The medical examiner in Santa Clara, California, confirmed Tuesday that two COVID-19 deaths happened there in early February, becoming the country’s first known coronavirus fatalities—and possibly providing clues about how early the virus was spreading in the U.S.
The Los Angeles Times reported that two people in Santa Clara County infected with coronavirus died on February 6 and February 17; an additional COVID-19 death was confirmed March 6.
Tissue samples were used to determine the Santa Clara County deaths were from coronavirus, and were confirmed by the Centers for Disease Control, the New York Times reported.
Prior to Tuesday, the first report of a U.S. COVID-19 fatality was on February 29 in Kirkland, Washington, and officials later determined two people who died in the area February 26 also had the virus.
The two California residents who died in February did not have travel histories that would have exposed them to COVID-19, according to the New York Times.
The newly confirmed deaths suggest COVID-19 was spreading earlier than was previously believed—likely “back in December,” Santa Clara County executive and medical doctor Jeffrey V. Smith told the Los Angeles Times.
“This wasn’t recognized because we were having a severe flu season,” Smith said, adding, “Symptoms are very much like the flu. If you got a mild case of COVID, you didn’t really notice. You didn’t even go to the doctor.”
“These three individuals died at home during a time when very limited testing was available only through the [CDC]. Testing criteria set by the CDC at the time restricted testing to only individuals with a known travel history and who sought medical care for specific symptoms,” said the Santa Clara County medical examiner in a statement. “As the Medical Examiner-Coroner continues to carefully investigate deaths throughout the county, we anticipate additional deaths from COVID-19 will be identified.”
Gene sequencing conducted in Washington State showed that the coronavirus might have been spreading there for weeks, with January 20 being the date for the state’s first confirmed case, according to a March 1, 2020, New York Times report. U.S. officials determined cases in travelers from abroad that same month, but did not confirm community spread of COVID-19 for weeks. Other possible indications that the virus was spreading earlier than was believed include the Grand Princess cruise ship that set sail from San Francisco, California on February 11, with passengers that later displayed symptoms. Researchers also believe that the virus was spreading in New York by the middle of February.
I’m a New York-based journalist covering breaking news at Forbes. I hold a master’s degree from Columbia University’s Graduate School of Journalism. Previous bylines: Gotham Gazette, Bklyner, Thrillist, Task & Purpose and xoJane.
With utmost caution, slowly, carefully and nervously watched, the process of relieving lockdown restrictions has started country by country in Europe, each at its own pace and according to its own approach as the continent marks a turning point in its coronavirus crisis.
As countries across the continent report further declines in new Covid-19 cases, governments are lifting some prohibitions, partially opening schools and permitting the reopening of some shops and public areas.
Italy, Spain, Germany, Austria, Denmark, Norway, Poland, Czech Republic and Iceland, where new infections have mostly plateaued, are among the first wave of countries easing their most severe restrictions, allowing partial returns to work and announcing other measures to help resuscitate their economies.
The official announcements have been extremely cautious and in a number of cases severely criticized, especially relating to plans for reopening schools because, as Danish Prime Minister Mette Frederiksen said: “If we open too quickly, we risk that infections rise too sharply and then we have to close down again.”
That warning also came from Ursula Von Der Leyen, the European Commission head who explained that life cannot return to full normality before a vaccine has been developed.
As for traveling, the European Commission has been very clear: “I’d advise everyone to wait before making holiday plans,” Von der Leyen told the German newspaper Bild am Sonntag. “At the moment, no one can make reliable forecasts for July and August.”
The need for caution and the step-by-step reopening plans are what the various countries have in common. While there’s consensus that societies should reopen segment-by-segment, governments cannot agree about which age groups or industries should be sent back first, which ones afterwards and when.
As countries unveil their “phase two” plans, it’s not the similarities in their approaches that prevail but their differences. “As Italy opens bookshops, stationers and children’s clothes shops, Spanish shops can expect to remain shut until April 26,” reports online news site The Wire. “While Spain’s factory staff returned to work on Monday, Italy’s factories (barring pharmaceutical and food-processing plants) are still closed. It is mandatory to wear masks outside the home in the Czech Republic, but not in Denmark.”
“A similar gulf in strategy has emerged between Austria and the Scandinavian countries,” The Wire continued. “Vienna is prioritizing the opening of non-essential stores while hinting schools could stay closed until September. Countries such as Norway and Denmark, however, are sending students – especially younger pupils – back to school this month.”
