How to Think About Your Cancer Care in the Time of COVID-19

Getting the news that you have cancer is overwhelming and frightening. The COVID-19 crisis adds another layer of anxiety. But know this: you can protect yourself from COVID-19 without compromising your cancer treatment. Don’t panic. In the vast majority of cases, a diagnosis of cancer is not an emergency even though it feels like one. There is time to learn about your options and sort out what is right for you.

For now, there will be changes to how we do things. Some of the changes will feel disruptive, but many will lead to better, more patient-centered care. Minimizing your chances of exposure to the virus doesn’t require sacrificing good care.

How you interact with your cancer care team will change during this period.
In keeping with directives to shelter in place, whenever possible, your visits will be by phone or video. In-hospital appointments will be kept to a minimum to reduce your potential for exposure.

Your treatment/screening schedule may change. Your care team will reschedule or delay treatment when it is safe to do so, without compromising the effectiveness of your treatment.

Many oncology societies have issued guidance for care *. Your care team will know best about your particular situation. Your cancer care teams are still at work.

If you are newly diagnosed with invasive cancer

There are safe ways to postpone surgery. Systemic therapies (chemotherapy, hormone therapy, biologics and immuno-oncology treatments) are already a part of cancer care. Starting with that therapy before surgery (neoadjuvant therapy) is a great approach and is not only equally safe but allows us to learn how your tumor responds, if additional treatment will help, and whether aggressive surgical procedures or radiation can be avoided. We use this for breast cancer routinely. Switching the order of therapy helps tailor your treatments to response.

If you are in the middle of chemotherapy treatments, you should continue. Your doctors may take more precautions to support your blood counts. Stay home. Have others grocery shop for you. Your physicians may have you come in less often and have your caregivers/support accompany you by phone/video.

A new precancerous/high risk lesion (Ductal Carcinoma in situ (DCIS), atypical lesions, cervical neoplasia) is not an emergency. Waiting a few months is safe and active surveillance and prevention medications are possible alternatives.

If you are waiting to start radiation, your radiation oncologist will prioritize when to start. For some, waiting up to 12 weeks is safe. Shorter courses of treatment may be appropriate and just as safe.

If you are due for routine cancer screening, don’t go in now for mammograms, lung CT, or repeat imaging for low risk findings. Waiting 3 months will not change your outcome.

If you have recently learned that you are at VERY high risk, because you have inherited a mutation that increases your risk for developing cancer, you can get a video consult, learn about options for risk-reduction and screening, and schedule appropriate screening 3 months out.

If you are a cancer survivor, follow-ups and screening can be safely put off 3 months.

If you have a new mass or a new symptom that worries you, that may be reason to go in for imaging or an exam. Cancer clinics are open to care for you. You can always start with a video-visit.

Why it is important to triage surgical cases – We still need to put the infrastructure in place and scale up the tools we need to take care of everyone safely. This includes COVID testing, personal protective equipment, beds, blood supply, and ventilators in place for safe care of cancer patients in the operating rooms and hospitals. Postponing surgical procedures using multidisciplinary approaches can also allow combined reconstructive cases to proceed safely. If everyone stays home now, we prevent our health care system from being overwhelmed, so emergent and urgent cases can proceed. As COVID testing becomes widely available, we can safely resume surgical procedures, and allow loved ones to be present. When possible, facilities will be separated for COVID and non-COVID related care.

The silver lining is that a crisis drives innovation and patient centered care. We have a strong foundation of science and clinical studies upon which to build, more effective treatments, more options and a better understanding of how to personalize care. We can safely do less for those with very low risk tumors, and more for those that need it. Even without COVID, we should be tailoring treatment to risk, biology, and evolving clinical data. When it is safe to do less, that is actually a benefit. This is a time when acting on such data is particularly important.

Many cancer research studies have been put on hold, but not all, and COVID 19 studies are starting in earnest**. Once the worst of the crisis passes, and COVID testing is in place, we need to safely re-open research studies because finding new and better ways to treat cancer is essential.

If everyone helps to do their part, we will all get through this better as a community, making sure we do what is best for you and everyone going through this incredibly challenging health pandemic.

Stay home, help flatten the curve, and know that we are here for you.

Resources

*Clinical guidance

https://www.asco.org/asco-coronavirus-information/care-individuals-cancer-during-covid-19

https://www.nccn.org/covid-19/

https://www.breastsurgeons.org/management/practice/covid19

https://www.facs.org/covid-19/clinical-guidance/elective-case/colorectal-cancer

https://www.facs.org/covid-19

https://www.ucsfhealth.org/education/breast-care-in-the-time-of-covid-19

**Research guidance

https://www.nih.gov/health-information/coronavirus

https://www.thewisdomstudy.org/

By Dr. Laura Esserman  April 28, 2020 6:30 AM EDT

Source: How to Think About Your Cancer Care in the Time of COVID-19

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Dr. Cardinale B. Smith, Chief Quality Officer for Cancer, shares information cancer patients need to know regarding COVID-19.

CDC: Here Are 6 New Possible Symptoms Of COVID-19 Coronavirus

It was only a matter of time before the Centers of Disease Control and Prevention (CDC) added to this list. For a while, the “Symptoms of Coronavirus” list on their Coronavirus Disease 2019 (COVID-19) website stayed at three symptoms: fever, cough, and shortness of breath or difficulty breathing. Not anymore. The CDC has now added six more to bring the total to nine.

