Travelers easily could adapt in the early days of the coronavirus outbreak, when the illness was mostly contained to a province in China. Then cases started turning up — and spreading — in other countries.

Concerns about widespread illness in such places as Italy have brought anxieties closer to American travelers. Late Friday, the U.S. State Department raised its advisory level to warn Americans to reconsider travel to all of Italy because of “sustained community spread” of the virus and warned against traveling in the Lombardy and Veneto regions. More than 1,600 people have tested positive there. The Centers for Disease Control and Prevention also elevated its language about the country, issuing a warning to avoid all nonessential travel.

“I wouldn’t have predicted a week ago that Northern Italy would be a place you wouldn’t want to travel to right now,” Robert Quigley, regional medical director for travel risk mitigation company International SOS, said Thursday before the advisories were raised. “You can’t predict where there’s going to be the next hit.”

Late last week, authorities confirmed cases in the United States with no known origin, marking a new chapter for the spread in the country.

As each day brings news of more cases, what is a potential traveler to do? Is it time to cancel a trip? Should people move forward with their already-scheduled vacations? And for those still set on traveling, what’s the best way to plan?

If you decide to cancel

Staying put is not an uncommon practice of late. Major corporations called off large gatherings, and hotel chains reported rising cancellations. Some travel agents report that clients are canceling cruise plans abroad and changing to U.S.-based sailings or all-inclusive resorts. Airlines including American, JetBlue and Alaska waived change and cancellation fees for new bookings in case customers get nervous about traveling.

Experts say there are resources potential travelers should consider when deciding whether to call off a trip, including advice and situation reports from the World Health Organization, advisories from the State Department — which often contain detailed information about specific regions within a country — and notices from the CDC. As of Monday, the health agency warned Americans to avoid nonessential travel to China, Iran, South Korea and Italy and to enhance precautions in Japan because of the coronavirus.

“I think right now what we’re seeing is there is more transmission in certain parts of the world, and so it’s important to keep an eye on where the transmission is being reported,” said Crystal Watson, an assistant professor at the Johns Hopkins Center for Health Security. “Right now those places might not be the best places to go if you can avoid traveling there. But I think soon we’re going to see a lot more transmission around the world.”

Those deciding what to do, Watson said, should consider whether they are at a higher risk for severe illness if they are infected. That includes people 65 and older and those with underlying health conditions.

Isaac Bogoch, an infectious diseases physician and scientist based at the University of Toronto, said that although patterns so far show most people infected with the coronavirus will have mild symptoms, there are still many questions.

“I think we still have to remain humble that we don’t have the answers yet,” he said. “Because of that and because we don’t have a vaccine and because we don’t know a lot about this virus, people may have some fear wherever there are unknowns.”

Squaremouth, the travel insurance comparison website, noted a “very large spike” in calls from customers last week after the virus spread to Italy. According to a survey the company provides after people buy insurance, 27 percent said they made the purchase because of the coronavirus.

“Right now we are primarily hearing from customers who want to cancel their trip because they are worried about how the virus is going to spread, just general feelings of fear and uncertainty,” said Squaremouth spokeswoman Kasara Barto. “Or they are still planning on traveling, but they want to be able to purchase a policy that lets them cancel in case the outbreak spreads.”

Most who have booked and want to cancel because they’re scared to travel — or because their original reason for traveling might no longer be valid — are out of luck, unless they bought a comprehensive policy that allows them to call off their trip for any reason.

Barto recommends calling hotels, airlines and cruise lines to find out if they can waive rebooking fees, change trip dates or otherwise offer flexibility. Those who booked a trip with a travel agent should ask whether that person — who may have ongoing relationships with travel companies — can help make changes without a penalty, Becky Powell, president of Protravel International, said in an email.

Laurel Brunvoll, owner of Unforgettable Trips travel agency, recommends taking a wait-and-see approach to cancellation to watch how the situation plays out.

“For areas with a heightened risk, it may all depend upon when someone is planning to travel there,” she said in an email.

If you go ahead with a trip

Maybe it would be too costly to cancel. Maybe travelers just don’t want to reschedule, they’re not in a high-risk group and the destination isn’t under an advisory. Whatever the reason, the trip is still on the table.

Experts say the key before heading out is preparing in case the situation changes.

“I think if you’re going to travel — and I’m not saying that’s a bad idea, I would really like to take a vacation myself — I think people should be aware that there’s a possibility you could get stuck somewhere for an extended period of time,” Watson said.

