Many of us have been itching to resume travel but are unsure of how to do it safely. The pandemic is unpredictable but there are several things you can do to make your trip safer and provide peace of mind. This article discusses how to plan for the unexpected Covid-19 illness while traveling.
This article is not meant to provide medical advice but rather general education regarding travel during the pandemic. Consult your physician regarding your personal risk and health related questions.
Disclaimer: This article is provided for general information purposes only and is not intended to constitute medical or other professional advice. You should obtain professional advice before taking, or refraining from, any action on the basis of the content in this publication. Deskless Nomad makes no representations, warranties, or guarantees, whether express or implied, that the content in the publication is accurate, complete, or up to date. Please see the full Deskless Nomad Disclaimer.
Know your personal risk before you book your travel
Many people don’t know that they are at increased risk of contracting Covid-19. Traveling as a high risk person is a deeply personal decision. You will want to weigh the reasons for your travel with your personal risk as well as many of the other factors listed in this article. Having certain medical conditions could mean you are at higher risk of being hospitalized or dying from a Covid-19 infection. Consult your physician to discuss your questions regarding your personal risk. You can find the list of conditions that increase the risk for hospitalization and death on the CDC website.
Know if Covid-19 treatments are available where you are traveling
Finding out if monoclonal antibodies, remdesivir and other covid-19 treatments are available where you are traveling can be complicated. Having any of the high risk medical conditions means you could be eligible for monoclonal antibodies to help you fight the infection and avoid hospitalization. The efficacy and availability of Covid-19 treatments is rapidly changing as new variants emerge, pharmaceutical companies introduce new medications, and supplies wax and wane.
Bamlanivimab combined with etesevimab is a monoclonal antibody treatment used to help prevent hospitalization in high risk people who contract the Covid-19 virus. The FDA lists the US states and territories where bamlanivimab is available. According to the Lilly website, bamlanivimab administered with etesevimab is currently available under emergency pathways in 15 countries around the world as of December 2021. Even government officials, like GOP state Senator Doug Erickson, had trouble acquiring monoclonal antibody treatment while traveling abroad in El Salvador and had to be evacuated to Florida.
Remdesivir is used to treat patients with Covid-19 who require hospitalization. Gilead, the manufacturer of remdesivir lists the countries where the medication is distributed however the actual supply within each country will be variable.
Know the level of Covid-19 community transmission at your destination and any stopovers
The CDC has a map showing covid case levels around the world. On the same page you can find their travel (avoidance) recommendations for each country based on a 4 tier risk system.
Check the Covid-19 related travel restrictions, vaccine, and mask requirements for your destination and return trip
On United’s website you can see which countries are open for travel. They have interactive maps of the USA and world countries where you can find travel restrictions and destination requirements for Covid-19 vaccination, testing, quarantine, proof of health insurance, and face masks. Check with your airline for additional guidance about vaccine requirements for entry and exit at your destination.
If your destination requires vaccination, plan ahead to make sure you received your last required dose no less than 2 weeks before you leave
The definition of “fully vaccinated” may change as new variants emerge and require booster shots. Previously, if you had two doses of an mRNA vaccine like Pfizer or Moderna, or one Johnson and Johnson vaccination, you were considered fully vaccinated. Now that we know that immunity wanes after 6 months, the definition of fully vaccination may change to include one or more booster shots. If you are eligible for a booster, get it at least 2 weeks before your trip since it takes 2 weeks to get the full effect of the booster. Talk to your doctor to determine if you are eligible for additional booster vaccinations.
Make sure your travel health insurance covers Covid-19 treatment, quarantine, and emergency evacuation
Not all travel insurance plans cover for Covid-19 related travel and health issues. Check the terms and conditions of your travel insurance or speak to a representative to make sure you would be covered for treatment and possible emergency evacuation if you contract Covid-19 while traveling. Also make sure that any additional quarantine costs would be covered in case you find yourself having to quarantine in a hotel for 10-14 days at any point during your trip before you are allowed to return home. Imagine finding yourself having to pay for an additional 10-14 days in a hotel at the end of your trip! Check out the Forbes list of the best pandemic travel insurance plans for 2022.
If you are taking a cruise, make sure your travel health insurance covers your specific travel needs which may differ from a traditional traveler. Cruise specific polices may include reimbursements for returning home early, shipboard disruption, missed excursions, missed connections, and ship to shore coverage if you are too sick to stay on board.
Some airlines also started providing free Covid-19 insurance in 2021 as an incentive to get people flying again. For example, Etihad, Emirates and, Cathay Pacific were providing insurance that covered the cost of testing, an allowance for quarantine, hospitalization, and evacuation. Check with your airline to see if they are currently offering this insurance.