The same can be said about the travel industry and the new directives necessary in order to emerge from the crisis. All the countries are carefully considering what to do and when as borders for the most part remain closed. But each is taking its own decisions, at the time of its choosing and, for now, confusion is widespread.
With so many people around the world having booked summer holidays before the crisis, and a tourism industry reeling globally and massively, one message seems to be getting clear: The lockdown, even in the countries already easing restrictions, will last ‘at least’ three more weeks before opening borders and maybe permitting short flights.
Industry experts are warning about the losses at all levels in the industry, with small, low-cost airlines and many in the cruise industry unlikely to survive.
While the vast majority of flights in April and May have been cancelled, excluding repatriation flights, airlines are hoping to resume operations ahead of the peak July and August season, despite more somber industry predictions.
Some airlines such as Jet2 and Ryanair expect to resume flights in June, while easyJet has launched holidays for late 2020 and is trying to convince travelers to book summer flights by cutting its fees for hold luggage to £1. Despite those moves, it’s becoming clear that overseas travel won’t be possible any time soon.
In a move that probably will be extended to the rest of the industry, the airline has announced that once travel restrictions are lifted it will encourage on-board social distancing by barring use of middle seats.
Such measures could become the new normal for travelers at airports, train and bus stations and aboard all their vehicles.
Domestic flights are more likely to resume before international bookings, airlines could start conducting on-site Covid-19 tests for passengers, while airports could install small testing centers to monitor heart rate, temperature and respiratory rates of passengers in order to reveal infection.
“Ahead of boarding their Emirates flight from Dubai to Tunisia last week, masked passengers were given blood tests for Covid-19, with results delivered within 10 minutes,” reports Quartz. “Emirates, which claims to be the first airline to perform these tests, now intends to scale up its capabilities until they are available before any flight to destinations requiring the Covid-19 test certificates currently under consideration by countries such as Germany and the U.K.”
Theories abound as to how the recovery will occur, starting most likely with permission for road trips, followed by green lights for short flights and train travel, with long-haul flight later.
“When will it be safe? Where to go? By plane, train or automobile?” asks the San Francisco Examiner. There are no clear answers. The general conclusion is that things won’t take a turn to “normal” until there’s a COVID-19 vaccine.
And that will take time. Experts agree that travel restrictions likely will remain in place for many more weeks. Extending France’s state of lockdown, President Emmanuel Macron has called for the external borders of the Schengen passport-free travel zone to stay closed until September, which has been interpreted by experts as a further indication that EU restrictions on travel are set to remain in force for months.
The British government, for its part, has advised people not to book summer holidays and to avoid all non-essential travel indefinitely, with no date suggested as to when domestic or overseas trips can resume.
However, each country will make its decisions, with destinations across Europe facing many different levels of lockdowns making predictions practically impossible.
One indication of light at the end of the tunnel: France decided to postpone the Tour de France until August, meaning that traveling around that country could be on the agenda by then.
There are other hopeful predictions coming from travel experts and agencies. “Autumn and winter getaways could prove more popular than ever as people still want their yearly holiday,” according to a poll by The Sun. “We may see more late bookers as people cautiously search for the best deals and popular familiar destinations. Family favorite destinations such as Florida, mainland Spain and the Canaries are still top on searched destinations and we may see a demand for Caribbean holidays for winter sun at the end of 2020 and into 2021.”
I’m a dual Colombian-Luxembourgish freelance journalist, inveterate traveler and writer based in the world’s only Grand Duchy. I write a column on European affairs for the editorial page of El Tiempo, Colombia’s main newspaper. I have been a columnist for Newsweek and written for, among others, the Los Angeles Times, Wall Street Journal, Chicago Tribune and Toronto Globe & Mail.
Subscribe now for more! http://bit.ly/1JM41yF As coronavirus continues to spread through Europe, infecting an estimated 400 people, the cost of travelling abroad has never been greater. At least 30 British tourists are currently quarantined in the popular H10 Costa Adeje Palace hotel in Tenerife after an infected Italian doctor stayed there on Monday. We speak to four of those tourists before Simon Calder explains your rights if the virus disrupts your holiday, and virologist Stephen Griffin discusses the ongoing health risks. Broadcast on 26/02/20 Like, follow and subscribe to This Morning! Website: http://bit.ly/1MsreVq YouTube: http://bit.ly/1BxNiLl Facebook: http://on.fb.me/1FbXnjU Twitter: http://bit.ly/1Bs1eI1 This Morning – every weekday on ITV and STV from 10:00am. Join Holly Willoughby and Phillip Schofield, Ruth Langsford and Eamonn Holmes as we meet the people behind the stories that matter, chat to the hottest celebs and cook up a storm with your favourite chefs! Dr Zoe and Dr Ranj answer all your health questions, stay stylish with Gok Wan’s fabulous fashion, be beautiful with Bryony Blake’s top make-up tips, and save money with Martin Lewis. http://www.itv.comhttp://www.stv.tv#thismorning#phillipandholly#eamonnandruth
(Washington) — The Federal Reserve announced late Wednesday that it will establish an emergency lending facility to help unclog a short-term credit market that has been disrupted by the viral outbreak.
