With cases reported in locations around the world, the spread of novel coronavirus has travelers on edge. Much is still unknown about the outbreak, and health officials are urging caution.

On Wednesday, President Trump announced that travel from parts of Europe to the United States will be suspended for the next 30 days.

He said the new rule will go into effect beginning Friday at midnight. Trump said there will be exemptions made for certain Americans “who have undergone appropriate screenings.”

These exemptions apply to all US legal permanent residents, citizens and some of their family members, according to a statement from the Department of Homeland Security.

Americans and US permanent residents who are in Europe will still be allowed to fly to Europe and be allowed back into the United States during this 30-day period.

They will simply be screened upon entry to the United States and face quarantine or restrictions on their movement in the US for 14 days.

However, it is not clear whether airlines will still fly the routes if passenger demand from European nationals dries up because of the ban.

The ban does not apply to all of Europe but to nations in the Schengen zone. That includes Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, The Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland.

Meanwhile, the US State Department raised the worldwide travel advisory to Level 3 on Wednesday night — meaning citizens should reconsider travel abroad.

“The Department of State advises US citizens to reconsider travel abroad due to the global impact of Covid-19. Many areas throughout the world are now experiencing Covid-19 outbreaks and taking action that may limit traveler mobility, including quarantines and border restrictions,” the statement said.

This announcement follows an advisory issued by the US State Deparment on Sunday warning against cruise travel.

“US citizens, particularly travelers with underlying health conditions, should not travel by cruise ship,” the warning reads.

“CDC notes that older adults and travelers with underlying health issues should avoid situations that put them at increased risk for more severe disease. This entails avoiding crowded places, avoiding non-essential travel such as long plane trips, and especially avoiding embarking on cruise ships,” the advisory says.

In the US, large gatherings such as concerts, parades and conferences are increasingly being called off or rescheduled. On Wednesday, the NBA announced that the season is being suspended after a Utah Jazz player tested positive for COVID-19.

All travelers should be aware of the virus, pay close attention to travel advisories and health guidance, steer clear of heavily impacted areas and exercise preventive measures.

Here’s what else travelers should know about the virus outbreak:

Cruise line cases and precautions

The State Department’s cruise advisory came shortly before the Grand Princess cruise ship, where more than 20 coronavirus cases were confirmed Friday, docked Monday at the Port of Oakland in California.

A multi-day disembarkation process and quarantining of passengers is under way.

In February, the Diamond Princess cruise ship was quarantined for two weeks in Yokohama, Japan. More than 700 people contracted the virus aboard the ship, and at least seven of those patients have died.

Cruise lines have recently instituted flexible rebooking policies.

Princess Cruise Line has created a temporary cancellation policy valid for cruises departing up to May 31, 2020.

Carnival Cruise Line recently sent letters to guests booked through May 31 offering options to reschedule and onboard credits for those who proceed with their plans. Other cruise lines have extended similar offers.

Many cruises to and from mainland China and other Asian destinations were canceled or modified earlier in the outbreak, according to Cruise Critic, an online cruise community and review site.

Cruise Lines International Association (CLIA) has continuously updated its protocols for members in efforts to prevent introduction of the illness aboard ships.

CLIA members are to “deny boarding to all persons who have traveled from, visited or transited via airports in South Korea, Iran, China, including Hong Kong and Macau, and any municipality in Italy subject to lockdown (quarantine) measures by the Italian Government … within 14 days prior to embarkation,” one of the organization’s guidelines reads.

Denied boarding for anyone who has had close contact with anyone suspected to have coronavirus and pre-boarding illness screening and temperature checks are also outlined.

Individual cruise lines also have their own policies, screening procedures and sanitation measures to guard against introducing the illness.

Flight cancellations and increased flexibility

Airlines all over the world have canceled flights amid the outbreak, with many suspending or vastly reducing service to hard-hit countries such as China and Italy.

Some airlines, including United, American, JetBlue and Delta, have recently built more flexibility into new bookings, waiving change fees for some travel periods in March.