Download your travel health insurance app
Many travel health insurance companies have apps that help you find local healthcare providers who speak English and can help you navigate the local health care system. The healthcare providers listed are also more likely to accept your travel insurance immediately instead of requiring you to pay for treatment in cash (and then submitting to your travel health insurance company to get reimbursed). For example, GeoBlue has an excellent app for BlueCross BlueShield customers to find healthcare providers overseas.
Consider an emergency cash fund to pay for healthcare
Make sure you have some cash easily accessible to avoid barriers to getting treatment if you are required to pay cash for healthcare up front in a foreign country.
Google hospitals in the general area you will be traveling
Knowing where the local hospitals are located ahead of time can help relieve anxiety if you find yourself needing medical care while traveling. This applies not only to Covid-19 but any illness or injury that occurs during travel. Some of most common injuries sustained while traveling are caused by tripping, traffic accidents, sports, slipping on wet surfaces, snake bites, and any activity undertaken while consuming alcohol.
Use google maps to type in your destination plus the word, “hospital.” Locations that are designated with pink on the map are more likely to be larger hospitals or tertiary care centers. If you are staying in a hotel you can ask your hotel reception or concierge for assistance. If you are staying in an Airbnb or other vacation rental you can still try asking for information at a nearby hotel reception or concierge, even if you aren’t staying at that hotel. Some visitors bureau websites will also list local hospitals and clinics.
Know the local emergency services phone numbers
Know the equivalent of the “911” phone number for your destination. Wikipedia has a list of emergency numbers organized by continent for countries around the world. Emergency numbers in any individual country may be different for each of the ambulance, police, and fire services. Write the numbers down on a piece of paper to keep in your purse or wallet in case your cell phone batter dies and you have to use a landline.
Bring your medications in your carry on
Don’t risk losing your medications if your luggage doesn’t make it to your destination. Keep your medications with you in your carry on bag. Make sure you are bringing a sufficient amount of your medication to last for your trip and an additional 10 or more days in case you are required to quarantine before departure home. Obtaining prescription refills abroad is often difficult, time consuming and can be costly. Your destination may not even have your specific medications available so make sure you bring what you will need. It is better to bring your medications in the original bottles for easy identification if your bag is searched by TSA or border patrol. You can dispense them into your weekly pill boxes once at your hotel.
Bring a list of your medications and medical conditions
If you take any medications, prescribed or over the counter, bring a list of these medications on your trip. Keep a small printed copy in your wallet as well as a photo of the list in your smartphone. If you find yourself trying to communicate with a foreign physician about your medications it will be much easier for them to read your list. Patients often do not know how to pronounce their own medications which can make it difficult for physicians to identify the medications. If you have a printed list, your physician in another country can at least google the names to find out the medication class and determine the locally available equivalent.
Similarly, bring a list of your medical conditions and past surgeries (or have them readily available on a digital health app). It can be difficult to remember your past medical history during a medical emergency. You may not know what medical history your physician will find relevant to your condition.
Sign up for your digital health records through your local clinic or health care organization
Many hospitals now provide easy access to your medical records and test results online through apps like MyChart. Enroll for access before your trip to give any physician a way to quickly and easily review your medical history on your phone in the event of a medical emergency.
Discuss your code status with your loved ones
Your code status describes measures you would like doctors to take in the event that your heart stops beating or you need to be put on artificial life support. For young people this is an easy decision, but older travelers may have different wishes about end of life care. If you are an older traveler, make sure your travel companion knows what your wishes would be.
Bring a pulse oximeter
If you get Covid-19 while traveling there is one tool in particular that can help you monitor your condition. A pulse oximeter is a small device placed on your finger that allows you to monitor your oxygen level. It can be used in conjunction with a telehealth visit for your doctor to evaluate you remotely. You can purchase a simple pulse oximeter from most drugstores or online for around $15.
Upgrade your mask
Upgrade your cloth mask to a KN95 or N95, especially for use while in enclosed spaces like airports, airplanes, trains, and buses. These masks will improve your protection over typical cloth masks. Masks come in various sizes so make sure you have ones that fit all of your party members, including children and smaller adults.
Bring some at-home rapid tests
Now that at-home rapid tests are available at your local pharmacy, bring some tests on your trip so that you can quickly and easily test any members of your travel party if someone starts to show symptoms.
If you are unable to bring at-home rapid tests, get tested as soon as you or any of your party starts to show symptoms. There is a 10 day window from the day of symptom onset when you might be eligible to receive monoclonal antibodies.