The Fed said it will lend money to banks that purchase financial assets from money market mutual funds, including short-term IOUs known as commercial paper.
By facilitating the purchase of commercial paper, which is issued by large businesses and banks, the Fed hopes to spur more lending to firms that are seeking to raise cash as their revenues plummet amid the spread of the coronavirus.
The program is the third facility the Fed has revived from the financial crisis days of 2008, when the central bank set up an alphabet soup of programs intended to keep financial markets functioning.
This facility, known as the Money Market Mutual Fund Liquidity Facility, is intended to help money market funds unload assets such as commercial paper, but also Treasury securities and bonds guaranteed by mortgage giants Fannie Mae and Freddie Mac.
Experts Weigh in on the Impacts of COVID-19 on the Global Economy
TIME spoke with four experts, across various disciplines, about how the COVID-19 pandemic could uproot the flow of business, money and labor around the world.
Money market mutual funds are owned by individual investors in brokerage accounts but also by institutional investors and businesses. Many of the funds have sought in the past two weeks to sell assets to raise cash as many investors redeem shares in the funds. Yet with demand for cash rising as stocks plunge and the economy slows sharply, money market funds have struggled to find buyers for their assets.
March 31 (Bloomberg) — The Federal Reserve released thousands of pages of secret loan documents under court order, almost three years after Bloomberg LP first requested details of the central bank’s unprecedented support to banks during the financial crisis. Bloomberg’s Margaret Brennan, Erik Schatzker and Peter Cook report. (Source: Bloomberg)
On Wednesday night, Trump finally took the coronavirus COVID-19 seriously. He banned all travel to EU countries for 30 days.
The disease may seem benign to some. Around 95% or more of the people who get it will survive and symptoms are generally mild and far from scary. But what is scary is how fast it spreads. And there are too many unknowns about the disease to find comfort in the fact that less than 1,000 people have it.
China went from 1,000 patients to 80,000 in a matter of roughly six weeks, mostly all of it in a self contained, quarantined state called Hubei.
Italy went from around 20 cases two and half weeks ago to over 12,000. It is now the Hubei of the Western world.
Travel bans on China helped mitigate spread from travelers coming to the U.S. from there. All early cases last month were from China travelers. They have since healed.
The U.S. was caught flat footed by Europe, cruises, and European business travelers at major conferences. The U.S. is now playing catch-up in the mitigation phase.
Trump reiterated what the World Health Organization said this week, calling the coronavirus a global pandemic.
We are probably one sick politician, or one more circuit-breaker on the Dow away from declaring a national emergency, forcing the NYSE to close.
“When people don’t want to go out to crowded events you start to wonder if fear begets more fear. We are seeing a lot of that now,” says Patrick Healey, founder and president of Caliber Financial Partners in Jersey City, N.J. “Until you see fewer cases in Europe, I’d be worried. The threat of spread is greater there than it was in China,” he says, citing France, Spain, Germany and the U.K.’s slow response to the crisis.
Cutting The Tail
Italy was about two weeks too late, but at least they are doing something to save Europe. They shut themselves off. This is literally a “stop the world I want to get off” moment. Italy took the China approach. They put themselves on lockdown.
The U.S. has two fairly solid case studies with how to respond to COVID-19. One is the China path of lockdowns and forced quarantining, coupled with massive stimulus.
The other model is South Korea’s massive free testing and treatment, which also corralled the disease and kept infection rates low. Mortality rates are even lower at just under 1%.
A hybrid model of both seems to be best: lockdown clusters of the virus. Test like crazy.
China is healing. It’s already got its stimulus plan lined up.