Delta Air Lines will waive change fees for any flights — domestic or international, to areas with coronavirus or without — booked between March 1-31, 2020. Flights must be rebooked and take place before the end of 2020. The rule does not apply to outright cancellations.

Meanwhile, United has announced that customers who had flights scheduled between March 3-31 will not have to pay a change fee for a flight of equal or lesser value that takes place within the next year.

Customers who opt to cancel their booking “can retain the value of the ticket” to use toward a new reservation up to 12 months after the original travel date.

United Airlines was the first US carrier to cut its domestic flight schedule due to a sharp drop in demand. Other carriers across the globe are similarly cutting service.

Delta has extended its suspension of flights between the United States and China through May 31. Service to Japan, Italy and South Korea has also been impacted, and waivers have been issued for various destinations heavily impacted by the outbreak.

Other airlines, including British Airways, Lufthansa, Air France, Cathay Pacific, Qantas, Emirates and more, have similarly slashed or suspended service.

Domestic carriers in many countries have reduced service due to declining demand.

Travelers with upcoming plans should check with their airlines and look for advisories posted on carriers’ websites.

Amtrak has also cut some rail service in the US due to a drop in demand. Amtrak is waiving change fees on all existing or new train reservations made before April 30, 2020.

Airline cleaning efforts

Airlines have bumped up their sanitation efforts to stem the virus’ spread, and the US Centers for Disease Control and Prevention recently released guidance on aircraft cleaning.

Delta Air Lines started using a fogging technique in February “with a highly effective, EPA-registered disinfectant” on flights arriving in the US from Asia.

Fogging is being performed on all trans-Pacific flights arriving into the US, the airline said, and those procedures are being expanded to more inbound international flights with a focus on flights coming from places with reported coronavirus cases.

While disinfecting is helpful, frequent hand washing is among a traveler’s best defenses, infectious disease experts say.

“Even if there is virus in the inanimate environment, it’s not going to jump off the seat and bite you in the ankle,” says Dr. William Schaffner, a professor of medicine in Vanderbilt University’s division of infectious diseases.

“You’ve got to touch it, and then touch your nose or your mouth. So it’s those hands we have that are the important intermediary. And that’s where I would put the emphasis,” he said.

Wash or sanitize your hands after touching surfaces in airports and planes.

“Hand sanitizers are great. So are antiseptic hand wipes, which you can also use to wipe down armrests, remote controls at your seat and your tray table,” said travel medicine specialist Dr. Richard Dawood.

The CDC advises washing hands often with soap and water for at least 20 seconds. An alcohol-based hand sanitizer with at least 60% alcohol can be used when soap and water are not available.

Most viruses don’t spread easily on airplanes because of how the air circulates and is filtered, the CDC says.

The CDC has issued guidance saying that older adults and people with serious, chronic medical conditions such as heart disease, diabetes and lung disease should “stay home as much as possible.”

US Surgeon General Dr. Jerome Adams echoes that advice.

“We want people who are older, people who have medical conditions, to take steps to protect themselves including avoiding crowded spaces, including thinking carefully about whether now is the time to get on that cruise ship, whether now is the time to take that long-haul flight,” Adams said.

Traveler screening procedures

US President Donald Trump announced additional screening of travelers from “designated high risk countries” in a tweet on March 1.

Vice President Mike Pence said that anyone traveling to the United States on a flight from Italy and South Korea will receive multiple screenings before arriving in the United States. His comments were made during a coronavirus briefing at the White House on March 2.

Health screenings are already in place in the US for those traveling from China. American citizens, lawful permanent residents and their family members who have been in China within the last 14 days require screening at one of 11 designated US airports.

Those screenings involve a temperature check and observations for symptoms.

Foreign nationals who have visited China in the past 14 days are barred from entering the US.

US citizens and permanent residents returning to the United States who have traveled to Iran within the previous 14 days must enter through an approved airport. Foreign nationals who have traveled to Iran within the last 14 days will be denied permission to travel to the US.

