The Centers for Disease Control and Prevention regularly issues "Travel Health Notices" that address disease outbreaks and other health-related matters in international destinations. The newly discovered coronavirus is now a topic of concern.
The point of the warnings is to indicate countries where the CDC believes there is a risk of infection with COVID-19, the disease caused by the virus.
There are three levels of notices based on the risk presented by the outbreak and what precautions are needed to prevent infection.
China and South Korea are in the highest notice level — "Warning Level 3." CDC advises travelers to avoid all nonessential travel to these countries. As part of the warnings, which were issued in late February, the CDC also cites limited access for visitors to adequate medical care. If travel is necessary, CDC advises travelers to discuss with their health-care provider.
Hong Kong, Macau and the island of Taiwan are excluded from this notice.
The only other country with a Warning Level 3 notice is Venezuela; CDC cites "outbreaks of infectious diseases" as well as the breakdown of the country's health-care infrastructure.
During the Ebola outbreak in 2014, this warning level was issued to Sierra Leone, Guinea and Liberia.
The second notice level, "Alert Level 2," suggesting that potential travelers "practice enhanced precautions," has been issued for travel to Iran, Italy and Japan, three countries experiencing person-to-person and community spread of COVID-19. This notice, according to CDC, is directed at older adults and those with "chronic medical conditions," who are at greater risk of developing a severe case of COVID-19 if infected. CDC advises them to consider postponing nonessential travel to these countries.
The third notice level is "Watch Level 1." At this level, the CDC does not recommend canceling or postponing travel but advises potential travelers to practice general precautions such as avoiding contact with sick people and washing hands for 20 seconds with soap and water or an alcohol-based hand sanitizer with 60% to 95% alcohol.
The CDC also currently has other travel health notices unrelated to COVID-19. For example, it has issued the Level 2 Alert for several countries in Africa and Asia because of polio and a Watch Level 1 for some parts of Central and South America for dengue.
Many countries with confirmed cases of COVID-19 do not currently have travel advisories from the CDC. Dr. Lin Chen, president of the International Society of Travel Medicine, said when deciding to go to these countries, travelers should look into the country's health-care system and make sure they have travel medical insurance that will provide coverage in their destination.
"I think it's important to identify what a traveler would do if they become sick," Chen said. "Having travel medical insurance is actually really important and gives you, perhaps, a peace of mind if you're going into a country that has some [confirmed] cases."
DOHA, Qatar — The United States is expected to sign a peace deal with the Taliban insurgency on Saturday that for the first time after two decades of grinding warfare would lay out the prospect of a final withdrawal of American troops from Afghanistan.
The signing in Doha, Qatar, is seen as a vital step toward negotiating a more sweeping peace deal that could end the insurgency altogether, after years of unrelenting violence that took the lives of more than 3,500 Americans and coalition troops and tens of thousands of Afghans since the U.S. invasion in 2001.
But the agreement is dependent on the Taliban’s fulfillment of major commitments that have been obstacles for years, including breaking with international terrorist groups such as Al Qaeda. And it hinges on far more difficult negotiations between the two Afghan sides to come, addressing the shape of a potential power-sharing government and a lasting cease-fire — both anathema to the Taliban in the past.
The Trump administration has cast the deal as its pledge to a war-weary American public, for whom the Afghanistan war has defined a generation of loss and trauma and roughly $2 trillion in expenditures but has yielded no victory.
“If the Taliban and the government of Afghanistan live up to these commitments, we will have a powerful path forward to end the war in Afghanistan and bring our troops home,” President Trump said on Friday ahead of the signing of the deal, which he dispatched Secretary of State Mike Pompeo to attend.
“These commitments represent an important step to a lasting peace in a new Afghanistan, free from Al Qaeda, ISIS, and any other terrorist group that would seek to bring us harm.”
At the height of the war, there were more than 100,000 American troops in the country, and tens of thousands of others from about 40 nations in the United States-led NATO coalition.
In recent years, it has been Afghan soldiers and police who have borne the brunt of the fighting, at a horrific cost in casualties and trauma.
From the start of the talks, late in 2018, Afghan officials were troubled that they were not at the table with American and Taliban officials. They worried that Mr. Trump would abruptly withdraw troops from Afghanistan without securing any of the conditions they saw as crucial, including a reduction in violence and a Taliban promise to negotiate in good faith with the government.
The best-case prospect laid out by the deal expected to be signed on Saturday is alluring: ultimately, the possibility for Afghans of an end to conflict that in one form or other has stretched for 40 years.