“The China approach has worked. It’s been a draconian clampdown and takes away quarterly growth,” says Philipp Carlsson-Szlezak, chief economist for Boston Consulting Group in New York. “The high frequency data in China, the proxies for movement for goods and people, all of those see a nice pick up. And the infection rate curve of new cases in South Korea has bent downward. Just hope we don’t see any worsening outbreaks.”
By slowing the spread of the virus, which includes potential spreaders who came from high risk countries like Italy, China, South Korea and Iran, buys healthcare officials time. It keeps hospitals from being overwhelmed, which is what is happening now in Italy as cases rise, Italy still seems to be fine with ICU bed capacity at hospitals.
A nearly three month lockdown of Hubei, the epicenter province, means Hubei now officially has fewer infections than Italy. The number of new patients in China’s “ground zero” has slowed to double digits, instead of thousands three to four weeks ago.
Eventually, South Korea may also be forced to implement a version of the lockdown model to stop the spread of infection after someone working in a call center tested positive for the disease.
Without any firm facts on transmission, the risk of spreading the disease without showing signs of it are high.
As a result, China has maintained strict control of peoples movements in major cities. The South Korea testing model is harder for China due to its massive, urban population, which is why it is so important to keep those cities fairly inoculated.
From on the ground accounts in Beijing, that inoculation requires school closures, no movies, no malls, no non-essential businesses open and most bank branches closed.
Businesses close at 6pm to get sprayed with disinfectant. Street fumigation takes place regularly. Building sterilization takes place several times a day.
Italy is doing exactly this now. Spraying public spaces, primarily.
In China, face masks must always be worn or else you can’t ride in taxis, take public transportation, or enter any business. Temperature readings are mandatory upon entering an office building. People with slight temps get sent straight to quarantine, according to sources there.
Entire neighborhoods are blocked off to non-residents, with security personnel patrolling to check for proof of residence.
Apartments housing someone with the coronavirus are forced into quarantine. No one can leave.
Beijing has under 200 cases today. Shanghai has under 30, according to Johns Hopkins University data.
“We just can’t impose a China style quarantine, but corporations can impose a work from home policy. You can cut off work travel and that is already happening,” says Brendan Ahern, CIO of KraneShares, who is working from home on Thursday. “Corporations here are acting pretty quickly.”
NBA has canceled its entire season. The NHL put the rest of its season on hold. Major League Baseball is thinking of postponing opening day. The BNP Paribas Tennis Open was canceled, scheduled for this week in Indian Wells. Coachella, the outdoor indie rock event, was postponed. Broadway has postponed shows for a month. Private colleges are sending kids home for the semester. Princess Cruises isn’t setting a course for adventure for the next 60 days.
If the U.S. is dragged reluctantly into a South Korea/China lockdown model, it would usher in a further drop in economic activity. Mega stimulus will be only thing keeping it alive.
It is unclear if Republicans and Democrats can work together on this, as some may see a destroyed economy as a way to finally get rid of Trump in 2021.
“You’ll have the market constantly repricing and mispring,” says Nancy Perez, a portfolio manager at wealth management firm Boston Private in Miami. “Both political parties will have to take this on. No party wants to be blamed for not doing something.”
To offset the drag, fiscal stimulus is necessary to make sure companies can meet payroll and rollover debts, preferably at no interest directly from the Fed.
Disaster relief legislation from Congress can draw on the unlimited checkbook of the Fed to help keep individual, corporate, and even municipal bankruptcies from soaring.
“I’m looking at dozens of companies in the S&P 500 right now that can literally go bankrupt if the government doesn’t act together on this,” CNBC star Jim Cramer said on Squawk Box this morning. “The government should not be collecting any cash right now.”
Quarantining a city like New York would represent a significant tax on all business activity. Administration talk of a payroll tax cut is not enough. Bold tax cuts and deferments would be best. For Cramer, a tax holiday for six months or longer is even better.
In the first 8 days of the month, China has:
Required banks to provide a grace period for the virus-hit small and medium sized enterprises (SME) immediately upon application in repaying the principal and interest of their outstanding loans until June 30.
Waived penalty interest
Banks are providing special loan quotas for firms in Hubei, and lowering the financing costs for SMEs.
The Politburo called for accelerating the investment on “new infrastructure”, including 5G networks and data centers
Beijing waived social security taxes for SMEs for five months retroactive to February 1.
Phases Of A Pandemic
According to the Center for Disease Control’s “Pandemic Influenza Plan,” updated in 2017, there are four distinct pandemic stages in terms of caseloads — initiation, acceleration, deceleration and preparation for the next wave.
Europe and the U.S. are now in the acceleration stage.
Hubei is in the deceleration phase, but this comes following two months of lockdown.
Self-protective quarantine, lockdowns of outbreak clusters and testing are the best precautionary approach to pandemic outbreaks, writes Nassim Nicholas Taleb, famous “black swan” forecaster and author of the book Skin in the Game.
Taleb and colleagues from New York University and the New England Complex Systems Institute wrote in a note published recently that cutting mobility in the early stages of an outbreak, especially when little is known about the pathogen, are essential.
“It will cost something to reduce mobility in the short term, but to fail do so will eventually cost everything,” they wrote.
Earlier this week, a shutdown announcement posted outside a hospital in Hubei province’s capital city of Wuhan, touted the treatment of more than 1,700 patients since February 2 without a single fatality.
“If a general return to work occurs this week and new infections do not spike, Chinese markets could quickly be on the mend,” thinks Vladimir Signorelli, head of Bretton Woods Research in Long Valley, New Jersey.
Indeed, they are doing better than the U.S. The S&P 500 is down 23.2%. The CSI-300 Index in Shanghai is down 8.3%.
Should new cases balloon out in Shanghai and Beijing, it would be a huge blow to containment efforts and worsen the global economic outlook. Investors would then calculate similar re-occurring outbreaks in Europe and then in the U.S. once they get cleared of the one they are dealing with now, possibly taking them well into the summer.
“We may have a couple quarters of negative growth and a technical recession because of demand destruction,” says Perez. “Prepare for the volatility.”
Says BCG’s Carlsson-Szlezak, “If we are still dealing with this until the summer, with China-style quarantine measures in effect in places like New York, it will have a massive impact on the economy,” he says. “How massive? We don’t know.”
I’ve spent 20 years as a reporter for the best in the business, including as a Brazil-based staffer for WSJ. Since 2011, I focus on business and investing in the big emerging markets exclusively for Forbes. My work has appeared in The Boston Globe, The Nation, Salon and USA Today. Occasional BBC guest. Former holder of the FINRA Series 7 and 66. Doesn’t follow the herd.
The Dow fell more than 12% in total last week. Peter Kraus, chairman and CEO of Aperture Investors, and Liz Young, director of market strategy at BNY Mellon Investment Management, join “Squawk Box” to discuss the week ahead in the markets as investors brace for more turbulence.
Connor Reed, a 25-year-old from Llandudno in North Wales, was working at a school in the Chinese city of Wuhan when he began to feel “a bit sniffly”. He would soon face a painful ordeal and become the first known British man to catch the coronavirus. It was 25 November, 2019, when he first felt unwell. He told Sky News: “I was feeling like I just had a normal cold and the problem with this virus is it progresses in stages. It started with a cold.”
It’s possible that Connor’s cold was unconnected with the virus and he just happened to catch it several days before he was struck by coronavirus. For a while he continued to work and was feeling relatively normal, but just as the cold was tailing-off, in early December, he was struck by flu. “I woke up and I was just feeling really bad. I was coughing a lot and subsequently I lost my voice.
“One of my Irish friends mentioned that hot whisky and honey really helps with symptoms. So, that’s what I tried and honestly, it did help. It really did. But in no way am I condoning that whisky and honey will cure the virus. I mean, it definitely doesn’t.”
At this point, in early December, Connor decided he wasn’t going to go back to work for a while. He had a fever and he didn’t want to pass the illness onto his colleagues. Despite living in what was the epicentre of the virus, as yet, the local authorities were unaware that Wuhan in China was incubating a nasty new disease that would spread across the globe.
“I was feeling achy,” says Connor “I just wanted to curl up into a ball and I had ear problems and sinus problems where it felt like there was a balloon being blown up in my face. And that was probably the worst symptom. It really bothered me. “I also had a raking cough. It was terrible. And it was happening so much, I lost my voice. Sometimes, I couldn’t make any sound at all. Sometimes, I sounded like a frog.”
For most people who catch the virus, it won’t get any worse than this, it may not even get that bad, but for Connor the scariest part was still to come. He actually felt like he was recovering from the flu and was feeling optimistic about going back to work when one morning he woke up struggling to breathe.
“It scared me because breathing is a necessity of life, like if you have the flu, you really feel like you’re going to die, but you’re really not. But when your lungs get affected, that’s where it scared me. And I couldn’t take a full breath. And the breaths I did take, it sounded like I was breathing through a bag. It was very crackly, and I could only take half breaths. If I walked to the kitchen, for instance, I’d be breathing really shallow and really fast.”
