As the coronavirus spreads, should you cancel vacation?

As spring break approaches, rapidly evolving coronavirus news casts a dark shadow over planned escapes to sunny destinations.

Travelers wonder whether to panic or pack.

Nearly every hour brings troubling updates of the virus' spread. At this writing, two passengers arriving at Minneapolis-St. Paul International Airport from Europe have been told to quarantine at home. Confirmed cases have popped up in 13 states, including Florida, Arizona and New York, and nine people nationwide have died. Worldwide, COVID-19 has hit popular destinations such as Italy, Sweden, Dominican Republic and India. In France, which has 100 confirmed cases, the Louvre Museum closed and is now reopened, and the Paris Half Marathon, slated for March 1, had been canceled to keep large crowds from amassing — and potentially spreading germs. Also shuttered until March 8 is the iconic opera house in Milan, Italy, Teatro alla Scala.

Meanwhile, airlines have canceled flights, not only to China, where the outbreak began, but also to Milan. Most are waiving hefty change fees on some flights.

"Right now, assume the world is one big COVID virus soup," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Faced with this fresh and growing health concern, winter-weary Minnesotans holding airline tickets are discussing whether they should cancel their upcoming trips, and how to stay safe if they decide to go.

Answers to frequently asked questions can help.

Americans should avoid all nonessential travel to China, Iran, South Korea and Italy, according to the U.S. Centers for Disease Control and Prevention.

The Seattle and Los Angeles areas in this country have reported significant numbers of infections. Seattle and Los Angeles County have declared civil and health emergencies.

Any region with a major outbreak should be avoided, not only because of the risk of illness, but also because the health care systems in those areas may already be stressed. People who are elderly, have a chronic disease or have underlying health conditions are especially at risk.

According to Osterholm, travelers should consider the health care system at their vacation destination. People should be asking themselves, "If I am there and I get sick, do I want to be hospitalized in Argentina or Thailand?"

He predicts that in the next several months, the risk of contracting the virus will be as high in Minneapolis as it will be in any other part of the world. That suggests that traveling may be fine, as long as travelers are prepared, in the worst-case scenario, to fall ill during their trips.

Osterholm noted another concern: "Do I worry about what my government might do in terms of cutting off my ability to return without quarantine?"

Currently, the U.S. has barred all travel to Iran and barred all non-U.S. citizens entry into our country from China and Iran. Travelers landing here from Italy and South Korea are subjected to screening.

If a trip to Italy is on the books, you might skip it since the virus is on the loose, and you may not be able to communicate effectively with hospital staff unless you're fluent in Italian. But Arizona? At least Phoenix has a Mayo Clinic.

With warm-weather destinations like Greece and Florida on the growing list of places hit by the coronavirus, it appears that travelers won't be spared because they are dining at open-air cafes and spending days on the beach.

"Breathing can be a major route of transmission," Osterholm warned. Air filters on airplanes can eliminate most viruses and germs, but if a person sitting near you sneezes or coughs, you could find yourself exposed. According to the CDC, "travelers should try to avoid contact with sick passengers and wash their hands often with soap and water for at least 20 seconds or use hand sanitizer that contains 60 to 95% alcohol."

Downtime between flights is usually limited, so travelers don't know when their plane was last cleaned. That means vigilance is required. Don't put your stuff in the seat-back pocket; there's a germ party in there. Wipe down surfaces at your seat, including the armrests and tray tables. And go to the airport "armed": Anecdotal reports suggest that wipes and hand sanitizers have been sold out at airport stores.

Facemasks are not an effective tool to prevent illness. Fliers who are sneezing or coughing should wear one, though, since a mask will catch germ-conveying spittle.

"I would stay away from cruises entirely," Osterholm said, pointing to the Diamond Princess as an example of what can occur aboard a ship with circulating air. While passengers were subjected to a two-week quarantine on the ship, the virus spread widely and more than 700 passengers were infected with the coronavirus.

The CDC notes, "This is a dynamic situation and those traveling by ship may be impacted by travel restrictions affecting their itineraries or ability to disembark or may be subject to quarantine procedures implemented by the local authorities."

Mostly, do what you would do at home: Do not touch your nose, eyes and mouth. Wash hands frequently. Stay away from people who are ill, especially if they are sneezing or coughing.

What does that mean for vacation activities? If you were going to a large event where people can crush together — music concerts, sporting events — think twice or stay on the margins of the crowd so you can move away if someone starts coughing.

Many airlines are waiving change fees. Delta, which already has suspended flights between the U.S. and Shanghai and Beijing, is waiving its change fee for people with tickets to Shanghai, Beijing, Seoul and all locations in Italy through April 30. JetBlue's policy is more forward-thinking; in case the coronavirus impacts one of the airline's destinations, JetBlue will suspend change and cancellation fees for new tickets booked Feb. 27 through March 11. The policy runs through June 1.

Airline policies differ, but most are offering some relief for wary passengers. Check with your airline.

Hotels may not be so generous, though you can ask to shift dates rather than cancel outright. That, after all, is what most airlines are offering.

Most travel insurance policies do not cover what in essence is a pre-existing condition. That means you are unlikely to be able to purchase a policy now because you may cancel due to coronavirus.

According to the website travelinsurance.com, the only way to cover a cancellation due to worries about the coronavirus for future travel is to purchase a Cancel for Any Reason (CFAR) policy. "With CFAR coverage, the insurance policy must be purchased within a set amount of days [usually 21 days or fewer, depending on the plan] after making the first payment for the trip, and the entire prepaid and nonrefundable cost of the trip must be insured, including any subsequent trip costs," the company said.

Anyone traveling out of the country should check the State Department's website for travelers at travel.state.gov. There, people can check on any advisories and read about the country they plan to visit. Travelers can also register their travel with the State Department's Smart Traveler Enrollment Program. This will ensure that travelers get up-to-date safety information and allow an embassy to reach them easily in the event of an emergency.

The situation is evolving rapidly and may have changed since the time of this writing. Check the CDC's most current travel information regarding COVID-19, including a list of countries of concern.

Read the World Health Organization's advice for travelers at tinyurl.com/snv4amo.