in Europe and elsewhere. Most events around the world are now canceled or postponed. The decision to postpone the Tokyo 2020 Olympics was made on March 24. The Olympics are now scheduled for July 23 to August 8, 2021, and the Paralympics for August 24 to September 5, 2021, though in late May 2020 officials speculated that the Games may not be able to go ahead without a vaccine, and may be canceled altogether.
More and more countries advised their citizens to avoid gathering in restaurants and bars, then closed nonessential businesses, and then told people to stay in their homes as much as possible under guidelines to self-isolate and shelter in place. Several countries enacted official lockdowns, some issuing severe penalties for violations. Public life around the world shut down, relatively easy for people with their own apartments or houses, but sometimes impossible for people with low incomes and homeless people.
The aim is to prevent the most at-risk populations from contracting the disease and not overwhelming health care systems. Known as “flattening the curve,” this NPR article explains what it means and why staying home and physical distancing can save lives. Individual action is critical in ensuring success and we all must take on responsibility in helping prevent those more vulnerable from getting sick.
New guidelines for the United States, called “15 Days to Slow the Spread,” were implemented on March 16 and later changed to “30 Days to Slow the Spread.” As USA Today describes, they include advice to “limit discretionary travel, shopping trips, and social visits,” avoid gatherings of more than 10 people and to avoid sitting in restaurants and bars.
The Guardian said March 25 that approximately 20% of the world is living in lockdown conditions. On April 5, the BBC reported it at 25% and other outlets said that half the world’s population faces movement restrictions. Generally, people are allowed out of their homes for essential purchases and, in most countries, to exercise. Several countries have begun warning citizens that COVID-19 restrictions could last for six months or longer.
In mid-March, officials in many countries expressed shock at the number of people, particularly young people, who were ignoring advice to maintain physical distance and not attend events of any kind, including going to bars and restaurants. There was grave concern about how much disease was spread because of these activities. News outlets report comments from spring breakers in Florida saying they didn’t care if they contracted COVID-19, seemingly unaware that young people can also have serious symptoms and of the significant role they would then have in spreading the disease and putting health care systems in jeopardy. A French minister said, “There are people who think they are modern-day heroes by breaking the rules while they are in fact idiots.”
In other parts of the world, South Korea monitors those in quarantine with electronic wristbands. After reports of recovered South Korean patients testing positive again for COVID-19, the WHO began a study on April 11 to find out why. CNN reported that Ecuador’s largest city, Guayaquil, was on the verge of collapse with bodies left in the street. In Peru, anyone who spreads fake coronavirus news could be arrested. In Panama, residents were only allowed to leave their houses for two hours at a time, and men and women were not allowed out on the same day. In the United States, at least 90% of the population was under some kind of lockdown; Al Jazeera describes the restrictions in each U.S. state in mid-April.
Travel Bans and Restrictions
Travel restrictions began in Wuhan in January and grew to almost every other country in March. Echoing the WHO, some infectious disease specialists say that not all of the travel bans are medically necessary but were put in place for political reasons. To non-experts, some of the decisions may sound like they make sense, but evidence-based scientific advice suggests otherwise. For example, Steve Hoffman, a professor of global health at York University, describes how a travel ban “actually undermines the public-health response because it makes it harder to track cases in an outbreak.” Bans encourage people to lie about their symptoms and about whether they may have been exposed to illness. Many people are so desperate to get to their destination that they board flights knowing they have symptoms. Axios describes how about 40,000 people flew to the U.S. on direct flights from China after the China-U.S. travel ban was in place, perhaps giving a false sense of security and delaying other actions that may have saved more lives.
Some decisions may even be driven by fear and xenophobia. Certainly, statements calling the virus “Chinese” or “foreign” are xenophobic and can make controlling COVID-19 and the consequences of it more difficult. Asians around the world report increased harassment and discrimination because of the virus. Public health experts reiterate that bans against travel and trade are ineffective, not scientifically or economically warranted, and can cause more harm than good. However, encouraging individuals to make decisions to avoid travel or self-isolate can help slow the spread of disease, flatten the curve, and reduce pressures on health care systems.