Connor continued drinking hot water to try and clear it up but, a day later when things didn’t improve, he went to hospital. On 5 December he had a day of blood tests, x-rays and breathing tests. The next day, two weeks after he’d first caught the cold, the results came back that he had pneumonia.
He said: “At no point was I thinking that I’m going to die. I mean, it wasn’t that serious. I’m a young person. I don’t smoke. I don’t drink. It really didn’t affect me as bad as if I was elderly or I had pre-existing health problems.” Connor recovered from his illness and a few weeks later doctors realised he had suffered from the virus that was now spreading across the province, which would become known as COVID-19.
Wuhan is still under quarantine. Connor recalls getting an alert on his phone at 3am announcing the quarantine for the city. “Luckily, I was awake to read that text message. So, I bolted out of the house and went to the 24-hour supermarket downstairs. I knew that it was going to be bad and I knew that shops were going be sold out.”
He stocked up. But weeks later the city continues to maintain strict rules. Connor said: “As more and more new cases came, and it started spreading, the government sanctioned harsher penalties and a lot harsher quarantine. For instance, at the moment, one person is allowed to leave their house every three days, and that’s just to purchase necessities.”
He said when going out there is “no atmosphere”, and very few people on the streets. “If you go to a shop, there are some shops that are open that have blocked the door off. You tell them what you want. They put it into a bag and then they pass the bag to you on a long stick just to avoid personal contact.”
Connor said the national government had dealt with the crisis well and learned lessons from previous outbreaks such as SARS. He believes the numbers for infected people that the authorities are releasing are accurate.
He added: “There are not many Western countries that can build a hospital in 10 days. China is one of the most efficient countries at getting stuff done. In regard to this outbreak, they’ve got it done. They had to. They had to take the drastic measures, that many other countries wouldn’t have taken.”
Have things gotten plane confusing for you? With the COVID-19 coronavirus outbreak occurring, are you having trouble deciding whether to cancel or postpone your air travel plans?
It seems like a fair number of people are trying to make such decisions right now. Social media certainly has had its share of “should I stay or should I go” clashes of opinions and discussions. For example, @scottbudman tweeted out these recommendations:
And someone here is worried about more than hot farts:
Then there was this question to Florian Krammer, PhD, a Professor at the Department of Microbiology Icahn School of Medicine at Mount Sinai:
On the flip side, if you don’t like lines and crowds at the airport, this may seem like a great time to fly, with an emphasis on the word seem. According to Rick Clough reporting for Bloomberg, commercial air traffic is on track to drop by 8.9% this year, which would be the biggest decline since 1978 and in fact only the fourth year that air travel has fell in that time frame. Declines also have occurred in 1991, 2001 after the 9/11 terrorist attacks, and 2009 amidst the recession and the H1N1 flu pandemic. Cecile Daurat and Justin Bachman have written for Bloomberg that the airline industry stands to lose up to $113 billion in sales and that some airlines are already cutting back on available flights. Who knows? Maybe you can even find a seat on the plane that has a free seat next to it, so that you can actually do things like see your feet while sitting.
So what should you do? Well, as you’ll see in a bit, there are clearer-cut situations in which air travel is not advisable and canceling or postponing makes sense. However, for some other situations, the answer is a bit more complicated and evolving. The SARS-CoV2 outbreak and accompanying travel recommendations are evolving and serious situations. The SARS-CoV2 seems to be significantly more contagious and more virulent than the flu virus. But it is not yet clear exactly how much more. Its reported case fatality rate has been in the 1.5% to 3.8% range, nowhere near that of the original SARS virus. But things continue to change as more info emerges. There is still much to learn about SARS-CoV2 and its spread. So caution but not panic is worthwhile. Moreover, you’ve got to weigh different factors, risks, and benefits.
If your destination has some major travel warnings or restrictions, then the answer may be easy. For example, China and Iran fall into the category of “widespread sustained (ongoing) transmission and restrictions on entry to the United States.” That means that you shouldn’t consider traveling to these countries unless you absolutely have to do so. South Korea and Italy are listed as having “widespread sustained (ongoing) transmission,” which also means that postponing travel to these countries is a good idea. There’s a warning about Japan as well, if you are an older adult or someone with a chronic medical condition.
As things are changing fairly rapidly, check this website often. Bookmark the site. Treat it like you would Cristiano Ronaldo’s Instagram feed. Follow it. Learn it. Absorb it.