But behind that hope lies a web of contradictions.
The United States, which struggled to help secure better rights for women and minorities and instill a democratic system and institutions in Afghanistan, is reaching a deal with an insurgency that has never renounced its desire for a government and justice system rooted in a harsh interpretation of Islam. Though the Taliban would get their primary wish granted by this agreement, the withdrawal of American troops, they have made no firm commitments to protect civil rights for people they brutally repressed when in power.
Among the Taliban, bringing the world’s premier military power to the point of withdrawal has widely been seen as a victory with few caveats. And the public messaging from Taliban officials has not been conciliatory.
“This is the hotel that tomorrow will turn into a historic hotel,” the Taliban’s multimedia chief posted on Twitter on Friday with a photograph of the Sheraton in Doha, site of the signing. “From here, the defeat of the arrogance of the White House in the face of the white turban will be announced.”
The expected deal provides a conditional schedule for the withdrawal of the 12,000 remaining American troops. In the first phase, about 5,000 are to leave in a matter of months. The withdrawal of the rest is expected to happen over the next 14 months, depending on the Taliban keeping their end of the bargain.
The insurgents had to pledge to break with international terrorist networks and forbid Afghanistan’s use as a base for attacks by groups like Al Qaeda, which launched the Sept. 11 terrorist attacks on the United States from the haven the Taliban granted it in Afghanistan.
As part of the deal, the Taliban would also agree to open talks directly with the Afghan government and other leaders, ostensibly to negotiate a political settlement and an eventual cease-fire. But an immediate cease-fire to address the bloodshed that regularly rips through Afghanistan is not part of the agreement.
While American diplomats had pushed for a cease-fire, they settled for a “reduction in violence” and tested it over a stretch of seven days before the signing. Officials said attacks had dropped by as much as 80 percent during that period, and the hope was that the reduction could continue in the next phase, until the two Afghan sides could agree to a more comprehensive cease-fire.
Zalmay Khalilzad, the veteran diplomat leading the American peace efforts and himself a native of Afghanistan, long insisted that the United States was not simply seeking a withdrawal agreement, but “a peace agreement that enables withdrawal.”
The Taliban’s willingness to enter negotiations with other Afghans, including the government, over a political settlement has offered hope and fear to the Afghan people.
The hope is that a durable peace can be reached after generations of conflict and suffering. The fear is that the most difficult work lies ahead, and that the Taliban will come to the negotiations emboldened by the American withdrawal announcement after years of insurgent gains on the battlefield against the badly bloodied Afghan security forces.
The nearly two decades of war have been devastating, both in human and economic terms, though exact numbers are in many cases hard to come by.
Much of the peace negotiations happened in a year of record violence from both sides. In just the last quarter of 2019, the Taliban carried out 8,204 attacks, the highest in same period over the past decade. The United States dropped 7,423 bombs and missiles during the year, a record since the Air Force began recording the data in 2006.
In the past five years, about 50,000 members of the Afghan security forces have been killed, and tens of thousands of others wounded. The Taliban’s losses are harder to verify, but their casualty rate is believed to be comparable. Out of about 3,550 NATO coalition deaths in Afghanistan, nearly 2,400 have been Americans.
Lara Jakes contributed reporting from Washington, and Thomas Gibbons-Neff from Kabul.
President Donald Trump announced Friday that he had dispatched Secretary of State Mike Pompeo to "witness the signing of an agreement with representatives of the Taliban" and Defense Secretary Mark Esper to "issue a joint declaration with the government of Afghanistan."
"If the Taliban and the government of Afghanistan live up to these commitments, we will have a powerful path forward to end the war in Afghanistan and bring our troops home," Trump said in a statement. "These commitments represent an important step to a lasting peace in a new Afghanistan, free from Al Qaeda, ISIS, and any other terrorist group that would seek to bring us harm."
The deal will be inked in Doha, Qatar, which served as the base for on-and-off talks between US and Taliban negotiators for more than a year. Those negotiations have been led on the US side by Special Representative for Afghanistan Reconciliation Zalmay Khalilzad. The two sides had reached "an agreement in principle" in early September 2019, Khalilzad said at the time. Shortly thereafter, Trump called off the talks and said he canceled a secret Camp David summit with the militant group after they took credit for a deadly attack in Kabul that killed a US service member.