The six new additions are:

  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

So if you have any of the nine listed symptoms, you may have a COVID-19 coronavirus infection. Or you may not. Unless you do. Such symptoms could be due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), except when they aren’t and something else is causing them. Got it?

Is all of this giving you a headache? Or is your headache from COVID-19? Probably not, if it just started from looking at the list. But if it continues, then maybe.

At least, if you have another diagnosis like an influenza, respiratory syncytial virus (RSV), or some other respiratory virus infection that can cause some of the above symptoms, you can be rest assured that you don’t have a COVID-19 coronavirus infection. Except when you have both types of infections at the same time.

A research letter published in JAMA revealed that 20.7% of specimens that tested positive for SARS-CoV-2 also tested positive for one or more other pathogens as well. For the study, David Kim, MD, PhD, James Quinn, MD, MS, Benjamin Pinsky, MD, PhD, Nigam H. Shah, MBBS, PhD, and Ian Brown, MD, MS, from the Stanford University School of Medicine reviewed result from 1217 specimens from 1206 patients who were tested for SARS-CoV-2 and other respiratory pathogens with 116 (9.5%) of these turning out to be positive for SARS-CoV-2. Of the 24 specimens that had SARS-CoV2 and at least one other respiratory pathogen, 6.9% tested positive for rhinovirus/enterovirus, 5.2% for respiratory syncytial virus (5.2%), 4.3% for other coronaviruses besides the SARS-CoV-2, and a little over 3% for some type of influenza. So if you have another respiratory virus infection, you could still have COVID-19. In the words of Bill Lumbergh from the movie Office Space, “that’ll be great.”

How’s that for freaking confusing? As more and more reports emerge of people having different groups of symptoms, it has become increasingly clear that fever, cough, and respiratory symptoms are not the only things that you should be looking for if you are worried about COVID-19. It’s also becoming increasingly clear that the course of COVID-19 can be very variable and reminiscent of that Michael Scott quote from the television show The Office: “Sometimes I’ll start a sentence and I don’t even know where it’s going. I just hope I find it along the way.” Your course of symptoms, of course, may make sense, except when it doesn’t.

The CDC list is far from exhaustive. What symptoms you get can seem like a game of craps, in more ways than one. For example, Robert Glatter has written for Forbes about how stomach ache and diarrhea could be the first signs of COVID-19. I have covered for Forbes some of the eye symptoms that may be present. Then, there’s the letter to the Journal of The European Academy of Dermatology and Venerealogy that reported on two patients with COVID-19 who initially had only fever and urticaria, which is medical-speak for hives.

It would certainly be a lot easier if COVID-19 had a clear classic symptom like the measles (a rash), the chicken pox (vesicles, which are fluid-filled little sacs on your skin), or foreign accent syndrome (take a wild guess). But the lack of such a clear symptom means that making COVID-19 coronavirus testing much more widely available is all the more important. The CDC does provide an online Coronavirus Self-Checker to help you determine whether you should contact your doctor. However, this is not a way to diagnose COVID-19. Neither is an app nor asking other people on Facebook. The only way to really diagnose COVID-19 is to get the cotton swab up the nose and to the back of your throat test to check the gunk for the RNA of the virus.

So far, other things on the CDC Symptoms of Coronavirus website haven’t really changed. It still indicates that you may begin experience symptoms two to 14 days after being exposed to the virus. And the list of emergency warning signs still includes trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face. If you have any of these symptoms, you may have severe COVID-19 that requires immediate medical attention. Unless of course, something else is causing these symptoms and you don’t have COVID-19. Either way get real medical attention as soon as possible.

Follow me on Twitter or LinkedIn. Check out my website.

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY) School of Public Health, Executive Director of PHICOR (@PHICORteam), Professor By Courtesy at the Johns Hopkins Carey Business School, and founder and CEO of Symsilico. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work has included developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.

Source: CDC: Here Are 6 New Possible Symptoms Of COVID-19 Coronavirus

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Watch the Osmosis Video here: https://osms.it/covid-19 What is COVID-19 (Coronavirus Disease 19)? The coronaviruses that circulate among humans are typically benign, and they cause about a quarter of all common cold illnesses. But occasionally, coronaviruses, like COVID-19, circulate in an animal reservoir and mutate just enough to where they’re able to start infecting and causing disease in humans. Find our complete video library only on Osmosis Prime: http://osms.it/more. Hundreds of thousands of current & future clinicians learn by Osmosis. We have unparalleled tools and materials to prepare you to succeed in school, on board exams, and as a future clinician. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways, and more when you follow us on social media: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Our Vision: Everyone who cares for someone will learn by Osmosis. Our Mission: To empower the world’s clinicians and caregivers with the best learning experience possible. Learn more here: http://osms.it/mission Medical disclaimer: Knowledge Diffusion Inc (DBA Osmosis) does not provide medical advice. Osmosis and the content available on Osmosis’s properties (Osmosis.org, YouTube, and other channels) do not provide a diagnosis or other recommendation for treatment and are not a substitute for the professional judgment of a healthcare professional in diagnosis and treatment of any person or animal. The determination of the need for medical services and the types of healthcare to be provided to a patient are decisions that should be made only by a physician or other licensed health care provider. Always seek the advice of a physician or other qualified healthcare provider with any questions you have regarding a medical condition.

