COVID-19 is a contagious respiratory disease caused by a coronavirus, from the same family that includes SARS, MERS, and some varieties of the common cold. The virus was identified in December 2019, has spread around the world, and was declared a pandemic in March 2020. While much about the disease is still unknown, it appears to be more virulent and contagious than the seasonal flu, and less virulent but more contagious than SARS and MERS. Older people and those with underlying conditions are the most at risk of serious complications including death.
Due to the spread of the disease, people in many parts of the world are advised not to travel unless necessary, to avoid being infected, quarantined, or stranded by changing restrictions and cancelled flights. In areas where the virus has been controlled, restrictions on travel are being loosened, beginning with shorter-distance domestic travel; pay close attention to up-to-date recommendations and restrictions – loosened restrictions can be tightened again. Avoid crowded places whenever possible. This is not just to protect you, but also those you come in contact with.
If you do have to travel, wear a face mask and take precautions as you would for other infections: wash your hands frequently, avoid touching your face, cough and sneeze into your elbow or a tissue, and avoid contact with sick people. Before traveling, read up on the extensive and fast-changing array of travel restrictions that have been imposed around the world. Be prepared for cancellations, closures, and all kinds of service modifications, which may change at any time. After travel, monitor your health and consider self-isolation for two weeks to avoid transmitting the disease to others.
Transportation from long-distance passenger flights to local buses has been curtailed or completely shut down in many countries due to low demand or government orders. Many international and regional borders are closed. If you can't find a way back to your country, contact your nearest embassy or consulate for assistance.
As of mid-October 2020, the global number of confirmed cases of COVID-19 is approaching 40 million, including almost 27 million recoveries, and over 1.1 million deaths. The situation varies widely by country and region. In a few countries, the virus has been controlled very successfully, with little or no transmission remaining. In others, cases are growing rapidly with no clear path to getting them under control, or the growth of new cases is accelerating again after having been lower during previous months. Others are somewhere in between, with low or moderate community transmission and substantial efforts to limit the spread of the disease. Even in places where COVID-19 has been brought under control, there is always a risk of another outbreak. That risk can be reduced with travel restrictions, extensive testing, and other interventions, but unexpected outbreaks can and do happen.
In some parts of Asia, Europe and Oceania the disease has subsided, and restrictions have been eased even for recreational travel. In other parts, the number of daily new cases is growing again, and during October there's been a rapid rise in new cases in many European countries. The number of infections is also growing rapidly in various Latin American countries. The situation in many countries, including a large chunk of the African continent, is unclear due to inadequate testing.
The full extent of the spread is uncertain, due in part to limited testing. Many countries are experiencing a severe shortage of test kits, and the authorities have not been able to test everybody who is at high risk, so the real number of cases is probably much higher than the official one. Countries also differ in their testing and reporting practices, so comparisons of the number of reported cases do not tell the full story of how the epidemic has progressed in different areas.
Symptoms and prognosis
Common symptoms include a fever, cough, loss of appetite, and fatigue. Other less common symptoms include shortness of breath, nausea, vomiting, diarrhea, sputum production, muscle pain and loss of sense of smell. Some patients have very mild symptoms, similar to a cold. Serious complications include pneumonia, acute respiratory distress syndrome, and multi-organ failure leading to disability or death. A significant fraction of infections are asymptomatic, but nevertheless still contagious. Most cases recover without special treatment, while some become seriously ill. The infection fatality rate is still unclear. Globally, the case fatality rate is 3.65% of confirmed cases, as of August 2020, but this varies widely from country to country. Fatality rates tend to be highest among the elderly, and lowest among young children and babies, though fatalities have been reported in all age groups.
Those most at risk of COVID-19 infection and serious complications are the elderly and those with weakened immune systems or underlying health conditions like cardiovascular disease, diabetes, hypertension, chronic respiratory disease, and cancer. Not many cases are reported in children and most of these are mild or moderate, though a significant fraction do get pneumonia.
