Since the CDC began warning Americans about the coronavirus, one of its most consistent instructions has been simple: try to avoid traveling. If you’re home, stay home. If abroad, come back. It isn’t just about clearing the beaches of Spring Break partiers. Certainly, close quarters hedonism is no way to keep a virus from spreading, but the truth is far more widespread than that.
For as long as humanity has dealt with disease, we’ve known that travel is a good way to spread infection. Even in the era of horses and wooden ships a virus could make its way around the world month by agonizing month. Today, when someone can finish that same trip in a matter of hours, the threat is magnified many times over.
When doctors warn us not to travel in times of a pandemic like the coronavirus, it’s not because they want to ruin your vacation. There are a few specific reasons why this activity, more than most, can put your health at risk and others.
Transportation Usually Means Close Quarters
Modern transit was designed for convenience, for speed, for efficiency and cost, but certainly not for comfort. When we travel, it inevitably means occupying close quarters for long distances with completely random strangers. This is true for systems like trains and busses, but it’s particularly true when it comes to air travel.
Far from six feet of social distancing, sitting on an airplane typically means less than six inches.
It’s impossible to avoid sharing space with people when you travel. A plane ride, or even a train or bus, means long exposure to a population you can’t control. There’s no way of knowing whether your seatmate will board with a virus, and no way for them to know if you did.
The same is true, to a lesser extent, in terminals and stations. A busy airport is a crowded place, with passengers waiting in tightly packed security lines and dense gate scrums. Passing through a train station at rush hour means fighting your way through a crowd, and bus stations gather people together in tight entrances and exits for each coach. The less said about cruise ships, even when there isn’t a public health crisis on, the better.
Constant physical contact with a large number of strangers is unavoidable while in transit. In ordinary times that makes hubs a major source of germs. (One 2018 study found that airport security trays carry more bacteria than the average toilet seat.) In extraordinary times, the threat is that much greater.
You Might Move The Virus
The biggest goal during a pandemic is simple: Stop the virus in place.
An infection is like a wildfire. It will die out if it runs out of fuel. If doctors can keep an illness like the coronavirus contained to a single population, eventually everyone will develop antibodies and the virus will have nowhere to go.
When people travel, they risk breaking that seal.
A traveler visiting a new destination risks bringing the virus with them, carrying it to a population that hasn’t been infected yet. Someone who returns home from an infected destination risks carrying it back with them. Movement can bring infection to entirely new parts of the world, which is why doctors recommend that it stop as much as possible.
This is particularly true for respiratory illnesses like the flu, the cold and COVID-19, which tend to be most contagious before they become symptomatic. The average patient carries one of these viruses for several days before they even know they’re sick, making it hard to tell when it’s safe to travel. You might have the best of intentions. You might fully intend to self-quarantine the minute you start feeling ill. You might check yourself every morning for a fever and a sore throat.
None of it will matter. By the time you feel those symptoms coming on, you’ve been sick for several days.
More importantly, you’ve been contagious.
Overloading Local Health Care Resources
Healthcare networks are built to serve the needs of their population. Most major tourist destinations will have some doctors used to seeing travelers, and most hospitals will have some excess capacity, but these are not substantial resources. By and large, a city will have the clinics, hospital beds and medical professionals it needs to care for its residents.
This is not a problem during ordinary times, when hospitals and clinics operate below capacity and can see some extra people. During a public health crisis, however, travelers create load balancing problems that can cripple certain parts of the health care network.
The local hospitals in popular destinations are not built to accommodate swarms of tourists as they fall ill. They have enough beds and doctors for the local community. Not the local community, plus the 10,000 travelers staying in local hotels.
And there is no counter-balancing factor here. Tourism draws people from around the world to a relative handful of popular destinations. Chicago might see a small dip during a public health crisis due to people having left on vacation, but Miami will see a surge beyond anything it can handle.
Minimal Local Health Care Resources
Too, it’s important to remember that many of the world’s most popular destinations tend to be in developing or resource-starved regions of the world.
This is not a universal truth, not by any stretch of the imagination. However many of the world’s most popular destinations are set in regions with minimal health care infrastructure. This is often because they are relatively poor, and that makes them cheap to visit for someone from a wealthy nation. Whether you’re visiting the Greek Cyclades, Cambodia’s Angkor Wat, Peru’s Machu Picchu or even the beaches of the U.S. Virgin Islands, these are often smaller, places with limited access to care.
These destinations need their resources for their own people. It isn’t just about overloading hospital beds. If you’re traveling, the good odds are that you’ll find yourself in a place where it is simply selfish and cruel for a mainland American to take up health care resources should you, eventually, get sick. You can go home to the relative security of an immensely rich nation. You have the luxury of seeing this as an adventure, knowing that even in the worst case scenario someone back home might airlift you to safety. (Although maybe during a quarantine.)
A community in Guatemala, Laos or Peru does not have that safety net. Those doctors need to make the most of their drugs, masks and time, and that does not include taking care of wealthy tourists.
Don’t Get Sick Abroad
Setting aside the issues of local health care resources, getting sick abroad is simply a miserable experience. It is also one which can turn a bad situation worse… fast.
While traveling you don’t have the comfort and luxuries of home. You need to sleep in a hotel room for the duration of your illness. (A choice which, over the course of a week-long recovery, can become expensive quickly.) You can’t access familiar pharmacies or drug labels, and may not be able to communicate your needs to the pharmacist. You don’t know the local health care network if your condition takes a turn for the worst, and may not have friends you can call on if you can’t take care of yourself.
Again, all of this is manageable on an ordinary basis. Getting sick abroad is a miserable experience, but when you’re the one sick person at the hotel, you can find help and make do. That will be much more difficult when the hotel staff has their own sick friends and relatives to care for.
Borders Might Close On You
To prevent a virus from moving, during particularly serious health crises, governments may temporarily close their borders. If this happens you will be stranded on the other side.
Remember, this is not a political conflict. There’s no version of “but I’m a citizen and belong over there” that will convince the guards. The border has been sealed because, during a pandemic, every single breathing body could carry the virus.
The CDC began warning Americans home for many reasons. One was because, once governments began sealing their borders, anyone left on the other side would be stuck there indefinitely. That might be fun under the right circumstances. If you’re in a country you can afford to stay in for weeks, or even months. If you’re in a country you want to stay in for weeks, or even months. If you don’t get sick and find yourself depending on an unfamiliar health care system during the peak of its demand. If all of that holds true then, yes, you’ll be fine.
If it doesn’t, though, you’ll wish you’d crossed that border while you had the chance.