Mapping the Spread of the Coronavirus Outbreak Around the U.S. and the World

ince the first case of COVID-19 was identified in central China in December, the illness has spread across the world, leading to an outbreak that the World Health Organization has called a pandemic. The maps and charts below show the extent of the spread, and will be updated daily with data gathered from over a dozen sources by the Johns Hopkins University Center for Systems Science and Engineering.

Where COVID-19 has spread in the U.S.

Testing for the novel coronavirus that causes COVID-19 was slow to roll out in the U.S., but as more and more Americans get tested, it’s becoming clear that the illness is already spreading in the U.S. It has now been confirmed in some three dozen states, with the largest clusters in Washington state, California and New York.

Where COVID-19 has spread around the world

Over 110 countries and territories, representing every corner of the globe, have now reported at least one case of the novel coronavirus. In total, there are now over 125,000 cases and over 4,600 related deaths.

Which countries have the most COVID-19 cases?

China remains the country with the most coronavirus cases and related deaths, by a significant margin. However, in recent weeks, China has seen fewer and fewer new cases per day, while the count in places like Italy, Iran, Germany, France and the U.S. have risen.

Keep up to date with our daily coronavirus newsletter by clicking here.

Here’s what you need to know about coronavirus:

By Elijah Wolfson

Source: Mapping the Spread of the Coronavirus Outbreak Around the U.S. and the World

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The video shows the timelapse of the coronavirus by map worldwide since January 20, 2020. It first started in Wuhan, Hubei, China, then spread to more than 80 countries by March 5, 2020. Twitter: https://twitter.com/wawamustats Facebook: https://fb.me/wawamustats Source: World Health Organization & CDC Special Thanks to Our Patron: C&MHansen Subscribe here: https://www.youtube.com/wawamustats?s…

Master List Of Airline Coronavirus Change And Cancellation Policies (Includes All American And European Airlines)

“What should I do about my trip?” It’s a question we are hearing often and frankly, the answers aren’t crystal clear. The best you can do is be sure you’re making decisions based on the best available information. Here’s how the airlines are handling issues regarding COVID-19, more commonly known as coronavirus. As policies change daily, we’ll be sure to update this regularly with the most current directives.

This list will be updated as soon as possible after we find out about a policy change. Last updated March 12, 1:04 p.m.

If your flight is cancelled by the airline, according to the US Department of Transportation you will be eligible for a cash refund, full stop. The European Union has a similar rule, commonly known as Rule 261, that provides for refunds for any flights that arrive into, travel through, or depart Europe.

This list is long and we are continually adding to it. The fastest way to find your airline is to press Control + F (Windows) or Command + F (Mac) on your keyboard to bring up a search menu. Type in the name of the airline you are looking for.

For more cancellation information about Sporting events, concerts, and other public gatherings check out our master list of event cancellations.

Related: Compare & Buy Travel Insurance for 2020

U.S. Airlines

Alaska Airlines

Alaska Airlines is allowing no-fee changes and cancellations to the following:

  • Tickets purchased on or before February 26, 2020
  • New tickets purchased between February 27, 2020 and March 31, 2020

Non-refundable first class, main cabin and award tickets may be changed for no fee, with new travel completed by February 28, 2021, or cancelled with travel funds placed into your Alaska Account or a credit card certificate via email. Fare difference applies. Saver fare tickets can only be cancelled with funds deposited into your Alaska Airlines account.

Alaska Airlines’ Full Policy

American Airlines

American Airlines is allowing customers who bought tickets before March 1, 2020 and scheduled to travel until April 30 to rebook without a change fee. Tickets need to be changed and travel must start before December 31, 2020. You’ll have to pay for any fare difference. Tickets booked between March 1 and 31, 2020 for any date can also be changed fee-free.

American is also allowing changes and refunds for tickets to:

  • Italy or South Korea purchased on or before February 24, 2020
  • Hong Kong purchased on or before January 28, 2020
  • China bought on or before January 24, 2020

American Airlines’s Full Policy

Delta Air Lines

Delta led the major US Airlines with flexible cancellation policies for customers affected by travel limitations due to coronavirus. All tickets purchased on or before March 9, 2020 for travel until April 30, 2020 can be changed without a service fee. Tickets must be re-issued and travel must begin by Dec 31, 2020.

Tickets purchased between March 1 and 31 for travel until February 25, 2021 are also eligible for fee-free changes. Travelers booked to COVID-19 affected destinations, including those in Italy, China and South Korea, before May 31st, 2020 can also be re-booked with waived change fees.

If you prefer, you can cancel your flight booked on or before March 9, 2020 and your funds will be available for one year from your original ticket’s issue date. Note that this does not mean that your money will be refunded, or even that you will be able to purchase a new ticket entirely with the funds from your ticket. Fare differences will apply, so if your new flight is more expensive you are on the hook for the difference.

Delta’s Full Policy

Frontier Airlines

Frontier makes the process more onerous than other airlines but has instituted some policies to make tickets more flexible in this challenging environment. To be frank, Frontier has the least customer-friendly policies of any US Airline.

Tickets may only be modified by phone and only may be modified or refunded for flight credit one time. Fare differences will apply. Frontier’s flight credits are only valid for 90 days from the cancellation date. For changed flights, travel must be completed by November 9, 2020.

  • Flights booked before March 10, 2020 for travel before April 30, 2020 may be changed.
  • Flights booked March 10-31, 2020 for travel through November 9 may be changed. Frontier has an existing policy that tickets changed more than 60 days before departure.