The time between being exposed to the virus and the emergence of symptoms (incubation period) is typically between 2 and 14 days. The disease is most contagious during the first three days of symptoms, but it can also be transmitted without symptoms. Recovered patients are believed to be immune to the virus, but it is unclear how long this immunity lasts.
Long-term effects for people who have recovered remain unclear, but there is evidence of reduced lung capacity in some recovered patients. There is also some evidence that people may develop Kawasaki disease-like symptoms after recovering from COVID-19, while the disease has also been linked with an increased risk of thrombosis.
Many governments around the world have advised their citizens not to travel unnecessarily amid the pandemic. Particularly avoid cruise ship travel. Older travelers and those with underlying health conditions are most at risk and should avoid travel that puts them at risk, such as long plane flights, visits to crowded places, and especially cruises, even outside of severely affected areas.
In affected areas, most experts recommend a practice known as physical distancing (or social distancing). This means minimising contact with others by keeping a distance of six feet or two meters from them and avoiding gathering together in groups. Measures you are encouraged to take include working from home whenever possible, avoiding crowds and avoiding leaving your home unless necessary. If you must go out, try to stay at least 2 meters (6 feet) away from other people. In many places these measures are required. Some areas prohibit gathering in large groups; others prohibit all group gatherings.
COVID-19 is transmitted through the air and through objects, and evidence suggests that it is contagious even without symptoms. Follow hygiene practices like for flu prevention. These include:
- Frequently wash your hands with soap and water, and then dry your hands on a clean towel. As coronaviruses are enveloped viruses, washing your hands with soap kills the virus by disrupting the mostly fat-based viral envelope. Effective hand washing requires rubbing your hands for at least 20 seconds. Drying your washed hands physically removes some germs from your skin (so don't skip that step, and don't share towels).
- If soap and water are not available, then use a >60% alcohol-based hand sanitizer. Alcohol is a quick germ-killer, but it's not quite instant, so this still requires the same 20 seconds of rubbing your hands together, making sure that every single scrap of skin gets wet, and then you have to wait about another minute, for the alcohol to completely dry.
- Wear a mask in public in areas where transmission is widespread, and especially where physical distancing isn't possible (such as shops and public transportation). Medical masks are recommended for people over 60, people with underlying conditions, those who are suspected of carrying the disease, and those who are in close contact with infected people. Wearing a mask is required in some countries and cities in an effort to reduce community transmission. In some areas any sort of face-covering is accepted, such as a scarf, or just a T-shirt. Even if you aren't worried about catching the virus, you should still cover your face, to avoid transmitting it to others in case you have an asymptomatic infection. Many countries are experiencing shortages of surgical masks.
- Make sure to use the mask correctly. The mask should cover your nose and mouth and fit without gaps. Wash your hands before putting on the mask and avoid touching the mask while wearing it. If you do touch it, wash your hands immediately afterwards. When the mask becomes damp, discard and replace it. Remove it from the back, throw it away, and then wash your hands. Don't reuse disposable masks. Remember that masks are not a substitute for good hygiene: continue to wash your hands frequently.
- Don't stock up on masks if you don't need them. Mask shortages mean that healthcare workers are having trouble getting a hold of masks, which puts everyone at risk. That includes N95 respirators, which are not recommended for the general public – these are specialist equipment which must be fitted to be optimally effective. Leave them for healthcare workers.
- Disposable gloves can also be useful if you have to handle multiple things others may have handled or sneezed on when it's not convenient or possible to wash your hands. One example would be going to a public building where you would have to open doors and push elevator buttons. After you're done using them, take them off touching them minimally (they will naturally fold inside out, hiding the outer possibly infected surface, and the one first off can be left inside the other), discard them and wash your hands as instructed above.