Some countries have put restrictions in place for travelers arriving from heavily impacted areas. Make sure that your destination has not restricted your arrival before embarking on an international trip.

Hand washing is a strong defense; masks are not

Dr. Schaffner has received a lot of questions about whether people should be wearing masks to avoid infection.

He realizes it’s culturally very common in Asia, but he says the CDC doesn’t recommend it for the general public because “the scientific basis showing that people in the community wearing masks actually has any benefit is very thin and questionable.”

More fitted respirator masks may be used in medical settings, but are generally impractical for the general public, Schaffner says.

Good hand hygiene is a better defense.

If you are sick, wearing a face mask when you are around other people can be helpful, according to the CDC. But those who are symptomatic should avoid travel.

Travel advisories

An increasing number of travel advisories have been issued by countries around the world, urging caution for select destinations, and discouraging travel to others.

The US State Department raised the worldwide travel advisory to Level 3 on Wednesday night — meaning citizens should reconsider travel abroad.

The US State Department’s travel warning for China is at the highest level — Level 4: Do not travel. The department’s warning for travel to Iran, which was already at Level 4 prior to the outbreak, was recently updated to add information about coronavirus.

Travelers should reconsider travel to Italy and South Korea, according to the State Department, while travel to specific areas of those countries — Lombardy and Veneto in Italy and Daegu in South Korea — is discouraged. The department also advises travelers to reconsider travel to Mongolia.

Level 2 warnings, urging increased caution, are in effect for Japan, Hong Kong and Macau due to the outbreak.

The United Kingdom and Canada are among many other nations that have issued travel warnings for China, South Korea, Italy and other destinations.

The US Centers for Disease Control and Prevention (CDC) is discouraging nonessential travel to China, South Korea, Italy and Iran.

Japan and Hong Kong carry lower-level CDC advisories.

All travelers should avoid contact with sick people and clean their hands frequently.

Attractions closed and events canceled

On Monday, Italy announced that a lockdown effective in the north would be extended to the entire country. Museums and archaeological sites in Italy have been shuttered.

Some museums in South Korea, Japan and elsewhere have closed temporarily to stem the spread of the virus.

A number of Ireland’s St. Patrick’s Day parades have been canceled. Boston, New Orleans and Pittsburgh are among US cities that have canceled their parades.

Disney parks in Asia are closed, as is Universal Studios Japan, and some of Japan’s crowd-pleasing cherry blossom festivals have been called off.

In Shanghai, Disney has reopened some shops and restaurants but the theme park remains closed.

In Thailand, several official Songkran (Thai New Year) festivals, due to take place in mid-April, have been canceled.

Travelers should monitor attraction closures and event status in their destinations.

Most travel insurance is unlikely to cover this situation

Airlines are relaxing their policies and some major hotel chains are waiving cancellation fees, but recouping all the costs associated with trips canceled due to coronavirus fears is far from guaranteed.

An outbreak of a virus is not covered under most standard trip cancellation insurance policies, according to TravelInsurance.com.

“For those who purchased a Cancel for Any Reason (CFAR) optional upgrade, however, some measure of trip cancellation protection may be available,” according to Stan Sandberg, co-founder of TravelInsurance.com.

Those holding existing policies should contact their providers to see if their plans offer any coverage.

An airport officer walks past international travelers arriving to Los Angeles International Airport on the first day of health screenings for coronavirus of people coming from Wuhan, China on January 18, 2020 in Los Angeles, California. Coronavirus is a new type of virus similar in the same classification as SARS and MERS that has health officials concerned. The outbreak that has infected dozens of people in Wuhan and killed at least two. (Photo by David McNew/Getty Images)
An airport officer walks past international travelers arriving to Los Angeles International Airport on the first day of health screenings for coronavirus of people coming from Wuhan, China on January 18, 2020 in Los Angeles, California. Coronavirus is a new type of virus similar in the same classification as SARS and MERS that has health officials concerned. The outbreak that has infected dozens of people in Wuhan and killed at least two. (Photo by David McNew/Getty Images)

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