In a surprise visit to Afghanistan in November, Trump announced that the talks had restarted. The US President made the announcement shortly after the Taliban released an American and Australian professor in exchange for the release of three Taliban prisoners by the Afghan government. The State Department announced in early December that Khalilzad had rejoined talks with the Taliban in the Qatari capital.
The signing of the agreement would see the realization of a campaign promise for Trump, who has sought to diminish US involvement in wars overseas. Under the plan, the American military presence would be reduced to 8,600 troops from the current 12,000 to 13,000 over the course of 135 days, according to two sources familiar with the agreement.
Pompeo, speaking at the State Department Tuesday, noted that such a drawdown would be "conditions-based," adding that it "sets a high bar for the things that will take place in order for America to ensure that we can accomplish both of those missions: a peace and reconciliation solution in Afghanistan and ensuring that the homeland continues to be as risk free as we can possibly make it."
A senior Afghan politician told CNN Friday that Afghan government is wary about the upcoming deal, which is meant to trigger intra-Afghan dialogue between Afghan stakeholders and the Taliban.
"These negotiations, if they take place, will be the first time that Afghans representing all sides of the conflict will sit down together and begin the hard work of reconciliation," Pompeo said Tuesday.
Developing the team to send to the talks has been deeply challenging but the tentative plan is for each side -- the Afghans and the Taliban -- to have 15 representatives, sources told CNN earlier this week.
Members of Congress and regional experts have raised concerns about the deal, which has yet to be made public. On Wednesday, Rep. Liz Cheney led a group of 21 other Republican lawmakers in expressing "serious concerns" about the anticipated agreement.
In a letter to Pompeo and Esper, they wrote that they are "are seeking assurances that you will not place the security of the American people into the hands of the Taliban, and undermine our ally, the current government of Afghanistan."
There were a record high number of attacks carried out in Afghanistan last year by the Taliban and other anti-government groups. The violence in Afghanistan has continued this year, with the Taliban killing two US service members earlier this month.
There are also concerns that a deal with the Taliban could put at risk the gains made by Afghan civil society and women. Repeatedly pressed about a commitment to women's rights, Pompeo on Tuesday did not specifically answer.
"Our mission set there has been much broader than that," Pompeo said.
"Our mission set there is to deliver good security outcomes for the Afghan people, to let their political process work its way through," he said. "I'm very confident that the very concerns that you raised will be addressed as part of these conversations."
CNN's Kylie Atwood, Nic Robertson and Nicole Gaouette contributed to this report.
Syrians in the northwestern city of Idlib perform funerary prayers for Turkish soldiers Friday. Turkey sought an urgent NATO meeting after at least 33 Turkish soldiers were killed in Syria's Idlib province Thursday.
Abdulaziz Ketaz/AFP via Getty Images
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Abdulaziz Ketaz/AFP via Getty Images
NATO is condemning "indiscriminate air strikes by the Syrian regime and Russia," Secretary General Jens Stoltenberg says, after 33 Turkish soldiers died in an attack near Idlib Thursday. The bombing caused Turkey to request an urgent NATO security meeting that was held Friday.
The NATO meeting was held in solidarity with Turkey, which says the troops were killed in an area where Russian-backed Syrian forces are fighting anti-regime militants. Russia denies playing a role in the strike, which came after weeks of heightened violence in Idlib province.
"I call on them to stop their offensive, to respect international law and to back U.N. efforts for a peaceful solution," Stoltenberg said. "This dangerous situation must be de-escalated."
Stoltenberg did not lay out any changes NATO might make to its current security arrangement in the area. But Turkey says its military struck 200 Syrian regime targets Friday, in retaliation for the strikes.
"This attack occurred even though the locations of our troops had been coordinated with Russian officials in the field," Defense Minister Hulusi Akar said, according to Turkey's state-run Anadolu Agency.
Listing the damage of the retaliatory attacks, Akar said, "Turkish forces destroyed five Syrian regime choppers, 23 tanks, 10 armored vehicles, 23 howitzers, five ammunition trucks, a SA-17, a SA-22 air defense system as well as three ammunition depots, two equipment depots, a headquarter and 309 regime troops."
Turkey requested the NATO meeting under Article 4 of the organization's founding treaty. The provision allows any ally to "request consultations whenever, in the opinion of any of them, their territorial integrity, political independence or security is threatened."
Russia's Defense Ministry says its military did not conduct any airstrikes in the area where the Turkish soldiers were killed, NPR's Lucian Kim reports from Moscow.