A second thing to do is double-check whether the meeting, the gathering, or whatever you’re going to may be canceled. Recently meetings have been like primary candidates in a political race: “it’s going to happen, it’s going to happen, no problems, oh, time to shut things down.” Last minute cancellations have been occurring, so you don’t want to be stuck with a ticket and no place to go, just like what may be going on, or perhaps not going on, here:
So what do you do if your destination doesn’t have a major warning and your event still seems on track? Air travel certainly isn’t the same as staying in your apartment or house surrounded by mounds and mounds of toilet paper rolls. The only way to completely avoid the possibility of infection is to completely avoid contact with people or any of the objects or surfaces that they touch. This is may not be practical. Life is never risk-free. So there will be risks with any activity, especially ones that involve larger numbers of people.
But let’s be clear what the real risks may be. For example, how much of a risk is the recycled air in airplanes? Well, the air does go through HEPA filters. HEPA stands for “high efficiency particulate air [filter]” and is supposed to filter out at least 99.97% of microbes, dust, pollen, mold, and any airborne particles that are 0.3 microns (µm) in size. The filter may even be more efficient at filtering particles that are smaller or larger than 0.3 µm, such as French fries.
Assuming that the HEPA filter is working properly then you may not have to worry so much about the air nozzle overhead that’s creating a mini-tornado on your face. Plus, SARS-CoV2 can only travel so far in the air. It’s not as if they have little wings. Viruses don’t drink Red Bull. Instead, they hitch rides on respiratory droplets that come out of an infected person through coughing, sneezing, spitting, or the like. These droplets can travel up to three to six feet from the person.
What may be of greater concern is the close proximity between passengers on the plane. Over the past decade or so, passengers haven’t exactly been declaring, “wow, what do I do with all this legroom? There’s just too much legroom here in economy seating.” In fact, Stephanie Robertson has written for the New York Times about “Fighting the Incredible Shrinking Airline Seat” and how airplane seat sizes have been shrinking since since the U.S. airline industry underwent deregulation in the 1970’s. Maintaining a three to six foot distance from other passengers may be tough even if you were to have excessive and obvious heated flatulence. So yes, if the person next to you is infectious, you could get exposed.
Then there are the various surfaces on the plane. You are probably more likely to catch respiratory viruses like coronaviruses and flu viruses through touching things that have been contaminated with the virus. That includes body parts like hands or surfaces like seat belt buckles and Baby Yoda figurines that have been touched by someone infectious. Quite a few of the surfaces in an airplane cabin would be considered “high touch,” meaning that different people touch them frequently. These include tray tables, seats, seat belts, video monitors, and that crypt-like pocket in the back of the seat in front of you. People shove who knows what in those pockets, including magazines, wrapping papers, used tissues, and maybe even a doughnut.
That’s why limiting what you touch, washing your hands thoroughly and frequently, and not touching your face with unwashed hands will be more important than holding your breath for the entire duration of the six hour or so flight. (By the way, you can only hold your breath for a few minutes before you pass out, so don’t even try it.) Of course, not touching your face is easier said than done, as I described previously for Forbes. Your face can feel like a gigantic planet with a massive gravitational pull on your fingers. Therefore, try keeping your hands occupied like putting them in your pockets, typing on a computer, or flashing gang signs to yourself.
Hand sanitizer can help but make sure you use it properly. Use enough sanitizer to cover all parts of your hands. Then massage your hands together as if they were the main characters in a romance novel. Keep up the rubbing until they become dry. Recite the alphabet while doing this so that you know that you’ve gone long enough, because isn’t that what lovers in a romance novel do?
Washing your hands with soap and water, if done properly, is always better than just using hand sanitizer. However, airplane bathrooms may be areas of really high touch, in more ways than one. A lot can go on in a bathroom and a decent percentage of it is not good, from a microbe standpoint, that is. The words “airplane bathroom” and “luxurious” usually don’t go together. While in a cramped airplane bathroom, it can be difficult to limit your touching, especially when turbulence makes it feel like you are an ingredient in a smoothie being made.
Therefore, definitely wash your hands thoroughly at the end of an adventure in an airplane bathroom. This may not be the easiest thing with the design of the bathroom sink. Many such bathrooms don’t have automatic sensor-driven faucets. Instead you’ve got to continuously hold down those little faucet handles, and keep pushing that lever that allows the sink to drain. After drying your hands with a paper towel, try not to touch other used items when throwing the towel away in the garbage. This can be tough when the garbage container lid slams back shut like gator’s mouth. When you are leaving the bathroom, use a paper towel to handle the door knob so that you don’t just re-contaminate your hands.
