What spread of deadly new virus means for travellers

Jan 30, 2020

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Editor’s note: This post will be updated as more information becomes available. It was originally published on 21 January 2020.

There are now five confirmed cases in the United States of the coronavirus strain that has killed at least 170 people in mainland China and infected over 7,700 people. The coronavirus outbreak is now more widespread in mainland China than the SARS outbreak of 2003, which infected nearly 5,327 people, according to CNN.

The Chinese government has confirmed that this strain of the virus can be spread from human to human, which is forcing airports around the world to take precautions. Since the first U.S. case was announced on 31 December, 20 U.S. airports have begun coronavirus screening and created quarantine stations for passengers arriving from Wuhan, China (WUH).

The U.S. Centers for Disease Control and Prevention (CDC) says the new coronavirus generally presents a low risk to U.S. citizens, but the agency is conducting screenings as a precaution. As of 27 January, the CDC confirmed that 73 patients in 26 states are being monitored for the virus. In total, 110 people have been screened, of which 32 have tested negative.

On Wednesday, British Airways suspended flights to and from mainland China. The Foreign and Commonwealth Office’s updated guidelines advise against all travel to Hubei province and encourages those who are still there to leave immediately. The FCO is now advising against all but essential travel to the rest of mainland China (not including Hong Kong and Macao).

We chatted with several experts about what travellers should know about the virus and how you can protect yourself.

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How is coronavirus like SARS?

The coronavirus outbreak sparks memories of the SARS (Severe Acute Respiratory Syndrome) crisis of 2003; this strain and the SARS virus are in the same family of coronaviruses. Nearly 800 people across Asia died because of SARS between 2002 and 2003. Officials were slow to identify and report SARS, which was one of the reasons it was so deadly.

So how is the coronavirus like SARS?

“Both SARS and the 2019 novel coronavirus are types of coronaviruses and are thought to have emerged in humans from a transmission event from an animal carrying the virus”, Dr. Theresa Madaline, hospital epidemiologist and assistant professor of infectious diseases at Montefiore Health System and Albert Einstein College of Medicine, told TPG. “Coronaviruses are a large family of viruses and several known types cause mild respiratory symptoms like the common cold. However, similar to SARS and MERS, the 2019 novel coronavirus can cause more severe lower respiratory disease”. (MERS — Middle East Respiratory Syndrome — broke out in South Korea in 2015.)

(Photo by Jeff J Mitchell/Getty Images)
(Photo by Jeff J Mitchell/Getty Images)

“But it is not clear if the likelihood of human-to-human transmission, the full spectrum of symptoms, mortality or complications are comparable to SARS at this time”, she added.

Who is at risk?

Since the virus is new, it’s not clear who should worry the most about catching it. But in the fatal cases so far, the majority were older adults and those with underlying health conditions.

“Everything is very preliminary and information is changing very quickly”, said Dr. Julie Fischer, a research associate professor in the department of microbiology and immunology at Georgetown University. “What we do know is that the severe cases and the fatalities were with people who had underlying health conditions, particularly older people who have underlying health conditions“.

She added, “I think that’s the other thing we also learned from SARS — that older people who have chronic diseases like heart disease or respiratory disease or diabetes are probably at a higher risk….They should have a higher level of concern and be more prepared to seek medical care if they find themselves developing severe symptoms”.

But she advises that everyone should take precautions when travelling, no matter their age or overall health.

How quickly could it spread?

A sick passenger who is not yet showing symptoms could board a plane in China and be in the U.S. within the likely incubation period for the virus, raising the possibility of more cases being identified in the U.S. But there are still questions about how transmissible this virus is from one human to the next.

“If the virus that has emerged in [Wuhan] follows the same pattern as SARS, we could see a rapid uptick in the number of infected health workers and exposures by ‘super-spreaders’ who have the potential to infect large numbers of people in the absence of prevention measures”, said Dr. Fischer.

“People who’ve been exposed to this novel coronavirus may not know of their exposure or yet have symptoms. So it’s very likely that some of them will get on planes and end up in the U.S. What we’re hoping for right now is that the screening measures will help identify them and make sure that they’re sent for appropriate care”, she added.

Screening measures are already in place at major hubs throughout the U.S. Before travel to and from Wuhan was shut down, passengers travelling from the city to the U.S. were being redirected to one of the five airports conducting screenings. That means a person flying from Wuhan who caught a connecting flight in Shanghai that would have landed in Boston (BOS) would have been rerouted to JFK for screening, CDC officials said.

China has shared the sequence of 2019-nCoV, which will aid the development of diagnostic tests and interventions to help experts predict how the virus is likely to behave.

How to stay safe while travelling

Coronaviruses are a group of respiratory-based viruses transmitted through coughs and sneezes by infected patients and by touching contaminated objects.

The CDC recommends that travellers avoid all nonessential travel to Wuhan. In fact, Chinese officials have closed transportation in and out of the area, including buses, subways, trains and flights.

