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• COVID-19 travel advice

Considering travel during the pandemic? Take precautions to protect yourself from COVID-19.

A coronavirus disease 2019 (COVID-19) vaccine can prevent you from getting COVID-19 or from becoming seriously ill due to COVID-19 . But even if you're vaccinated, it's still a good idea to take precautions to protect yourself and others while traveling during the COVID-19 pandemic.

If you've had all recommended COVID-19 vaccine doses, including boosters, you're less likely to become seriously ill or spread COVID-19 . You can then travel more safely within the U.S. and internationally. But international travel can still increase your risk of getting new COVID-19 variants.

The Centers for Disease Control and Prevention (CDC) recommends that you should avoid travel until you've had all recommended COVID-19 vaccine and booster doses.

Before you travel

As you think about making travel plans, consider these questions:

• Have you been vaccinated against COVID-19 ? If you haven't, get vaccinated. If the vaccine requires two doses, wait two weeks after getting your second vaccine dose to travel. If the vaccine requires one dose, wait two weeks after getting the vaccine to travel. It takes time for your body to build protection after any vaccination.
• Have you had any booster doses? Having all recommended COVID-19 vaccine doses, including boosters, increases your protection from serious illness.
• Are you at increased risk for severe illness? Anyone can get COVID-19 . But older adults and people of any age with certain medical conditions are at increased risk for severe illness from COVID-19 .
• Do you live with someone who's at increased risk for severe illness? If you get infected while traveling, you can spread the COVID-19 virus to the people you live with when you return, even if you don't have symptoms.
• Does your home or destination have requirements or restrictions for travelers? Even if you've had all recommended vaccine doses, you must follow local, state and federal testing and travel rules.

Check local requirements, restrictions and situations

Some state, local and territorial governments have requirements, such as requiring people to wear masks, get tested, be vaccinated or stay isolated for a period of time after arrival. Before you go, check for requirements at your destination and anywhere you might stop along the way.

Keep in mind these can change often and quickly depending on local conditions. It's also important to understand that the COVID-19 situation, such as the level of spread and presence of variants, varies in each country. Check back for updates as your trip gets closer.

Travel and testing

For vaccinated people.

If you have been fully vaccinated, the CDC states that you don't need to get tested before or after your trip within the U.S. or stay home (quarantine) after you return.

If you're planning to travel internationally outside the U.S., the CDC states you don't need to get tested before your trip unless it's required at your destination. Before arriving to the U.S., you need a negative test within the last day before your arrival or a record of recovery from COVID-19 in the last three months.

After you arrive in the U.S., the CDC recommends getting tested with a viral test 3 to 5 days after your trip. If you're traveling to the U.S. and you aren't a citizen, you need to be fully vaccinated and have proof of vaccination.

You don't need to quarantine when you arrive in the U.S. But check for any symptoms. Stay at home if you develop symptoms.

For unvaccinated people

Testing before and after travel can lower the risk of spreading the virus that causes COVID-19 . If you haven't been vaccinated, the CDC recommends getting a viral test within three days before your trip. Delay travel if you're waiting for test results. Keep a copy of your results with you when you travel.

Repeat the test 3 to 5 days after your trip. Stay home for five days after travel.

If at any point you test positive for the virus that causes COVID-19 , stay home. Stay at home and away from others if you develop symptoms. Follow public health recommendations.

Stay safe when you travel

In the U.S., you must wear a face mask on planes, buses, trains and other forms of public transportation. The mask must fit snugly and cover both your mouth and nose.

Follow these steps to protect yourself and others when you travel:

• Get vaccinated.
• Keep distance between yourself and others (within about 6 feet, or 2 meters) when you're in indoor public spaces if you're not fully vaccinated. This is especially important if you have a higher risk of serious illness.
• Avoid contact with anyone who is sick or has symptoms.
• Avoid crowds and indoor places that have poor air flow (ventilation).
• Don't touch frequently touched surfaces, such as handrails, elevator buttons and kiosks. If you must touch these surfaces, use hand sanitizer or wash your hands afterward.
• Wear a face mask in indoor public spaces. The CDC recommends wearing the most protective mask possible that you'll wear regularly and that fits. If you are in an area with a high number of new COVID-19 cases, wear a mask in indoor public places and outdoors in crowded areas or when you're in close contact with people who aren't vaccinated.
• Avoid touching your eyes, nose and mouth.
• Cover coughs and sneezes.
• Wash your hands often with soap and water for at least 20 seconds.
• If soap and water aren't available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub your hands together until they feel dry.
• Don't eat or drink on public transportation. That way you can keep your mask on the whole time.