In the United States, travel restrictions strengthened during February and March. The CDC and the State Department use different warning scales and issued differing advice. As of March 19, the State Department’s warning is at “Level 4: Do Not Travel,” the highest level. It advises Americans to “arrange for immediate return to the United States unless they are prepared to remain abroad for an indefinite period.” This follows the State Department’s March 11 Level 3: Reconsider All Travel advisory. The CDC issued level 3 “warnings” to avoid nonessential travel to a list of countries that changed frequently. On March 11, a global outbreak was noted with a level 2 alert, but later changed to level 3, the highest, meaning “avoid all nonessential travel.”
The U.S. began implementing new border rules on February 2, prohibiting foreign nationals who had visited China in the previous 14 days from entry and subjecting U.S. citizens traveling from there to health screenings and, potentially, restrictions on their movements for 14 days. A ban on travelers from Iran was added on February 29. Advice for travelers from other high-incidence countries, including all countries with a level-3 warning, includes that they should self-isolate for 14 days. On March 11, Donald Trump announced that all travel from Europe is suspended for 30 days as of midnight March 13. Originally the U.K. and Ireland were exempt from this ban, but on March 14, the ban was revised to include them and clarifications issued about who the ban did and did not apply to.
On March 13, the United States declared a state of emergency. On March 28, the CDC issued travel advisories within the United States, recommending no nonessential travel to New York, New Jersey, or Connecticut for 14 days. That restriction has been lifted, but the CDC provides advice about travel within the U.S. Nonessential travel across the U.S.-Mexico border was barred as of March 21. The Guardian reported that the construction of the southern border wall would be increased.
The U.S.-Canada border closed to all but essential travel as of March 21 and the closure was extended until at least June 21. Nationals of each country can return home and commercial goods are still allowed through. Canada was following the WHO’s advice but on March 16, the prime minister announced new restrictions on who can enter the country. Canada’s advisory recommending that Canadians not travel abroad at all was released March 13 and on March 14, Canada advised Canadians who are abroad to return home. Anyone coming into Canada, regardless of where from and regardless of whether they have symptoms, must self-isolate for 14 days and provide border officials with a quarantine plan.
On March 26, the Canadian prime minister confirmed rumors that the White House discussed putting troops near the U.S.-Canada border. Canadian officials were not supportive, with Justin Trudeau saying “Canada and the United States have the longest un-militarized border in the world and it is very much in both of our interests for it to remain that way.” At the time, Canada had about 4,000 cases while the U.S. had about 81,000. On March 31, the CBC reported that a U.S. Department of Defense official said, “As of last night, that is no longer under consideration.” The Nation reported on a leaked Customs and Border Protection memo requesting $145 million in funding to monitor the activities of Canadians.
Most countries screen arrivals at their borders, and some require testing on arrival. Self-isolation or quarantine for 14 days is encouraged and often mandatory. Al Jazeera has a list of border restrictions.
Air Travel Restrictions
Airlines began canceling flights and adjusting schedules in January in response to government bans and because of reduced customer demand. Many airlines discontinued international flights, reduced domestic flights, and some are temporarily shutting down operations. Some countries grounded all international flights. Passengers around the world reported showing up for flights at airports only to find they’ve been canceled, with the pattern repeating with subsequent flights.
Air travel is starting up again, though many airlines are laying off staff and are worried about their ability to stay in business. Airlines have enhanced cleaning protocols, for example with electrostatic spraying of disinfectant nightly and sometimes between flights. Many require that both crew and passengers wear masks and are attempting to seat passengers to allow for more physical distancing.
In May, however, some air passengers posted photos of packed planes on social media, complaining that airlines misled them about their new policies. For example, United Airlines posted “we’re automatically blocking middle seats to give you enough space on board,” which customers took to mean that it would not be physically possible to sit in middle seats. The airline’s website, however, detailed that while United blocked the ability to book middle seats, those seats could still be assigned to passengers if needed, for example when flights are consolidated. Since airlines have cut or reduced flights to secondary airports (such as Oakland, in favor of San Francisco), flights that were half-empty a week ago are now full.
