Travel Guard Health Advisory: Coronavirus (COVID-19) outbreak

Date issued: 3 March 2021, Travel Health Advisory #17

As of 3 March 2021, there have been at least 128,301,662 total cases worldwide with 2,806,679 reported deaths; 390,026,186 total positive test results in the United States. Countries with the highest numbers of reported COVID-19 cases are the United States, Brazil, India, France and Russia. The World Health Organization (WHO) advised that if any traveler has symptoms suggestive of acute respiratory illness during their travel period or after returning, they should seek medical attention and highlight their recent travel to medical personnel

Vaccine Treatment

The Pfizer-BioNTech, Moderna, and Johnson and Johnson’s Janssen COVID-19 vaccines are authorized and recommended for use in the United States. Studies show that COVID-19 vaccines are effective at keeping you from getting COVID-19 and will also help keep you from getting seriously ill even if you do get COVID-19. The COVID-19 vaccination works by teaching your immune system how to recognize the virus that causes COVID-19, and this protects you from getting sick with COVID-19. Contact your local health department to learn how and when you can get vaccinated.

Advice for Daily Activities and Going Out

The CDC and the WHO published health resources with advice for daily life. These include recommendations for school and work, going out, events and gatherings, travel, recreation and transportation to help protect yourself, reduce exposure and limit community spread:

  • Wash hands with soap and water for at least 20 seconds before and after you wear your mask and if you touch it while wearing it.
  • Store your mask in a clean plastic bag after taking it off and wash it daily if it is a reusable cloth mask.
  • Obtain a COVID-19 vaccine when it is available to you.
  • Stay home if you are sick or have been in close contact with someone who has COVID-19.
  • Avoid touching your mouth, nose, or eyes before washing your hands.
  • Practice social distancing. Social distancing means staying out of crowded places, avoiding group gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible.
  • Wash hands with soap and water especially after going to the bathroom; before eating; and after sneezing or coughing. If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Travel Information for U.S. Citizens

On 28 January 2021, the U.S. Department of State issued COVID-19 testing required to advise U.S. citizens and permanent residents two years of age and over that a negative COVID-19 test taken within three days of departure will need to be presented prior to boarding when entering the United States. COVID-19 country specific travel information from the U.S. Department of State may be found at

Traveling During COVID-19

The CDC issued information for traveling during COVID-19 containing resources on travel risks, international travel, travel health notices, air travel and cruise ship travel. These include taking the following steps to reduce exposure and slow community spread:

  • Obtain a COVID-19 vaccine when it is available to you.
  • Get tested for COVID-19 one to three days before your trip.
  • Stay home and postpone travel if you are sick or if you have been exposed to someone with COVID-19 in the past 14 days even if they do not have symptoms.
  • After returning from your trip, get tested three to five days upon your return and self-quarantine for seven days. If you do not get tested, self-quarantine for ten days.
  • Wear a mask and continue to social distance.
  • Avoid touching your mouth, nose, or eyes before washing your hands.
  • Wash hands with soap and water for at least 20 seconds especially after going to the bathroom; before eating; and after sneezing or coughing. If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Supplies of hand sanitizer, tissues, and other hygiene products may be limited, so consider bringing them with you.
  • Older adults and people of any age with serious chronic medical conditions are at increased risk for severe disease.
  • Additional destination travel health notices from the CDC may be found at

What is COVID-19?

A new outbreak of pneumonia was first seen in early December 2019 in Wuhan, Hubei Province, China. On 7 January 2020, this outbreak was identified as being caused by novel Coronavirus (2019-nCoV). On 11 February 2020, the World Health Organization (WHO) announced an official name for the disease that is causing the coronavirus disease, COVID-19.

Coronavirus refers to a family of respiratory viruses that can range from the common cold to a more severe disease, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

The first Coronavirus was isolated in birds in 1937 and the first Human Coronavirus (HCoV) was identified in the nasal swab of patients with the common cold in the mid-1960s. Until now, seven strains of Coronavirus infecting humans have been identified. The newest strain, known as novel Coronavirus (2019-nCoV), was identified in China on 7 January 2020.

Mode of Transmission

The virus is mainly zoonotic, which means that the disease normally exists amongst animals, but some of the viruses have the ability to spread to humans in what is known as a spillover event.

There is limited research on the exact mode of transmission of COVID-19, but the most likely route for a human-to-human transmission is via contact with an infected person’s secretions.

Depending on the virulence of the Human Coronaviruses, the most common transmission from an infected person to others would be through the air (coughing and sneezing), close personal contact (touching or shaking hands), touching an object or surface that an infected person has touched and then touching your mouth, nose, or eyes before washing your hands and, in some rare cases, via fecal contamination.

The novel Coronavirus was initially linked to the Wuhan food market, as many of the initial patients were customers of the market where a positive sample was isolated. 


The common Human Coronaviruses mainly present as mild to moderate upper respiratory tract illnesses similar to the common cold. Symptoms may include runny nose, cough, fever, sore throat, headache, loss of taste or smell, shortness of breath, and may progress to pneumonia or bronchitis with shortness of breath and easy fatigability.

Those at high risk of developing complications include those with underlying chronic conditions, such as respiratory and cardiac diseases, immunocompromised individuals, diabetics, as well as those in extreme age groups (e.g. infants or the elderly). In addition, pregnant women are also at higher risk if infected by COVID-19.


There are several types of tests for this virus available. This would include serum PCR assay, nasal swab, broncho-alveolar lavage, sputum and sometimes stool samples.


The WHO published advice to help reduce the chances of being infected and prevent the spread of infection. These include:

  • Wear a mask.
  • Avoid ccrowded places especially within a closed and confined space and try instead to meet people outdoors. Avoid shaking hands and greet people with a wave instead.
  • Wash hands with soap and water for at least 20 seconds.
  • Use an alcohol-based sanitizer if soap and water are unavailable.
  • Cover mouth and nose when sneezing and coughing and follow with hand hygiene.
  • Avoid contact with people suffering from acute respiratory illnesses.
  • Stay home when you are having symptoms of upper respiratory tract infection or have minor symptoms.
  • Drink plenty of water and keep well hydrated.
  • Regularly clean and disinfect objects and surfaces touched by an infected person.

The above measures are effective against all infectious agents, including Influenza A and B (“the flu”), which sickens millions of individual worldwide and kills thousands each year.


The CDC issued guidance after returning home from travel. These include taking the following precautions and steps to reduce exposure and limit transmission:

  • After returning from your trip, get tested three to five days upon your return and self-quarantine for seven days. If you do not get tested, self-quarantine for ten days.
  • Avoid being around people who are at increased risk for severe disease for 14 days.
  • Wear a mask in shared spaces of your household if there are people in your household who did not travel with you.
  • Wear a mask, stay away from crowds and continue to practice social distancing.
  • Cover mouth and nose when sneezing and coughing by using disposable tissue and follow with hand hygiene by washing hands with soap and water for at least 20 seconds.
  • Take your temperature with a thermometer two times a day and watch your health.

If you develop a fever (100.4F/38C), cough or have difficulty breathing call your health department for advice before seeking care. If you can’t reach your health department, call ahead before going to a doctor’s office or emergency room. 

WHO has advised all worldwide healthcare personnel and airport security personnel to be extra vigilant and enact enhancement of surveillance at airports for early detection and prevention of spread of the disease.

Please visit the WHO website for further information.

AIG Travel will continue to monitor the situation and provide periodic updates as needed.


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AT-12280-20 (03/2021 R17)