On Thursday, Russia's foreign ministry acknowledged that the country's air force is supporting the Syrian army's "Dawn over Idlib" operation. But the agency also said the offensive "focuses exclusively on the terrorists who are holed up in the deescalation zone."
Turkish President Recep Tayyip Erdogan spoke with Russian President Vladimir Putin by phone on Friday, in a conversation that the Kremlin says included a "substantive exchange of views" on Syria and an agreement to improve coordination between Russia's and Turkey's defense ministries.
"The two leaders have a thorny relationship," NPR's Lucian Kim reports from Moscow. "Putin has sold Erdogan an advanced air defense system and last month opened a natural-gas pipeline from Russia. But in 2015, Russia nearly went to war after Turkey shot down a Russian fighter plane."
In Friday's phone call, Putin and Erdogan agreed to look at the possibility of "soon holding a meeting at the highest level," the Kremlin says.
Stoltenberg said Turkey's NATO allies are "constantly looking" for ways to support Turkey, as a bloody and destabilizing civil war plays out in neighboring Syria. He added that the group will continue to augment Turkey's air defense, to prevent missile attacks from Syria.
"There's a Patriot missile battery in southern Turkey and AWACS flights keeping an eye from above," Teri Schultz reports for NPR's Newscast. "Turkey has reportedly asked the U.S. directly to share more missile-defense capabilities."
Fears over the rapid spread of the COVID-19 coronavirus have been growing, with California reportedly monitoring around 8,400 people after the first possible case of person-to-person transmission of unknown origin was confirmed this week.
Cases have been confirmed in at least 10 new countries as of Friday, including New Zealand, the Netherlands and Nigeria, as the death toll climbed to more than 2,850 across the globe.
The deadly virus, which was first identified in China's Wuhan city in Hubei province, has now infected nearly 84,000 people across more than 50 countries, including more than 4,000 people outside China, according to the latest figures from Johns Hopkins University.
For the first time since the outbreak of the virus, the number of new cases reported outside China has surpassed the number of new cases within the country, with at least 746 reported outside China, while 439 new cases have been recorded within, according to a February 27 report by the World Health Organization.
Some countries have taken drastic measures to prevent the virus from spreading. This includes banning the entry of travelers from countries most affected by the outbreak such as South Korea, which now has the highest number of cases outside of China, with nearly 2,400 infected patients.
The Royal Caribbean cruise company is rejecting travelers from South Korea, China, Hong Kong, Macau, and Italy, while Japan, Singapore and the Philippines are also banning travelers from South Korea.
Several nations in the Middle East, where Iran has seen 26 deaths from the virus (the highest outside China so far), have also taken heightened precautionary measures. This week Saudi Arabia banned all pilgrimages to the cities of Mecca and Medina, two of Islam's holiest sites, in a bid to prevent the virus from entering the country.
WHO issued a set of temporary recommendations after the virus was declared a public health emergency in January. But the body "did not recommend any travel or trade restriction based on the current information available."
"Tourism's response needs to be measured and consistent, proportionate to the public health threat and based on local risk assessment, involving every part of the tourism value chain – public bodies, private companies and tourists, in line with WHO's overall guidance and recommendations," WHO said in a statement on Thursday.
"UNWTO [UN World Tourism Organization] and WHO stand ready to work closely with all those communities and countries affected by the current health emergency, to build for a better and more resilient future. Travel restrictions going beyond these may cause unnecessary interference with international traffic, including negative repercussions on the tourism sector," it added.
Despite the sudden spike in outbreaks in different regions, WHO has not declared the virus a pandemic.
"For the moment, we are not witnessing sustained and intensive community transmission of this virus, and we are not witnessing large-scale severe disease or death," WHO director-general Tedros Adhanom Ghebreyesus said at a WHO weekly mission briefing on Wednesday.
"Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralyzing systems," he added.
More than half of U.S. coronavirus cases are in California
California confirmed 33 patients tested positive for the virus and the state is monitoring at least 8,400 others, California's governor Gavin Newsom said at a press briefing on Thursday.
The U.S. Centers for Disease Control and Prevention (CDC) confirmed there are around 60 cases confirmed in the U.S., 42 of which were passengers on board the Diamond Princess, the cruise ship which was quarantined off the coast of Japan for two weeks after a passenger from Hong Kong was diagnosed earlier this month.
"We are currently in deep partnership with CDC on one overriding protocol that drives our principal focus right now and that's testing, and the importance to increase our testing protocols and to have point of contact diagnostic testing as our top priority not just in the state of California but I imagine all across the United States," Newsom said at the press conference.