Some countries’ skies remain closed. On April 27, Argentina announced that tickets for commercial flights to, from, or within the country cannot be sold until September 1. Other countries are still flying and there are signs of what air travel in the COVID world could look like. On April 15, with a Dubai-Tunis flight, Emirates began testing passengers for COVID-19 prior to boarding via a 10-minute blood test. Emirates plans to expand testing, particularly for countries that require COVID testing certificates. Passengers on flights departing from or arriving at Canadian airports must demonstrate they have a non-medical face covering and wear it when physical distancing is not possible. Anyone entering Canada must provide a written quarantine plan when they arrive at the border. In the U.K., the training of dogs to sniff out COVID at airports is underway, as some dogs can already detect malaria and cancer. Arrivals in Hong Kong must undergo a COVID test and await the results, provide a quarantine plan, and get set up with a monitoring bracelet and app to record their temperature, a process that takes about eight hours. As travel restarts again, The Guardian describes how airfares might rise by 50% if physical distancing rules remain in force.
The International Air Transport Association (IATA) released a Roadmap for Restarting Aviation providing advice for both airports and airlines. For now, there is no consistency of rules or policies across countries or even within them. The air travel situation remains fluid and travelers should check with their airline or travel agent for the latest news. Flexibility to postpone travel with change fees waived is still possible as airlines try to reignite business. Find more information at:
- American Airlines Travel Alerts
- Delta Air Lines Current Advisories
- United Airlines Important Notices
Cruise Ship Restrictions
Cruise ship travel was significantly disrupted during the height of the pandemic with the first major outbreak outside of China aboard a cruise ship. Cruise lines around the world began suspending their operations in March 2020 and most ended up canceling the rest of their 2020 cruises altogether. The CDC put a No Sail Order in place on March 14, 2020, and on November 1 replaced it with a Conditional Sailing Order for Cruise Ships. Ships must apply for a Conditional Sailing Certificate 60 days prior to resuming operations, essentially extending the cruise hiatus until at least early 2021. Cruise Critic explains the CDC’s framework.
In a few jurisdictions, cruises were allowed to restart in summer and fall 2020—usually restricted to nearby residents—with extensive new measures in place. Most countries continue to advise their citizens to avoid both ocean and river cruises. On November 24, 2020, the CDC changed their advisory from Level 3 which had been in place since March to Level 4, the highest. The CDC also recommended U.S. travelers to quarantine for at least seven days and to get a COVID three to five days after disembarking. Anyone who does not get that initial negative test should quarantine for the full 14 day period.
Due to COVID outbreaks, the rerouting of cruise itineraries began in January 2020, as did enhanced health checks and limitations on who can board, sometimes based on travel history and sometimes just based on passport regardless of the person’s country of residence. Cruise Critic tracks cruise lines’ latest COVID-19 updates and port closures.
In April, dozens of cruise ships were stranded at sea and unable to dock to allow their passengers and crew, some of whom were sick, to return home. As an example, Florida Governor Ron DeSantis initially did not allow two Holland America ships to dock, first saying he did not want passengers “dumped” in Florida and then said only Floridians could disembark. Eventually, Carnival Corporation arranged a charter flight and most passengers were home by early April.
Crews of cruise ships had a more difficult time. On May 3, CBC reported information from the U.S. Coast Guard that 122 cruise ships with 80,000 crew members were stuck in U.S. waters, their crews not allowed to disembark until strict CDC requirements were met, including charter flights home. At the end of April, The Guardian said that at least 100,000 crew were living in close quarters on cruise ships around the world, either on ships that weren’t allowed to dock in port, in countries they couldn’t fly out of, or because they couldn’t fly to countries that closed their borders even to citizens. Many were ill, at least 17 died, and reports circulated that some crew were no longer being paid and had limited means to send and receive information. Some cruise lines, like MSC Cruises, allowed crew to use larger passenger cabins, provided free internet, and secured and paid for flights home.
Norwegian was the first cruise line to announce how they’ll operate going forward. Measures include a public health officer onboard to oversee health practices, fogging with electrostatic disinfectant, passenger temperature checks prior to all public activities, including meals, and the elimination of self-serve buffets.
As for the future of the cruise industry, Travelweek interviewed Vanessa Lee, President of Cruise Strategies, in April. She said that “certain areas of the world will not lend themselves to cruising for some time and others will be more logical recipients for cruise guests.” She explained that itineraries will need to be changed to accommodate outbreaks and new rules and predicted “shorter, closer to home cruises” and river cruises as likely preferences. She also predicted the increased popularity of “visits to private islands where the cruise companies can manage their own guest experience onshore as well as at sea.” See our What Needs to Change Before You Go on a Cruise Again.