Preventive measures that travellers can take include sanitizing the airplane seat and the surrounding area with disinfecting wipes, Naomi Campbell-style. Carry and use alcohol-based hand sanitizer and wash your hands frequently.

“You get sick when viruses on those surfaces are introduced to your nose and mouth”, Dr. Fischer said. “So limit that risk by being really conscientious about handwashing”.

(Photo by Steve Parsons/PA Images/Getty Images)
(Photo by Steve Parsons/PA Images/Getty Images)

Also, although it won’t protect against this particular coronavirus, get your flu shot, said Dr. Jesse Goodman, a professor of medicine and director of the Center on Medical Product Access, Safety and Stewardship. “It’s not too late to reduce your risk of flu, which causes similar symptoms and could be confused with coronavirus”, she explained.

Do face masks work to protect against coronavirus?

Wearing a face mask is no guarantee against transmission of the virus. You might think it’s a good idea, given that the virus can be transmitted through coughs and sneezes and many photos from China show people taking this preventive measure. Many others who are travelling in a closed environment, such as an airplane also take this precaution.

“Most of the evidence with the use of surgical masks is that it’s helpful for people who already have respiratory symptoms, not to infect others”, said Dr. Fischer. “But they’re not so effective at protecting people who are healthy from those who are sick. It might be better to convince people who have respiratory symptoms to wear masks so that they are not sneezing and coughing out in the open”.

There is no CDC recommendation regarding the routine use of masks.

Should you wear gloves to protect against coronavirus?

If masks are helpful for those who are sick, do gloves make a difference for travellers?

“Gloves are useful in that they remind people not to touch their own noses and mouth”, said Dr. Fischer. “Because when you’re wearing gloves, you become hyperconscious of that. But the best protection for individuals is to be very careful about handwashing”.

How to protect yourself against Coronavirus in a hotel

There are warnings from the SARS outbreak that are not necessarily comforting when it comes to the spread of the virus in hotels. According to Dr. Fischer, the initial spread of SARS internationally in 2003 happened when a clinician who had been infected travelled to Hong Kong for an event and transmitted his infection to other hotel guests. Most of those guests were international travellers and boarded planes and flew home to their respective countries while incubating the virus.

So what can you do?

“Again, for routine travel, handwashing is the most effective way to prevent illness”, said Dr. Fischer. “And you can take other general precautions like avoiding large crowds and close spaces”.

What to do if you’re travelling and feel sick

Common symptoms of the novel coronavirus include fever, dry cough, mild breathing difficulties, stomach issues, diarrhea and general body aches. If you experience these symptoms while travelling, take these measures:

First, take action to prevent transmitting to others around you. As Dr. Fischer advises, wear a mask, avoid large crowds and situations where you might come in contact with a lot of people and surfaces.

“Also, if you have travelled to affected areas and become sick, or have had contact with someone who has [been] or is under investigation for coronavirus, let your healthcare provider know”, said Dr. Goodman. “Many clinics prefer that, if possible, you call ahead if you have a respiratory illness so they can take steps to avoid the spread of infection in healthcare facilities”.

What coronavirus means for travel and tourism

Officials are especially worried about the spread of the virus because of the Lunar New Year — a holiday during which Chinese residents travel within China and beyond.

A popular online travel agency, Trip.com, has begun waiving cancellation fees on all hotels, car rentals and tickets for tourists in Wuhan until 31 January 2020. Since that announcement, a few other smaller booking companies have followed suit.

Both Tianjin Airlines and Hainan Airlines have announced fee waivers. In those cases, however, cancellation and change fees will only be waived for those who have been quarantined for showing signs of the virus. American, Delta, British Airways, Virgin Atlantic and United— have now issued travel waivers for travel to, through and from Wuhan. (According to USA Today, none of these carriers fly nonstop to Wuhan, but they offer connecting service and partner airlines operate the intra-China flights.) The waivers are effective between now and 31 March.

Disney says it will refund admission fees, hotel bookings and other prepurchased tickets for visitors, but would not say when it plans to reopen the park in Shanghai.

The SARS outbreak had a huge impact on the Chinese economy, leading to a 45% drop in the growth of domestic tourism and a 64% decrease in revenue from domestic tourism, according to Rory Green, an economist who specializes in China and South Korea.

Bottom line

(Photo by Jeff J Mitchell/Getty Images)
(Photo by Jeff J Mitchell/Getty Images)

With memories of SARS and its deadly impact, countries around the world have acted quickly to control the coronavirus outbreak by implementing screening for signs of the virus at airports and restricting travel. According to experts, the best thing that you can do is watch the CDC recommendations before canceling an existing trip. The agency is closely monitoring the outbreak and updating its website and announcements often. China is taking measures to reduce travel to at-risk areas.

Additional reporting by Liz Hund. 

Featured photo by Thanit Weerawan/Getty Images.

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