Here's how to plan your travel health and safety in 2021.

The ultimate guide to travel health and safety

Health and safety isn’t an afterthought for travelers anymore. It’s the first thing they consider before they plan a trip. It’s often the only thing they worry about in the hours before their departure. Health and safety is everything in a post-COVID world.

There’s a popular misconception that you can somehow guarantee a safe trip as long as you take enough precautions. That’s simply untrue. You can take every step in this article to protect yourself and your family. But things still happen. The world is filled with wonderful but often frightening uncertainties. If you want absolute safety, and you’re unwilling to take any risks, maybe travel isn’t for you.

Should I stay or should I go?

Determining if a destination is “safe” isn’t easy. It depends on you, your risk tolerance, where you’re going, and what you’re doing.

When to go

  • If large numbers of other tourists are traveling there, and there are no government warnings about safety conditions or health problems, such as an outbreak.
  • You’re returning to a place that is well known to you, meeting with people you know, and following a familiar itinerary. You also know how to stay away from circumstances that may have a harmful effect on your health.
  • You’re going to be under the care and supervision of an experienced tour operator who can keep you out of harm’s way.

When to stay home

  • Your government has warned against citizens traveling to that destination, and many people are canceling their trips to that place.
  • You have reason to believe your safety or health might be compromised, and you don’t have any knowledge of the language, local customs, or potential dangers.
  • You are going to an unfamiliar location without a clear itinerary of safe activities, and you have no sense of whether it’s safe or not.
  • Your doctor advises you to stay home.

When should I research a destination for safety?

Do your due diligence before you make your reservations. It’ll save you a lot of grief later on. Many insurance policies won’t cover political unrest or general security problems that arise. Airlines and hotels are generally unwilling to issue refunds if you decide to cancel a trip.

Where can I get reliable safety information about my destination?

The most recommended resource for travel safety is the State Department’s Bureau of Consular Affairs website. It offers tips for travelers and warnings on potentially dangerous areas. The State Department travel site can be a good starting point if you’re trying to get an idea of whether your destination is safe. It classifies countries on a scale of 1 to 4, with 1 being safe and 4 dangerous.

Travel health and safety is in the front of everyone's mind during the pandemic. Visit the US State Department for travel advisory levels for international destinations.
The travel advisory chart is provided by the US State Department for every international destination.

Get a second opinion

The Canadian government, for example, issues direct warnings, such as “AVOID ALL TRAVEL.” This can be helpful when the wishy-washy wording on a State Department site leaves you a little confused. Other places to check include the British government and the Australian government sites.

Typically, if three of these major advice sites agree on a place, you should probably heed their advice. Take it all with a large chunk of salt. As a baseline, a search of the international government sites will reveal how “dangerous” they think your hometown or home state is.

Which shots do I need before I go?

One critically important resource is the Centers for Disease Control and Prevention travel site, which offers information about potential health problems and important advice, the most important of which is to get recommended inoculations well in advance of your trip.

Do your own sleuthing. An Internet search of the name of the destination alongside keywords such as “murder,” “robbery,” “rape,” and “kidnapping” (feel free to add your own horrible event, depending on the place) should yield news and blog reports that can offer a clue as to how safe a place is. Many mainstream media outlets can be censored by governments, or may practice self-censorship, which is more troubling. You may need to read between the lines.

Finally, a competent travel advisor should know a thing or two about the place you’re going to, especially if that agent has recommended it. If you’re getting answers like, “I don’t know how safe it is — you should check with the State Department,” then you have a clueless agent, and may need to find yourself a new one.

What’s the biggest threat to my safety when I’m traveling?

A car accident. About 30,000 motorists die in auto accidents every year in the United States, and about 2 million are injured. That works out to about 10 fatalities per 100,000. But in some countries, where roads are less reliable, driving can be far more dangerous. Traffic accidents are the leading cause of medical evacuations.

You can easily avoid becoming a victim:

  • Don’t drive after a long flight.
  • Use safety belts and child safety seats.
  • Rent larger vehicles if possible because they offer more protection in a crash.
  • Make sure the car is well-maintained.

If you have to get somewhere by car, consider hiring an experienced driver who is familiar with the destination and language, and is an expert at maneuvering through local traffic. Being a pedestrian can also be dangerous in certain highly populated third-world cities where traffic doesn’t stop for pedestrians. If you want to stay safe while you’re on vacation, the remedy is fairly obvious: stay off the road.