If you need to pick up someone from the airport (or drive them for a COVID test), you’ll want to know about a paper published December 4, 2020, in the ScienceAdvances journal. It outlined the safest scenarios for traveling by car, including that the more windows that are open the better.
If you have to close a window, their study showed it’s best to close only the window next to the person who you’re trying to protect from infection—the window next to the potentially-infected person should be open. The safest seating arrangement is with just one passenger and for that person to sit in the backseat behind the passenger seat, as far away from the driver as possible.
Treatments, Vaccines, and Hope for the Future
Using an emergency approval process, the U.K. approved the Pfizer/BioNTech vaccine as safe on December 2. It is the new messenger RNA (mRNA) type of vaccine—unlike all other forms of vaccine, it does not contain the actual weakened virus but only contains the virus’s genetic code. It sends a “message” to cells to create antigens which prepare the body to fight COVID-19. Because it uses genetic code, mRNA vaccines can be manufactured more quickly and less expensively than regular vaccines and, in theory, can be modified if COVID-19 mutates. Trials show it has a 95% effectiveness rate. However, mRNA vaccines need to be stored at extremely cold temperatures, which makes distribution in remote areas and developing countries a challenge.
Care home residents, their caregivers, health care workers, and those aged 80 and over will be the first in the U.K. to receive the two necessary doses of the Pfizer/BioNTech vaccine starting next week, with enough doses for five million people expected before the end of December. The vaccine is manufactured in Belgium. The U.K. has secured enough doses for 20 million of its citizens.
The U.K.’s health minister said December 2 that there is no plan for a “vaccine passport” and cautioned that while the Pfizer/BioNTech vaccine protects people from getting ill from COVID-19 in 95% of cases, the extent to which it prevents a person from transmitting the virus is not yet known. He asked people not to reduce the precautions they take to prevent contracting the highly-infectious disease.
It’s likely that other countries will approve this and other vaccine candidates over the next days and weeks. Germany flagged that it will not use emergency approval processes but instead use the slower regular approval process. Experts say members of the general population in most countries should not expect to receive their first dose of vaccine until spring at the earliest. Normal life cannot resume until large segments of the population have been vaccinated.
The head of the International Federation of Red Cross and Red Crescent Societies said November 30 that misinformation about vaccines is a “second pandemic” and that “to beat this [COVID] pandemic, we also have to defeat the parallel pandemic of mistrust.” Francesco Rocca cited a John Hopkins study of 67 countries that showed declines in acceptance rates for vaccination in many countries. Interpol issued a global alert about organized crime networks trying to steal vaccine supplies and sell fake vaccines, The Guardian reported.
Officials are starting to talk about what post-vaccine life could look like. Last week, the first airline (Qantas) said that international passengers will require vaccination to board their planes. On November 30, the U.K.’s new vaccine minister said that he expected that many businesses, including restaurants and sports venues, would choose to implement rules that vaccination would be required for entry in order to protect their staff and customers from COVID transmission.
So far 189 countries have signed on to the WHO’s COVAX vaccine development and distribution agreement. They include 27 E.U. member states, Norway, Iceland, Australia, New Zealand, Japan, Singapore, Canada and, one of the last to sign on, China. The U.S. and Russia have not agreed to participate. These countries will first receive enough vaccine for the most vulnerable 3% of their populations, such as health care workers and those who live in care homes. The rationale is that pooling money together funds more vaccine candidates, allowing the world to more quickly find, manufacture, and then distribute a safe and effective vaccine. Distributing it first to high-risk people around the world will help protect health care systems and strengthen economies more quickly, essential given the extent individual countries and the global economy rely on international trade and travel. Most large and developed countries also secured agreements with individual vaccine manufacturers.
On March 18, the head of the WHO described a new study to collect data on the effectiveness of the variety of treatments around the world, naming it the SOLIDARITY trial (a reminder to world leaders that the only way to combat COVID-19 is to work together).
False reports continue to circulate about new “miracle cures” for COVID-19, often about specific drugs that are effective for other diseases, but which can harm or kill people who don’t have those illnesses. Drug shortages are affecting the lives of people with those other illnesses. In the spring and summer of 2020, reports of new tests and treatments come almost daily, usually without being studied thoroughly. What seems like good news one week turns out to be problematic the next.
Perhaps a New Normal?