She said during a trip, travelers should watch for news of changes and adjust their behavior accordingly if the disease is circulating in a community by staying away from public places, anyone who appears sick and large gatherings of people.

Some countries are restricting where people can go or whether anyone is allowed to enter from affected areas, which could interfere with travel plans. Popular attractions might not be open; the Louvre closed Sunday, and Disney’s theme parks in Shanghai, Hong Kong and Tokyo all closed temporarily.

Tony Roccaforte, senior security adviser at risk management company WorldAware, said in an email that travelers should build redundancy into their plans, adding time for delays and preparing to improvise if conditions change.

“Have backups for your backups for everything from your communications devices, batteries, food/water, medication/eyeglasses, financial tools, transportation, lodging, airfare, etc.,” he said.

Before leaving, he said, vacationers should get all their ducks in a row back home: update their will and powers of attorney, confirm life insurance and health insurance coverage and update their international immunization record. Travelers should create a detailed itinerary of where they’ll be and when and give it to a colleague or someone they trust at home.

Erika Richter, spokeswoman for the American Society of Travel Advisors, said in an email that travelers might consider bringing work materials with them in case they end up marooned and that they should bring extra copies of their passport, itinerary and proof of health insurance.

Watson said the recommendation is for people to have 30 days of prescription medications with them, and they also should bring their original prescription in case they need more on the road.

Anyone who is sick should not travel — not just to keep from spreading illness but also to avoid getting pulled out of lines and potentially quarantined, said Quigley, of International SOS.

As of early March, people have tested positive for the coronavirus in about 70 countries. Officials are taking "unprecedented" actions. (The Washington Post)

He said thoroughly wiping down surfaces while traveling is “always in order,” because many viruses and bacteria can survive on objects. The CDC said it may be possible for someone to get the coronavirus by touching something that has the virus on it and then touching their mouth, nose or eyes, but it’s still not known how long the virus can survive on surfaces.

The basics are key to preventing infection, Courtney Kansler, senior health intelligence analyst at WorldAware, said in an email.

“This includes frequent hand washing with soap and water or use of an alcohol-based hand sanitizer if soap and water are unavailable,” she said. “Use social distancing and avoid obviously sick people. Transit quickly through airports or similarly crowded transportation hubs.”

Travelers who didn’t buy travel insurance when they booked a trip should consider adding a medical policy before heading out, Squaremouth’s Barto said — though coverage is limited. She said last week that about a third of providers on the site are offering coverage that would include the virus.

If you plan future travel

For some travelers, no spreading virus will be enough to stifle wanderlust, especially with spring break and summer vacation season approaching. So how to proceed?

There are official travel advisories and warnings on where not to go. And there are maps showing where the virus has spread. But experts caution against merely picking a spot that has not yet seen a confirmed case.

“Every day we see more and more countries reporting their first case of this virus, and in addition to that, we see countries known to have this virus reporting an increase,” said Bogoch, the infectious diseases specialist, who has co-written research on the spread of the virus. “If we’re not calling this a pandemic, we’re at least sitting at the precipice of a pandemic.”

Quigley said it’s important for travelers to look constantly at the regulations and rules being enforced wherever they’re going — and to realize everything could change if and when the World Health Organization declares a pandemic.

“The responses will all be different, but clearly there will be a significant impact on travel both domestic and across borders,” he said.

Travelers considering where to go need to factor potential consequences of the virus’ spread into their decision-making, said Roccaforte, of WorldAware. He said that includes the possibility of quarantines, travel restrictions, public transportation bans, food and water rationing, civil unrest and strained health-care systems.

Anyone traveling should think about how they would find medical care if they got sick or hurt.

“This is more important for people who have underlying health conditions, and it becomes even more important if there is an infectious disease outbreak,” said Watson, of the Johns Hopkins Center for Health Security.

Those making plans now still can buy insurance if they decide later to cancel because of coronavirus fears — though the policy won’t be cheap.

“Right now, the only and best option we are recommending for people is a ‘cancel for any reason’ policy,” Barto said. That’s only available within the first 10 to 21 days of booking a trip, she said, and it costs about 40 percent more than a standard cancellation policy. It reimburses 75 percent of the cost of the trip.

Richter, the spokeswoman for the American Society of Travel Advisors, suggests using a professional to help make plans for the spring or summer.

“A travel adviser can help talk you through your list of options and pricing — they can help you come up with a plan A, B and C and having those back-up options on hand might put your mind at ease,” she said in an email. “In times like these, you need a travel advocate.”

Read more: