Coronavirus: Answers to travellers' questions

An arriving passenger has his temperature checked at Changi Airport, Singapore. Photo / AP

The coronavirus outbreak that has sickened almost 75,000 in China and killed more than 2,000 worldwide has upended travel and commerce across the world. In light of the spread of the disease, which has been named COVID-19, would-be travellers to Asia and even parts of the world with few or no cases are wondering what to do.

The New York Times asked readers for their most pressing questions and got a flurry of queries: Should I cancel my trip to Asia, despite the financial penalties? Or go ahead? What about going to other parts of the world? How hard is it to disinfect an airplane, anyway, and is a mask enough to protect from the virus?

For anyone planning to travel, the website of the World Health Organisation is a good starting point. (The WHO has been issuing daily updates about the spread of COVID-19 and the status of cases.) The Centers for Disease Control and Prevention, which has advised Americans to cancel all nonessential travel to China, also offers information and guides for travellers.

In addition to those agencies, travellers should consult the websites of their home country and their intended destination to see what policies have been put in place.

"You should also be double careful to do the things we say everyone should always do, like hand washing with soap and water, especially after touching surfaces or coming in contact with someone who has been coughing," said David Eisenman, director of UCLA's Center for Public Health and Disasters and professor of community health sciences at the university's Fielding School of Public Health. "You should be avoiding close contact with others if you're sick, and you should have your flu shot."

Here are some of the most common questions and the current advice from health and travel experts. Questions have been combined and condensed for clarity.

Q: I have a trip planned that is not to Asia. Is it safe to go?

A: Readers asked about destinations thousands of kilometres from Wuhan, China, where the coronavirus outbreak started, including Ireland, Argentina and Vancouver, British Columbia (the last city made one traveller nervous because of its close ties to China).

Eisenman and other doctors said that from a medical standpoint, there isn't any current reason to skip a trip to a country where few or no cases of the coronavirus have been reported.

"You have to evaluate your trip week to week, if not day to day," said Bernard Camins, medical director for infection prevention at the Mount Sinai Health System. "But if you're looking at a place where there are no cases, there's no question you should continue on your trip." (Camins has trips to Europe planned for this spring and is not cancelling).

The question becomes more difficult the closer to the heart of the outbreak you are planning to travel, Camins said. In places like Singapore and Thailand, there have been cases, but there is no evidence that there is a lot of person-to-person transmission, and the virus doesn't seem to be out of control, he said. "The chances of you running into a person with it there is low, unless you're a health care professional and you're going to work in a hospital," he said.

He added, "The golden rule for travel right now should be this: If you're the one who is sick, stay home, do not travel, wear a mask, even for the flu."

Steve Kuriga, an independent travel adviser at Cadence, a San Diego agency affiliated with the Virtuoso network, said, "It's a personal decision, but unless you're going through an infected area I don't see any reason to put off your travels."

Kuriga added that he has clients who are looking at South America as an alternative to Asia for an upcoming trip because no cases of COVID-19 have been reported there.

Q: I have a trip planned to Vietnam in April. What is the situation in that country?

A: There have been 16 confirmed infections, no deaths, 14 recoveries and 1,538 quarantined cases in Vietnam. The country's prime minister officially declared COVID-19 an epidemic in Vietnam on February 1, and authorities closed land borders with China, indefinitely stopped flights to and from China, and instituted a 14-day quarantine for anyone coming from affected areas in China. The government is also encouraging people to avoid public gatherings at the moment.

Although some cities that have registered infections have closed tourist attractions and heritage sites, the majority are still open to the public. Many festivals and events are going on as planned, but others have been postponed. For a detailed list, consult Vietnam's tourism site, which has detailed information about traveling to the country.

Q: What about Cambodia?

A: Until recently, Cambodia said it had only one case of the coronavirus, and Prime Minister Hun Sen made a point of not wearing a surgical mask in public. But then a passenger on the Westerdam, a Holland America Line boat that had been blocked from docking in five countries over fear of the virus, was diagnosed with COVID-19 after disembarking from the ship in Sihanoukville, Cambodia, throwing into question how well the virus was being contained.

The US State Department has a Level 1 warning about traveling to Cambodia, which means that in its assessment there is currently no danger in traveling to the country. You can keep up to date with the department's advisories at its website.

Q: Can I go to Japan?