Frontier’s Full Policy

Hawaiian Airlines

Hawaiian Airlines is offering a flexible ticketing policy. Guests who book any flights between March 1 and March 31, 2020, can change travel to future dates without incurring fees. The waiver allows a one-time change per ticket and fare difference applies.

Travelers with bookings made prior to March 9, 2020, with travel between March 1, 2020 and April 30, 2020 can make flight changes with new travel commencing no later than December 31, 2020. This waiver allows a one-time change per ticket and fare difference applies.

Hawaiian Airlines has additional waivers for flights to Japan, South Korea and China.

  • Japan: Flights booked for new travel on or before April 23, 2020 will have no change fee and no fare difference. Flights booked for new travel on or after April 23, 2020 will have no change fee but will be charged fare difference. Tickets must have been issued by March 6, 2020 and must be rebooked by April 12, 2020 to qualify.
  • South Korea: Flights rebooked for new travel on or before October 31, 2020 will have no change fee and no fare difference. Flights booked for new travel on or after October 31, 2020 will have no change fee but will be charged fare difference. Tickets for scheduled travel between February 24, 2020 to May 1, 2020. New travel must be booked by October 31, 2020.
  • China: Flights rebooked for new travel on or before May 31, 2020 will have no change fee and no fare difference. Flights booked for new travel on or after May 31, 2020 will have no change fees but will be charged fare difference. Tickets must have been issued prior to January 27, 2020 with affected flights scheduled between January 27, 2020 and March 31, 2020. New travel must be rebooked by March 31, 2020.

Hawaiian Airlines’ Full Policy

JetBlue

JetBlue is waiving cancellation and change fees for all flights based on the purchase date.

  • Travel dates of March 10 to April 30, 2020, regardless of the ticket purchase date.
  • Tickets for travel before June 1, 2020 may be exchanged if they were purchased after February 27, 2020.
  • For new bookings between March 6 and 31, 2020 for flights before September 8, 2020, change and cancellation fees are also waived.

New flights must be completed by October 24, 2020. Refunds are issued as JetBlue credit, valid for one year from the issue date. This is the longest window of any US airline, as most others’ credits are valid for one year from ticket purchase date.

JetBlue’s Full Policy

Southwest Airlines

Southwest Airlines doesn’t have to make special accommodations for COVID-19 because it already offers the most generous change and cancellation policies in the airline industry.  As long as you change your ticket ten minutes before flight time, you can get your flight re-booked or refunded into travel credit without penalty. You’ll just have to pay any fare difference that applies when you re-book your flight.  Note that travel funds are good for one year and must be used by the person whose name is listed on the ticket.

Southwest’s Full Policy

Spirit Airlines

Unlike the other airlines, Spirit has not instituted a date-specific change policy. Instead, they are extending an offer of a one-time fee-free change or cancellation.  Fare difference will apply. If you choose to cancel, you will receive flight credit that is valid for six months. Note that this means you have six months to book your flight, so effectively you will have 9-12 months to use it based on how far in advance Spirit has posted its schedule.

Spirit is not allowing fee-free changes online, but you can use their customer service via text option, which in my experience is quite responsive.

Spirit’s Full Policy

United Airlines

Tickets purchased from March 3 to 31, 2020 can be changed or canceled without fees for dates through the end of schedule. All tickets purchased prior to March 3, 2020 can be re-booked until December 31, 2020, or a year from the original ticket issue date.

Tickets booked to China and Hong Kong with a travel date before June 30, 2020 are eligible for fee-free rebooking or a cash refund, even on non-refundable fares. Tickets to Italy and South Korea before June 30 are eligible for re-booking without fees, but not for cash refunds.

A fare difference will apply for more expensive tickets. If the new ticket is cheaper than the one you purchased, the difference will not be refunded. In that case you are better off cancelling the ticket and rebooking at the cheaper price. . Canceled tickets retain their original value for travel on United 12 months for following their original issue date.  You could then use the remainder towards a new ticket.

United’s Full Policy

Other American Airlines

Air Canada

Like many other North American carriers, Air Canada is offering a free one-time change for any new tickets booked between March 4, 2020 and March 31, 2020. All travel must be completed by December 31, 2020. Fare difference applies.

Air Canada is also providing flexibility for existing bookings purchased before March 4, 2020 with travel on or before April 30, 2020. A free one-time change will apply. All travel must be completed by December 31, 2020. Fare difference applies.

Air Canada’s Full Policy

Aerolineas Argentinas

  • Passengers flying to and from Italy, Spain, France, Germany, Israel and the U.S. until May 31, 2020, may change their flights one time to travel until November 30, 2020. Fare difference will apply.
  • Passengers who purchase tickets to/from Europe and the United States from March 10 to March 31, 2020 can change their flight once without penalty. Fare difference will apply.

Aerolineas Argentinas’ Full Policy

AeroMexico

AeroMexico is offering flexibility for all ticket purchases between March 9 and 31, 2020. These tickets can have departure date changes and route changes without paying a change fee. Fare difference applies. Tickets can be reissued until May 31, 2020 and the rescheduled trip must begin on or before May 31, 2020.

