As COVID restrictions continue to ease across the globe, many experts are predicting one of the busiest summer travel seasons on record. Curious about how to prepare for a safe and healthy trip this summer? Our Chief Medical Officer, Dr. Michelle Nathan, weighs in on COVID, Monkeypox, and her overall sentiments on the current travel health landscape in this informative seasonal update:
How has the COVID-19 pandemic changed over these past few years?
Dr. Nathan: COVID-19 has become a regular part of day-to-day life. In the past few years, experts have learned more about managing the illnesses associated with the virus. Vaccines have helped reduce the severity of illness with COVID-19 infection. New treatments have evolved for people who are hospitalized, and more recently, for high-risk individuals who do not need hospitalization. Many countries are also easing or removing COVID-19-related entry requirements altogether—for example, the U.S. recently dropped its requirement for a negative COVID-19 test to enter the country. With all these advances and evolutions, countries have been able to return to a more normal state, and COVID-19 has become something we all are learning to live with.
How do you think the new COVID testing guidelines for inbound travel will affect international travel?
Dr. Nathan: International travelers entering the US will have one less stressor when they travel! Many travelers identify the time sensitive COVID testing requirement as a major stress when traveling and eliminating the need for the test should only make travel more pleasant! However, I do want to emphasize that travelers who have symptoms should still be tested and follow current CDC travel health guidelines.
What are the most prevalent COVID variant(s) that travel health experts are watching right now?
Dr. Nathan: Most of the current variants are lineages of Omicron. Omicron BA2 is still dominant in Europe and the Americas, but there are scattered cases of BA4 and BA5 in those regions. BA4 and BA5 are more transmissible than BA2 and previous vaccination or infection may provide less immunity to BA4 and BA5 lineages. BA4 and BA5 are being monitored; thus far, they do not seem to cause more severe disease than previous variants.
What do we currently know about immunity to COVID-19?
Dr. Nathan: We know that we get immunity from vaccination and from previous infection with COVID-19. The goal of vaccination is to protect against serious illness and not to prevent all infections. Immunization with an mRNA vaccine provides limited protection against symptomatic disease from Omicron variants. There is a boost in immunity after a booster, but the protection seems to decrease after a few months. Prior infection with COVID 19 provided good protection against earlier variants (Alpha, Beta and Delta) but has limited protection against Omicron lineages. Hybrid immunity (a combination of prior infection and vaccination) seems to be the most protective. We still see COVID -19 infections with hybrid immunity, but they tend to be minimally symptomatic.
What happens if a traveler gets COVID while traveling? What should they do?
Dr. Nathan: Travelers need to have a plan in place before traveling! If a traveler has symptoms, they should get tested and be prepared in the event of a positive test. They should also make sure they have travel insurance and assistance coverage in the event they become ill and/or in case of required quarantine/isolation. Each country has different rules about isolation/quarantine for COVID-19 infection, and travelers need to abide by those rules. Travelers should also bring over-the-counter medications with them including fever reducers, cough medication, and decongestants; these will help them manage the most common symptoms of COVID-19. Travelers may also want to pack some face masks and a few COVID-19 home tests, as they may not be as easy to find abroad.
Moving on to monkeypox. The CDC recently moved monkeypox from Level 1 to Level 2. How concerned are travel health experts about monkeypox at this time?
Dr. Nathan: Monkeypox is an orthopoxvirus that is related to smallpox and circulates in Africa. In the current outbreak, cases are still rare among travelers. However, the CDC is recommending enhanced precautions for travelers; these include avoiding close contact with people who are sick or have a rash, frequent hand washing, avoiding animals that are sick or dead, avoiding eating meat from wild game or using products derived from wild animals from Africa, and avoiding contact with contaminated materials used by sick people or infected animals. These are simple, common-sense steps that most travelers would probably follow, even in the absence of monkeypox! At this point, the risk of travelers contracting monkeypox is very low. I should also point out that the WHO is likely to rename monkeypox soon, so don’t be alarmed if you suddenly see a new virus name popping up in your newsfeed.
How is monkeypox spread?
Dr. Nathan: Monkeypox is spread by direct contact with body fluids or the sores of an infected person or infected animal. Direct contact with materials (clothing, bedding) that have touched infected body fluids or sores can also spread monkeypox. Among people, the primary method of transmission is through direct contact, including intimate contact during sex. There is some limited spread through respiratory secretions, but there needs to be close, prolonged, face-to-face contact; this is why wearing a mask won’t necessarily help prevent monkeypox.
Is there a monkeypox vaccine?
Dr. Nathan: There is a live vaccine for monkeypox. At this time, since the risk of monkeypox remains low, the vaccine is only recommended for individuals whose jobs may expose them to orthopoxviruses (monkeypox, smallpox etc.). Experts also believe that vaccination after a monkeypox exposure may help in preventing the disease or making it less severe. Currently, vaccination is not recommended for travelers.
If a traveler had smallpox vaccine as a kid, are they protected against monkeypox? How about chickenpox?
Dr. Nathan: The smallpox vaccine has an 85% efficacy rate for monkeypox in recently vaccinated people. Since vaccinations stopped by the 1980’s, it is unclear if those who received the vaccine several years ago still have significant immunity for monkeypox. Chickenpox is a different type of virus, and the chickenpox vaccine (or having had chickenpox) does not provide immunity for monkeypox.
What are your final thoughts in terms of how travelers can protect themselves this busy summer travel season – whether it be from COVID, monkeypox, or even the common cold?
Dr. Nathan: Common sense and preparedness go a long way in protecting travelers. Before travel, know what the risks are (not just for COVID) for the intended destination. Travel with a small first aid kit, pack extra prescription medications, prepare a list of emergency contacts, and know where to find medical care in a destination if it becomes necessary. As I noted earlier, frequent handwashing, avoiding people who are sick, minimizing time spent in large crowds—these are all simple precautions that can help protect travelers from most common illnesses. All of these factors combined can give travelers the peace of mind they need to enjoy the travel process and experience.
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The information provided within this post has been compiled from a multitude of available sources, and is based on the current news and situational analysis at the time of writing.