Because of the high air flow and air filter efficiency on airplanes, most viruses such as the COVID-19 virus don't spread easily on flights. Wearing masks on planes has likely helped lower the risk of getting the COVID-19 virus on flights too.

However, air travel involves spending time in security lines and airport terminals, which can bring you in close contact with other people. Getting vaccinated and wearing a mask when traveling can help protect you from COVID-19 while traveling.

The Transportation Security Administration (TSA) has increased cleaning and disinfecting of surfaces and equipment, including bins, at screening checkpoints. TSA has also made changes to the screening process:

• Travelers must wear masks during screening. However, TSA employees may ask travelers to adjust masks for identification purposes.
• Travelers should keep a distance of 6 feet apart from other travelers when possible.
• Instead of handing boarding passes to TSA officers, travelers should place passes (paper or electronic) directly on the scanner and then hold them up for inspection.
• Each traveler may have one container of hand sanitizer up to 12 ounces (about 350 milliliters) in a carry-on bag. These containers will need to be taken out for screening.
• Personal items such as keys, wallets and phones should be placed in carry-on bags instead of bins. This reduces the handling of these items during screening.
• Food items should be carried in a plastic bag and placed in a bin for screening. Separating food from carry-on bags lessens the likelihood that screeners will need to open bags for inspection.

Be sure to wash your hands with soap and water for at least 20 seconds directly before and after going through screening.

Public transportation

If you travel by bus or train and you aren't vaccinated, be aware that sitting or standing within 6 feet (2 meters) of others for a long period can put you at higher risk of getting or spreading COVID-19 . Follow the precautions described above for protecting yourself during travel.

Even if you fly, you may need transportation once you arrive at your destination. You can search car rental options and their cleaning policies on the internet. If you plan to stay at a hotel, check into shuttle service availability.

If you'll be using public transportation and you aren't vaccinated, continue physical distancing and wearing a mask after reaching your destination.

Hotels and other lodging

The hotel industry knows that travelers are concerned about COVID-19 and safety. Check any major hotel's website for information about how it's protecting guests and staff. Some best practices include:

• Enhanced cleaning procedures
• Physical distancing recommendations indoors for people who aren't vaccinated
• Mask-wearing and regular hand-washing by staff
• Mask-wearing indoors for guests in public places in areas that have high cases of COVID-19
• Vaccine recommendations for staff
• Isolation and testing guidelines for staff who've been exposed to COVID-19
• Contactless payment
• Set of rules in case a guest becomes ill, such as closing the room for cleaning and disinfecting
• Indoor air quality measures, such as regular system and air filter maintenance, and suggestions to add air cleaners that can filter viruses and bacteria from the air

Vacation rentals, too, are enhancing their cleaning procedures. They're committed to following public health guidelines, such as using masks and gloves when cleaning, and building in a waiting period between guests.

Make a packing list

When it's time to pack for your trip, grab any medications you may need on your trip and these essential safe-travel supplies:

• Alcohol-based hand sanitizer (at least 60% alcohol)
• Disinfectant wipes (at least 70% alcohol)
• Thermometer

Considerations for people at increased risk

Anyone can get very ill from the virus that causes COVID-19 . But older adults and people of any age with certain medical conditions are at increased risk for severe illness. This may include people with cancer, serious heart problems and a weakened immune system. Getting the recommended COVID-19 vaccine and booster doses can help lower your risk of being severely ill from COVID-19 .

Travel increases your chance of getting and spreading COVID-19 . If you're unvaccinated, staying home is the best way to protect yourself and others from COVID-19 . If you must travel and aren't vaccinated, talk with your health care provider and ask about any additional precautions you may need to take.

Remember safety first

Even the most detailed and organized plans may need to be set aside when someone gets ill. Stay home if you or any of your travel companions:

• Have signs or symptoms, are sick or think you have COVID-19
• Are waiting for results of a COVID-19 test
• Have been diagnosed with COVID-19
• Have had close contact with someone with COVID-19 in the past five days and you're not up to date with your COVID-19 vaccines

If you've had close contact with someone with COVID-19 , get tested after at least five days. Wait to travel until you have a negative test. Wear a mask if you travel up to 10 days after you've had close contact with someone with COVID-19 .

• How to protect yourself and others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed Feb. 4, 2022.
• Domestic travel during COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html. Accessed Feb. 4, 2022.
• Requirement for face masks on public transportation conveyances and at transportation hubs. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/face-masks-public-transportation.html. Accessed Feb. 4, 2022.
• International travel. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel/index.html. Accessed Feb. 4, 2022.
• U.S citizens, U.S. nationals, U.S. lawful permanent residents, and immigrants: Travel to and from the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html. Accessed Feb. 4, 2022.
• Non-US. citizen, non-U.S. immigrants: Air travel to the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/noncitizens-US-air-travel.html. Accessed Feb. 4, 2022.
• People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed Feb. 4, 2022.
• Stay up to date with your vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Accessed Feb. 4, 2022.
• Pack smart. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/page/pack-smart. Accessed Feb. 4, 2022.
• Travel: Frequently asked questions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/faqs.html. Accessed Feb. 7, 2022.
• Coronavirus (COVID-19) information. Transportation Security Administration. https://www.tsa.gov/coronavirus. Accessed Feb. 7, 2022.
• WHO advice for international traffic in relation to the SARS-CoV-2 Omicron variant (B.1.1.529). World Health Organization. https://www.who.int/news-room/articles-detail/who-advice-for-international-traffic-in-relation-to-the-sars-cov-2-omicron-variant. Accessed Feb. 7, 2022.
• VRHP/VRMA Cleaning guidelines for COVID-19. Vacation Rental Management Association. https://www.vrma.org/page/vrhp/vrma-cleaning-guidelines-for-covid-19. Accessed Feb. 7, 2022.
• Safe stay. American Hotel & Lodging Association. https://www.ahla.com/safestay. Accessed Feb. 7, 2022.
• Khatib AN, et al. COVID-19 transmission and the safety of air travel during the pandemic: A scoping review. Current Opinion in Infectious Diseases. 2021; doi:10.1097/QCO.0000000000000771.

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There is a different procedure in place for arranging the limited number of trip days allowed after retirement and a different mechanism for reimbursement. The following guidelines and tools provide assistance in navigating the retirement travel policy.

Procedure for Mayo Trips - the travel policy and procedure for arranging and receiving reimbursement of Mayo trips has  changed but is still distinctly different than you experienced when you were an active staff member.

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Raj Palraj, M.B.B.S., M.D.

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9 common questions about vaccines and travel

• Immunizations

Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.

One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.

Here are answers to common questions about travel medicine:

1. who should make an appointment with a travel medicine specialist.

Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.

2. What vaccinations do I need to travel overseas?

All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.

In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:

• Chickenpox (varicella)
• Diphtheria, tetanus and pertussis (DTP)
• Pneumococcal
• Measles, mumps and rubella (MMR)

Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.

3. Are there travel destinations that have different vaccination recommendations?

Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.

Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.

The Centers for Disease Control and Prevention (CDC) has good information online for travelers for each travel destination.

Recommended vaccines may include:

• Hepatitis A
• Hepatitis B
• Japanese encephalitis
• Yellow fever

4. Can my primary care provider give me travel vaccinations?

It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the CDC recommendations .

If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.

5. How long before my trip should I go to the travel clinic?

Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.

If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.

6. Can I only go to the travel clinic before I travel?

No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.

7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?

Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.

8. How do I lower my risk of malaria when traveling?

Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.

9. How do I stay healthy while traveling?

Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.

Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.

Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.

As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.

Raj Palraj, M.D. , is a physician in Infectious Diseases and Travel and Tropical Medicine in La Crosse , Wisconsin.

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Infectious diseases.

Our infectious disease specialists in Eau Claire, Wisconsin, provide information, consultation and treatment for bacterial, fungal, viral and parasitic infections, including bloodstream infections and complex or rare conditions caused by emerging infectious diseases and multidrug-resistant microbes. We also specialize in the optimal use of antimicrobials — agents that eliminate microorganisms or bacterial growth — to reduce the chances of developing drug resistance.

Our experts provide care for people with HIV, bone infections and infections related to complications from cancer, critical care and many other conditions. We also manage complex infections that can be encountered in the hospital setting by continuously developing strategies to reduce the risk of infection for hospitalized patients and after surgical procedures.

Infectious disease problems often are related to other medical conditions. Our team works closely with clinicians from other specialty care areas to ensure you receive the right care for your medical need.

Depending on your situation, your care team may include clinicians from:

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With a focus on infection prevention and antimicrobial care, our infectious disease team is committed to developing a plan to meet your individual concerns and needs related to infections and infectious diseases.

International Travel Clinic

With an increasing number of people leaving the U.S. for business and pleasure trips, medical concerns while traveling are becoming increasingly complicated. If you or members of your family are planning trips to underdeveloped countries, our International Travel Clinic can help prepare you to have a healthy trip.

You'll meet with a travel medicine expert who is knowledgeable on current health risks worldwide. We promote safe, healthy travel by offering counseling, recommendations, vaccinations, prescriptions and, if needed, a referral to another expert for complex medical conditions.

Before your trip

Schedule an appointment for a pretravel consultation with us about four to eight weeks before you depart so we can help you prepare. Ideally, this appointment should be scheduled as soon as your travel plans are established. Some vaccines require several weeks for immunity to develop, while others require more than one dose for full protection.

Be prepared to inform the patient appointment specialist with this information:

• Countries you will visit
• Travel dates and duration
• Any unusual circumstances

At your appointment, or preferably before, bring copies of all available immunization records, including the International Certificate of Vaccination, commonly known as the yellow card. This will expedite your appointment and may decrease the number of vaccines you are advised to receive.

Your pre-travel consultation may include:

• A country-by-country assessment of all health risks specific to your travel itinerary, such as exotic infectious agents, altitude sickness and heat exhaustion
• A review of your medical and immunization history profile with advice for health promotion and illness prevention
• Advice for the high-risk traveler
• Immunization recommendations, counseling and administration of vaccines to prevent illnesses
• Vector precautions counseling
• Malaria prevention counseling with prescriptions, if needed
• Traveler's diarrhea counseling for prevention and self-treatment with antibiotic prescription, if needed
• Identification of health resources in the countries on your travel itinerary
• Counseling on travel-related risks, such as altitude sickness with preventive prescriptions, if needed
• An opportunity to ask questions about the unique health and safety concerns of your travel itinerary

After your trip

Depending on where you're going and for how long, our travel clinic may recommend a routine follow-up evaluation after your return. If you return sick, our travel medicine team, who also are infectious disease experts, can provide comprehensive post-travel consultations for evaluation and treatment of travel-related illnesses, including parasitic and other diseases common to tropical regions, but uncommon in the U.S.

Call to schedule your appointment today.

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• Global Security

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This role represents Mayo Clinic as one of the first contact points a patient or visitor will encounter upon arriving to campus and serves as a critical team member in facilitating patient & visitor visits. 

The Security Ambassador I demonstrates professionalism, effective communication and listening skills, empathy, and ability to effectively interact with patients, visitors, family members, staff and others who may present to Mayo Clinic. The Security Ambassador I will establish and maintains a courteous, respectful, and helpful demeanor while assisting and engaging with patients, visitors, and other Mayo Clinic personnel. In addition to providing overall presence, the Security Ambassador I will verify patient appointments, communicate with colleagues within the Practice to gather appointment details, understand and enforce the institutional visitor policy, following designated screening script and process flows, enforce entrance utilization and any related policies (ex: masking, badging), and greet patients and visitors and assist in navigation. 

The Security Ambassador I primarily works at patient designated buildings/entrances to ensure policy enforcement and to monitor patient and visitor flow within the building. Job responsibilities also include remaining calm and composed during stressful situations and effectively de-escalating conflict or stressful situations (by use of AVADE, Verbal Judo, and SIRA training). This role may have view only access to the electronic medical record to support verifying information. This role will interact with security technologies, such weapons detection systems. This position will be required to work varied hours, which may include days, evenings, days/evenings, holidays and/or weekends with rotating days off.

This vacancy is not eligible for sponsorship/ we will not sponsor or transfer visas for this position. Also, Mayo Clinic DOES NOT participate in the F-1 STEM OPT extension program.

A high school diploma or GED required. Two years of previous customer service experience in healthcare, hospitality, or service industry required. 

Demonstrated problem-solving and critical thinking skills. Evidence of conflict management and resolution skills, ability to pass training in AVADE, Verbal Judo and SIRA training. Demonstrates understanding and use of software programs and security related equipment

Must complete training in SIRA, Verbal Judo, and AVADE® within 6 months of hire.

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9 common questions about vaccines and travel

Joel Streed

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Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.

One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.

Here are answers to common questions about travel medicine:

1. who should make an appointment with a travel medicine specialist.

Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.

2. What vaccinations do I need to travel overseas?

All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.

In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:

• Chickenpox (varicella)
• Diphtheria, tetanus and pertussis (DTP)
• Pneumococcal
• Measles, mumps and rubella (MMR)

Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.

3. Are there travel destinations that have different vaccination recommendations?

Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.

Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.

The  Centers for Disease Control and Prevention (CDC)  has good information online for travelers for each travel destination.

Recommended vaccines may include:

• Hepatitis A
• Hepatitis B
• Japanese encephalitis
• Yellow fever

4. Can my primary care provider give me travel vaccinations?

It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the  CDC recommendations .

If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.

5. How long before my trip should I go to the travel clinic?

Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.

If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.

6. Can I only go to the travel clinic before I travel?

No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.

7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?

Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.

8. How do I lower my risk of malaria when traveling?

Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.

9. How do I stay healthy while traveling?

Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.

Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.

Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.

As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.

Raj Palraj, M.D. , is a physician in  Infectious Diseases  and  Travel and Tropical Medicine  in  La Crosse , Wisconsin.

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Meet My Team: Learn about Mayo Clinic Networks staff, a.k.a. ‘network plumbers’

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Mayo Clinic Networks staff work behind the scenes to ensure electronic data gets where it needs to go — and much more. Learn how many pieces of equipment they maintain, what a 'typical' day looks like, and what they'd be called if they were a band.

Valmik Patel had a goal: to work at Mayo Clinic.

He achieved that goal on Jan. 31, 2022. He says his greatest accomplishment was convincing his manager to hire him.  

Patel was drawn to Mayo Clinic for its focus on people over profits.

"Healthcare is perhaps the most unique environment to work in since financial revenue is not the only priority," he says. "Knowing that the work I do enables the organization to provide a service that is driven not by a need for financial gain, but rather a passion for healing and empathetic care is what gets me out of bed every morning."

His colleagues keep him motivated, too.

"I often find myself in awe of how passionate and dedicated my teammates can be," he says.

That became apparent to him just a few months into his time at Mayo, when a water pipe burst in one of Mayo Clinic's connectivity hubs, dumping water onto networking equipment.

"I was only five months into the job," he says. "Seeing the sheer dedication of my colleagues working tirelessly to restore services and capacity back to Mayo's network was something I had never witnessed before. Engineers, specialists, architects and managers were working around the clock to safely decommission the water-damaged hardware, source replacement hardware, configure the replacements, reinstall and validate the equipment, and brainstorm unique solutions on-the-fly for services we could not immediately remedy."

He says that early experience and those he's had since then have made him "Team Mayo for life."

"The support, education and genuine care that I believe Mayo provides for its staff are a rarity," Patel says. "I can near-guarantee that I will always be part of the Mayo family in one way or another."

The News Center team asked Patel to answer questions about his job and his team.

Tell us about your team. What is it your team does?

Mayo Clinic Networks is a team of over 60 talented individuals spread across the enterprise. We have a Plan, Design and Architecture group (responsible for our overall network design and future-needs planning), an Operations group (responsible for keeping our infrastructure online and updated), and the group that I belong to, Implementation (responsible for  fun and parties  renewing, building and expanding the Mayo network).

Together, we are responsible for ensuring that data across Mayo Clinic is shuttled efficiently and securely to where it needs to go, whether it's a patient record going from Gonda to Cannaday, digital pathology slides going from Hilton to a pathologist's laptop, or the latest Mayo research being published on the web.