AeroMexico is offering additional flexibility specific tickets:

  • To/from Italy: Tickets purchased prior to March 6, 2020 with travel dates between February 28 and May 31, 2020 can change travel dates but not origin or destination without paying a change fee or fare difference. Ticketing changes are allowed until August 31, 2020 and the rescheduled trip must begin before August 31, 2020.
  • To/from Europe: Tickets purchased prior to March 9, 2020 with travel dates between March 1 and April 30, 2020 can change travel dates but not origin or destination without paying a change fee. Ticketing changes are allowed until May 31, 2020 and the rescheduled trip must begin before October 30, 2020. Fare difference applies.
  • To/from Mexico: Tickets purchased prior to March 1 with travel dates between March 1 and 31, 2020 can have a fee-free date change. Tickets must be reissued by May 31, 2020 and travel must begin before the same date. Fare difference applies.
  • To/from Mexico: Tickets purchased after March 1, 2020 with travel dates between March 1, 2020 and February 25, 2021 can have a fee-free date change. Tickets can be reissued until February 28, 2021 and the rescheduled trip must begin before February 28, 2021. Fare difference applies.
  • To/from Asia/Europe: Tickets for travel between Mexico and Asia/Europe between March 6 and March 31 can have a no-fee departure date change. Routing must stay the same and fare difference applies. Ticket reissuing is allowed until May 31, 2020 and the rescheduled trip must begin before May 31, 2020. Fare difference applies.
  • To/from Seoul: Tickets purchased prior to March 6, 2020 are eligible for no change fee or fare difference as long as the route remains the same. Effective travel dates are February 24 to May 31, 2020. Tickets can be reissued until August 31, 2020 and travel must begin before August 31, 2020.
  • To/from China: Tickets purchased between January 28 and May 31, 2020 are eligible for no change fee or fare difference as long as the route remains the same. Effective travel dates are January 28 to May 31, 2020. Tickets can be reissued until August 31, 2020 and travel must begin before August 31, 2020.

AeroMexico’s Full Policy

Avianca

Avianca is offering the option to change itineraries purchased between March 4 and 31, 2020 with cash or miles without penalty on routes to and from the United States, Canada and Europe or between March 11 and 31, 2020 on routes to and from other international routes operated by Avianca. The new trip must be completed by December 31, 2020 and can only be changed once without a fee. At least 15 days of notice to the original flight date must be given. Fare difference will apply.

For flights booked prior to March 10 for international travel scheduled from March 10 to 31, Aviana is offering the option to rebook for travel for one year from issue date. Fare difference will apply.

Avianca’s Full Policy

Copa

Copa is currently only offering flexibility for tickets purchased until March 4, 2020. If you’re a passenger with connections on other airlines to or from China, South Korea, Italy or Iran, with travel between February 3 and June 15, 2020, you can change your flight dates, use your ticket toward a future trip, or receive a refund of your ticket if permitted by the fare terms. Fare difference applies. Changes must be completed by June 15, 2020 and the new itinerary must start before December 31, 2020.

Copa is also allowing the same flexibility for passengers traveling to countries with travel restrictions, providing tickets were purchased prior to March 4.

Flights to the U.S. are allowed similar changes, providing tickets were purchased prior to March 4 with original travel dates between February 3 and June 15. Changes can be made until June 15, 2020 and the new trip must be initiated on or before December 31, 2020. The type of changes permitted vary slightly depending on if you are a U.S. resident.

  • For U.S. residents: Flight date and destination changes are permitted, in addition to using the value of your ticket for a future trip and refunds, if permitted by the fare terms.
  • For non-U.S. residents: Date changes, applying the value of your ticket to a future trip, and refunds are possible if permitted by the fare terms. The credit received for your future trip is value for one year from the original purchase date.

Copa’s Full Policy

LATAM

LATAM has a variety of policies depending on when your ticket was purchased and where you are traveling.

All international tickets issued between March 6 and 22 allow changes without penalty providing your journey has not started yet, the ticket is reissued at least 14 days before the start of travel and the new trip commences no later than December 31, 2020. All fare differences will be charged.

Passengers with tickets issued until March 5, 2020  and original flight dates between March 6 and April 30, 2020 to the following destinations are eligible to fly today until December 31, 2020 without paying a change fee. Tickets are still subject to fare difference.

  • To/from Italy
  • Chile from Spain (round trip)
  • To Colombia from/via Spain, Italy, France or China (round trip)
  • To Peru from Spain, Italy, France or China (round trip)
  • To Argentina from Italy, Spain, France, Germany, U.S., Iran, Japan, China, and South Korea (round trip)

Passengers with tickets to/from Israel issued until March 5, 2020 with original flight dates between March 6 and April 1, 2020 can fly from today until December 31, 2020 without paying a change fee. Tickets are subject to fare difference.

LATAM has additional policies for tickets issued in China and South Korea.

LATAM’s Full Policy

WestJet

WestJet is offering flexibility for both existing reservations and new reservations.

Flights booked before March 3, 2020 for travel in March or April 2020 are eligible for a one-time fee-free change. The change or cancellation must be made at least 24 hours before departure. The value of cancelled flights will be put in your travel bank. Fare differences apply to flight changes.

For new bookings, WestJet is allowing a one-time fee-free change for all new flight bookings made between March 3, 2020 and March 31, 2020. The change must be made at least 24 hours before flight departure.

WestJet’s Full Policy

European Airlines

Some countries not on the list of most affected countries, notably Israel and Kuwait, have cancelled all flights from a long list of countries.Things are fluid to say the least, but this list will be updated daily.

European Arrival Restrictions

The most important thing to know is that US citizens and legal residents ARE allowed to travel to the United States from Europe. However, we should expect widespread cancellations of flights to and from Europe due to diminished demand.

