CDC adds 1 destination to ‘very high’ risk category for travel

By Marnie Hunter and Forrest Brown, CNN

The US Centers for Disease Control and Prevention added just one new destination, the Indian Ocean island nation of Mauritius, to its highest-risk category for travel on Monday.

The weekly travel risk-level update brought good news for islands clustered in and around the Caribbean Sea with nine destinations — including the Bahamas, Jamaica and the Dominican Republic — dropping down one rung from Level 4.

The CDC places a destination at “Level 4: Covid-19 Very High” risk when more than 500 cases per 100,000 residents are registered in the past 28 days.

Mauritius, located off the eastern coast of Africa, recently logged a 180% increase in weekly cases, according to World Health Organization figures. Located about 700 miles (1,100 km) east of Madagascar, Mauritius had previously been on Level 3.

Last week, Hong Kong, New Zealand and Thailand were added to Level 4.

To recap, just one destination was added to Level 4 on March 14:

• Mauritius

After declines in global cases since the end of January, WHO logged an uptick in cases worldwide for the week of March 7.

CDC: Avoid Level 4 destinations

There are about 125 destinations currently at Level 4. While the number of places in the “very high” risk category has dipped since topping around 140 in February, there are still more places in the Level 4 category than in all the other categories combined.

The CDC advises avoiding travel to Level 4 countries. CDC 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 list of advisories, but it was color-coded at Level 4 on March 14 on the agency’s map of travel risk levels.

Tourist favorites stalled on Level 4 include Aruba, Brazil, Canada, Egypt, France, Greece, Peru and Spain. The United Kingdom 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 guidance, the CDC has recommended avoiding all international travel until you are fully vaccinated.

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 residents in the past 28 days — saw nine additions on Monday — all islands clustered in the Caribbean and Atlantic. They were:

• Cuba
• Bahamas
• British Virgin Islands
• Dominican Republic
• Jamaica
• Saint Kitts and Nevis
• Saint Vincent and the Grenadines
• Sint Maarten
• Turks and Caicos Islands

They were all previously listed at Level 4.

Levels 2, 1 and unknown

Destinations carrying the “Level 2: Covid-19 Moderate” designation have seen 50 to 99 Covid-19 cases per 100,000 residents in the past 28 days. The four new entries to Level 2 on March 14 are:

• Cruise ship travel
• Gabon
• Kyrgyzstan
• Zambia

They were all previously listed at Level 3. Cruise travel previously dropped from Level 4 to Level 3 in mid-February and is now considered “moderate” risk at Level 2.

To be in “Level 1: Covid-19 Low,” a destination must have fewer than 50 new cases per 100,000 residents over the past 28 days. Eleven places moved to Level 1 on Monday:

• Angola
• Burkina Faso
• Comoros
• Djibouti
• Equatorial Guinea
• Liberia
• Mali
• Mauritania
• Saba
• São Tomé and Príncipe
• Senegal

The only destinations now listed at Level 1 outside of Africa are China, Taiwan and the small Caribbean island of Saba.

Finally, there are destinations for which the CDC has an “unknown” risk because of a lack of information. Usually, but not always, these are small, remote places or places with ongoing warfare or unrest. The CDC made no new additions to the category on Monday.

Tanzania, Cambodia and Macau are among the more-visited locations currently listed in the unknown category. The CDC advises against travel to these places precisely because the risks are unknown.

A medical expert weighs in on risk levels

Transmission rates are “one guidepost” for travelers’ personal risk calculations, according to CNN Medical Analyst Dr. Leana Wen.

“We are entering a phase in the pandemic where people need to make their own decisions based on their medical circumstances as well as their risk tolerance when it comes to contracting Covid-19,” Wen said in mid-February.

“You should interpret Level 4 to mean this is a place with a lot of community transmission of Covid-19. So if you go, there is a higher chance that you could contract the coronavirus,” said Wen, who is an emergency physician and professor of health policy and management at the 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 am vaccinated and boosted, I am willing to take on that risk.’

“So this really needs to be a personal decision that people weigh understanding that right now the CDC is classifying the different levels based on community transmission rates, and basically only that,” Wen said. “They’re not taking into account individual circumstances.”

More considerations for travel

There are other factors to weigh in addition to transmission rates, according to Wen.

“The transmission rates are one guidepost,” Wen said. “Another is what precautions are required and followed in the place that you’re going and then the third is what are you planning to do once you’re there.

“Are you planning to visit a lot of attractions and go to indoor bars? That’s very different from you’re going somewhere where you’re planning to lie on the beach all day and not interact with anyone else. That’s very different. Those are very different levels of risk.”

Vaccination is the most significant safety factor for travel since unvaccinated travelers are more likely to become ill and transmit Covid-19 to others, Wen said.

“People who are unvaccinated remain at high risk and really should not be traveling at this point,” she said.

People should be wearing a high-quality mask — N95, KN95 or KF94 — anytime they’re in crowded indoor settings with people of unknown vaccination status, she said.

And it’s also important to consider what you would do if you end up testing positive away from home. Where will you stay and how easy will it be to get a test to return home?

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Top image: Flic en Flac beach on the western coast of Mauritius on November 3, 2021. (Photo by Laura Morosoli / AFP via Getty Images)