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Skyscanner Is Answering Your COVID-19 Travel Questions With an Interactive Map

Skyscanner launched an interactive map to help travelers monitor COVID-19 restrictions.

Meena Thiruvengadam is a lifelong traveler and veteran journalist who has visited more than 50 countries across six continents. Her writing has appeared in The Wall Street Journal , Departures , TripSavvy , and other publications.

Planning a trip during a pandemic is no easy task, especially when travel restrictions around the world are constantly changing, sometimes overnight.

To help, Skyscanner, the company best known for its flight price comparisons , just launched a color-coded interactive travel map to show people what areas of the world are (and aren't) open to them.

A study of British travelers inspired the map, Skyscanner said in announcing the project. A survey with more than 2,100 Brits found that more than half didn't have a clear understanding of where they could and could not travel.

"People want to travel and we know there is pent-up demand from the searches we are seeing for flights and for more information; but confidence has been hit by the lack of consistency between countries worldwide regarding measures and restrictions," Jo McClintock, Skyscanner's senior director of global marketing, brand, and content, said in a statement. "Consumers just do not understand the complex rules and are crying out for transparent, detailed information."

Skyscanner's map allows users to set their country of origin. It marks countries users can visit in green, countries that might be an option in yellow, and those that are off-limits in red.

The site also includes information on countries that require quarantine and the volume and direction of COVID-19 cases locally. If a specific country is on your radar, you can set an alert for changes to travel regulations in that country.

For Americans, much of the map remains red. U.S. passport holders face limited restrictions in 13 countries, Skyscanner's map shows. Brazil, which like the U.S. is struggling to control the spread of coronavirus, is among those countries.

Meena Thiruvengadam is a Travel + Leisure contributor who has visited 50 countries on six continents and 47 U.S. states. She loves historic plaques, wandering new streets and walking on beaches. Find her on Twitter and Instagram .

clock This article was published more than  3 years ago

This interactive tool tracks covid-19 travel restrictions by country

Skyscanner’s detailed travel map is color-coded in stoplight-style green, yellow and red.

There are many regulations for travel abroad during the pandemic, especially for Americans, amid rising coronavirus cases. If you do need to travel, or are considering making a trip abroad, it can be hard to find the most up-to-date information on entry requirements for both your destination and your home base, as country-specific regulations are frequently changing to reflect quickly shifting coronavirus trends.

But several months into the pandemic, more detailed tools for monitoring restrictions on travel by country are emerging. And Skyscanner’s interactive covid-19 travel map is perhaps the most detailed option.

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Accessible through Skyscanner’s homepage, the restrictions map is in beta, and it can be set to different origin countries to display varying restrictions. Color-coded, it displays low-restriction, moderate-restriction and major-restriction destinations in stoplight-style green, yellow and red. Countries without data on their restrictions, as well as the origin country, appear in gray.

Clicking through to specific destinations, or scrolling down to see a curated list of the ones you can visit, yields the most current information on quarantine restrictions, coronavirus case rate, the change in cases from the prior week, and the option to sign up for email updates on the country’s coronavirus situation.

The tool launched in November, and uses data from the International Air Transport Association (IATA) for the travel restrictions as well as Johns Hopkins University coronavirus data for case rates.

Skyscanner launched the interactive map in response to a survey of Americans the website conducted about attitudes surrounding travel restrictions. Of the 1,000 respondents surveyed, 51 percent of said they did not feel confident about their knowledge of where they could and could not travel.

Despite this, many are still searching for international airfare.

“People want to travel and we know there is pent-up demand from the searches we are seeing for flights and for more information; but confidence has been hit by the lack of consistency between countries worldwide regarding measures and restrictions,” Mark Crossey, U.S. travel expert for Skyscanner, said in a statement. “Consumers just don’t understand the complex rules and are crying out for transparent, detailed information.”

Americans can easily see from the map that they have very few options for quarantine-free travel: Only 13 nations are green; 212 are orange or red.

Crossey also says the map is only “one piece of the puzzle,” and global uniformity in quarantine and testing requirements will be required for a strong return to travel.

Until then, maps like this one will aim to bridge the gap between complex travel restrictions and travelers.

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Travel Restrictions to Prevent the Spread of Disease

Credit: David Snyder

Disease is just a flight away. To protect America’s health, CDC partners with the Department of Homeland Security to prevent the spread of serious contagious diseases during travel. CDC uses a Do Not Board list to prevent travelers from boarding commercial airplanes if they are known or suspected to have a contagious disease that poses a threat to the public’s health. Sick travelers are also placed on a Lookout list so they will be detected if they attempt to enter the United States by land or sea. These tools can be used for anyone who poses a threat to the public’s health.

Local and state public health officials can request CDC’s assistance if a person who poses a public health threat intends to travel. CDC helps ensure these people do not travel while contagious.

Placing people on the lists

The criteria for adding people to the Do Not Board and Lookout lists are

• not  aware of diagnosis or not  following public health recommendations, or
• Likely to travel on a commercial flight involving the United States or travel internationally by any means; or
• Need to issue travel restriction to respond to a public health outbreak or to help enforce a public health order.

Criteria number one plus one of the three subsets must be met for a person to be placed on the Do Not Board and Lookout lists.

Credit: David Heaberlin

Once a person is placed on these lists, airlines will not issue a boarding pass to the person for any commercial flight within, arriving to, or departing from the United States.