Any U.S. citizen or lawful U.S. permanent resident returning to the United States who has traveled to one of the Schengen Area countries within the previous 14 days must enter the United States through an approved airport. The list of airports currently processing flights from COVID-affected areas are:

  • John F. Kennedy International Airport (JFK), New York
  • Chicago O’Hare International Airport (ORD), Illinois
  • San Francisco International Airport (SFO), California
  • Seattle-Tacoma International Airport (SEA), Washington
  • Daniel K. Inouye International Airport (HNL), Hawaii
  • Los Angeles International Airport (LAX), California
  • Hartsfield-Jackson Atlanta International Airport (ATL), Georgia
  • Washington Dulles International Airport (IAD), Virginia
  • Newark Liberty International Airport (EWR), New Jersey
  • Dallas/Fort Worth International Airport (DFW), Texas
  • Detroit Metropolitan Wayne County Airport (DTW), Michigan

Foreign nationals who have visited the following European countries in the last 14 days preceding their entry are affected by the new restrictions. This list includes:

  •  Austria
  • Belgium
  •  Czech Republic
  • Denmark
  • Estonia
  • Finland
  • France
  • Germany
  • Greece
  • Hungary
  • Iceland
  • Italy
  • Latvia
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Malta
  • Netherlands
  • Norway
  • Poland
  • Portugal
  • Slovakia
  • Slovenia
  • Spain
  • Sweden
  • Switzerland

Aegean

Flights booked before March 9, 2020 to any destination traveling before April 30, 2020 can be rebooked for travel until October 20, 2020.

  • Flights booked after March 9, 2020 for any travel date up to October 20,2020 can be rebooked for travel up until October 20,2020.

Aegean’s Full Policy

Aer Lingus

Aer Lingus has not established a policy regarding flights booked prior to March 6, 2020 at this time. This stance seems untenable and we will monitor it for changes.  Flights booked on March 6 and later are eligible for re-booking without restriction. Fare difference will apply.

Aer Lingus’ Full Policy

Aeroflot

Passengers with tickets to Italy and Israel until May 31, 2020 may:

  • Rebook to a different date up until December 31, 2020. Fare differences apply.
  • Rebook to a different destination up until December 31, 2020. Fare differences apply.
  • Get a full cash refund.

Passengers with tickets to Germany, Spain or France until May 31, 2020 may:

  • Rebook to a different date up until May 31, 2020. Fare differences apply.
  • Rebook to a different destination up until May 31, 2020. Fare differences apply.

Aeroflot’s Full Policy

Air Europa

  • Customers with new reservations booked from March 4 to 31, 2020 are eligible for rebooking for travel up to 12 months after original booking date.  Fare difference will apply.
  • Customers with tickets to most destinations dated between March 11 and April 30, 2020 may rebook to any destination for selected dates until November 30.  You could also receive a voucher good for travel until December 31, 2020. Fare difference will apply.

Air Europa’s Full Policy

Air France/KLM

Air France and KLM have instituted a flexible booking policy for all tickets issued up to March 31, 2020. Tickets may be rebooked for a later date up until May 31, 2020, or passengers have the option to receive a non-refundable voucher good for 12 months. The voucher can be used interchangeably on Air France, KLM, Delta or Virgin Atlantic.

  • Tickets booked to China before May 31, 2020, may be re-booked no later than June 30, 2020. They are also eligible for re-booking onto another route or for a cash refund.
  • Tickets booked to Italy before April 30, 2020, may be re-booked no later than May 31, 2020. You can also receive a voucher good for travel for the value of your ticket.
  • Tickets booked to Singapore on KLM only before February 27, 2020 for travel until March 31, 2020 may be rebooked no later than April 30, 2020. You can also receive a voucher towards a new ticket to another destination.
  • Tickets booked to Seoul, South Korea until April 30, 2020 are eligible for re-booking until May 31, 2020. They are also eligible for a cash refund if the ticket was booked via KLM or a voucher if the ticket was issued via Air France.

Air France/KLM’s Full Policy

Alitalia

As one might imagine, Italy’s national carrier has been heavily affected.  That said, its policy is quite limited. Passengers who purchased their tickets Internationally are eligible for changes.  Tickets issued before March 3, 2020 with travel until April 3, 2020 can have the date changed up to June 30 ,2020. They also have the option of changing the destination and flying on the date of their original ticket.

Alitalia’s Full Policy

British Airways

Tickets purchased before March 3, 2020 to Italy and Hong Kong may be modified or cancelled with limitations.

  • Tickets from London to all Italian destinations through April 4, 2020 can either be rebooked for a later date or refunded.
  • Tickets to and from Hong Kong before May 31, 2020, you have the option to rebook to a later date. Both departure and arrival gateways must remain the same.

Tickets purchased between March 3 and March 31, 2020, can be either rebooked within 12 months of departure or refunded via flight voucher. The flight voucher is good for 12 months from original date of departure.

British Airways’s Full Policy

EasyJet

No change and cancellation policy specific to the COVID-19 outbreaks; policies are proceeding as normal at this time. Flight that are cancelled by EasyJet will be eligible for refund, but otherwise you’re out of luck.

EasyJet’s Full Policy

Finnair

Flights booked with Finnair until April 30, 2020, may be rebooked without charge up until November 30, 2020. Fare difference will apply. In addition, Finnair has cancelled many flights. In the case of cancellation your ticket price will be refunded.

