Caroline Bologna – HuffPost.
Here's what you should consider before dusting off your passport and visiting another country.
Many Americans are longing for the days when they could take a dream vacation to Paris, Bali, or even just over the border to Toronto. As vaccine availability increases in the U.S., people are feeling a glimmer of hope that international travel will be back on the table soon.
But even as more people get vaccinated and countries open up to American tourists, traveling abroad may remain inadvisable for a time, especially to places with less widespread vaccine access. As we move forward and start planning trips again, there are important factors to consider before grabbing our passports and jetting off.
HuffPost asked bioethicists, as well as public health and travel experts, to weigh in on the ethics of traveling abroad before vaccines have been widely administered worldwide. Read on for their thoughts.
We haven’t ruled out transmission risk.
“Individuals who are vaccinated have protection ― although not 100% protection ― against developing severe disease if infected with SARS-CoV-2,” said Amy McGuire, professor of biomedical ethics and director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. “However, we are still generating evidence of how well different vaccines protect against transmission of the virus.”
It’s possible that vaccinated travelers could still transmit the virus to others, so until we have more data on how much vaccines reduce transmission risk, we can’t draw particularly meaningful conclusions about the ethics of travel in the coming weeks and months.
“If someone in the U.S. travels to another country, they may have an asymptomatic infection that they bring with them to the other country, putting people there at risk,” William Miller, senior associate dean for research at the Ohio State University’s College of Public Health, told HuffPost in an email. “Or they may acquire an infection there and bring it back with them to the people they are close to. The vaccinated traveler may not get sick but they may cause others to become sick ― that’s why, in general, it still is not a good idea to travel yet.”
Virus variants can be a cause for concern.
“Other countries may have higher rates of virus variants that are more transmissible and, in some cases, may cause more severe disease,” Miller said. “The transmission of these variants to and from vaccinated people is a concerning possibility.”
As we still have much to learn about new variants (like whether the currently approved vaccines protect against them and reduce their transmission), it’s important to remain cautious and keep unnecessary travel to a minimum.
“Travelers may be infected with a novel variant and get sick, and potentially increase its spread in the U.S.,” said Gabriel Lázaro-Muñoz, an assistant professor at Baylor’s Center for Medical Ethics and Health Policy.
All health care infrastructure is not created equal.
“Please keep in mind that vaccine rollout in most countries is just getting started and they may not have COVID under control,” Lázaro-Muñoz noted. “Travelers could add more pressure to strained health care systems in other countries.”
Countries with minimal outbreaks can also be vulnerable, especially if they don’t have the same health care and vaccination resources that wealthier nations do. A recent piece by James Hamblin in The Atlantic pointed to the disparities in vaccine access.
“Vietnam, for example, is a country of 97 million people that has had fewer than 1,600 cases of COVID-19 and 35 deaths,” Hamblin wrote. “They have done an exemplary job of controlling the virus, and presumably have very low levels of immunity.”
Nicole Hassoun, a visiting scholar at Cornell University and professor of philosophy at Binghamton University who studies public health ethics, made a similar point to HuffPost.
“While most people in rich countries will probably have access to a vaccine this year, those in poor countries will likely have to wait years to get vaccinated,” Hassoun said.
“However, poor countries might rely on the tourism international travel brings, and in some cases even do worse, all things considered, without it,” she added. “So if you decide not to travel, you might consider finding other ways to support businesses and people in poor places this year. If nothing else, you might consider donating the money you would have used traveling for fun.”
There’s reason to be cautiously optimistic for the future.
As the number of vaccinated people increases worldwide, prospects for international travel may improve as well.
“As vaccine rollout advances, there will be much less community transmission, less likelihood of infection, and less likelihood of novel variants emerging,” Lázaro-Muñoz explained. “This will likely make tourism more manageable for host countries and greatly decrease the risk you may pose to others. At that point, you should feel more comfortable traveling to other countries.”
High vaccination rates and low COVID-19 rates, in both the traveler’s destination and country of origin, may make travel possible again, assuming we learn the current vaccines provide lasting immunity and considerably reduce transmission rates.
“One way to think about this is that you want to be in a fairly normal situation where your own local situation is open, with more or less normal activities albeit with masking and distancing,” Miller said. “And you want to be going to a place that is also fairly normal. And in both of those situations, you want rates low, despite the openness.”
