GRAPHICAir Travel Between U.S. and Zika-Affected Areas
Air travel has been a factor in the spread of Zika virus, but some countries are better at detecting and preventing the spread of diseases.
 
Which sounds like the most dangerous way to spend your next vacation?
1. Going to Brazil, epicenter of the Zika virus, for the Olympics.
2. Visiting Istanbul, where eight German tourists died in a terrorist attack last month.
3. Taking a road trip through Thailand.
4. Staying home to work on a long-put-off home improvement project.
It’s tricky, but it’s not a trick question: There is no wrong answer. The way that you measure risk is based on complex factors, including personal ones. Mosquitoes may love you, terrorism may have touched you directly, your husband may be a terrible driver, and that project may include asbestos removal.
The number of Americans making such calculations is growing: We’re traveling abroad more often and to more places, perhaps because our globalized world — Starbucks in 65 countries! — seems smaller and safer. Until it isn’t. The Zika virus is spreading through the Americas not long after chikungunya infected thousands of American travelers there and Ebola ravaged West Africa. It’s not just disease: Recent terrorist attacks targeting tourists (Tunisia, Egypt, Istanbul) and tourist areas (Paris) have also made such decisions more wrenching.
“There’s a lot going on in the world,” said Daniel Durazo, director of communications at Allianz Global Assistance USA, which sells travel insurance. “There’s a lot of noise out there about the dangers of traveling.”
Yet we’re generally terrible at adjusting the volume.
“How scared or not you are is an emotion, not a statistic,” said David Ropeik, a risk consultant and the author of “How Risky Is It, Really?” As fans of haunted houses will attest, risk and being scared are two different things. But Mr. Ropeik’s point is that in the battle between your gut and your brain, your gut will win. One way to make sensible choices as a traveler is to nudge your gut toward rationality by feeding it accurate information, which is easier said than done.
Zika and terrorism are the latest high-decibel threats. But there are also some deafening silences. For example, you hear very little about the leading cause of nonnatural deaths among Americans abroad: motor vehicle accidents.
According to the latest figures available from the State Department, 223 Americans died abroad in car, bus or motorcycle accidents between July 2014 and June 2015. Other causes of death (homicide, suicide and drowning) also far outweigh terrorism. Sixteen Americans died of “terrorist action” in that period, all but four in places you already know not to go: Syria, Libya, Afghanistan and Somalia.
So before you even think about terrorism, you may want to check road safety in countries you hope to visit. A ranking of countries by car crash deaths per capita, based on a 2014 report by the respected University of Michigan Transportation Research Institute, shows that among the 10 most dangerous are two beloved destinations: Thailand and the Dominican Republic.
This is not to suggest that you should rush out and cancel your trip to Punta Cana. There, as in many places in the Dominican Republic, travelers tend to stay in resorts, and it is extraordinarily rare to die in a car accident while lying on the beach. As for Thailand, maybe you’d consider a less ambitious road trip, or domestic flights, though I’m not convinced that driving there is much more dangerous than renting a car in any country where you drive on the “wrong” side of the street. (A New Zealand police officer I met in a rural inn told me one of his main duties was to rush to crashes caused by Americans driving on the right.)
Even staying in the United States doesn’t always protect you. Repeated studies showed that after the Sept. 11 attacks, many Americans opted out of flying and drove instead, resulting in at least hundreds of additional road deaths. In hindsight, it would have been better to fly. But at that time, no one could say for sure if more airplanes would be hijacked, and fear was running high. “Not knowing is vulnerability and powerlessness and that raises precaution instinctively,” Mr. Ropeik said.
A similar sort of uncertainty is playing out now with the Zika virus, helped out by dramatic reports. Some people I know have even conflated the virus’s potential danger to pregnant women — it is suspected of causing a birth defect called microcephaly — with the relatively mild illness it causes in the overwhelming majority of those who suffer symptoms at all.
