(CNN) — Germany and Denmark were added to the US Centers for Disease Control and Prevention’s list of “very high” risk travel destinations on Monday as a winter Covid-19 surge sweeps much of Europe.
Germany is battling a fourth wave and reported a record single-day surge in cases last week.
Some of the charming Christmas markets that typically draw crowds in Germany this time of year have already been canceled, including the popular Christmas market in Munich.
After lifting domestic Covid restrictions in September, Denmark is once again fighting a spike in Covid cases and is weighing renewed restrictions. In Copenhagen, the famed Tivoli Gardens opened its Christmas season on Friday.
Destinations that fall into the CDC’s “Covid-19 Very High” Level 4 category have had more than 500 cases per 100,000 residents in the past 28 days.
People should avoid traveling to locations designated with a “Level 4” notice, the CDC recommends. Anyone who must travel should be fully vaccinated first, the agency advises.
To recap, these two destinations moved to Level 4 on November 22:
Previously, the two destinations had been listed in the Level 3 category of “Covid-19 High” risk. By moving to Level 4, they join the ranks of other travel favorites in Europe and elsewhere. They include:
• Costa Rica
• Czech Republic
In all, about 75 destinations are currently at Level 4. The United Kingdom and British Virgin Islands have been lodged at Level 4 since July 19.
New entries on Level 3
The Level 3 category — which applies to destinations that have had between 100 and 500 cases per 100,000 residents in the past 28 days — had five updates this week, with a big showing in the Caribbean.
These five destinations moved to Level 3 on November 22:
• US Virgin Islands
The move was actually good news for all five destinations, which had been at Level 4.
You can view the CDC’s risk levels for global destinations on its travel recommendations page.
There are other factors for travelers to consider beyond the Covid-19 incidence rates that figure prominently in the CDC’s travel notices, according to CNN Medical Analyst Dr. Leana Wen.
“The transmission rates are one guidepost. Another is what precautions are required and followed in the place that you’re going and then the third is what are you planning to do once you’re there,” said Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health.
“Are you planning to visit a lot of attractions and go to indoor bars? That’s very different from you’re going somewhere where you’re planning to lie on the beach all day and not interact with anyone else,” said Wen, who is also author of a new book, “Lifelines: A Doctor’s Journey in the Fight for Public Health.”
Most importantly, travelers should be vaccinated, she said.
Update on Level 2
The CDC moved three African countries — Benin, Equatorial Guinea and Ethiopia — down from Level 3 to the less-risky Level 2.
For the fourth new Level 2 entry, New Zealand, the situation has worsened. The nation, which moved up from Level 1, has recently moved away from its zero-Covid strategy, focusing now on vaccination efforts and living with the virus.
These destinations moved to Level 2 on November 22:
• Equatorial Guinea
• New Zealand
Destinations carrying the “Level 2: Covid-19 Moderate” designation have seen 50 to 99 Covid-19 cases per 100,000 residents in the past 28 days.
Keep in mind the CDC list updates weekly, and the situation in any country can change for better or worse from week to week.
Level 1 and no ratings
In the best news category, there were some significant additions, with a dozen countries moving into the Level 1 “low” risk category. The news from Africa was especially good. African countries made up three-fourths of the new entries.
In “Level 1: Covid-19 Low” destinations, fewer than 50 new cases per 100,000 residents have been logged over the past 28 days.
The 12 destinations moved into Level 1 on November 22 are:
• South Africa
• United Arab Emirates
Several of those — including Kenya, Morocco and South Africa — are among Africa’s most significant tourism draws.
Finally, there are destinations for which the CDC has an “unknown” risk because of a lack of information. As of November 22, that list included Burundi, Madagascar, Cambodia, Nicaragua and Macau.
In its broader travel guidance, the CDC has recommended avoiding all international travel until you are fully vaccinated.
“Fully vaccinated travelers are less likely to get and spread Covid-19. However, international travel poses additional risks, and even fully vaccinated travelers might be at increased risk for getting and possibly spreading some Covid-19 variants,” the agency said.
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