COVID-19 may become a new normal. In the short-term at least, the new normal means, at a minimum, physical distancing, enhanced cleanliness, and vigilance in monitoring ourselves for symptoms, even the most mild. While travel is starting up again and people want to return to normal life, staying six feet from others and minimizing social interactions will save lives.
In the long term, the new normal might mean COVID-19 becomes a new disease we always have to watch out for. The Atlantic reports that “‘cold and flu season’ could become ‘cold and flu and COVID-19 season’” and describes the situation according to Marc Lipsitch, an epidemiology professor from Harvard. He predicts that “some 40 to 70 percent of people around the world will be infected” with COVID-19 over the next year, but “many will have mild disease or may be asymptomatic.”
COVID-19, like the flu, is a significant health risk to the elderly, people with pre-existing illnesses, and to countries with underfunded health care systems and where many citizens live with low incomes. COVID-19 cases are pressuring the health care systems of all countries, and more so during flu season. While health care workers are trained to take extra precautions, they are also at greater risk of getting sick from the virus as well as from burnout.
Also serious is the economic risk of COVID-19. Not being able to go to work is having significant financial effects on individuals without paid sick leave and on businesses without workers. Economies around the world were affected as commerce and production slowed almost to a standstill. Small businesses are at particular risk. Governments are implementing monetary and fiscal stimuli to protect citizens and businesses and ward off the worst of the recession (and perhaps depression) that is expected.
How Does COVID-19 Compare to Other Respiratory Diseases?
Spangler says that it’s important to put COVID-19 in the context of other diseases. SARS had a mortality rate of 9.6% and MERS’ rate is 34% (the disease is still active, the most recent case was reported on February 18, 2020, in Qatar). 2013’s H7N9 “Bird Flu” had a 39.3% mortality rate and 1997’s H5N1 “Bird Flu” was 57%.
The 2009 H1N1 “Swine Flu” was designated as a pandemic and hit 214 countries. The CDC provides these estimates for April 2009 to April 2010 period:
- 8 million H1N1 cases (range 43.3-89.3 million)
- 274,304 hospitalizations (range: 195,086-402,719)
- 12,469 deaths (range: 8,868-18,306) (fatality rate 0.02%); note that as of April 7, 2020, the U.S. had more COVID-19-related deaths than H1N1-related deaths.
- 151,700 to 575,500 H1N1 deaths, 80% of which were in people younger than age 65.
Consider annual flu statistics too. The CDC says that during the current 2019-2020 flu season (October 1, 2009 to present, as of April 4, 2020):
- 39 million to 56 million annual flu cases
- 24,000 to 62,000 deaths (fatality rate 0.06-0.11%)
During flu season, every week or so, the number of annual flu cases in the U.S. climbed by a million or two and the number of deaths by one or two thousand. Many Americans aren’t getting a flu shot despite the number of deaths from flu. Last year, 62.6% of U.S. kids got a flu shot while only 45.3% of adults did. And many people who have the flu—14%—don’t have symptoms, but can spread the flu virus.
In comparing how contagious the new coronavirus is, Spangler says the average person with COVID-19 “can transmit it to 2.00 or 2.5, even, [other] people,” while the annual flu spreads to about 1.0 or 1.2 people.
COVID-19 is new and there’s still a lot we don’t know about it. There are millions more cases of H1N1 and annual flu. COVID-19’s fatality rate is higher than H1N1 and annual flu, but much lower than SARS and MERS and some other flus. SARS got a lot of worldwide attention and COVID-19 has been top of the daily news. Everyone needs to take precautions to stop the spread of the disease, particularly to prevent health care systems from being overwhelmed. But is there a reason to panic more over COVID-19 than we did over H1N1 or seasonal flu or even SARS? Take the advice of governments seriously, but panic behaviors are making the situation worse. Consider this article by infectious disease specialist Dr. Paul Sax who explains What Does (and Doesn’t) Scare Me About the Coronavirus from the U.S. perspective. Visual Capitalist put COVID-19 in the context of other infectious diseases throughout history: Visualizing the History of Pandemics shows that HIV/AIDS, which has killed 25 to 25 million people, is by far the modern world’s worst pandemic.
If Bans and Restrictions Don’t Affect Me, Should I Still Travel?
Most countries are advising their citizens to reconsider or avoid nonessential international travel. Minimizing contact with other people as much as possible is still essential to slow the spread of COVID-19. We all need to practice the WHO’s advice of physical distancing, washing hands, and avoiding touching faces (see below).