The antidote is good information. Travelers should seek out information specifically for them like the website of the federal Centers for Disease Control and Prevention, which cautions pregnant women against travelingbut restricts its warnings to most others to preventing mosquito bites, rather than changing travel plans. The State Department has yet to issue any travel warnings about Zika (nor does it have any current terrorism-related warnings in Europe, though it mentions Istanbul in its Turkey warning, principally dealing with the southeast part of the country).
Dr. Martin Cetron, director of the Division of Global Migration and Quarantine at the C.D.C., told me that even the warning for pregnant women is based on suspected rather than proven links. “In an era of uncertainty,” he said, “it’s reasonable to take a cautious approach and step back, rather than take a cavalier approach that the consequences won’t happen, and miss an opportunity to protect individuals.” But “you don’t want to swing so far the other way and say from now on no one should go to these places,” he said.
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| David Plunkert |
Numbers are often misreported, which can undermine popular understanding of risk. Over 5,000 cases of microcephaly had been reported in Brazil since January 2015. That sounds scary. But a deeper look tells a more complex story. The government investigated 1,345 of those cases, and found 837 were misdiagnoses. That means incidences of microcephaly are maybe a third of what is largely being reported, and it is unknown how many would have occurred without Zika. And Zika cases as a whole have been mostly concentrated in a few states of northeast Brazil, far from Rio de Janeiro’s Olympic venues, and anecdotally at least, mostly in poor neighborhoods where the Aedes aegypti mosquito thrives and repellent use is less common. That is a public health crisis and perhaps a social justice issue, but a far lesser risk to most travelers, especially nonpregnant ones.
Here we also have a deafening silence. Unmentioned in much of the coverage of Zika is that last year, 1.5 million Brazilians caught dengue fever, which is transmitted by the same mosquito but causes far more serious symptoms: over 800 died. This year has seen new outbreaks. So if you’re a man or nonpregnant woman more scared of Zika than dengue, it’s too late: You’ve already been infected by the news media.
If that is the case and you decide to stay home, keep in mind that carries its own risks. “We are more scared of the unfamiliar than the familiar,” Mr. Ropeik said. Yet we run long- and short-term risks every day: eating fast food, walking under a crane and crossing busy streets, not to mention drinking water tainted with lead.
Arthur Frommer, the octogenarian guidebook guru, has another to add: “I have recently been struck by the fact that you encounter greater danger in the U.S. from gun violence than the popular destinations to which people travel.” He noted that Tim Fischer, a former deputy prime minister of Australia, recently suggested that his country issue a travel warning about the widespread prevalence of guns in the United States; the government did not, but does tell Australians on its Smartraveller site: “You should be vigilant to the possibility of gun crime in all parts of the U.S.”
Some Americans would argue that the United States is in fact safer because of the wide presence of guns; they might logically choose to defer travel to Australia.
Instead of holding off on a trip — or becoming a hermit — the best way to stay safe is to reduce risk on the road. That may be by using mosquito repellent religiously at the Olympics, taking public transport in New Zealand, and spending less time in big European cities and more in small towns. Another way to knock risk down a notch is to mitigate the impact of potential crises by, say, buying medical evacuation insurance. Keeping a list of top hospitals and emergency numbers at the ready helps as well. Allianz’s free TravelSmart app puts that information in your phone, though in developing countries I would check JustLanded.com for the number of a private ambulance service as well.
Once you have assessed potential travel risks, you should compare them with potential travel rewards. That can vary greatly among individuals. Exhibit A: “Travel to me is too vital, too important a part of civilized life that I feel we would give up too much by not traveling for fear of terrorism to France, Belgium and other destinations,” Mr. Frommer said. But for less gung-ho travelers, any added risk could tip the scales and land them at the municipal pool or on the local golf course.
The final thing you have to fear is fear itself. If after careful deliberation you’ve decided that the risks are slim, but you’re still terrified, then consider staying put. Not because of the risk to your health, but the certainty that you’ll be too nervous to appreciate your travels.
Correction: March 6, 2016
An article last Sunday about minimizing risk while traveling misstated the name of an app from the insurance company Allianz. It is TravelSmart, not Smart Traveler.
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