Pay attention to how everything in the cabin is maintained and cleaned. As a customer, consider it a right to know what safety and disinfection procedures are in place during and between flights. According to the World Health Organization (WHO), the new coronavirus may be able to survive on surfaces for “a few hours or up to several days.” That means what happened in the cabin during the flights before yours may stay in the cabin. Therefore, before a flight, consider inquiring about the specifics of an airline’s cleaning policies. After all, scrimping and saving on such things may be one way some airlines try to cut costs, unless customers shine more of a light on such practices.
Another question that is coming up is whether flights will be canceled or grounded due to the outbreak, leaving you stranded. That will depend on where you are flying, how the outbreak proceeds, and what the governments and the airlines plan on doing. It is difficult to predict what may happen. Therefore, follow closely official CDC announcements and the news, the real news that is and not what Uncle Joey or Aunt Marmy are saying on Facebook.
Stick with airlines that have more flexible cancellation and change policies. Beware of the airlines that say, “oh, you can change your flight but it will require this massive fee and a body part.” If you have already booked a flight and the airline has instituted a new more flexible change policy, see if you can benefit from that policy too. For example:
Consider purchasing travel insurance or a Cancel for Any Reason (CFAR) policy to cover you in case plans have to change. As always, read the fine print of such policies, which may not always be so fine.
Also, look into alternatives to air travel. Even if you do end up taking a flight, it is helpful to know how you may get back if your return flight ends up getting canceled. Make sure that the options are viable. After all, find a bicycle and pedal like mad may not work if you are going from San Francisco to New York City.
Ultimately, it’s difficult to make blanket recommendations about air travel. (Oh, by the way, make sure that airline blankets are properly cleaned before using them.) In general, this doesn’t seem to be the best time to schedule optional travel. There’s still a fair amount of uncertainty. So if you can easily cancel your air travel, then you may want to do so.
If your travel isn’t completely optional, try to identify alternatives such as video-conferencing or sending a gigantic cake. Cutting down air travel not only may decrease your risk of getting sick but also reduce the risk of you carrying the virus to others who may be of even greater risk for bad health outcomes if they have other diseases or are older. It ain’t a bad thing for the environment either.
If you are over 65 years of age or have a chronic medical condition like lung disease, have a very low threshold for canceling your air travel. You may be at risk for worse health outcomes if you get infected. Check with your doctor before considering such travel. If you are a little kid, enjoy smearing things on your face, and don’t quite understand boundaries yet, you may not want to travel either because you won’t be able to maintain the necessary aforementioned infection control precautions. Besides if you are a kid, you are probably less likely to have essential work travel.
If canceling or postponing your air travel is difficult to do and you do end up having to travel by air, no need to be paranoid. “Be paranoid” is rarely the recommendation for any situation. Just take the precautions mentioned above, which are probably precautions that you should always take when traveling by plane regardless of whether a novel virus is circulating.
So, again, right now, you should avoid the locations that the CDC website warns you to avoid and consider canceling or postponing all non-essential air travel if it is reasonably feasible to do so. You also may want to avoid air travel if you are in a higher risk group such those over 65 years of age or with a chronic medical condition.
Of course, lots of air travel doesn’t quite fall into these categories, which makes decision making more difficult. As with all difficult decisions, your decision on whether to cancel your flight plans is personal, depending on your risk tolerance and needs. Yes, being confined close together with others in a cabin for several hours does have its risks. Yes, you are depending on others to keep surfaces clean and disinfected. Yes, you don’t know exactly what will happen in the ensuing weeks. But there are things that you can do to reduce the accompanying risks. Realize that nothing has no risk.
Be aware of the real risks and not what so-and-so with ten followers on Twitter is trying to get you to believe. Don’t listen to some of the panicky chatter out there or anyone who tells you that there is one definitive answer for everyone, such as all air travel should be canceled immediately or that no one should be concerned about air travel at all. Keep in mind the expertise and agendas of anyone who may be giving advice. Follow closely announcements from trusted sources. If you can follow what a celebrity is doing with his or her hair each day on social media, you can frequently check websites like the CDC’s. In other words, just stay appropriately grounded when making your decision of whether to fly.
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), Executive Director of PHICOR (@PHICORteam), Associate Professor 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 involves 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.