Wash your hands. Bring hand sanitizer and antiseptic wipes
Airplane, train, and bus seats and tray tables are not cleaned as thoroughly as you think. Bring your own antiseptic wipes to clean your space. Wash your hands regularly while traveling. When you don’t have access to soap and water, use your hand sanitizer.
Consider protective eyewear
Although considered to be much less common than getting Covid-19 through the nose or mouth, the eyes are also a portal of entry for the virus. Covid-19 can also cause conjunctivitis or pink eye, an inflammation of the protective tissue lining your eyelids and white part of your eyes. Consider wearing protective eyewear, even just non-prescription lenses or your regular prescription lenses, when in public.
Use your private hotel or vacation rental toilet rather than public toilets as much as possible
While you shouldn’t torture yourself by resisting the urge to go to the bathroom in public, make an effort to use your private hotel or vacation rental toilet prior to going out. This will help you avoid the need to use public bathrooms that are higher risk areas for transmission.
Fly during times of low travel volume and avoid high travel volume days around holidays
Travel volumes tend to spike from roughly December 20 to January 3, around President’s Day holiday weekend, the month of March due to Spring Break, around the July 4 holiday weekend, from the Wednesday before Thanksgiving to the Sunday after, any time on a Monday or a weekend, and Fridays in the summer. Consider planning your travel to avoid these high volume times and the associated crowds.
Choose accommodations with private outside entrances rather than communal lobbies
The less you have to be in an enclosed space with other people the better. Even the relatively large areas of hotel lobbies and hallways can be areas of transmission. There have even been reports of people getting infected in rooms across the hall in quarantine hotels in New Zealand. Hotel brands that often have exterior corridors with outside room entrances include Red Lion, Signature Inn, America’s Best Value Inn, Knights Inn, Motel 6, Super 8, and Marriott Residence. Airbnb, Vrbo, and other short term and vacation rental sites are also great places to find accommodations with private exterior entrances.
See also Deskless Nomad’s Blog Post: Alternatives to Airbnb for Short Term and Vacation Rentals
Consider accommodations that allow you to cook some of your own meals
Many hotel brands offer kitchens as amenities. On your preferred hotel and vacation rental search engines you can filter properties to include accommodations with kitchens. By making your own meals you can avoid potential exposures in restaurants. If you choose to eat at a restaurant, consider eating outside where increased air flow will help to decrease spread of the virus. You can also choose to have your food delivered to you or you can pick up takeaway/takeout meals.
Avoid indoor tourist attractions
Choose activities where you can enjoy the outdoors but still keep your distance from others. Go to outdoor markets, outdoor concerts where you can maintain a distance from others, outdoor cafes with spaced out seating, or botanical gardens. Go on hikes and bike rides, go surfing and snorkeling, and participate in any other sports activities that allow you to keep a distance from others.
Get the appropriate digital health pass for your destination
Contact your airline to find out how to obtain any digital health pass that may be required for your destination. You can also find country specific information for digital health passes on the U.S. Department of State website.
If you test positive while traveling, do not go into public spaces. You could end up fined or in jail
Some countries impose strict punishment and fines for people who knowingly enter public spaces while infected with the virus. Plus, it is just disrespectful and wrong to expose others to a deadly virus. The US Department of State website lists fines and jail time for non-compliance with Covid regulations in each country.
Know the quarantine rules at your destination in case you test positive
The U.S. Department of State website has country specific information regarding quarantine requirements for entry into each country as well as isolation requirements if you have a high risk exposure or test positive while in that country.
If someone in your party gets sick, get a separate room for them to quarantine
You don’t want your entire party to get sick so book a separate room for any sick individuals who need to isolate. The longer you are exposed to someone who is sick, the higher the likelihood you will contract the virus from them.
Be prepared that your travel insurance may only allow the sick individual to extend their stay
If only one member of your party gets sick while traveling, be aware that your travel insurance may not cover the cost of other party members to extend their trip while waiting for the sick person to isolate for the recommended period of time. Check with your insurance to see if the cost of trip extension is covered for additional party members who don’t get sick.
If your wanderlust is pushing you to travel away from home, prepare yourself by reading all about the regulations at your destination ahead of time. Traveling during the pandemic is still complicated. With no clear end in sight for the pandemic we have to find a way to safely live and travel with this new reality. Travel and health recommendations continue to be updated hroughout the pandemic so make sure to check the CDC website for the latest Covid-19 news, treatments, and recommendations before booking your next trip.