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Americans Abroad Ask Whether to Stay, and Risk Infection, or Fly Home, and Risk Infection Americans Abroad Ask Whether to Stay, and Risk Infection, or Fly Home, and Risk Infection
(1 day later)
WASHINGTON — The travel plan was as exhausting as it was risky for the 77-year-old cancer survivor wondering how to leave self-isolation in Ecuador and return home to New Hampshire without catching the coronavirus.WASHINGTON — The travel plan was as exhausting as it was risky for the 77-year-old cancer survivor wondering how to leave self-isolation in Ecuador and return home to New Hampshire without catching the coronavirus.
“It’s not for the faint of heart and promises to be very grueling, but we wanted to gauge interest,” the American Embassy in Quito, Ecuador, wrote in a notice last month to Americans looking to get back to the United States as the deadly pandemic spread.“It’s not for the faint of heart and promises to be very grueling, but we wanted to gauge interest,” the American Embassy in Quito, Ecuador, wrote in a notice last month to Americans looking to get back to the United States as the deadly pandemic spread.
It was a nonstarter for Bob Rand, who remains in Ecuador with an immune system already compromised from previous rounds of chemotherapy to treat Stage 4 cancer. He makes annual trips there to visit a son working in Quito.It was a nonstarter for Bob Rand, who remains in Ecuador with an immune system already compromised from previous rounds of chemotherapy to treat Stage 4 cancer. He makes annual trips there to visit a son working in Quito.
But it turned out to be the last U.S. government flight out of Ecuador, leaving few, if any, options available for American citizens trying to avoid becoming sick.But it turned out to be the last U.S. government flight out of Ecuador, leaving few, if any, options available for American citizens trying to avoid becoming sick.
The March 29 itinerary called for Mr. Rand and other travelers to take a C-130 military cargo plane to Panama, where they would remain onboard for a 12-hour layover. They would have no food or water, except what they carried in the single 50-pound bag each passenger was allowed to bring.The March 29 itinerary called for Mr. Rand and other travelers to take a C-130 military cargo plane to Panama, where they would remain onboard for a 12-hour layover. They would have no food or water, except what they carried in the single 50-pound bag each passenger was allowed to bring.
From Panama, they would fly to a naval base in Norfolk, Va., and passengers would have to find their own transportation the rest of the way home.From Panama, they would fly to a naval base in Norfolk, Va., and passengers would have to find their own transportation the rest of the way home.
For Mr. Rand, that meant booking a commercial flight or renting a car for the trip back to North Hampton, N.H. — almost certainly coming into contact with people who had not spent weeks in isolation, as he had.For Mr. Rand, that meant booking a commercial flight or renting a car for the trip back to North Hampton, N.H. — almost certainly coming into contact with people who had not spent weeks in isolation, as he had.
“But at the end of the day, you’ll be back in the United States and will have a great story to tell,” the embassy said in its notice.“But at the end of the day, you’ll be back in the United States and will have a great story to tell,” the embassy said in its notice.
Mr. Rand does not regret passing up the cargo flight. “That would have been tough on me,” he said this week in a telephone interview.Mr. Rand does not regret passing up the cargo flight. “That would have been tough on me,” he said this week in a telephone interview.
But a month later, and with coronavirus cases doubling by the week in Ecuador, Mr. Rand now wonders whether he would be better off taking one of a dwindling number of weekly commercial flights to the United States — even if it means interacting with strangers who ultimately could infect him.But a month later, and with coronavirus cases doubling by the week in Ecuador, Mr. Rand now wonders whether he would be better off taking one of a dwindling number of weekly commercial flights to the United States — even if it means interacting with strangers who ultimately could infect him.
“I think I’d rather be home surrounded by doctors than be sick down here,” he said.“I think I’d rather be home surrounded by doctors than be sick down here,” he said.
Those who had assumed they could stay overseas, and wait for the pandemic to ebb, now face an unnerving choice: Either stick it out, and prepare for the possibility they will be infected with the virus and treated in foreign hospitals, or chance catching it on the way back to the United States.Those who had assumed they could stay overseas, and wait for the pandemic to ebb, now face an unnerving choice: Either stick it out, and prepare for the possibility they will be infected with the virus and treated in foreign hospitals, or chance catching it on the way back to the United States.
The State Department is winding down government-organized flights that have so far brought home 65,000 Americans from across the world. Some continue in limited numbers, in areas like the Indian subcontinent and Africa, but “these flights will not go on forever,” Ian Brownlee, a deputy assistant secretary of state, told reporters on Wednesday.The State Department is winding down government-organized flights that have so far brought home 65,000 Americans from across the world. Some continue in limited numbers, in areas like the Indian subcontinent and Africa, but “these flights will not go on forever,” Ian Brownlee, a deputy assistant secretary of state, told reporters on Wednesday.
