By Marnie Hunter, CNN
For the second week in a row, the US Centers for Disease Control and Prevention has not added a single new destination to its highest risk Level 4 category for travel.
More than a dozen destinations, including Canada and several Caribbean countries, moved from Level 4 to Level 3 on Monday.
The CDC places a destination at “very high” risk level 4 when more than 500 cases per 100,000 residents are recorded in the past 28 days. The Tier 3 “high” risk category applies to destinations that have recorded between 100 and 500 cases per 100,000 population in the past 28 days.
A total of 14 destinations moved to Level 3 on April 4:
• Antigua and Barbuda
• St. LUCIA
All 14 locations were previously listed at Tier 4. The CDC advises avoiding travel to Tier 4 countries.
The CDC’s thresholds for travel health notices are based primarily on the number of Covid-19 cases at a destination.
Although the CDC does not include the United States in its advisory list, it is part of its color-coded global map of travel risk levels. On Monday, the United States joined its northern neighbor in moving to Level 3 color coding on the map.
Falling risk levels are a bright spot in the travel landscape. Still, nearly 100 destinations remained at Level 4 on April 4 — about 40% of the nearly 240 locations covered by the CDC.
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 to level 2, level 1 and “unknown” status
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. The five new Tier 2 entries on April 4 are:
• South Africa
• Dominican Republic
All except Iraq were at level 3. Iraq was previously at level 4.
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. Six places moved to level 1 on Monday:
All six were at Tier 2. Tier 1 is dominated by destinations in Africa. Only seven Tier 1 places are outside of Africa.
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.
The CDC made three additions to the unknown category on Monday: French Guyana, Greenland and Ukraine.
The ongoing war in Ukraine has undoubtedly disrupted testing, treatment and the collection of Covid-19 case numbers.
The Azores, Cambodia, Macao, and Tanzania 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.
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 in “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.
“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.”
More Travel Considerations
There are other factors to weigh in addition to transmission rates, according to 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.
“Are you planning 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.
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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Top image: A view of the Château Frontenac in Quebec. (Alice Chiche/AFP via Getty Images).