By Forrest Brown and Marnie Hunter | CNN
For the third week in a row, the US Centers for Disease Control and Prevention has not added a single new destination to its highest-risk Tier 4 category for travel.
In fact, seven destinations in Asia and the Caribbean have moved to the CDC’s lowest-risk category for travel during the pandemic, which is Tier 1. On Monday, island getaways entered that enviable ranking. The Philippines and Saint Kitts and Nevis.
But much of Europe – including its popular travel engines – has remained stubbornly lodged in Level 4.
Take the UK, for example. It has been in Level 4 since July 19, 2021. This puts England, Scotland, Wales and Northern Ireland in the ‘very high’ risk category for Covid-19.
The CDC designates a destination as a Level 4 risk when more than 500 cases per 100,000 population been recorded in the last 28 days.
CDC: avoid Tier 4 destinations
It’s not just the UK. Many of the big names in Europe remain in Tier 4 as winter lifts and the spring travel season begin. On April 11, this list included the following locations:
• France• Germany• Greece• Ireland• Italy• Malta• Netherlands• Portugal• Spain
However, it’s not just Europe that has highly visited destinations stuck at Tier 4 for now.
In Asia, Hong Kong, South Korea and Thailand are at Level 4. In South America, Brazil and Chile are still in the highest risk category. The same goes for the lush Central American getaway of Costa Rica. Other favorites awaiting a higher rating from the CDC: Aruba, Australia and Bermuda.
Yet the general trend in the level of risk has been downward for much of the world in recent weeks, and Africa in particular has seen its risk assessments plummet.
By the end of February, the number of spots at Level 4 increased to over 140, illustrating Omicron’s wide range and rapid spread. But on April 11, that number dropped to around 90 destinations. This is less than half of the approximately 235 places monitored by the CDC.
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 in a destination.
The CDC does not include the United States in its advisory list, but it was color-coded to Level 3 on April 11 on the agency’s travel risk levels map.
You can view the CDC’s risk levels for any global destination on its travel recommendations page.
In its broader travel advice, the CDC recommended avoiding all international travel until you are fully immunized.
Few changes at level 3
The Tier 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 just two additions on Monday. They were:
• Egypt• Saint-Martin
Both were previously at level 4.
People who want to take a trip to Europe but want to avoid the most risky destinations have only a few choices here: Albania, Bosnia and Herzegovina and Kosovo, all located in the Balkan Peninsula, or Armenia, in the Caucasus mountain region.
Destinations with the designation “Level 2: Moderate Covid-19” have recorded 50 to 99 cases of Covid-19 per 100,000 population in the past 28 days.
The only new Tier 2 entry on April 11 is Guyana, a small nation in the northern part of South America that sees few international visitors. Guyana was at level 3.
In a sign of hope for travelers, Level 1 has seen the most movement.
To be at “Level 1: Covid-19 low”, a destination must have registered fewer than 50 new cases per 100,000 inhabitants in the last 28 days. Seven places moved to level 1 on Monday:
• Bangladesh• Haiti• Burma• Philippines• Saint Kitts and Nevis• Saint Vincent and the Grenadines• Saudi Arabia
The largest moves were from Haiti, Myanmar, and Saudi Arabia, which were in Tier 4. Saint Vincent and the Grenadines was in Tier 3, and the rest went down from Tier 2.
Most Tier 1 destinations are in Africa, including Ghana, Kenya, Morocco and Senegal.
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 category on Monday:
•Burkina Faso• Faroe Islands• Madagascar
Burkina Faso was at level 1 and the other two at level 4.
The Azores, Cambodia, Macau, and Tanzania are among the locations 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 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 in mid -february.
“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. It’s 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.
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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