A: Japan has reported more than 700 cases of coronavirus, with 621 of them coming from the Diamond Princess cruise ship, which has been quarantined in Yokohama; two passengers on the ship have died. Japanese authorities allowed a number of people from the ship to leave, a decision that some health experts have questioned.

The CDC has a Level 1 watch for coronavirus in Japan, which advises travellers to "practice usual precautions."

Since February 13, non-Japanese nationals who have visited Hubei and Zhejiang provinces in China within 14 days of arrival in Japan, or who have a Chinese passport issued in those provinces, are not allowed to land in Japan except under special circumstances.

Japan's National Tourism Organization is advising travellers that medical expenses may be high in the event that you become sick or injured and need to go to the hospital in Japan. "Please do not forget to take out the necessary travel insurance," the tourist board said in a statement on its website. It is also encouraging tourists to take the same precautions people take during flu season when traveling.

Tourists wearing face masks line up to a departure gate at Bali airport, Indonesia. Photo / AP

Q: What's happening in South Korea?

A: South Korea has 104 infections, 53 of which were added Thursday, nearly doubling the number from the day before. The mayor of the city of Daegu asked residents to stay indoors after several people associated with a church contracted COVID-19. On Thursday, authorities announced the first death in the country, and the US Army Garrison Daegu restricted access to its base, according to a statement.

Currently, the CDC has no advisory for South Korea, according to its site.

Q: I am scheduled for a layover at Singapore's Changi Airport. Is that a problem?

A: As of Wednesday, Singapore had 84 cases of coronavirus, but transiting through the airport is unlikely to bring travellers in contact with any of the sick. Earlier this month the airport implemented rules to help keep the virus at bay. Anyone who has travelled to mainland China within 14 days of arriving at Changi is not allowed to enter Singapore or to travel through it. Additionally, Singapore's Immigration and Checkpoints Authority suspended the issuance of new visas to people with Chinese passports. The airport also said it increased the frequency with which the airport is being cleaned and is using more disinfectants in the cleaning process.

Kuriga said that in his estimation, "Right now it's safe to travel through there, but like with everything else, keep checking."

Q: Do airlines sanitise planes between flights? Are they instituting any new policies?

A: Planes are small spaces with a lot of people on them and can be involved in transmitting diseases. While it's not clear if most airlines are changing their cleaning procedures because of the coronavirus, we do know how they typically clean airplane cabins.

"At Southwest, aircraft undergo regular cleanings in between flights and a comprehensive cleaning when the aircraft is parked overnight," a spokesman for the airline said. When the plane is cleaned, surfaces — including tray tables, seats and carpets — are cleaned.

Curtis Blessing, a spokesman for American Airlines, said planes are cleaned on a regular basis and the depth of the cleaning varies depending on turn times and type of flight, but bathrooms are cleaned, floors are spot-cleaned and visible trash is removed from seat pockets on all flights.

"When ground time allows, galleys are cleaned, as are tray tables," Blessing said. "Transcontinental, Hawaii and international flights see an even deeper level of cleaning that includes cleaning of lavatories, tray tables and galley areas as well as any surface areas throughout the aircraft. Floors are also vacuumed."

Delta is supplying kits with hand sanitiser, gloves and surgical masks to passengers on all flights to and from Asia. A Delta spokeswoman said the airline's planes are "thoroughly cleaned for the safety of our customers and crew."

A spokesman for Alaska Air said that bathrooms on the airline's planes are cleaned between every flight, and tray tables are cleaned when a layover is longer than an hour. A thorough cleaning of the plane happens whenever a plane stays at an airport overnight.

"Our existing cleaning and disinfecting chemicals are effective against viruses, and nothing about the novel coronavirus indicates that it's resistant to these efforts," he said.

Q: What about a cruise ship?

A: Cruise lines have learned how to combat the norovirus after more than two decades of outbreaks, but some passengers still get sick.

Ross Klein, a sociologist at Memorial University of Newfoundland who studies the cruise industry, said, "The cruise ships are well trained in 'killing' a virus and are quite proficient if they follow what they know and the protocols they have for norovirus."

Those protocols don't seem to have been followed on the Diamond Princess, the cruise boat that was quarantined in Yokohama, Japan, for two weeks and had 621 sick passengers, he said. The quarantine has been criticized by experts for failing to keep COVID-19 from spreading between passengers and crew members, and two passengers on the ship have died. "But that doesn't mean the ship can't be sanitized before taking on new passengers," Klein said. "It is no more difficult than a land-based hotel."