- Avoid touching your eyes, nose and mouth with your hands. Most people touch their faces every few minutes, all day long. Try to do this less, and try to wash your hands before touching your face. Also, try to avoid touching surfaces you don't have to touch in the first place, at least with your bare hands.
- Cough and sneeze into your elbow or a tissue, and then immediately throw away the tissue and wash your hands.
- Don't stand or sit near people who might be sick. Stay at least one meter – and ideally two meters (six feet) – away. As a quick way to eyeball this distance, imagine that you and the other person both reached your hands towards each other. Could you touch the other person's hand without taking a step towards that person? If the answer is yes, then you're too close.
Other actions include:
- Clean objects and surfaces that a lot of people touch, such as doorknobs, phones, and television remotes with regular household cleaner. Disinfect the surfaces with a suitable disinfectant, such as diluted household bleach.
- Stay home when you are sick, and avoid contact with other people until your symptoms are gone.
- Open windows of rooms and vehicles when possible, for good ventilation and airflow.
- Do not share personal items that come into contact with saliva, such as toothbrushes, eating utensils, drinks, water bottles, and towels.
- The practice of serving yourself from a common plate with your own chopsticks, common in China, should be avoided. Instead, you should use communal chopsticks to prevent contact with saliva.
- Greet people without touching them. Avoid hugs, kisses, handshakes, fist bumps, and any other contact. If it's impossible to avoid contact, then wash your hands both before and after.
- Get a flu vaccine. It won't stop you from catching COVID-19, but it will partially protect you from the flu. This also saves you from unnecessary worry if you get the flu and think it might be the coronavirus. In addition, a bout of flu may leave you vulnerable to a more severe case of COVID-19, and you don't want to end up needing treatment for the flu at a time when hospitals are overwhelmed with COVID.
- If you are elderly or otherwise in a high-risk group and can be vaccinated for pneumonia, get that vaccination. It won't protect you from viral pneumonia from COVID-19, but some COVID-19 patients have died of bacterial pneumonia that attacked their weakened lungs, so a pneumonia vaccination could save your life.
- Take a note of the locations you visit and make sure you complete the location's contact tracing register (if they have one). If someone catches COVID-19, public health officials can use the information to identify those at risk of catching the virus through close contact and requiring them to self-isolate and get tested. Ultimately, the aim of contact tracing is to identify chains of transmission, allowing public health officials to get ahead of the chain and stopping further spread.
Lots of museums, attractions, and even national parks are offering virtual tours, so that would-be visitors cooped up at home can experience them over the internet. Some institutions were already offering virtual tours to begin with; others have worked hard during the crisis to get online visits up and running. Closed performance venues are streaming recordings of past performances. At other attractions, live webcams let you see for yourself what's going on at zoos, parks, and famous tourist sites.
Avoid crowded areas, especially enclosed areas without much air circulation, such as conferences, performances, shopping malls, public transportation, and religious services. Events which involve a large scale gathering of people, from religious pilgrimages to music concerts, are being canceled worldwide, in an effort to contain the spread of the virus. Tourist attractions, businesses, and transportation may be closed. Some canceled events, especially performances, sporting events, and classes, are being moved online, which means you can experience them without traveling.
At petrol/gas stations, use gloves or wipe down the handle with a disinfectant wipe if you can. After filling up, clean your hands with hand sanitizer.
The U.S. and Canadian governments recommend avoiding travel by cruise ship. Infections can spread easily onboard, and on-ship medical care is limited. Amid a cruise ship outbreak, quarantines and docking are challenging partly due to the large numbers of people aboard. Even cruise ships without confirmed cases have been denied permission to dock due to virus fears, and in the high-profile case of the Diamond Princess in Japan, hundreds of people were infected on the ship.
- See also: Flight and health
Before arriving at the airport, make sure you have purchased your necessities in the city. Many airport amenities – like duty-free shops, restaurants, convenience stores, even currency exchange – are closed due to low traveller volume.
