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(CNN) --
The US Centers for Disease Control and Prevention (CDC) on Monday added even more destinations to its growing list of places considered "very high" risk for travel. by covid-19.
Level 4, the CDC's highest, has risen to nearly 135 locations, illustrating the rapid spread of the omicron variant of the new coronavirus around the world.
At the beginning of January, there were around 80 destinations on the list.
Tier 4 now has more destinations than all other CDC categories combined.
Joining the Tier 4 ranks this week are two island nations on opposite sides of the world: Japan, in Asia, and Cuba, the largest and most populous island in the Caribbean.
The other new Tier 4 nations are also spread across various parts of the world.
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Armenia is in the mountainous region of the Caucasus, on the borders of Eastern Europe.
The Democratic Republic of the Congo is in the heart of Central Africa, while Libya is on the Mediterranean coast of North Africa.
Oman is on the Arabian Peninsula, while Israel is on the Mediterranean coast of the Middle East.
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The CDC places a destination at level 4 when there are more than 500 cases per 100,000 inhabitants in the last 28 days.
The CDC advises travelers to avoid traveling to countries considered to be in Tier 4.
To recap, this week's Tier 4 additions are:
- Armenia
- Cuba
- Democratic Republic of Congo
- Israel
- Japan
- Libya
- Oman
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Last week, the Democratic Republic of the Congo was at level 2 "moderate".
Armenia, Cuba, Japan, Libya and Oman had been at level 3, in the "high" risk category.
Israel was added to Tier 4 on January 18, along with 21 other destinations, and remained there in subsequent updates.
However, the CDC included Israel in an updated version at level 4 on Monday because the agency added information on Gaza and the West Bank.
The CDC does not have separate listing additions for those locations.
Other significant places in level 4
The CDC does not include the United States on its advisory list, but on February 7 it was listed as level 4 on the agency's map of travel risk levels.
Last week, Mexico and Brazil were the most notable of a dozen places added to Tier 4.
Other tourist favorites that stay at level 4 even longer include Australia, Canada, France, Peru, Singapore and Spain.
The UK has been there since July 2021.
You can check the CDC's risk levels for any global destination on their travel advice page.
In its most comprehensive travel guidance, the CDC recommended avoiding all international travel until fully vaccinated.
Ray of hope at level 3
Cape Town in South Africa is considered one of the most beautiful urban settings in the world.
South Africa was downgraded to CDC Level 3 on Monday.
The Tier 3 category – which applies to destinations that have had between 100 and 500 cases per 100,000 residents in the last 28 days – saw three additions on Monday.
Is about:
- Bangladesh
- Montserrat
- South Africa
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South Africa, where the omicron variant of the new coronavirus was first reported, dropped from level 4, offering a glimmer of hope for the coming weeks and months that other places will follow suit.
However, the move to level 3 meant worsening conditions in populous Bangladesh, in South Asia, and in Montserrat, a small British island in the Caribbean.
They had both been at level 2.
Levels 2, 1 and unknown, according to the CDC
Destinations with the "Level 2: Moderate COVID-19" designation have seen between 50 and 99 cases of COVID-19 per 100,000 residents in the past 28 days.
At this level there was only one addition this Monday: Pakistan.
Previously it was at level 1.
Currently, there are only five destinations in Tier 2, including New Zealand, which has some of the strictest travel restrictions in the world.
To be in "tier 1: low covid-19", a destination must have less than 50 new cases per 100,000 residents in the last 28 days.
This Monday, no destination went to level 1. There are currently only seven destinations in this category.
Among them is China, which hosts the Winter Olympics.
Finally, there are destinations for which the CDC has an "unknown" risk due to lack of information.
These are usually, but not always, small, remote places or places with war or unrest.
This week there have been no additions.
Tanzania, Cambodia and the Canary Islands, the Spanish archipelago in the Atlantic, are some of the most visited places currently listed in the unknown category.
The CDC advises against traveling to these places precisely because the risks are unknown.
Cruise ships, on the CDC list
A Norwegian Gem cruise ship docked in the Port of Miami in 2021.
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 has become optional for many cruise ships.
The CDC's expanded conditional sailing order recently expired, and the agency moved to a voluntary program for foreign-flagged cruise ships operating in US waters.
Travel Considerations
Virus transmission rates are important to consider when making travel decisions, but other factors also need to be considered, according to Dr. Leana Wen, a CNN medical analyst, emergency room physician and professor of politics. and Healthcare 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.
He said people should wear a high-quality mask — N95, KN95 or KF94 — whenever they're in crowded, closed places with people of unknown vaccination status.
Before traveling, it's also important to consider what would be done if you tested positive away from home, Wen said.
Where will you stay and how easy will it be to get tested for the new coronavirus to return home?
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