During the pandemic, check the website of the public health authority of the destination you plan to visit to see their latest advice, including for entry requirements and how strained their health care system is. Travelers should still assume that new restrictions and bans could arise at any time, that flights will be canceled with little to no warning, and that their travel history will be scrutinized. Travelers may be asked to self-isolate for 14 days upon arrival, including to their home country. Some are implementing mandatory quarantine periods for travelers from some destinations or if they have been abroad at all.
It’s not new to the COVID-19 situation, but keep in mind that airlines have the right to refuse passengers who appear to have a communicable disease. The captain has the final say and many airlines employ medical consultants. As fears over COVID-19 rise, expect increased vigilance and potentially restrictions on people who simply have a cold or allergy symptoms.
You should consider whether it’s wise to book new travel, even for months from now. It’s true that there are deals to be had and many airlines, cruise lines, and tour groups are offering unprecedented flexibility to make changes. However, most travel insurance will not reimburse you for coronavirus-related cancellations so check policies very carefully. Further travel bans, restrictions, and advisories are possible. And you need to consider how you may be contributing to the spread of disease, particularly to vulnerable populations.
Easy and Common Sense Protections
Following the advice of health experts like the WHO will minimize your chance of getting sick from this new coronavirus. The advice to protect yourself from getting sick—and to minimize the spread to others—is pretty easy to follow, and it’s what we should all be doing anyway to prevent colds and flus.
- Wash Your Hands: A 20-second scrub using warm running water and soap is best (the Mayo Clinic says to sing “Happy Birthday” twice); one of Canada’s provincial health officers says “wash your hands like you’ve been chopping jalapenos and you need to change your contact [lenses]”). Then, rinse with clean water and dry your hands. It’s important to dry them, though the jury is out about the best way (some studies say hot air blowers spread germs and that paper towels or clean fabric towels are best; other studies disagree). Soap and water are more effective, but if you don’t have access to a sink, using a hand sanitizer that contains at least 60% alcohol is fine (scrub well). Regardless, wash your hands often: certainly after coughing, sneezing, or blowing your nose; before you prepare food; before and after eating, and after using the restroom. And throw those used tissues away immediately (and then wash your hands).
- Avoid Touching Your Face: Most viruses and bacteria enter the body through mucous membranes like the mouth, nose, and eyes. It’s easy to re-contaminate your hands after washing them, so keeping your hands away from your face is the best way to prevent germs of any type from getting in you.
- Cough and Sneeze Into Your Elbow: Yes, covering your cough or sneeze with your hand is preferable to spraying all those tiny virusy droplets directly into the air. But then you’ve contaminated your hand and you’ll inevitably touch something or someone. So, make a new habit of coughing/sneezing into the inside of your elbow (although a tissue should be your first choice). And while you’re at it, break that other habit of crossing your arms and putting your hands right onto your sneeze spots.
- Physical Distancing: It’s always wise to keep your distance from sick people. During the COVID-19 outbreak, try to keep a three- to six-foot distance from others. No hugs, kisses, or handshakes, please. And really, during cold and flu season why not keep close contact just for loved ones?
- Don’t Touch Animals You Don’t Know: Regardless of whether there’s a new virus circulating, staying away from animals when you travel (even that cute stray cat or dog) is a sensible precaution. They likely carry bugs that your body isn’t used to. The WHO is also reminding people of its general advice to be extra careful in markets that have live animals or non-refrigerated meats and fish.
And of course, to prevent others from getting sick, isolate yourself if you have COVID-19 symptoms.
People who have higher risks—the immunosuppressed, those with other health conditions, and older adults—should follow the advice of their doctor.
Still feeling a little paranoid? It’s good practice to regularly disinfect surfaces that get handled frequently (your phone is filthy). You can use a wipe to clean off your tray table, armrests, and seatbelt, though the evidence is unclear whether this is effective in killing germs or just cleaning up that bit of sticky spilled Coke. Don’t assume you’re safer in a taxi or Uber: it’s easier not to touch surfaces on the subway or bus, and those vehicles have a regular cleaning schedule while cars do not.