The department is also helping commercial airlines cut through foreign regulations that have restricted flights during the pandemic. At least four flights carrying Americans to the United States left Peru over the last week, officials said, after diplomats lobbied the government in Lima to ease its closed borders.The department is also helping commercial airlines cut through foreign regulations that have restricted flights during the pandemic. At least four flights carrying Americans to the United States left Peru over the last week, officials said, after diplomats lobbied the government in Lima to ease its closed borders.
But there still are at least 17,000 American citizens or legal residents abroad who have indicated they need help and, at this point, the State Department is urging them to take any available flights out.But there still are at least 17,000 American citizens or legal residents abroad who have indicated they need help and, at this point, the State Department is urging them to take any available flights out.
Dr. William Walters, the State Department’s deputy chief medical officer, said the risk of catching the virus was nearly as high on the government-sponsored flights as it was on commercial airlines. What will make a difference in Americans’ health, he said, is where they will be able to get medical treatment.Dr. William Walters, the State Department’s deputy chief medical officer, said the risk of catching the virus was nearly as high on the government-sponsored flights as it was on commercial airlines. What will make a difference in Americans’ health, he said, is where they will be able to get medical treatment.
“You can come back to the United States where you are a citizen and you have access to health care and you have access to an infrastructure that is still intact,” Dr. Walters said.“You can come back to the United States where you are a citizen and you have access to health care and you have access to an infrastructure that is still intact,” Dr. Walters said.
But by hunkering down, in developing countries in particular, where the virus has yet to peak, “you will be an American citizen in a foreign country that didn’t have great infrastructure to begin with,” he said. “And now you have less rights and less access to less infrastructure.”But by hunkering down, in developing countries in particular, where the virus has yet to peak, “you will be an American citizen in a foreign country that didn’t have great infrastructure to begin with,” he said. “And now you have less rights and less access to less infrastructure.”
Updated May 28, 2020 Updated June 1, 2020
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Mr. Brownlee warned that commercial flights to the United States also might end in the coming days — making it all the more urgent for Americans to grab any opportunities “while they exist.”Mr. Brownlee warned that commercial flights to the United States also might end in the coming days — making it all the more urgent for Americans to grab any opportunities “while they exist.”
More than half of the Americans the State Department has helped so far were departing from countries in Central and South America; an additional 4,000 are still seeking assistance, Mr. Brownlee said.More than half of the Americans the State Department has helped so far were departing from countries in Central and South America; an additional 4,000 are still seeking assistance, Mr. Brownlee said.
Hundreds of thousands of Americans live in Brazil, Mr. Brownlee said, but there are now fewer than a dozen flights to the United States each week. The number of commercial flights from Honduras, Guatemala and Ecuador have also decreased in recent days.Hundreds of thousands of Americans live in Brazil, Mr. Brownlee said, but there are now fewer than a dozen flights to the United States each week. The number of commercial flights from Honduras, Guatemala and Ecuador have also decreased in recent days.
The death toll in Ecuador during the outbreak was 15 times higher than the official number of coronavirus deaths reported by the government, according to an analysis by The New York Times. The numbers suggest that the South American country is suffering one of the worst outbreaks in the world.The death toll in Ecuador during the outbreak was 15 times higher than the official number of coronavirus deaths reported by the government, according to an analysis by The New York Times. The numbers suggest that the South American country is suffering one of the worst outbreaks in the world.
The State Department so far has helped more than 3,500 Americans leave Ecuador, including more than 110 this week. But Mr. Rand so far has been unable to book a seat.The State Department so far has helped more than 3,500 Americans leave Ecuador, including more than 110 this week. But Mr. Rand so far has been unable to book a seat.
As he considers where he might receive medical treatment should he need it, Mr. Rand has grown increasingly anxious. Most well-equipped private hospitals in Quito are not treating coronavirus patients, he said, and the public hospitals are already overextended.As he considers where he might receive medical treatment should he need it, Mr. Rand has grown increasingly anxious. Most well-equipped private hospitals in Quito are not treating coronavirus patients, he said, and the public hospitals are already overextended.
He is now hoping to fly out on a United Airlines flight next week that will route him from Quito through Houston for an overnight layover, and then to Chicago, before he arrives in Boston — ironically, as many transfers as the trip on the U.S. military cargo plane.He is now hoping to fly out on a United Airlines flight next week that will route him from Quito through Houston for an overnight layover, and then to Chicago, before he arrives in Boston — ironically, as many transfers as the trip on the U.S. military cargo plane.
But at least he will be back in the United States. “Things could get tricky here,” said Mr. Rand, who has been in self-isolation in Ecuador with his son and a small group of friends since March 16. “I’m beginning to think, ‘Uh-oh.’”But at least he will be back in the United States. “Things could get tricky here,” said Mr. Rand, who has been in self-isolation in Ecuador with his son and a small group of friends since March 16. “I’m beginning to think, ‘Uh-oh.’”