In this scenario, travel demand is likely to reach new heights, said Konrad Waliszewski, co-founder and CEO of the travel app Tripscout.
“Once a high percentage of the world is vaccinated, prepare to witness the biggest travel boom the world has ever seen,” he said. “Pent-up demand from a year of lockdown, combined with a significant increase in remote work flexibility, a decrease in required business travel, and respect for the fact you never know when the world will shut down again, will cause people to travel like never before.”
Still, it’s imperative we continue to act with caution. The key to global travel will be making the vaccine accessible to as many people around the world as possible, and preventing the development and spread of new coronavirus variants.
“We are currently in a race to get enough people vaccinated that we achieve herd immunity before new viral strains that are resistant to the vaccines emerge and spread,” McGuire said. “So the answer to that question depends on how successful we are over the coming months at vaccinating large percentages of the population, while controlling the spread of new viral strains.”
The answer may vary based on the destination.
If we’re in a position to travel abroad this year, there will still be factors to consider when choosing a destination.
“I would look at how well the virus is being controlled in a certain destination, number of deaths and health care access,” said Jagdish Khubchandani, a professor of public health at New Mexico State University.
In addition to community transmission and health systems, Khubchandani advised taking into account the prevalence of new variants of the virus. Even if you are vaccinated, a country with a rapidly spreading variant is not the best place to visit, since we aren’t yet sure how well the current vaccines protect against them. A country’s vaccination rate will also affect the health care situation there.
“Many countries are heavily dependent on tourism and may allow travelers because it is such an important part of their economy, but that may not mean that they have COVID under control, and their health care system could be struggling,” Lázaro-Muñoz said. “Think of yourself as being a guest at a friend’s house. If your friend was having some serious difficulty, and your presence at the house somehow added to that, you would not want to add more trouble.”
Check the latest COVID stats on the State Department’s website or elsewhere. Consider the public health measures that a given destination has in place. If there are strict lockdowns and quarantine requirements (likely for good reason), you probably won’t be able to have the tourism experience you’d prefer.
Still, there are some international travel scenarios that could be lower-risk and doable this year. Just think about the impact of your travel on yourself, the people who live wherever you’re going, and the ones you’ll be returning home to.
One big consideration is “whether the visit will be spent mostly indoors or outdoors,” Miller said. “If someone goes to a Caribbean island and will be spending all of their time outside, including when they are eating, and only spend time inside in their hotel room, then the risk would be very low. The same would be true of any vacation or trip where the activity is primarily outside ― hiking and boating. But a trip with a focus indoors, like visiting museums, eating inside in restaurants, [and] visiting pubs, will have a higher risk.”
If you do travel, take precautions.
Some reasons for international travel are better than others ― like an emergency, visiting a dying relative, or getting a rare treatment for a serious disease. Still, many people are choosing leisure travel, and that number will inevitably grow as vaccinations rates increase. If you decide to travel abroad, it’s important to take the necessary health precautions to protect yourself and the people you’ll encounter.
“You have to be willing to follow the COVID preventive measures those countries have in place,” Lázaro-Muñoz said. “This could include pre-travel COVID testing and wearing masks. Being a tourist does not mean local rules do not apply to you.”
Keep your distance from others, mask up and wash your hands. Follow public health measures, and make smart decisions as the situation evolves. Make sure your travel companions, and the businesses and lodgings you plan to visit, do the same.
“Research and detailed trip planning is more important than ever,” Waliszewski said. “American travelers must constantly stay up to date on rapidly changing situations on the ground and the corresponding guidelines in the States and abroad. Travelers must also consider testing and quarantine requirements, safety guidelines, and local health care infrastructure prior to departing for any destination. I don’t see this sort of planning going away anytime soon, even after a high vaccination rate [is achieved].”
Ultimately, it’s important to remember that your personal health isn’t the only thing that matters.
“In this pandemic, we always have to consider how our behavior affects others,” Miller emphasized. “Your vaccination protects you, for sure, and it may protect others. But until we know for sure that it protects others by reducing transmission, we have to remain cautious.”
Jim Hepple is an Assistant Professor at the University of Aruba and is Managing Director of Tourism Analytics.