On a plane, follow the same hygiene practices as anywhere else: wash hands frequently, or use alcohol-based hand sanitizer if it's not convenient to leave your seat, wear a mask, and avoid touching your face.
Researchers have found that passengers in window seats have less risk of contact with sick people. Avoid moving around the cabin during the flight.
After washing your hands and before sitting down, use disinfectant wipes to wipe down the area around your seat. Wipe hard surfaces, and if your seat is leather you can wipe that too. Don't wipe a cloth seat, as the moisture can make transmission easier. When using disinfectant wipes, follow the instructions on the packaging. And remember, viruses enter through your mouth, nose, and eyes – wiping down the area doesn't hurt, but it's not a substitute for proper hygiene. Wash your hands and avoid touching your face. And use a tissue to touch the touch screen or other controls.
When using the lavatory, use paper towels to turn off the faucet and open the door, then throw them away.
Airlines are taking steps to reduce transmission and keep passengers safe. For instance, these may include cleaning facilities more frequently, allowing or requiring flight attendants to wear masks, and serving prepackaged instead of freshly heated meals. Some airlines require passengers to wear masks and may remove you from the flight if you refuse. If a group of passengers is connecting from an area with a severe outbreak, the flight attendants may be able to seat them away from the rest of the passengers (and if you were recently in a high-risk area, consider telling the flight attendants for this reason). If possible, flights may keep middle seats or alternating rows empty to increase distance between passengers. Some airlines are allowing passengers to cancel if the flight gets above 70% capacity.
You may be prohibited from changing seats on the flight. This is so that, if someone on the flight turns out to be infected, the authorities can track down the people who were sitting near them for testing or quarantine.
Testing and treatment
If you believe you may be infected, call a hospital or local emergency medical services instead of going in person to avoid infecting others. Mention your symptoms and travel history. Wear a medical mask and follow the instructions of authorities and doctors. Don't try to self-medicate with unproven treatments.
Tests are available to see if you are infected with COVID-19. Many of them use a technique called "polymerase chain reaction", so you'll see references to "PCR tests". Countries' testing policies vary: in some places you can only get tested with a good reason (such as symptoms or recent travel), but in other places you can get tested on demand. Testing may be free, covered by insurance, or you may have to pay for it yourself.
Some countries require a recent negative PCR test for travel. The tests are not completely reliable, especially if you take them too soon or too late after infection. That's why quarantine may still be required. Public test facilities (intended for those with symptoms) may be unable to provide tests for travel, make arrangements in advance to get a suitable test on the correct day, with appropriate documentation.
In some countries, the healthcare system has been stretched to the point of not being able to handle the sheer number of patients, and there is a chance you may be refused treatment due to the lack of available medical staff, supplies or equipment.
If you're planning to travel, especially internationally, stay up to date about any pandemic-related restrictions and requirements in your destination, your home country, and any transit stops. Restrictions vary widely and can change frequently.
Passenger registration forms
Some countries and regions require incoming passengers to fill out a form with their personal information, recent travel history, and intended lodging upon arrival. This is to ensure you're aware of any restrictions, to determine whether you need to quarantine, and to make sure the authorities can contact you if another passenger tests positive. In some cases the form must be filled out online before you arrive, so check the official government website a few days before you depart.
Many countries have shut down or severely limited flights, ships, and border crossings, especially to and from severely affected areas. Even more countries have imposed restrictions on arriving travelers, either barring entry (maybe with an exception for local citizens and permanent residents), requiring a negative test result within 72 hours before travel, or requiring you to be quarantined, typically for 14 days and possibly at your own expense. Even if a mandatory quarantine is not imposed, you may be asked to "self-quarantine" by staying at home and not interacting with other people. Many restrictions vary depending on where travelers are coming from or their citizenship or residency, but many countries apply them to all incoming travellers. Some countries have even prohibited all or almost all foreigners from entry. At the very least, expect to be screened and questioned about your travel history and any symptoms.