American citizens wave from a bus as they leave the quarantined Diamond Princess cruise ship at Daikoku Pier to be repatriated to the United States on February 17, 2020 in Yokohama, Japan.
The state was said to be conducting a "deep tracking and tracing" of anyone who may have come into contact with the latest infected patient this week, who had no known exposure to the virus via close contact with an infected person or from traveling. The case was reported to be the first possible indication of a community spread of the virus where the source of the infection is unknown, the California Department of Public Health (CDPH) said.
The latest patient, who is being treated in Sacramento County, was reported to be in serious condition, according to Representative John Garamendi, who represents the California district where the patient is from.
"Whether this person can actually talk or not is of question. She's been intubated, and so may not be in a position to discuss it," he told CNN.
"This is a fluid situation right now and I want to emphasize the risk to the American public remains low," Dr. Sonia Y. Angell, the director of the CDPH and the state's health officer, said at a press conference. "There have been a limited number of confirmed cases to date," she added.
The virus spreads to 10 new countries
New cases of the virus have been reported in at least 10 additional countries, including New Zealand, the Netherlands and Nigeria.
New Zealand became the 48th country to be affected by the outbreak, the country's ministry of health confirmed in a statement on Friday.
The infected patient was reported to be in their 60s and had recently returned from Iran on a flight with Emirates (Flight EK450) via Bali, arriving in Auckland on February 26.
"The patient confirmed with COVID-19 is being treated in Auckland City Hospital. They are in an improving condition in isolation, in a negative pressure room to prevent any spread of the disease.
"Contact tracing has started and close contacts are in isolation. Other close family contacts will also now be tested for COVID-19," the ministry said in the statement.
"Although we have our first case of COVID-19, the chances of community outbreak remain low.
"The Ministry of Health is confident the public risk from this new infection is being well managed because of the public messaging, awareness of COVID-19 disease and our public health response to managing cases and contacts," the ministry said.
Nigeria has also reported its first infection, becoming the first case in sub-Saharan Africa.
The patient, an Italian national working in Nigeria who had flown from Milan to Lagos on February 25, was reported to be in stable condition, with no serious symptoms, at the Infectious Disease Hospital in Lagos, the BBC reports.
"We have already started working to identify all the contacts of the patient, since he entered Nigeria," the Nigeria Centre for Disease Control said in a statement.
Two South African nationals aboard a cruise ship in Japan were also reported to have tested positive for the virus, according to South Africa's ministry of health, while Egypt and Algeria previously reported cases.
Kenya has seen a public outcry after China's Southern Airlines resumed flights to Nairobi amid the growing outbreak.
WHO recently warned that the continent's "fragile health systems" meant the threat posed by the virus was "considerable" in Africa, the BBC reports.
Lithuania, Belarus, Denmark, Estonia, Romania and Pakistan also reported their first infections in the last 24 hours or so.
Italy, Europe's worst-hit country, has now reported a total of 655 cases, an increase of more than 200 within a day, with a death toll of 17. Other popular European destinations continue to report more cases, including Germany, which has 48 cases, while France has 38 and Spain has 25 confirmed cases, according to the latest figures from Johns Hopkins University.
South Korea faces more travel bans, Japan weighs Olympics
Confirmed cases in South Korea have climbed to 2,337, most of which have been linked to members of a religious group known as the Shincheonji Church of Jesus, the Temple of the Tabernacle of the Testimony (SCJ). The secretive group holds services in large masses with members sitting on the floor in close proximity for periods of one to two hours.
Vietnam will suspend visa-free travel for South Koreans from Saturday, while Russia is planning to restrict the entry of South Koreans (and ban the entry of Iranians) from March 1.
Disney theme parks in Asia have been temporarily shut in view of the growing outbreak. Japan's Disneyland Tokyo will be closed until March 15, while all schools in Japan (which has confirmed 226 cases so far) will be closed from March 2 until the next spring break session later that month, Japanese Prime Minister Abe Shinzo confirmed.
Japan is due to host the 2020 Olympics this summer in July and fears over the virus have cast doubts over whether the games will go ahead.
Olympic organizers are scheduled to decide on the ceremonial torch relay, which is due to begin in the country on March 20 for a 121-day journey through the country's landmarks, Reuters reports.
The graphic below, provided by Statista, illustrates the spread of the COVID-19 virus as of February 28.
A map showing worldwide cases of COVID-19.Statista