Look both ways before crossing

I know, I know. Your parents told you, and now I’m telling you. But I have my reasons. On a visit to New Zealand, one of my colleagues stepped into traffic without looking to the right. A car struck her, and she died. Yes, they drive on the other side of the road over there. Mom is right — look both ways. You’ll have a better chance of coming home alive.

What else can make a trip dangerous?

Danger can lurk around every corner when you’re traveling. Sometimes, literally. Here are some of the most common security problems, along with their remedies.

  • Robberies and pickpocketing. No one really knows how many of these petty thefts are pulled off, because they aren’t always reported to authorities. The criminals are after your wallet and cell phone, and not necessarily in that order. Always carry a decoy wallet with your daily cash and old photos, but nothing that would make you want to keep the wallet in a robbery situation. In case of a robbery, hand over this wallet without hesitation. Carry a credit card and cash in an inside pocket. Carry your pocketbook on the shoulder facing away from the street to deter drive-by thefts. Leave pricey jewelry and watches at home. Otherwise, you’re advertising for a robbery. Also, consider a portable hotel door lock or other device that will alert you if someone is trying to break in.
  • Animal bites and scratches. Dog, cat, monkey, and bat bites are major problems for curious tourists. What’s more, many locations around the world do not have access to anti-viral rabies shots, meaning you might have to cut your trip short to seek medical attention. Keep your distance from animals when you’re on the road, and never attempt to pet them, no matter how cute they appear to be.
  • Riots and mob violence. If you’re visiting a place where strikes, demonstrations, or even just large gatherings are common, you’re better off keeping your distance. Large crowds, even in a destination that isn’t known for violence, can suddenly turn dangerous. If you find yourself in a mob, leave the area right away. Do not take photos and try to capture “history” in the making. You could become history in the process.
  • Scams and swindles. Many travelers let their guard down when they are on the road. In fact, this is the time to be most vigilant. The old saying “If it sounds too good to be true, it probably is” holds true all around the world. Be cautious of timeshare sellers, especially those who single out travelers at the airport. In fact, you might want to cast a skeptical eye toward anything you’re offered. Chances are, the scammers have pegged you as an out-of-towner, and see an easy opportunity to make a quick buck. Worse, if you challenge them, they could hurt you.

What kind of situations should I try to avoid?

Here are a few common scenarios that could lead to serious problems, and even make your trip less safe. Avoiding them will, at the very least, make your journey less stressful.

  • Lost or stolen passport. The U.S. State Department reports about 300,000 passports are lost every year. The absence of a passport can leave you stranded. [SMART: How to replace your stolen passport faster. Keep a color copy of your passport in a safe place in your hotel room. Also, leave a copy with friends or family at home. Scan a copy as an e-document. If your passport is lost, contact your embassy immediately. When traveling abroad, take extra passport photos with you, just in case.]
  • Cultural faux pas. Hand gestures mean many different things in different parts of the world. Before traveling, do some basic research on cultural do’s and don’ts. Many countries have strict prohibitions on males touching females, even for friendly greetings. Respect other cultures and their beliefs. Don’t go skinny-dipping in Dubai, for example. Remember, if you’re not taking a staycation, you’re a guest. If you behave like one, you should stay out of trouble.
  • Pay a bribe. Although requests for a “special” payment are uncommon in the most popular tourism destinations, they become an issue when you go off the beaten path. The two most common forms of bribes requested of tourists are for bogus traffic tickets, and bribes collected at the border, sometimes euphemistically referred to as exit fees or departure taxes (note: some of these fees are legit, and listed on your embassy website). You can avoid most of these fees by following local traffic laws — better yet, stay off the road — and traveling with all the right documentation. If someone demands a bribe, it is often better to pay one than to possibly end up in a local jail. If you do end up in jail, refuse to sign anything, and firmly request to speak to your embassy or consulate. Reach out to any locals you know. They may be able to help resolve your issues.

HEALTH

Should I worry about my health when I travel?