Some general information about entry restrictions is maintained by the International Air Transport Association (IATA), it doesn't cover all the restrictions, but it's still useful. The most reliable source of restrictions information should be published on each country's foreign ministry or customs and immigration website. For EU countries, the most detailed database/map of up-to-date restrictions is listed on the official website of the European Union. Keep up to date — outbreaks and travel restrictions are changing rapidly.
Your own country's restrictions may prevent you from travelling abroad as well. Some countries' governments are prohibiting their citizens and residents from leaving the country, with exceptions. Even countries that allow citizens to leave may strongly recommend avoiding travel. Some countries have suspended passport renewals and visa applications; even where passport and visa processing continues, it is likely to be delayed. And on top of all that flights have been severely reduced all over the world.
For travel in the near future, consider making refundable reservations in case the changing situation forces you to change your plans. Avoid buying tickets with a connection in an affected area – even changing planes can make you subject to restrictions. Since COVID-19 is now a pre-existing event, travel insurance won't cover you if you have to cancel or change your plans.
Flights, trains, and buses may get canceled with little notice, either due to the disease's spread and ever-changing entry restrictions, or simply because there aren't enough travelers to fill the seats. You might be denied boarding due to a restriction you weren't aware of, or even because the person checking your ticket has gotten the restrictions wrong. And you might also be delayed for hours upon arrival waiting for temperature checks and related procedures and paperwork, or even get quarantined for two weeks. Be prepared for disruption to your travel plans, especially if traveling internationally.
If you are infected with COVID-19, you may be isolated until several consecutive tests for COVID-19 are negative, or until a certain number of days after symptoms have stopped. If you have been in close contact with someone infected with COVID-19, many countries will quarantine you for 14 days since the last exposure and monitor you for signs and symptoms. Some countries will also test you even if you don't have symptoms.
Lockdowns and other internal restrictions
Some countries and regions, especially severely affected ones, have implemented emergency lockdowns and restrictions on people's movements and activities, even for those who haven't recently been abroad. These include the temporary reintroduction of some border controls, restrictions on travel within the country (for instance, mandatory registration or quarantine upon arrival in some states or provinces), closing or limiting service at restaurants and other establishments, banning large public events, and in the most severe cases prohibiting people from leaving the house except for essential reasons. Beyond government restrictions, individual establishments have shut their doors and cancelled events to try to reduce the spread of the virus.
With lots of flights canceled, warnings issued, and restrictions imposed, flying in the time of coronavirus can be a challenge. Some routes are not possible. Others will require more inconvenient connections than usual—multiple stops and long waits between flights. In some cases that means more expensive tickets.
On the other hand, the good news is that many flights are cheaper than usual due to decreased demand, and there's a decent chance you'll get an empty seat next to you.
Build in extra time for your connections, especially if transferring from an international flight to a domestic flight and especially if your itinerary involves a country that has stringent restrictions. Screenings, temperature checks, extra paperwork, and the associated waiting around can add minutes or hours before you're allowed to continue on your journey.
You may find it harder than usual to buy a ticket to or from a destination subject to warnings and restrictions. For instance, most aggregators are not selling tickets from China to the United States (presumably to avoid falling afoul of restrictions and being on the hook for a passenger's flight out). To buy a ticket for an itinerary like this, you may have to contact the airline or use a lesser-known aggregator. Another possibility is to buy two separate tickets (for instance, a ticket from China to Cambodia and a second ticket from Cambodia to the U.S.), but be careful you won't get quarantined or lose your luggage in between.
Connecting flights can be a problem. The risk of getting stuck in the connection city is higher than usual right now, due to delays for screening and testing as well as extensive cancellations. Connecting in an affected area may lead to entry restrictions later on, and if you've been in an affected area recently some countries won't even let you change planes. On certain itineraries there is a risk of getting quarantined somewhere along the way. So book a non-stop flight if you can, and if not, think carefully about where to connect. Avoid short layovers.