Finnair’s Full Policy

Iberia

Iberia has quite an elaborate set of conditions listed on their website, but they all share in common the ability to request a voucher for the amount of the flight if the other conditions are met. The vouchers are valid for travel until December 31.

  • Italy: In general, flights can be rebooked to travel as late as June 15, 2020. The valid dates for this offer vary by city in Italy, but all cities are eligible for the flight voucher if re-booking isn’t an option.
  • Madrid: If you have a flight to Madrid before April 30, 2020, you can rebook for selected dates up until November 30, 2020. Blackout dates include most of the summer and other peak dates so the voucher option may make more sense.
  • From the U.S. to Europe: Same policy as Madrid. If you are flying to Europe, it is likely you are transiting Madrid anyway.
  • Japan: If you have a flight to Japan before April 30, 2020, you can rebook for selected dates up until November 30, 2020.
  • Shanghai: If you have a flight to Shanghai before April 30, 2020, you can rebook for selected dates up until November 30, 2020.

Iberia’s Full Policy

LOT Polish Airlines

Flights booked on March 6 or later for travel between March 12 and April 24, 2020 are eligible for rebooking for travel until December 31, 2020.  Fare difference will apply.

LOT’s Full Policy

Lufthansa, Austrian, Swiss, Brussels, Air Dolomiti (Lufthansa Group)

The Lufthansa group of airlines has a sweeping policy that is quite clear.  All tickets booked before March 5, 2020, with travel before April 30, 2020 can can re-booked as late as December 31, 2020 without a change fee. Flights booked between March 6 and 31, 2020 are also eligible for re-booking until December 31.  Fare differences will apply.

Lufthansa Group’s Full Policy

Norwegian Airlines

Norwegian Airlines is waiving change fees for flights to Italy booked before March 6 for travel until March 19, 2020. Flight dates may be changed to travel up until May 18, 2020. At this point there are no other policies in place, however Norwegian expects to cancel 3,000 flights to and from the USA between Mid-March and Mid-June. In the case of cancellation you are eligible for a full refund.

Norwegian Airlines’ Full Policy

Ryanair

No coronavirus-specific policy is in effect at this time, policies are proceeding as normal at this time. Flights cancelled by Ryanair will be eligible for refund, otherwise you’re out of luck.

Ryanair’s Full Policy

SAS, Scandinavian Airlines

Tickets booked before March 5, 2020 for travel until April 30, 2020 to, from and within Europe (except within Scandinavia) are eligible for rebooking for a departure date before November 30, 2020.

Tickets booked between March 6 and 19, 2020 for travel until November 30, 2020 may be changed for a different flight date until November 30, 2020 without a fee.  Fare differences apply and destination and return must be the same.

SAS’s Full Policy

TAP Air Portugal

  • TAP Air Portugalickets booked between March 8 and 31, 2020 are eligible for rebooking without restriction through end of schedule. Changes must be made 21 days prior to departure and fare difference will apply.
  • Tickets to Italy purchased before March 8, 2020 may be rebooked for any destination for travel up until May 31, 2020.

TAP Air Portugal’s Full Policy

Turkish Airlines

Turkish has a fee-free change policy for all international bookings. If you purchased your ticket before March 5, 2020, you can re-book for a travel date until December 31, 2020 provided you make the request before March 16, 2020.

Tickets purchased between March 6 and March 24, 2020, are eligible for rebooking until December 31, 2020, as long as you re-book within five days of the new flight.

Information for additional international carriers will be added as soon as possible.

Turkish’s Full Policy

Virgin Atlantic

  • Flights booked before March 4, 2020 for travel before April 30, 2020 may be rebooked for travel until September 30, 2020. Fare differences apply.
  • Flights booked on or after March 1, 2020 may be rebooked for travel until September 30,2020. Fare differences apply.

Virgin Atlantic’s Full Policy

Related: Compare & Buy Travel Insurance for 2020

Bottom Line

Based on the situation on the ground, it may be more likely that your flight gets cancelled than you having to rebook on your own. If your flight gets cancelled, you will be eligible for a cash refund. If you want to change your plans before flights are actually cancelled, here are the most recent policies.

Additional reporting by Kelly Anne Smith

Read More:

Source: Master List Of Airline Coronavirus Change And Cancellation Policies (Includes All American And European Airlines)

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Concerns over the coronavirus may have you thinking twice about that vacation you’ve been looking to book, but a local travel agency says they are seeing airlines and cruise lines loosen restrictions when it comes to cancellation policies.

Coronavirus Live Updates: As Lockdowns Expand, Global Markets Plummet

Markets in Asia and the Middle East opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets. Shares in Saudi Aramco, the state oil giant, dropped 10 percent leading to a halt in trading on the Riyadh stock market.

Asian markets opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets.Tokyo was down 4.7 percent at midmorning on Monday, while Hong Kong was down 4.1 percent. Futures markets showed investors predicting sharp drops in Wall Street and Europe as well.

The coronavirus has unnerved investors as it spreads, clouding the prospects for global growth. Italy on Sunday put a broad swath of its industrial northern region under lockdown as the virus has spread, making it one of the biggest sources of confirmed infections outside China. France, Saudi Arabia, Iran and other countries also took further steps to stop the spread.

In the United States, the number of confirmed infections exceeded 500 cases. A top American expert said on Sunday that regional lockdowns could be necessary.A clash over oil between Russia and Saudi Arabia, two major producers, further unnerved investors. As the coronavirus hits demand for fuel, Saudi Arabia slashed its export oil prices over the weekend, starting an apparent price war aimed at Russia.