At restaurants, do an extra hand wash after you’ve given back the menu and before you start to eat. Assuming buffets ever return, use hand sanitizer before and after you touch serving utensils and be sure to only put food on a clean plate; don’t bring your used plate back to the smorgasbord. And while we’re at it, let’s call a halt to waiters at fancy restaurants picking up your used napkin and refolding it when you step away from the table. Let’s all just keep our germs to ourselves, yes? Here’s what restaurants may look like in the age of COVID.
Yes, You Should Wear a Mask
As understanding of how COVID transmits improves, face masks are becoming mandatory in more countries, both indoors and outdoors, sometimes enforced with fines for non-compliance; Al Jazeera lists various countries’ rules. Masks are required on public transportation in almost all countries. National Geographic explained the importance of masks on planes in How clean is the air on planes? The CDC recommended April 3 that Americans wear one in public and the WHO updated its mask advice on June 6.
Awareness amongst the public is growing about how COVID is transmitted and that masks offer the best protection when you’re near people you don’t live with. Masks are essential both for protecting nearby people and there’s evidence masks also help protect the wearer from COVID-19. Masks reduce the chance of you spreading your illness to other people when you cough, sneeze, laugh, or talk, especially when people don’t realize they have the virus, as they have no symptoms. However, studies show that masks are not more effective than physical distancing measures, and keeping six feet apart from others is still the most effective way of preventing COVID-19 spread.
Masks can give a false sense of security and most people don’t use them correctly: people wear them over just their mouth and not their nose, fidget with them, put them on and off without washing their hands, don’t wash them properly, and re-use masks that are meant to be single-use. Remember that it’s easy to contaminate yourself just by touching or taking off your mask. If you take it off to eat or drink, be sure to store it in a clean place. The virus can still enter your body through your eyes, and glasses or a face shield may bring additional protections for you. However, face shields alone are ineffective at trapping droplets and do not protect others.
Several companies are introducing new products to help make wearing masks more comfortable and, perhaps, safer. For example, Cabeau Tape is an FDA—and dermatologist-approved reusable tape for use with both paper and fabric masks. Sealing the top of a mask also helps prevent glasses from fogging, and the tape can prevent masks from slipping below the nose, prevent the need to keep readjusting the mask (which spreads contamination to the mask and to your hands), and reduces the need to use mask ear loops, which can cause irritation. People who find wearing a mask uncomfortable might find that the new HeartFormSF device improves their ability to wear a mask, particularly for longer periods of time and during exercise. The thin plastic shield sits between the mask and the wearer’s mouth and prevents the mask fabric from being “sucked” close to the mouth when breathing (alongside the feeling of pending suffocation some people complain of).
What If I’m Sick?
Stay home and self-isolate if you feel sick. To help stop the spread of COVID-19, the WHO and other experts are asking people to stay home from work, school and travel if they have symptoms of a cold, even if they’re mild.
Given the increased monitoring since the discovery of the new coronavirus, anyone who shows signs of illness could be prevented from entering a store let alone boarding a plane, cruise, train, or bus. Many airports, seaports, hotels, and tourist attractions have installed thermal imaging cameras to scan people as they walk by. Anyone showing a fever is pulled aside for additional questioning and maybe quarantine.
If you exhibit symptoms of the coronavirus—for example, fever, cough, or difficulty breathing—follow the instructions of your health care provider as soon as possible. Usually, this means calling ahead to your doctor or hospital so that they can take precautions to isolate you from other patients while they carry out testing. Be sure to advise doctors if you’ve been traveling. Many jurisdictions have contact tracing programs and apps—participating in them can drastically reduce the spread of disease.
Where to Get Updated Information
A new virus like this coronavirus means a rapidly changing situation. Scientists at the WHO have the up-to-date intel on the virus. Rely on their information, advice, and travel restrictions on the WHO’s website. Other reliable government advice includes Canada’s.
Note that fake coronavirus news (see these busted COVID-19 myths) is spreading fast with the WHO calling it an “infodemic.” Well-meaning people are also spreading misinformation or opinions presented as facts, which is increasing fear and confusion. Trust in governments, public health institutions, and scientists is being affected, which could have more serious consequences than COVID-19 itself.
Scams related to COVID-19 exist. False claims about cures and treatments are frequent. People have died by following them. The WHO provides myth-busting information and reports that criminals are using the WHO’s name to steal personal information and money. Text messages and emails are impersonating governments and tempting clicks by offering income supports. Always go directly to a government website before giving your personal information. Do not click through links in suspicious messages.