If you have to ask, then the answer is “yes.” Certainly, your health can fail any time, but many travelers wait too long to take that “bucket list” trip, and they try to hedge that big vacation with a travel insurance or medical evacuation policy. It is these good people who I hear from, after they slipped in the shower on their first day of a round-the-world cruise and needed to be airlifted to the nearest hospital. To them, I wish I could say a few things:

  • Please don’t wait too long to take a vacation of a lifetime. Too many readers want a sure thing, which is to say, they wait until the kids are grown up and out of college, and they’ve retired, before embarking on that adventure of a lifetime. By then, they may already have serious health limitations.
  • Easy is better than nothing. If you want to visit a destination that requires lots of stamina (skiing at altitude in Colorado, for example), the time is now. Do it when you have the endurance, and go for the cruise or all-inclusive vacation later. An easy trip is better than no trip at all.
  • Don’t play games with your health. People lose their minds when they’re on vacation, no two ways about it. They hike up Mt. Vesuvius when they wouldn’t even try to climb the stairs at home. I have no idea why. Needless to say, you should apply all the same precautions when you’re away as when you’re home. Don’t do anything stupid. Please.

Don’t forget to take your medicine

Losing or misplacing your prescription medication can significantly shorten your trip, if not end it. How do you prevent that?

  • Carry a spare prescription from your physician.
  • Keep medication in its original container with the label intact, and always keep it in your carry-on.
  • Don’t consolidate medications in one container to save space.
  • Keep a list of the generic equivalents, and always carry spare medication in case of an emergency.
  • Check to make sure your medication is allowed in the destination country. If not, determine a solution before your trip, not when the medicine is confiscated at entry.

Should I see a doctor before I travel?

If you’re visiting a country without modern medical facilities and standards, consider scheduling a visit with a travel medicine clinician at least one month before departure. During the assessment, the clinician will review your itinerary (including specific cities and types of accommodations), as well as the season of the year and the mode of travel. They will also take your medical conditions, daily medications, and allergies into account. The assessment will result in a list of appropriate medications and vaccinations for your trip. The American Society of Tropical Medicine and Hygiene publishes an online directory of physicians who offer clinical consultative service in tropical medicine, medical parasitology and travelers’ health.

What’s the biggest threat to my health when I’m traveling?

Diarrhea. It affects between 30 to 70 percent of travelers outside the U.S., depending on where you visit. That means you’ll probably get it at some point. Sure, you can take some precautions — the adage “Boil it, peel it, cook it — or forget it” comes to mind — but even so, you may get sick. The Centers for Disease Control says food preparation using poor hygiene is to blame, and that boiling and peeling doesn’t offer failsafe protection.

Don’t consume foods where water has been added (such as fruit juices), or where raw vegetables have been rinsed in water. When purchasing fruits, choose fruits based on the number and not the weight. Water is often injected into watermelons and such to add weight and bring a higher price in markets. Use bottled water for brushing your teeth, and avoid swallowing any water during showers. Check with your physician before departure about carrying an antibiotic for self-treatment of moderate to severe diarrhea or an over-the-counter medication such as Imodium.

What should I do about malaria?

Malaria has the potential to not only end your trip, but affect future trips. As such, it deserves a special mention. In 2020, there were an estimated 219 million cases of malaria worldwide. Of those, 660,000 people died, according to the CDC. Think you’re immune? Check the CDC’s country-specific malaria tables before you make up your mind. The flu-like symptoms, which include fever, headache, joint pain and fatigue, can develop as early as seven days after initial exposure to the anopheles mosquito bite. In severe cases, seizures, mental confusion, kidney failure, coma, and death may eventually occur.

Malaria mosquitoes feed during the dusk to dawn hours. The greatest risk of infection is in Sub-Saharan Africa. You can reduce your risk by not traveling there. But if you do go, avoid contact with the mosquitoes by staying in well-screened areas, using insecticide-treated bed nets, and wearing clothes that cover most of your body.

Remember, not all medications are effective in all regions. A travel medicine clinician will know what medications are effective in the areas you plan to visit. Discuss the details of your trip, and share the exact itinerary with your clinician. If you have a map of your trek, cruise, or adventure, bring it along to share with a professional. Keep in mind that malaria can cause death if treatment is delayed.

I’m feeling a little queasy. What should I do?

Motion sickness, sometimes referred to seasickness or car sickness, is a common disturbance of the inner ear that is caused by repeated motion. You may experience dizziness, nausea, vomiting, and cold sweats. You can prevent it by avoiding alcohol before and during travel. Stay away from heavy, spicy, or fatty foods, which may worsen symptoms. Avoid strong odors. Also, find a place on the ship or plane where there is less motion, such as over the wing on an aircraft. Cabins on lower decks and closer to midship have less rocking motion than those on higher decks or near the bow or stern. Bonine tablets can help with motion sickness and can be purchased over the counter.