Lower oil prices could help consumers, but it could unsettle countries that depend on oil revenue to prop up their economies. In futures markets, the benchmark price for American and Europe oil supplies tumbled $10, or about one-quarter.Investors fled to the safety of the bond market, driving yields lower. In the market for U.S. Treasury bonds, yields broadly fell below the 1 percent level for both short term and long term holdings. The 10-year Treasury bond, which is closely watched, was yielding about 0.5 percent.

In other Asian markets, South Korea was down 3.6 percent. Shanghai was down 1.5 percent.

Italy reported a huge jump in deaths from the coronavirus on Sunday, a surge of more than 50 percent from the day before, as it ordered an unprecedented peacetime lockdown of its wealthiest region in a sweeping effort to fight the epidemic. The extraordinary measure restricted movement for a quarter of the country’s population.“We are facing an emergency, a national emergency,” Prime Minister Giuseppe Conte said in announcing the government decree in a news conference after 2 a.m.

The move is tantamount to sacrificing the Italian economy in the short term to save it from the ravages of the virus in the long term. The measures will turn stretches of Italy’s wealthy north — including the economic and cultural capital of Milan and landmark tourist destinations such as Venice — into quarantined red zones until at least April 3.

They will prevent the free movement of roughly 16 million people. Funerals and cultural events are banned. The decree requires that people keep a distance of at least one meter from one another at sporting events, bars, churches and supermarkets. The Italian outbreak — the worst outside Asia — has inflicted serious damage on one of Europe’s most fragile economies and prompted the closing of Italy’s schools. The country’s cases nearly tripled from about 2,500 infections on Wednesday to more than 7,375 on Sunday. Deaths rose to 366.

More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks. More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks.

On Sunday, Saudi Arabia cut off access to Shiite Muslim towns and villages in the east of the kingdom, cordoning off an area in Qatif Governorate where all 11 of the country’s confirmed coronavirus cases have been identified. And local Saudi media reported that the country would temporarily close down all educational institutions and block travel to and from a number of countries in the region. The kingdom had already suspended pilgrimages to the Muslim holy cities of Mecca and Medina.

In Iran, which has been hit the hardest in the Middle East, state media reported that all flights to Europe would be suspended indefinitely. The health minister in France, one of Europe’s bigger trouble spots, announced a ban on gatherings of more than 1,000 people. The U.S. has counted at least 539 cases across 34 states — Connecticut reported its first case and Washington announced another patient being treated for coronavirus had died on Sunday — and the District of Columbia, and logged 22 deaths. Washington State, New York, California, Maryland and Oregon have declared emergencies.

A growing number of schools are shutting down across the country, raising concerns about the closings will affect learning, burden families and upend communities. The U.S. Army suspended travel to and from Italy and South Korea, now the world’s third largest hot spot, until May 6, an order that affects 4,500 soldiers and family members. And the Finnish armed forces announced that troop exercises planned for March 9-19 with Norway would be scrapped.

On Sunday, the leading U.S. expert on infectious diseases, Dr. Anthony S. Fauci, said that it was possible that regional lockdowns could become necessary and recommended that those at greatest risk — the elderly and those with underlying health conditions — abstain from travel. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the Trump administration was prepared to “take whatever action is appropriate” to contain the outbreak, including travel restrictions in areas with a high number of cases.

“I don’t think it would be as draconian as ‘nobody in and nobody out,’” Dr. Fauci said on “Fox News Sunday.” “But there’ll be, if we continue to get cases like this, particularly at the community level, there will be what we call mitigation.”

Even as the rate of new infections appeared to taper in China, the number of cases around the world continued to rise on Sunday, with some of the biggest clusters emerging in Europe. Besides the sharp rise in Italy, Germany reported more than 930 cases; Switzerland’s total reached 281; and Britain’s health department said that three people with the virus had died and that the number of cases in the country had jumped to 273 by Sunday. The smallest E.U. nation, Malta, reported its first confirmed case on Saturday: a 12-year-old girl recently returned from a vacation in northern Italy. Her condition was described as good.

The Spanish authorities announced on Sunday that three more people diagnosed with coronavirus had died in Madrid, raising the number of coronavirus fatalities in the country to 13. There are now over 500 cases, the authorities said. Salvador Illa, Spain’s health minister, said at a news conference in Madrid that several cases in Spain were linked to people who recently traveled to Italy.

Source: Coronavirus Live Updates: As Lockdowns Expand, Global Markets Plummet

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Invesco Global Market Strategist Brian Levitt and Brown Brothers Harriman Chief Investment Strategist Scott Clemons joins Yahoo Finance’s Alexis Christoforous, Brian Sozzi and Jared Blikre to discuss the latest market trends on The First Trade. #coronavirus #markets #stocks Subscribe to Yahoo Finance: https://yhoo.it/2fGu5Bb About Yahoo Finance: At Yahoo Finance, you get free stock quotes, up-to-date news, portfolio management resources, international market data, social interaction and mortgage rates that help you manage your financial life. Connect with Yahoo Finance: Get the latest news: https://yhoo.it/2fGu5Bb Find Yahoo Finance on Facebook: http://bit.ly/2A9u5Zq Follow Yahoo Finance on Twitter: http://bit.ly/2LMgloP Follow Yahoo Finance on Instagram: http://bit.ly/2LOpNYz
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