CDC Adds 22 Destinations to Highest Risk Travel List

New CDC update on masks 0:58

(CNN) --

On Tuesday, the US Centers for Disease Control and Prevention (CDC) added 22 countries to the highest risk category for travel due to COVID-19.

By contrast, last week only two countries were listed at level 4, or "very high" risk.

To add to this impact: The CDC also added 22 more countries to its Tier 3 category, which is considered "high" risk for Covid-19.

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Among the nations moved to Tier 4 this week are

and

, which have maintained some of the strictest border controls throughout most of the pandemic.

The CDC places a destination at level 4 when there are more than 500 cases per 100,000 residents in the last 28 days.

The CDC advises travelers to avoid traveling to Tier 4 countries.

Egypt, where the Giza pyramids are a major tourist attraction, moved into the CDC's highest-risk category for travel on Tuesday.

Credit: Safin Hamed/AFP via Getty Images

The 22 new destinations, with at least one entry from each continent except Antarctica, at level 4 are:

• Albanian

• Argentina

• Australia

• Bahamas

• Bahrain

• Bermuda

• bolivia

• Cape Verde

• Egypt

• Grenada

• Guyanese

• British Virgin Islands

• Israel

• Panama

• qatar

• Saint Kitts and Nevis

• St. Lucia

• Sao Tome and Principe

• San Martin

• Suriname

• Turks and Caicos

• Uruguay

The

, in the Caribbean, have risen the most on the list.

Last week they were at level 1 (or "low" risk).

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Grenada,

another Caribbean island, and

, off the coast of Africa, were at level 2 (or "moderate" risk) last week.

The other 19 destinations were at level 3.

Sydney's city skyline is seen as people party on boats at Athol Beach, Australia, on January 15.

situation in Europe

In Europe there has only been one new entry at level 4 this week: Albania.

This is because much of Europe has remained firmly at CDC level 4 risk for weeks or months now.

Among the European destinations at this level are some of the biggest names on the continent:

• Germany

• Spain

• France

• Greece

• Ireland

• Iceland

• Italy

• United Kingdom

Other popular destinations, such as

and

, are also at Tier 4. With the addition of 22 new destinations, the Tier 4 list now exceeds more than 100 locations.

You can check the CDC's risk levels for worldwide destinations on their travel advice page.

The CDC does not include the

on its advisory list, but on January 18 it was assigned level 4 on the agency's map of travel risk levels.

In its broader travel guidance, the CDC has recommended avoiding all international travel until you are fully vaccinated.

Additions to level 3

The level 3 category, which applies to destinations where there have been between 100 and 500 cases per 100,000 residents in the last 28 days, also registered 22 new additions on Tuesday:

• Costa Rica

• Ivory Coast

• Cuba

• fiji

• Gabon

• Ghana

• Jamaica

• Kuwait

• Madagascar

• malawi

• Morocco

• Mauritania

• Mozambique

• Nigeria

• Paraguay

• Philippines

• Saba

• San Bartolome

• Saint Eustatius

• Saint Pierre and Miquelon

• Togo

• Uganda

People line up to vaccinate children in San José, Costa Rica, on January 12.

Costa Rica moved to level 3 this week in the CDC's travel warnings.

Credit: Ezequiel Becerra/AFP/Getty Images

There was some good news from South East Africa's neighbors

and

, both down from Tier 4.

The move to Tier 3 was bad news for

in Africa, which moved up two notches from Tier 1. The Caribbean islands of

and

also moved up from Tier 1, as did than

in South America and the

in Southeast Asia.

Half of the new Tier 3 destinations moved up this week from Tier 2:

.

There are now almost 60 destinations at level 3.

Levels 2, 1 and unknown

Destinations that carry the "Level 2: Moderate Risk of COVID-19" designation have recorded between 50 and 99 cases of COVID-19 per 100,000 residents in the last 28 days.

At this level there were four new additions on Tuesday:

• India

• Kosovo

• Montserrat

• Djibouti

All four destinations were at level 1 last week.

To be in "Tier 1: low risk of covid-19", a destination must have less than 50 new cases per 100,000 residents in the last 28 days.

On Tuesday there were no new additions.

Featured destinations in Tier 1 include

and

.

Finally, there are destinations for which the CDC has an "unknown" risk due to lack of information.

Usually, but not always, these are small and remote places.

On Tuesday, the remote sultanate of

was added to the group of unknowns.

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Cruise ships

Royal Caribbean's Mariner of the Seas departs from Port Canaveral, Florida, on Jan. 11, 2021.

Credit: Joe Burbank/Orlando Sentinel/AP

The CDC includes cruise ships in its list of destinations.

On December 30, the CDC raised the risk of cruise travel to level 4 and said cruise travel should be avoided, regardless of vaccination status.

In the last update level 4 is maintained.

Meanwhile, CDC COVID-19 guidance will now be optional for many cruise ships.

The CDC's expanded conditional shipping order expired last week, and the agency has moved to a voluntary program for foreign cruise ships operating in US waters.

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Travel Considerations

Transmission rates are important to consider when making travel decisions, but there are other factors to consider as well, according to Dr. Leana Wen, a CNN medical analyst, emergency room physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health.

"The transmission rates are a benchmark," Wen said.

"Another is what precautions are required and followed where you're going, and the third is what you plan to do once you're there."

"Do you plan to visit a lot of attractions and go to closed bars? That's very different than going to a place where you plan to lie on the beach all day and not interact with anyone else. That's very different. Those are very different levels of risk."

Vaccination is the most important safety factor for travel, as unvaccinated travelers are more likely to get sick and spread COVID-19 to others, Wen said.

The doctor recommends that people wear a high-quality mask, N95, KN95 or KF94, whenever they are in closed and crowded places with people of unknown vaccination status.

Before traveling, it's also important to consider what you would do if you tested positive for COVID-19 away from home, Wen said.

Where will you stay and how easy will it be to get tested to return home?

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