The Do Not Board and Lookout lists have been used for people with suspected or confirmed infectious tuberculosis (TB), including multidrug-resistant tuberculosis (MDR-TB), and measles. During 2020-2022, CDC used these authorities to restrict travel of people with COVID-19 and close contacts who were recommended to quarantine. These authorities were also used for mpox during 2022. Travel restrictions can also be used for other suspected or confirmed contagious diseases that could pose a public health threat during travel, including viral hemorrhagic fevers such as Ebola.

Preventing people with contagious diseases from traveling also helps to make sure they get or continue medical treatment, such as for infectious tuberculosis.

Taking people off the lists

Once public health authorities confirm a person is no longer contagious, the person is removed from the lists (typically within 24 hours). Also, CDC reviews the records of all persons on the lists every two weeks to determine whether they are eligible for removal.

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• v.27(5); 2021 May

Epidemiologic Findings from Case Investigations and Contact Tracing for First 200 Cases of Coronavirus Disease, Santa Clara County, California, USA

In January 2020, Santa Clara County, California, USA, began identifying laboratory-confirmed coronavirus disease among residents. County staff conducted case and contact investigations focused on households and collected detailed case demographic, occupation, exposure, and outcome information. We describe the first 200 test-positive cases during January 31–March 20, 2020, to inform future case and contact investigations. Probable infection sources included community transmission (104 cases), known close contact with a confirmed case-patient (66 cases), and travel (30 cases). Disease patterns across race and ethnicity, occupational, and household factors suggested multiple infection risk factors. Disproportionately high percentages of case-patients from racial and ethnic subgroups worked outside the home (Hispanic [86%] and Filipino [100%]); household transmission was more common among persons from Vietnam (53%). Even with the few initial cases, detailed case and contact investigations of household contacts capturing occupational and disaggregated race and ethnicity data helped identify at-risk groups and focused solutions for disease control.

On January 31, 2020, the Santa Clara County Department of Public Health (SCCDPH) in San Jose, California, USA, identified its first case of coronavirus disease (COVID-19) in a resident who had recently returned from Wuhan, China ( 1 ). On February 28, the county reported its first case of COVID-19 associated with probable community transmission, 48 hours after the first presumed community-acquired case in the United States was identified 91 miles north in Solano County ( 2 ). Staff of the SCCDPH, the California Department of Public Health, and the Centers for Disease Control and Prevention (CDC) began conducting detailed interviews with each case-patient or their surrogate to identify, quarantine, and monitor close contacts, and isolate and test those who were symptomatic. Santa Clara initiated a series of community mitigation strategies to slow the spread of the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including canceling large gatherings ( 3 , 4 ). On March 16, Santa Clara and 5 adjacent San Francisco Bay Area counties became the first US region to implement shelter-in-place orders requiring all residents to limit activity outside of their home and to order nonessential businesses and operations to close ( 5 ). SCCPHD collected detailed information on demographic characteristics to help identify communities at risk and those disproportionately affected by COVID-19. Since the initial identification of cases, surges in COVID-19 incidence have often constrained public health and community capacity to respond, including overwhelming case and contact investigation efforts. We describe the epidemiology of the first 200 COVID-19 cases reported to SCCPHD to identify key transmission factors that could already be identified early in the COVID-19 pandemic through detailed case investigation and contact tracing focused on households and to demonstrate the utility of focusing these efforts throughout the pandemic response.

Case Identification and Testing

We defined a confirmed COVID-19 case as an illness in a resident of Santa Clara County with SARS-CoV-2 detected by reverse transcription PCR (RT-PCR) on a nasopharyngeal or oropharyngeal swab specimen by a public health, hospital, or reference clinical microbiology laboratory or CDC. Testing was recommended in line with the following evolving CDC Person Under Investigation case definition: clinical findings of lower respiratory illness and travel to a Wuhan, China (later expanded to all of China) or an epidemiologic link to a laboratory-confirmed COVID-19 case ( 6 , 7 ); hospitalization for severe respiratory disease and no alternative diagnosis ( 8 ); and clinically compatible illness regardless of travel or known contact with a confirmed case-patient. Included COVID-19 case-patients comprised those reported to SCCDPH and those identified by a community-based sentinel surveillance project for COVID-19 conducted during March 5–14, 2020, among clinic patients with respiratory illness who tested negative for influenza virus ( 9 ). This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.

Case Investigation and Contact Tracing

SCCDPH, California Department of Public Health, and CDC staff identified cases reported to California’s electronic reportable disease system. Staff interviewed COVID-19 cases or their surrogates for information on case age, sex, race, ethnicity, address, occupation, travel history, known contact with another confirmed case-patient, symptom onset (earliest of any symptoms listed on CDC’s standardized case report form) ( 10 ), and hospitalization. Investigators collected detailed race and ethnicity data, including racial subgroup among case-patients reporting Asian ancestry.

Case-patients with no recent travel and no known close contact with another confirmed case-patient in the 2 weeks before symptom onset were classified as probable community transmission. Known close contact was defined as living with, caring for, working with, transporting, or prolonged exposure (close contact <6 feet for > 30 minutes) to a person with confirmed COVID-19. Case-patients with any travel outside of Santa Clara County in the 2 weeks before their symptom onset were considered travel-associated cases.

SCCPHD’s contact tracing involved identifying persons with close contact with the case-patient 2 weeks after the case-patient’s symptom onset and notifying contacts of their exposure. Owing to the rapid rise in case counts and limited personnel capacity, the team focused on following up with household contacts. In-hospital outcomes were collected from review of medical records and case-patient interviews. Deaths through May 20, 2020 (60 days after the 200th case was reported), were defined as COVID-19–associated if the cause or other contributing cause on the death certificate was listed as COVID-19.

Data Analysis

We collected data using standard forms and open-ended case-patient interviews and entered results into Excel 365 (Microsoft, https://www.microsoft.com ) and California’s electronic reportable disease system. Categorical variables were described as counts and percentages, and continuous variables were described using median and range. We estimated associations between illness severity measures (hospitalization defined as admission for > 1 night in an inpatient acute-care facility [including intensive-care unit (ICU) stay and mechanical intubation with ventilation]; ICU stay [including mechanical ventilation]; mechanical ventilation; and death) as the dependent variables, and age and sex as independent variables with odds ratios (ORs) and 95% CIs using bivariate logistic regression. Because of the limited number of cases, to avoid invalid results or unstable models, measurements were not adjusted. We analyzed data using Stata 14 (StataCorp, https://www.stata.com ) and Epi Info version 7 (Epi Info, https://www.cdc.gov/epiinfo ) and generated maps using Excel 365 (Microsoft, https://www.microsoft.com ).

Case Description

Of the 200 cases with laboratory confirmation of SAR-CoV-2 positivity during January 31–March 20, 2020, a total of 191 (96%) were identified through routine surveillance and contact tracing and 9 (4%) were identified through clinic-based sentinel surveillance. Onset of illness ranged from January 24 through March 18; these case-patients were exposed before shelter-in-place orders were invoked ( Figure 1 ). Among the first cases identified during January 31–February 2, travel accounted for the largest reported source of exposure. Over subsequent weeks, case-patients reported unknown and household exposure at higher frequencies than other exposures. The percentage of case-patients who were hospitalized decreased over time as testing availability increased and focus of testing broadened to include additional populations, including symptomatic contacts.

Week of symptom onset, for first 200 confirmed coronavirus disease cases, by exposure source, Santa Clara County, California, USA, January 31–March 20, 2020.

Among the 200 case-patients, 112 (56%) were male, and the median age was 50 years (range 6 months–94 years); only 10 (5%) case-patients were <20 years of age, whereas 71 (36%) were > 60 years of age ( Table ). The racial and ethnic distribution of case-patients was similar to that of the county population overall: 70 (35%) reported as Asian, 52 (26%) Hispanic, 52 (26%) White non-Hispanic, 4 (2%) Black non-Hispanic, and 3 (1%) Pacific Islander; race or ethnicity was unknown for 19 (9%) case-patients. Although Asian-identifying persons comprised a similar proportion of case-patients as that of Santa Clara County, a higher proportion of case-patients identified as Filipino (10% vs. 5%), a similar proportion as Vietnamese (7% vs. 7%), and a lower proportion as Indian (4% vs. 9%) or Chinese (4% vs. 10%) than among the general population of Santa Clara County ( 11 , 12 ). Of the 200 case-patients, 89 (44%) were hospitalized ( Table ); 45 (23%) were on a general ward, 18 (9%) were admitted to an ICU without requiring mechanical ventilation, and 26 (13%) required mechanical ventilation in an ICU. The proportion of case-patients hospitalized, admitted to the ICU, requiring mechanical ventilation, and who died each increased with increasing age ( Figure 2 ). Compared with case-patients <60 years of age, case-patients > 60 years of age had higher odds of hospitalization (OR 4.4 [95% CI 2.4–8.3]), ICU stay (OR 10.9 [95% CI 4.9–24.2]), mechanical ventilation (OR 6.3 [95% CI 2.5–16.0]), and death (OR 9.0 [95% CI 2.9–28.4]). No statistically significant association was observed between clinical outcomes and sex.

*COVID-19, coronavirus disease; ICU, intensive care unit. †Occupations reported by < 2 case-patients. ‡Classified by most severe status at time of case investigation. ¶As of March 20, 2020. Deaths for which COVID-19 was listed as the cause or other contributing cause on the death certificate were defined as COVID-19-associated deaths.

Hospitalization status and outcomes, for first 200 confirmed coronavirus disease cases, by age group, Santa Clara County, California, USA, January 31–March 20, 2020. Outcomes are classified by most severe status at time of case investigation. Deaths are as of May 20, 2020. ICU, intensive-care unit.

Among the 200 case-patients, 20 (10%) had a matching death certificate. The median age of deceased case-patients was 70.5 years (range 42–87 years), and 15 (75%) were male. Among the 20 case-patients who died, 9 (45%) were Asian, 5 (25%) were White non-Hispanic, 2 (10%) were Hispanic, and 4 (20%) had unknown race or ethnicity. Five (25%) of the 20 deaths occurred among persons of Filipino ethnicity; these case-patients did not have a known close contact to one another.

Case-patient residences were distributed among 47 (79%) of the 59 ZIP codes in the county; 18 (30%) ZIP codes had 1–2 cases, 13 (22%) had 3–4 cases, and 16 (8%) had > 5 cases ( Figure 3 , panel A). Case-patient residences clustered in the northeastern part of the county, where 2 adjacent ZIP codes accounted for 36 (18%) of the 200 case-patients; in the ZIP code with the most cases, 9 were associated with a single household. COVID-19 incidence rates by ZIP code ranged from 0–113 cases/100,000 persons; rates were generally highest in eastern ZIP codes in the county ( Figure 3 , panel B).

Geographic location of first 200 confirmed coronavirus disease cases, by case-patient’s ZIP code area of residence (for those areas with >2,000 residents), Santa Clara County, California, USA, January 31–March 20, 2020. A) No. cases; B) case rate (cases/100,000 population).

Exposure Type and Setting

Of the 200 case-patients, 66 (33%) had known close contact with another confirmed case-patient, 30 (15%) were considered travel-associated cases ( Table ), and 104 (52%) were attributable to probable community transmission. Among the 66 case-patients with known close contact with another confirmed case-patient, 49 (74%) were exposed to a household member, and 17 (26%) had occupational exposures. Most households with evidence of transmission (13/15 [86%]) had 2–3 confirmed case-patients identified. However, 2 multigenerational households each had 9 and 4 case-patients; the cluster of 4 case-patients was only identified as a result of contact tracing.

Of the 200 case-patients, 159 (79%) were adults with reported occupation. Of these, 111 (69%) were actively employed (not retired and reported employment), and of these, 82 (73%) reported jobs requiring work outside the home, which included healthcare workers, firefighters, food service workers, retail employees, construction workers, housekeepers, and other workers. Among these 82 case-patients reporting jobs requiring work outside the home, 46% of exposures were attributable to probable community transmission, followed by 22% household and 21% occupational exposures.

Type and location of exposure, as well as having an occupation that requires work outside the home, varied by race and ethnicity. Among 49 cases in Hispanic adults, occupation was known for 44 (89%); of the 38 actively employed, 89% held occupations that required them to work outside of the home. Occupation was known for 16 of 20 Filipino case-patients; for the 9 case-patients who were actively employed, all had jobs outside the home. Occupational exposure to a confirmed case-patient, including in a healthcare setting, accounted for 5 (25%) of 20 cases in Filipino persons, compared with 12 (7%) of all other cases with reported race and ethnicity. Household transmission accounted for exposures in 53% of Vietnamese case-patients and 32% of Hispanic case-patients, compared with 23% of all other case-patients with known race/ethnicity. Among case-patients of Indian and Chinese ethnicity, >50% had travel-related exposures.

Among the 17 case-patients with an occupational exposure to a confirmed case-patient, 11 (64%) exposures occurred in a nonhealthcare setting. Of these 11, all were employed as essential workers in occupations or settings in which they had frequent contact with many persons in the community. Occupational clusters and groupings included 6 airport employees, 4 employees at a supermarket, 3 childcare workers who shared a classroom and bathroom, and 2 firefighters who worked at the same station. At least 3 additional cases were identified among other firefighters who worked at the same station or attended a common function but were not Santa Clara County residents.

Of the 200 case-patients, 16 (8%) were healthcare workers with jobs that provided direct patient care or were first responders with direct patient exposure, of whom 8 (50%) were nurses. Only 6 transported, cared for, or had other known close contact with a confirmed case-patient in a healthcare setting. Of the other 10 cases in healthcare workers, 1 case-patient had travel-related exposure, 3 had known close contact with a case-patient in their household, and 6 did not have exposure to a known COVID-19 case-patient and were categorized as attributable to probable community transmission.

Detailed case investigations and household contact tracing of the first 200 case-patients of COVID-19 in Santa Clara County were able to help elucidate factors associated with being a COVID-19 case-patient and identify populations at risk for infection early in the response, including possible racial and ethnic disparities, elevated risks within households, and high-risk occupational groups. Many of these factors and populations at risk were subsequently confirmed by studies later in the pandemic ( 13 , 14 ). Case investigations identified possible sources of transmission in 96 (48%) of cases, and for those case-patients with known exposure, household transmission was the most commonly reported source, especially in Vietnamese and Hispanic communities. Work outside the home was commonly reported by Hispanic case-patients. Case-patients > 60 years of age had significantly higher odds of being hospitalized, being admitted to the ICU, requiring mechanical ventilation, and dying; these findings are consistent with reports from China, Italy, and other parts of the United States ( 15 – 17 ).

Because SCCPHD conducted contact tracing and monitoring specifically among household contacts of case-patients, the finding that approximately one quarter of the first 200 case-patients were household contacts of a confirmed case-patient is not surprising. However, SCCPHD’s prioritization of contact tracing and monitoring contacts within households early in the pandemic was high-yield, and findings were consistent with disease transmission factors for COVID-19 reported in subsequent studies ( 18 , 19 ). Investigations identified not only that older persons had increased odds of poor outcomes from COVID-19 but also that case-patients with multiple factors potentially increased risk. For example, several large clusters were identified within families that consisted of members of multiple generations, and several individuals >80 years of age might have been exposed. In 2 of these clusters, the index case-patient was a nonelderly household member who presumably transmitted SARS-CoV-2 to elderly household members. Anecdotally, several of these households also reported crowding and inability to self-isolate from other members within the home (Santa Clara COVID-19 Case Investigation Team, pers. comm., group discussion during case review, March 2020). Households have been identified as a high-risk setting for SARS-CoV-2 transmission ( 20 – 22 ), and household crowding is a risk factor for COVID-19 ( 23 ). In the ZIP code with the highest case rate in northeast Santa Clara, 14% of households are overcrowded (>1.0 persons/room), as measured by the American Community Survey, compared with the median of 6% of households in Santa Clara County as a whole ( 24 ). Although information on an individual case-patient’s household density was not collected as part of case and contact investigations, 4 (33%) of 12 ZIP codes where household transmission was identified reported >10% frequency of overcrowded households, compared with 7 (20%) of 35 ZIP codes where cases were identified but no household transmission was noted. Household density might be associated with other factors, such as high-risk occupations of household members ( 25 , 26 ), to increased risk for COVID-19 within households. Case investigators collecting information regarding household density during interviews can help not only to elucidate transmission risk in a particular household, but also link persons at high risk for poor outcomes to resources to prevent household transmission. One example of a solution to prevent household transmission is The NYC Test and Trace Corps, a collaborative public health program led by NYC Health + Hospitals in collaboration with the New York City Department of Public Health and Mental Hygiene, which offers hotel stays for persons who have COVID-19, exhibit COVID-19 symptoms, or are contacts of a known COVID-19 case-patient and who need to isolate or quarantine from household members ( 27 ).

Working outside the home, especially with public-facing duties (e.g., airport workers), was especially common in this early cohort; >40% of case-patients reported an occupation that did not allow them to work from home. A large frequency of case-patients who performed work outside the home did not report a known exposure or travel, suggesting that difficult-to-trace exposures, such as exposure to someone the case-patient did not know or did not know was infected, probably occurred ( 28 ). Moreover, occupational exposures were probably more common than we reported, because case-patients who did not have known exposure to a person with confirmed COVID-19 and had not traveled were classified as having community exposure. Identifying the source of exposure for case-patients with occupations that interact with the public might prove to be very labor-intensive or impossible, given the number of potential contacts involved. However, case and contact investigations, at a minimum, should include notifying co-workers and alerting employers to a positive case in a workplace ( 29 ) and collecting occupation data to help identify occupational subgroups at risk.

Occupational exposures probably differed by racial and ethnic groups among the first 200 case-patients in Santa Clara County. Among employed Filipino case-patients, all held jobs that required work outside the home. Although few Hispanic case-patients reported an occupational exposure with a confirmed COVID-19 case-patient, a greater percentage of Hispanic case-patients (89%) had occupations that required them to work outside the home than did White non-Hispanic case-patients (56%). Many of the Hispanic case-patients in Santa Clara County communicated that they could not afford the lost wages that would result from staying home from work (Santa Clara COVID-19 Case Investigation Team, pers. comm., group discussion during case review, March 2020). Hispanic persons nationwide have reported higher frequencies of job loss and wage reduction because of the COVID-19 pandemic compared with persons from other racial and ethnic minority groups, and less than one third of Hispanic persons surveyed reported that they could weather a financial emergency ( 30 ). These financial and occupational factors together might be critical drivers for transmission within the Hispanic population in Santa Clara County and perhaps statewide, where Hispanic persons have accounted for a disproportionately high number of cases ( 31 ). A disproportionately high percentage of COVID-19 cases and deaths occurred in Filipino persons; cases among Filipino persons associated with occupational exposures involved providing direct patient care to known COVID-19 patients or contact with a person with confirmed COVID-19 in public-facing service jobs.

Household exposures also differed by racial and ethnic groups. Vietnamese and Hispanic case-patients more frequently reported exposure to a person with confirmed COVID-19 in their household compared with case-patients from other race and ethnicity groups. Anecdotally, among Vietnamese and Hispanic case-patients, > 3 reported living in multigenerational households with high densities of persons and an inability to self-isolate within the home, posing a serious risk to older adults residing in these households. Household case clusters occurred in eastern ZIP codes that had high percentages of Hispanic persons (58% of the population in the ZIP code with the most cases and highest rates) and Vietnamese persons (22%), compared with 26% of Hispanic and 7% of Vietnamese persons in the county as a whole ( 32 – 37 ). Together, these findings suggest that household crowding might be an especially important driver of household transmission in traditionally underserved communities.

Few of the first 200 COVID-19 cases in Santa Clara County occurred in healthcare workers or persons in institutional or congregate living settings. Although more than one third of infected healthcare workers reported an occupational exposure and a quarter traveled or had a nonoccupational close-contact exposure, none of these exposures was identified for 40% of them. Evidence to date does not support substantial occupational transmission of SARS-CoV-2 to healthcare workers ( 38 ). Community transmission could have been an important source of exposure for healthcare workers, given the widespread community transmission occurring simultaneously in Santa Clara County.

One limitation of this analysis is, as with most reports on COVID-19, case identification was largely dictated by testing practices. At the start of the outbreak, the number of persons eligible for testing according to CDC criteria and testing capacity were limited, biasing these initial findings to case-patients with higher disease and mortality rates and to persons with recent travel or known contact with a confirmed case-patient. Had testing been more widely available and criteria included milder symptoms or risk for exposure regardless of symptoms, broader or earlier detection of community transmission might have occurred. This investigation occurred when information was limited for this new and emerging disease. The definition of prolonged COVID-19 exposure and guidance for case and contact investigations has been updated since this investigation concluded ( 39 ). Although we observed differences in sources of exposure by race and ethnicity, data on race were missing for 19 (9%) cases and racial subgroup for 16 (23%) of 70 cases among Asian persons; therefore, these data should be interpreted with caution. Our data reflect the epidemiology of COVID-19 in Santa Clara early in the pandemic among those with clinical manifestations that were eligible for testing and probably are not reflective of the current epidemiology ( 40 ).

Even with results from only the first 200 case-patients, detailed case investigation and contact tracing focused on households revealed patterns of at-risk populations, including older age adults, racial and ethnic subgroups, occupational categories, and potentially crowded households. Detailed case reviews, including disaggregation of race and ethnicity data, helped identify local factors of transmission and disparities important for public health intervention. Importantly, occupational exposures continue to be a source of infection ( 41 ), and understanding transmission risk within specific occupational settings, especially among professions that require persons to work outside their homes, is important to ensure safe workplaces and reopening of economies as the pandemic continues to evolve. As mitigation measures to suppress community transmission evolve throughout the pandemic response, novel preventive measures (e.g., temporary housing) might continue to be necessary to protect disproportionately affected subpopulations and older adults.

Acknowledgments

We thank the Case Investigation Team for their support in the field.

Dr. Ortiz is an Epidemic Intelligence Service Officer in the Division of Scientific Education and Professional Development, Center For Surveillance, Epidemiology, And Laboratory Services, Centers for Disease Control and Prevention.

Suggested citation for this article : Ortiz N, Villarino E, Lee JT, Bajema KL, Ricaldi JN, Smith S, et al. Epidemiology of first 200 cases of coronavirus disease, Santa Clara County, California, USA. Emerg Infect Dis. 2021 May [ date cited ]. https://doi.org/10.3201/eid2705.204876

1 Members of the Santa Clara County COVID-19 Case Investigation Team are listed at the end of this article.

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Skyscanner reveals travel insights for 3Q2024

Skyscanner’s latest Horizons report shared insights into booking windows, destination choices, and trending destinations across the Asia-Pacific region for the period June to August 2024.

The analysis is based on its  Skyscanner Travel Insight Data , which compares traveller behaviour and search trends year-on-year.

Booking windows reflect confidence to plan ahead At the start of 2024, Skyscanner saw record travel demand, outperforming the global flights market and was the fastest growing metasearch in 2023.

Across the board, travellers are planning further ahead compared to the previous year, marking a return to traditional seasonality in 2024.

Among Asia-Pacific travellers, there is a greater distribution of booking windows compared to other regions but an overall increase in bookings over 30 days (including a 2% jump in the 90+ day segment). Booking windows of two months or more now represent over a third of demand in this region.

Destination choices highlight regional preferences Asia-Pacific travellers are turning their focus towards intra-regional destinations, with a notable decrease in trips to Europe compared to last year. Seat capacity is returning to the region and many travellers are indicating a desire to swap longhaul trips with short or medium ones, or even domestic trips with an eye on their budget to help keep costs down.

Shorter trip lengths to top destinations Across all regions, average trip lengths are slightly down or flat year-on-year for many popular destinations.

Well-known European and US destinations are most popular among Asia-Pacific travellers, with Athens experiencing the biggest increase in trip length. “Everywhere” also ranks highly, and Tokyo is the only destination with a single-digit trip length.

Trending destinations Destinations with the biggest year-on-year increases in search volumes reflect a mix of wanting to explore new places, as well as those with new route connections.

New Delhi, India and China’s Shanghai are experiencing the biggest growth among Asia-Pacific travellers, while Jeddah, Saudi Arabia; Dubrovnik, Croatia; and Victoria, Canada are also trending. Pangkalan Bun in Borneo, Indonesia is the only trending destination with an increase in average trip length.

Zeynep Mutlu Bigalı, head of destination partnerships: “Our latest Horizon insights reveal a travel landscape that is both familiar and evolving. While traditional seasonality is returning and popular destinations remain in demand, travellers are also seeking value and exploring options closer-to-home. Across Skyscanner’s platforms we have seen incredible demand at the start of the year, and we expect this to continue as we head into the summer, especially in regions such as North Asia.”

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PRESSR: Skyscanner reveals regional 2024 travel outlook

• Analysis of booking windows, top and trending destinations across EMEA

Global travel leader, Skyscanner, today released its latest Horizons report, highlighting insights into booking windows, destination choices, and trending destinations across the EMEA region.

The analysis is based on Skyscanner’s proprietary forward-looking Travel Insight data, comparing traveller behaviour and search trends year-on-year.

Read the full report HERE.

Booking windows reflect confidence to plan ahead

Across the board, travellers are planning further ahead compared to the previous year, marking a return to traditional seasonality in 2024.

Travellers in EMEA are exhibiting strong confidence, with increases in trips booked further in advance (greater share of 60-89 day and 90+ day booking windows).

Destination choices highlight regional preferences

A significant 53% of EMEA travellers are opting to explore Europe, marking a 4% increase from the previous year.

According to Skyscanner’s Travel Trends Report 2024*, there’s an increasing demand of UAE and Saudi travellers craving culture, with many European capital cities trending for 2024. In addition, Italy is one of the most alluring holiday destinations, with its iconic monuments and irresistible cuisine, appearing three times on Saudi’s top trending destinations list.

