John Davis was finally going to take a cruise he booked more than two years ago. But when the cruise line, Royal Caribbean International, announced plans in August to drop its COVID-19 vaccine mandate for many sailings, he and his wife, Laura, decided to cancel their trip.
The 51-year-old, who has Type 2 diabetes and is at higher risk of complications from COVID-19, said the couple was already on the fence about going on the seven-day Caribbean cruise – which they had already postponed once – but the vaccine rule had given them some peace of mind.
"And then when the announcement came out that they were dropping the vaccine requirement and it was going to be a mix of vaccinated and unvaccinated guests, it was like, 'Well, now the odds are changing,'" Davis, a tech support engineer for an audio equipment company, told USA TODAY.
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For the Houston-based couple, the risk of getting sick seemed too high. "We're kind of out of cruising for a while, I think," he said.
Davis is one of a number of travelers with health concerns who have limited their options or have stopped traveling altogether as COVID-19 requirements have been dropped.
Travel requirements have been dropped as the pandemic has waned.
Major cruise lines, including Royal Caribbean and Carnival Cruise Line, began welcoming all travelers regardless of vaccination status on many sailings last month and have eased testing rules for vaccinated travelers. Those changes came months after a federal judge struck down the mask mandate for air travel and other public transportation settings on April 18.
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For some high-risk people, travel has stopped entirely
More than 1 million people have died as a result of COVID-19 in the U.S., according to data from Johns Hopkins University, and more than 6.5 million have died worldwide.
Other travelers feel particularly homebound. Angel Storey, who grew up in Baltimore but lives in London, has not been back to the United States to visit family since 2018 because of COVID-19.
Storey, 40, has rheumatoid arthritis and takes medication that suppresses her immune system. To make matters more complicated, she had a stroke in 2020. She rarely leaves home except to walk her dog or for medical appointments and has not traveled at all during the pandemic, forgoing long-planned vacations, like one to Japan to see cherry blossoms in March 2021.
"I have a (Japan) guidebook that I bought, and I've never opened, and it's sat on my side table being used as a paperweight," Storey, who is an advertising copywriter, said, laughing. "It's the saddest thing every time I look at it."
Storey's family has also held off on visiting her for fear of exposing her to the virus, particularly with rules like the U.S. mask mandate for planes gone.
"It's an accessibility issue is what it is, at the end of the day because by not having these protections in place, you're effectively banning (people with disabilities) from your event, from your business, from travel," she said. "You're saying, 'We don't mind if (people with disabilities) are excluded, if chronically ill people are excluded, so that healthy people can have normalcy.' "
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Dr. Henry Wu, an associate professor of medicine at Emory University School of Medicine and director of Emory TravelWell Center, said we are in "a transitional period" in the pandemic. For many people, he said, COVID-19 concerns have decreased, while others – including those who are medically vulnerable – want to take precautions, but may also want to travel.
The U.S. saw a seven-day case rate of 90.3 per 100,000 people as of Oct. 3, according to the Centers for Disease Control and Prevention's website, a higher rate than spring lows but lower than last year during the same time period.
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"I think first and foremost is to understand what your risks are, whether you do have a vulnerable immune system where you may not even have responded well to the vaccination or if you're just in a group where any infection may be maybe more serious," Wu said.
Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University's Mailman School of Public Health, said travelers should speak with their doctor to determine how best to protect themselves, such as by being up to date on their vaccines – including booster doses – which she called "the baseline."
Travelers can also wear a non-cloth mask in crowded settings, particularly indoors, El-Sadr, said, which can protect the wearer even if others are not masked. She said she recommends people wear the highest quality mask they have access to, but also the kind they can best tolerate. "If you can't tolerate (it), you're going to take it off," she said.
She also suggested travelers maximize time spent outdoors and bring rapid tests with them on their trip in case they start showing symptoms, so they don't have to worry about finding one at their destination.
Taking those kinds of steps is particularly important for people who are high-risk but want or need to travel.
"I feel like for someone who is immunosuppressed or have other severe comorbidities that are not well-controlled, I think it behooves them to do whatever they can within reason to protect themselves, while at the same time enjoying all the pleasures of travel," she said.
Different types of trips also bring different risks. "I think air travel alone is not particularly risky," Wu said, noting that travelers can wear high-quality masks for the majority of their trip and that air filtration systems on planes are very good.
Cruises, meanwhile, El-Sadr said, pose a higher level of risk because they are "almost congregate living most of the time," and the two modes are difficult to compare (though she noted the cruise industry "has tried its best" to minimize the risk of transmission).
As cruise lines ease testing and vaccine requirements, however, Wu said he "would expect the risk level to increase."
Some high-risk travelers, such as Davis, may not want to go on a cruise but feel comfortable with other types of travel. He takes work trips regularly and travels for fun once or twice a year.
Others, like Storey, said they cannot risk getting COVID-19 by traveling. "I have a big map on my wall that has little push pins of everywhere that I've been, and I haven't been able to add anything to it for years," she said. "And I don't know when I'm going to be able to add to it again."
This article originally appeared on USA TODAY: As COVID-19 travel rules end, some high-risk travelers face new limits