By Marnie Hunter and Forrest Brown | CNN
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The US Centers for Disease Control and Prevention on Monday designated half a dozen new “very high” risk locations for travel, including South Korea and French Polynesia.
The six new additions to the Tier 4 “Very High” risk category range widely: Azerbaijan on the Caspian Sea; Belarus, located in a currently very tense area on the border of Russia and Ukraine; the Comoros, an archipelago off the east coast of Africa; French Polynesia in the South Pacific; Saint Pierre and Miquelon, a French archipelago south of Newfoundland in Canada; and South Korea.
Level 4, the CDC’s highest risk level, has now reached nearly 140 spots, illustrating the rapid rise of the Omicron variant around the world. At the beginning of January, around 80 destinations were listed there.
Tier 4 now has more destinations than all of the other CDC categories combined and represents more than half of all destinations listed by the CDC.
Destinations added to Tier 4 on February 14:
• French Polynesia
• Saint Pierre and Miquelon
• South Korea
Last week, all six destinations were at Level 3, or “high” risk for Covid-19.
The CDC advises travelers to avoid traveling to Tier 4 countries. The CDC’s thresholds for travel health notices are based primarily on the number of Covid-19 cases in a destination.
The CDC places a destination at Level 4 when more than 500 cases per 100,000 population are recorded in the past 28 days.
Medical expert weighs in on risk levels
Transmission rates are “a benchmark” for travelers’ personal risk calculations, according to CNN medical analyst Dr. Leana Wen.
“We are entering a phase of the pandemic where people have to make their own decisions based on their medical situation as well as their risk tolerance when it comes to contracting Covid-19,” Wen said Monday.
“You have to interpret level 4 to mean that this is a place with a lot of community transmission of Covid-19. So if you go there, you have a higher chance of getting the coronavirus,” said Wen, an emergency physician and professor of health policy and management at George Washington University Milken Institute School of Public Health.
Some people will decide the risk is too high for them, Wen said. “Other people will say, ‘Because I’m vaccinated and vaccinated, I’m willing to take that risk.’
“So it really has to be a personal decision that people weigh knowing that right now the CDC is categorizing the different tiers based on community transmission rates, and basically just that,” Wen said. “They don’t take into account individual circumstances.”
Other significant places at level 4
The CDC does not include the United States in its advisory list, but it was color-coded to Level 4 on Feb. 14 on the agency’s travel risk levels map.
Last week, Japan was among the top tourist destinations added to Tier 4.
Mexico, Canada, France, Peru, Singapore and Spain are other favorites for tourists parked in Level 4 even longer. The UK has been there since July 2021.
You can view the CDC’s risk levels for any global destination on its travel recommendations page.
In its broader travel guidelines, the CDC recommended avoiding all international travel until you are fully immunized.
Changes at Level 3
The Level 3 “high” risk category – which applies to destinations that have had between 100 and 500 cases per 100,000 population in the past 28 days – saw four additions on Monday. They were:
• El Salvador
Eswatini and Mauritius have dropped one notch from Level 4. El Salvador’s risk level has increased from its previous position at Level 2, and Indonesia has increased by two risk levels from Level 2. 1.
Levels 2, 1 and unknown
Destinations with the designation “Level 2: Moderate Covid-19” have recorded 50 to 99 cases of Covid-19 per 100,000 inhabitants in the last 28 days. On Monday, the CDC updated its guidance on Pakistan, which was moved to Level 2 last week. There were no other changes to Level 2.
Currently, there are only four Tier 2 destinations, including New Zealand, which has some of the toughest travel restrictions in the world.
To be at “Level 1: Covid-19 Low”, a destination must have less than 50 new cases per 100,000 inhabitants in the last 28 days.
No destinations were moved to Level 1 on Monday. There are currently only six destinations in the category. This includes China, which hosts the Winter Olympics.
Finally, there are destinations for which the CDC has an “unknown” risk due to a lack of information. Usually, but not always, these are small, remote places or places where war or unrest is going on. There were no additions this week.
Tanzania, Cambodia and the Canary Islands are some of the most visited places currently listed in the unknown category. The CDC advises against travel to these places precisely because the risks are unknown.
The CDC includes cruise ships on its list of destinations. Cruise travel has been at level 4 since December 30. The CDC’s advice is to avoid cruise travel at this time.
“It is especially important that travelers who are at increased risk of serious illness from Covid-19 avoid traveling on cruise ships, including river cruises,” the CDC says in its travel advisory.
On Feb. 9, the CDC updated its travel health notice for cruise travel by adding criteria for how it determines the level of risk for cruise travel. Cruise travel remained at Tier 4 in the February 9 update.
For cruise travel, the CDC’s main criteria for assessing the level of risk are the number of new Covid-19 cases among crew and the trajectory of cases among crew over the past 14 days.
Level 4 means more than 2,000 cases detected among cruise ship crew in the past 14 days. Level 3 is 1,000 to 2,000 new cases. Tier 2 is 500-999 new cases and Tier 1 is below 500 new crew cases.
Meanwhile, the CDC’s Covid-19 risk mitigation guidelines have become optional for many cruise ships.
The CDC’s extended conditional navigation order expired in January, and the agency transitioned to a voluntary program for foreign-flagged cruise ships operating in U.S. waters.
More Travel Considerations
Transmission rates are important to consider when making travel decisions, but there are also other factors to weigh, according to Dr. Wen.
“Transmission rates are a benchmark,” Wen said. “Another is the precautions needed and followed where you are going, and then the third is what you plan to do once there.
“Do you plan on visiting a lot of attractions and going to indoor bars? It’s very different from going somewhere where you plan to lay on the beach all day and not interact with anyone outside. It’s very different. They’re very different levels of risk.
Vaccination is the most important safety factor for travel, as unvaccinated travelers are more likely to get sick and transmit Covid-19 to others, Wen said.
“Unvaccinated people remain at high risk and really shouldn’t travel at this point,” she said.
People should wear a high-quality mask — N95, KN95 or KF94 — whenever they’re in crowded indoor settings with people whose vaccination status is unknown, she said.
And it’s also important to think about what you would do if you became positive outside of your home. Where will you be staying and how easy will it be to take a test to return home?
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