Shorter trip lengths to top destinations

Across all regions, average trip lengths are slightly down or flat year-on-year for many popular destinations.

Spanish and Greek destinations dominate the most popular destinations searched on Skyscanner, with Bangkok, New York City and Sydney also popular for long-haul travel.

Trending destinations

Destinations with the biggest year-on-year increases in search volumes reflect a mix of wanting to explore new places, as well as those with new route connections.

Victoria, Canada; Marmagao, India; Panama City; Bol, Croatia; Pristina, Kosovo; and Lampedusa, Italy are all experiencing significant search volume growth with EMEA travellers

Ayoub El Mamoun, Skyscanner Travel Expert: “Our latest Horizon insights reveal a travel landscape that is both familiar and evolving. While traditional seasonality is returning and popular destinations remain in demand, travellers are also seeking value and exploring options closer-to-home. Across Skyscanner’s platforms we have seen incredible demand at the start of the year and we expect this to continue as we head into the summer.”

At the start of 2024, Skyscanner saw record travel demand, outperforming the global flights market and was the fastest growing metasearch in 2023.**

Skyscanner continues to be a strategic partner for some of the biggest brands, airlines and DMOs in the world; working with companies from across the travel ecosystem including DMOs like Visit California to promote destinations, powering the next generation of AI travel tools such as Bing Chat and Layla, as well as helping airlines promote their unique offers via NDC and launch new routes based on data intelligence.

*Between the end of 2023 and the start of 2024, Skyscanner outperformed the global flights market, recording +16% growth in visitors compared to the wider market’s +3%. SimilarWeb data based on global flight sessions of tracked brands between 29th Dec -4th Jan. Analysis includes 272 tracked brands and 34 markets. Full list of markets and brands tracked available on request.

Methodology:

*Skyscanner Travel Trends Report 2024 UAE and KSA

 https://traveltrends.skyscanner.com.sa/

https://traveltrends.skyscanner.ae/

**Skyscanner Travel Insight data; flight redirects and flight searches from 01/01/24-31/01/24 departing 01/06/24-31/08/24 and compared to the equivalent period in 2023. Analysed between 12/02/24 and 16/02/24.

About Skyscanner Partners

Skyscanner is a global leader in travel connecting over 110m users in 52 countries and 33 languages to more than 1200 flight, hotel and car hire partners every month. 

Skyscanner’s global audience provides unrivalled reach into geographies and deep insight into traveller search and redirect behaviour in almost every market. Skyscanner’s app, desktop and mweb metasearch platforms offer next generation, best-in-class brand and performance capabilities to deliver on partners strategic priorities. Skyscanner is using the latest technology to build dynamic distribution and advertising solutions to connect businesses with highly qualified audiences, using real-time, actionable intelligence. 

Founded in Edinburgh in 2003, Skyscanner has offices worldwide, in Asia-Pacific, Europe and North America. Skyscanner is committed to helping shape a more responsible future for travel in collaboration with our partners, so that every traveller can explore our world effortlessly for generations come.

For more information visit: https://www.partners.skyscanner.net/

© Press Release 2024

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Brazil Police Recommend Criminal Charges Against Bolsonaro

The federal police accused the former president of falsifying his Covid-19 vaccination records.

By Jack Nicas

Reporting from Rio de Janeiro

Brazil’s federal police recommended that former President Jair Bolsonaro be criminally charged in a scheme to falsify his Covid-19 vaccine card, partly to travel to the United States during the pandemic, in the latest sign of criminal investigations closing in on the former president.

Federal prosecutors will now decide whether to pursue the case. If they do, it will be the first time the former president has faced criminal charges.

Brazilian police accused Mr. Bolsonaro of ordering a top aide to obtain falsified Covid-19 vaccination records for himself and his daughter, 13, in late 2022, just before the former president traveled to Florida to stay for three months following his election loss.

Brazilian police said they were awaiting an answer from the U.S. Justice Department on whether Mr. Bolsonaro used a fake vaccination card to enter the United States, which could bring different criminal charges.

At the time, most international visitors to the United States were required to show proof of Covid-19 vaccination to enter the country, and a U.S. official said even a foreign leader would have had to comply with such rules.

Mr. Bolsonaro has said he did not receive a Covid-19 vaccine, but he has denied accusations that he was involved in any plan to falsify his vaccination records. His lawyer said in a text message that he was still reviewing the accusations.

If he is convicted of forging his vaccine card, Mr. Bolsonaro could face prison time.

The federal police’s indictment is the first time the various criminal investigations into Mr. Bolsonaro have moved toward charges.

Mr. Bolsonaro has been subject to questioning and searches as part of several inquiries, including into the selling of watches and jewels he received as presidential gifts from Saudi Arabia and other countries, as well as accusations that he worked with top government officials to hatch a plan to try to hold onto power after his 2022 election loss .

Brazil’s electoral court has already ruled Mr. Bolsonaro ineligible for public office until 2030 for spreading false information about Brazil’s voting systems on state television, forcing him to sit out the next presidential contest in 2026.

During the pandemic, Mr. Bolsonaro was critical of the Covid-19 vaccine , joking that it would turn people into crocodiles and instead promoting unproven treatments, such as hydroxychloroquine, an antimalarial drug.