How about altitude sickness?

Few travelers consider the altitude of their destination until it’s too late. After arriving, you have a little wine with a large dinner, and the next thing you know, you’re flat on your back in bed, having difficulty breathing. The best advice is to climb high and sleep low — meaning you should not only try not to think about your elevation, but also find accommodations at as low an altitude as possible. This is particularly relevant when you’re skiing or visiting a high-altitude destination such as Machu Picchu.

Also, avoid drinking alcohol, and maintain adequate hydration and a high-carb diet. To do that, start drinking lots of water a few days before your trip and drink even if you aren’t thirsty. For the first 48 hours at your destination, participate in only mild exercise. Treat an altitude headache with over-the-counter analgesics. Consider hydrating with water or Gatorade. Listen to your body, and don’t ignore the warning signs — and never, ever ascend with symptoms.

Packing tips to boost your travel health and safety

Here are a few must-haves for a healthy trip. Bear in mind that you can probably buy some or all of these items at your destination, so unless you’re heading somewhere that doesn’t have drug stores, you may want to wait until you arrive, or until you need them, to buy them.

Oral rehydration solution. That’s used to treat dehydration and travelers diarrhea, and can be a lifesaver in the event of prolonged exposure to heat or fluid loss due to
illness.

Epinephrine auto-injector (Epi-pen). If you have any kind of allergy, you may want to get one of these, or carry an over-the-counter antihistamine for milder reactions. Even if you don’t have a known allergy, health experts recommend taking these precautions in case you’re exposed to local foods, plants, stings, or bites that could trigger a deadly reaction.

Pain relief. Carry a bottle of acetaminophen, ibuprofen, or aspirin.

SAM splint. Get one with Ace bandage for sprains and strains. It’s lightweight, moldable, and has multiple uses for treating minor injuries.

Antiseptics and antibiotic ointment. For treatment of cuts, abrasions, lacerations, and bug
bites. Also, don’t forget the gauze, non-adherent, and quick-clot dressings for deep wound lacerations, and Coban wrap to secure dressings in place. If you have no idea what I’m talking about, don’t worry — these items are in most small first-aid kits. Just get one of those.

Tweezers and scissors. For cutting of gauze bandages, and removal of ticks and leeches.

Emergency eye wash. That’s especially important for those facing extensive outdoor exposure, or traveling to sandy and windy environments.

Sunscreen and lip balm with SPF, and insect repellent (DEET). Mosquitoes can carry a host of diseases. Also, pick fabrics and bed nets that contain permethrin for protection against mosquito bites.

Potable aqua iodine tablets and filters. Travelers use these for water purification. Just in case.

A headscarf or belt. These can double as a tourniquet in the unlikely event that one is needed. You can also wrap coins, fishing weights, or other heavy objects in the scarf to make a handy defensive weapon (hey, you never know).

A flashlight. In some countries, electricity isn’t always available. Don’t get left in the dark. Also, pack a fresh set of batteries.

Should I consider a medical evacuation or security policy?

In addition to your travel insurance, companies such as Medjet, Global Rescue and International SOS offer programs that offer 24-hour security and medical evacuation services. These can be helpful when you’re away from modern medical facilities, or suffer from a medical problem that requires the attention of a specialist. A good policy should offer a 24/7 call center with physician support.

You should consult with your travel agent and doctor when making the decision about whether to buy such a policy, but here are a few general guidelines.

Check your existing insurance coverage. Read your travel insurance coverage and medical insurance carefully. Many of the services offered by medical evacuation companies may be included in your policy. Why pay for the same thing twice?

Run a worst-case scenario. Many of these companies offer a full range of services, including extracting you from countries during civil unrest, and helping secure your release if you’re taken hostage. You may not need that if you’re going on a road trip to visit grandma (unless she packs heat and is a little unstable).

Kick the tires. If you decide a medical evacuation policy is a must for your next trip, check several providers before settling on one. Some companies have a strong presence in certain areas; others try to cover it from a control center 12 time zones away. Read each policy carefully before making a purchasing decision. Bear in mind that for most of these companies, the core customer is the business traveler.

The bottom line: Don’t overlook your travel health and safety in 2021!

You can’t control your health or safety when you’re traveling, but don’t overlook the basics. If you take a few simple precautions, you can avoid many of the biggest dangers. The time to think about both of these important issues is long before you hit the road.

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