Bus carrying the passengers from the quarantined Diamond Princess cruise ship leave a port in Yokohama. Photo / AP

Q: Is a mask sufficient to protect me on an airplane?

A: The WHO said that if you are healthy, you only need to wear a mask if you are taking care of someone with a suspected coronavirus infection. The organization also suggests wearing the mask if you are the person sneezing or coughing.

"Masks are only effective when used in combination with frequent hand cleaning with alcohol-based hand rub or soap and water," the organization said in its guide about how to best choose a mask, use it and dispose of it.

The type of mask also makes a difference. An N95 mask reduces a wearer's exposure to airborne particles, from small-particle aerosols to large droplets, according to the CDC, which has a guide for understanding the differences between a regular surgical mask and an N95 respirator.

Q: My flight has been cancelled, but my travel insurance won't pay. How, in the middle of a medical crisis, could that not be considered a qualifying event for travel insurance?

A: Bizarre as it may sound, standard travel insurance doesn't cover losses caused by a global health crisis — even one that's been declared "a public health emergency of international concern" by the WHO and for which the CDC has issued a Level 3 travel notice recommending that travellers avoid all nonessential travel to China.

When it comes to travel insurance, so-called Cancel For Any Reason upgrades are the best course here. But they're also very expensive and tend to cover only 50 per cent to 75 per cent of your trip, said Stan Sandberg, an industry expert and co-founder of TravelInsurance.com, a site that allows travellers to compare and buy travel insurance online.

"It's important to note that with Cancel For Any Reason coverage, the insurance policy must be purchased within a set amount of days — usually 21 days or fewer, depending on the plan — after making the first payment for the trip, and the entire prepaid and nonrefundable cost of the trip must be insured. The trip must also be cancelled more than 48 hours before the departure date," Sandberg said.

At Berkshire Hathaway Travel Protection, for example, CFAR coverage costs an additional 40 per cent of your total travel insurance premium.

The risk-reward ratio will vary by traveller. In addition to ratings and reviews of specific policies, TravelInsurance.com's information about the claims process — and their respective outcomes — may be helpful in determining whether or not CFAR coverage is worth the outlay.

Q: My credit card provides travel insurance. Will that actually do anything for me?

A: The short answer: Not really.

Trip cancellation and interruption insurance, designed to reimburse certain nonrefundable expenses when a trip is cancelled or delayed, is a perk of many travel-focused credits cards, including American Express Platinum and Delta SkyMiles Reserve as well as both Chase Sapphire cards (Preferred and Reserve).

But what's actually covered varies, and health crises are particularly unforgiving to consumers. Chase Sapphire cards, for example, will only reimburse you if you're quarantined "due to health reasons by a competent governmental authority having jurisdiction" — but not a "disinclination to travel due to an epidemic or pandemic." In other words, if you choose not to travel — even to quite reasonably avoid a region affected by the coronavirus — trip cancellation and interruption insurance won't help. American Express doesn't have explicit epidemic inclusions (or exclusions), but cardholders might have luck claiming reimbursement by getting a doctor's note stating that "a covered trip is medically inadvisable."

Q: What if I'm immune-compromised and have a doctor's note to that effect. Still no refunds?

A: Older adults and people with underlying health conditions may be at increased risk for severe disease. According to medical experts, many of those who have died in the coronavirus outbreak had preexisting conditions that weakened their ability to fight it. Travellers with an immune-suppressed system should talk to their health care providers before traveling.

Kuriga, the travel adviser in San Diego, said that it's a good idea to reach out to a travel agent or the travel company you booked a trip with because some companies might be flexible in their cancellation and refund policies.

"Not all companies are coming up with broad policies," he said. "Some companies are dealing with it on a case-by-case basis."

Q: I am planning to go to Japan. If I decide to travel anyway, what is the best way to arrange for medical assistance if I need it?

A: The simplest precaution is to purchase medical travel insurance — in particular, a primary-coverage plan that substitutes for your existing US health insurance while you're abroad. Look for hefty emergency medical coverage (at least US$50,000, according to most experts) and emergency medical transportation coverage (upward of US$100,000, depending on how remote your destination is). Deductibles, waivers for preexisting conditions and pricing vary by a number of factors; you can comparison-shop on TravelInsurance.com, Squaremouth and a host of other sites.

Written by: Tariro Mzezewa and Sarah Firshein
Photographs by: Adam Dean
© 2020 THE NEW YORK TIMES