His administration hesitated to secure vaccines when they were first being distributed, exacerbating the pandemic in Brazil, according to a Brazilian congressional investigation that recommended in 2021 that the former president be charged with “ crimes against humanity, ” among other charges, for his actions during the pandemic.

Prosecutors at the time did not charge him. More than 700,000 people have died in Brazil because of Covid-19, the second-highest national death count after the United States.

In May 2023, the police searched Mr. Bolsonaro’s home , confiscated his cellphone and arrested one of his closest aides and two of his security guards as part of the investigation into the fake vaccination records.

In a complaint unsealed on Tuesday, Brazil’s federal police said records showed that Mr. Bolsonaro’s personal aide, Lt. Col. Mauro Cid, and Mr. Cid’s wife used fake vaccination cards to enter the United States in 2022. Mr. Cid, who was arrested last year as part of the investigation, told the police that once Mr. Bolsonaro found out that Mr. Cid had a fake vaccine card, he ordered the aide to get him one, too, the police said.

The police said records showed that on Dec. 21, 2022, an official in a suburb of Rio de Janeiro then entered false records into the city’s health database that Mr. Bolsonaro and his daughter had received two doses of Pfizer’s Covid-19 vaccine earlier that year. The police said that during one of the two dates on which the records said Mr. Bolsonaro received a vaccine, the former president was not in the Rio de Janeiro suburb.

In addition to Mr. Cid, the police said, several other allies of the former president falsified vaccination records in a similar scheme, some of whom used the records to accompany Mr. Bolsonaro to the United States. The police also recommended charges against them.

Mr. Bolsonaro spent his first three months after the presidency staying in a rented home near Disney World outside Orlando.

Mr. Bolsonaro entered the United States several other times while the country required visitors to show proof of vaccination, including to attend the United Nations General Assembly and to meet President Biden in Los Angeles, though those 2022 trips preceded the plan described by investigators to falsify vaccine records.

In 2021, Mr. Bolsonaro, who was perhaps the only unvaccinated world leader at the U.N. General Assembly, opened that proceeding with a speech that said Brazil would not require anyone to get vaccinated. He added that he had recovered from Covid-19 by using “off-label” drugs.

“History and science will hold everyone accountable,” he said .

During that trip, he and his entourage struggled to enter New York restaurants that required proof of vaccination. Instead, he posted a photo of his team eating pizza on the sidewalk. Mr. Bolsonaro’s health minister, who was biting a piece of pizza in the photo, tested positive for Covid-19 hours after attending the U.N. meetings.

Flávia Milhorance contributed reporting from Rio de Janeiro, and Paulo Motoryn from Brasília.

An earlier version of this article misstated the number of Covid-19 deaths in Brazil. There have been more than 700,000 deaths, not nearly 600,000 deaths.

How we handle corrections

Jack Nicas is the Brazil bureau chief for The Times, based in Rio de Janeiro, where he leads coverage of much of South America. More about Jack Nicas

How US life expectancy rates changed as COVID deaths wane, drug overdoses persist

Life expectancy rose to 77.5 years on average in 2022, a slight increase of 1.1 years from 2021, according to new studies from the Centers for Disease Control and Prevention.

"Life expectancy at birth increased 1.1 years...largely because of decreases in mortality due to COVID-19, heart disease, cancer, unintentional injuries, and homicide," the report stated.

Although life expectancy has slightly improved, it continues to remain below its peak of 78.9 years, occurring a decade ago. The U.S. life expectancy also falls behind other comparable countries.

Life expectancy varies by sex

For men, life expectancy increased 1.3 years from 73.5 in 2021 to 74.8 in 2022. For women, life expectancy increased 0.9 year from 79.3 in 2021 to 80.2 in 2022. That's a 5.4 year age difference in life expectancy between men and women, according to the CDC.

What is contributing to the decade-long decline in life expectancy?

The COVID-19 pandemic and fatal drug overdoses are causing a large death toll in the U.S. COVID deaths  took about 186,552 lives in 2022. In comparison, fatal overdoses consumed 107,941 lives.

According to the study, "Age-adjusted rate of drug overdose deaths nearly quadrupled from 8.2 in 2002 to 32.6 in 2022." The rate did not significantly change between 2021 and 2022.

Heart disease and cancer are the leading causes of death in the U.S and have been so since the early-to-mid 1990's, according to the CDC. COVID-19 was the third-leading cause of death in 2021, but in 2022 it fell behind "unintentional injuries," which includes drug overdoses.

Want to live healthier longer?: Visual guide shows how longevity science looks to slow diseases of aging

Feeling hangry?: From food cravings to brain fog, blood sugar spikes may be the cause

Why do some people live longer than others? 

Dr. Amit Shah, an internist and geriatrician with Mayo Clinic in Arizona told USA TODAY that "up to 25% of longevity is genetic." The rest, he says, comes down "to factors that are in our control." Diet and exercise are two factors that can impact our longevity.

Socioeconomic status also plays a major role in healthy aging and longevity, with impoverished areas that have  limited access to healthcare  being the hardest hit. "People who live in societies that have the most long-lived individuals (as outlined in the book "Blue Zones" by Dan Buettner), have a high level of social engagement with roles for older individuals to have in the family and society," Shah told USA TODAY.

Contributing: Daryl Austin