Once your ticket is booked, monitor the reservation in case your flight gets cancelled. Airlines are drastically cutting back flights, and flight cancellations have become common. If your flight is cancelled, contact your airline or travel agency. Depending on the route, another flight the same day may not be available, or not in the same price range, so you may have to reschedule for a different day. No small number of travellers have been stranded by widespread cancellations.
In uncertain times, plans can change. Consider buying refundable tickets.
Many embassies and consulates have evacuated nonessential staff, and some have shut down operations completely. Emergency assistance should still be available, though it's possible you may have to contact a further-away consulate if your local one has shut down. If you have been stranded due to the pandemic, your nearest consulate may be able to help you find a flight home, arrange an emergency loan so you can buy a ticket, or provide an emergency passport. At the very least they can keep you informed about the local situation and notify you about recently introduced travel requirements and restrictions.
Ordinary consular services such as visa and passport processing may be suspended or restricted to urgent need, depending on the location and the consulate.
Although some people call the disease "Wuhan pneumonia", "Wuhan disease", or "Chinese virus", the use of these terms is considered racist in China and by many people of Chinese origin. It is still common to refer the disease as "Wuhan pneumonia" or "Chinese virus" in places like Hong Kong and Taiwan. In the United States, the choice of name has political connotations. To be safe, use location-neutral terms when referring to the disease, such as "COVID-19", "coronavirus", or just "the virus" or "the pandemic".
Many areas that have ordered restaurants to be closed to dine-in customers allow them to serve takeaway and delivery customers. In countries where tipping is common such as the United States and Canada, tip more generously than usual, due to the heightened risk for delivery personnel, and tip electronically when possible to avoid possible contagion. Where dine-in service is allowed, keep your mask on when the server is at your table, and wait for them to walk away before you take the mask off and start eating.
Particularly in developing countries where law enforcement are poorly trained, enforcement of curfew, lockdown or stay-at-home orders are often brutal, often using forces not proportionate against crowds. Comply with these orders, and avoid crowds in public.
As a result of the coronavirus pandemic, xenophobia has risen in many countries, primarily but not exclusively targeting people perceived to be Chinese. There has been a worldwide spike in racist incidents targeting people of East Asian origin, including physical assaults, and including in major cities such as New York, London and San Francisco.
In Hong Kong, Sinophobia, which was already high to begin with, has intensified as a result of the pandemic, with the result that many shops and restaurants are now denying service to mainland Chinese customers and banning Mandarin speakers from their premises (with the exception of Taiwanese).
Levels of xenophobia have also risen in Asia, with some restaurants, hotels, and other businesses in China, Japan, and India refusing service to foreign customers. In China, discrimination is particularly severe against black people, with some having been evicted by their landlords.
Government travel advisories
Sources for further information on the coronavirus outbreak include:
- World Health Organization
- The US government Centers for Disease Control and Prevention
- European Centre for Disease Prevention and Control (daily updates)
- An online map and dashboard from the Johns Hopkins University Center for Systems Science and Engineering with live updates
- Partial list of entry restrictions from IATA
If you're abroad, your country's embassy is also a source of information about the local situation and travel restrictions. The embassy website may have a dedicated COVID-19 page, and now is an excellent time to register with the embassy for email updates. In particular, a lot of British and American embassies are maintaining detailed information in English about local restrictions, which might be worth checking even if you're not an American or British citizen.
A variety of misinformation and conspiracy theories about the virus are being promoted online and even by some government officials, so be careful which sources you check for information. Ensure that all information and advice you receive has been backed by reputable doctors and scientists.
In a crisis, it's natural to want to keep following the latest updates, but it may be better for your mental health to moderate the amount of news that you look at. If you normally watch the news twice per day then stick to this schedule and do something else, rather than having the 24-hour news on continuously.