We support over 25,000 pieces of equipment that provide connectivity to our colleagues in each shield and the millions of patients we serve.

How do you spend most of your day?

Each day is unique. As an engineer within Implementation, I can find myself installing new network equipment for projects, collaborating and problem-solving with various technical teams, performing construction site surveys, meeting with shield leaders, or planning and optimizing internal workflows.

What might surprise people about the work your team does?

Mayo Networks supports almost every aspect of modern healthcare.

Not only do we connect computers, phones and printers together for tools such as Plummer Chart, SCC Soft, Teams, Outlook and EmployeeConnect, but also equipment such as MRI/CTs, simulators, proton beam controllers, real-time location tracking, digital pathology scanners, Pyxis, nurse call systems, temperature and vitals monitors, and much more.

As healthcare progresses into the future, Networks works collaboratively to ensure we can provide a robust, reliable and secure connectivity service that complements our status as the No. 1 hospital in the world and is ready for our Bold. Forward. 2030 Strategic Plan vision to Cure, Connect and Transform.

Everyone at Mayo contributes to caring for patients. How does your team do that?

The needs of the patient come first, and that doesn't change within IT. We design our infrastructure to be highly redundant and resilient. We know that our 80,000-plus colleagues rely on our service 24/7/365 to provide the best care to our patients. Every change to our network is calculated, well thought out, and peer-reviewed to ensure we do not cause unnecessary disruptions to our practice. Of course, there are times when problems do arise (thank you IT gremlins). When that happens, every teammate understands the critical nature of the disruption and is committed to repairing the service as swiftly as possible.

You're going to hire a new team member. Describe your ideal candidate.

An ideal candidate for this team would be someone who can learn, communicate with nontechnical people, has strong emotional intelligence and, most importantly, has a solid sense of humor. Technical skills can be taught, but knowing how to provide customer service in a healthcare setting is not something taught in a classroom.

What is a recent team success that you're proud of?

Over the past few years, Mayo has seen tremendous growth across the institution. We have successfully installed/uninstalled equipment for the Kellen Building, Colonial Building, Discovery Square Ramp, Logistics Facility East and Ozmun Complex in Rochester; the La Crosse and Mankato hospital towers; Discovery Oasis in Arizona; the Carbon Beam Facility in Florida; and three archive warehouses. We are proud to be able to successfully support these endeavors, while also ensuring continued support for existing buildings and teams.

If your team was a band, what would it be called?

Lost Packeteers. (Packets are the units of information that traverse a network. Sometimes they get lost and so do we.)

If you had to describe your team's work in six words, what would your six-word story be?

Bashful and dysfunctionally competent network plumbers.

Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection

Collaborators.

• Sechenov StopCOVID Research Team : Anna Berbenyuk ,  Polina Bobkova ,  Semyon Bordyugov ,  Aleksandra Borisenko ,  Ekaterina Bugaiskaya ,  Olesya Druzhkova ,  Dmitry Eliseev ,  Yasmin El-Taravi ,  Natalia Gorbova ,  Elizaveta Gribaleva ,  Rina Grigoryan ,  Shabnam Ibragimova ,  Khadizhat Kabieva ,  Alena Khrapkova ,  Natalia Kogut ,  Karina Kovygina ,  Margaret Kvaratskheliya ,  Maria Lobova ,  Anna Lunicheva ,  Anastasia Maystrenko ,  Daria Nikolaeva ,  Anna Pavlenko ,  Olga Perekosova ,  Olga Romanova ,  Olga Sokova ,  Veronika Solovieva ,  Olga Spasskaya ,  Ekaterina Spiridonova ,  Olga Sukhodolskaya ,  Shakir Suleimanov ,  Nailya Urmantaeva ,  Olga Usalka ,  Margarita Zaikina ,  Anastasia Zorina ,  Nadezhda Khitrina

Affiliations

• 1 Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 2 Inflammation, Repair, and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
• 3 Soloviev Research and Clinical Center for Neuropsychiatry, Moscow, Russia.
• 4 School of Physics, Astronomy, and Mathematics, University of Hertfordshire, Hatfield, United Kingdom.
• 5 Biobank, Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 6 Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 7 Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
• 8 Department of Polymers and Composites, N. N. Semenov Institute of Chemical Physics, Moscow, Russia.
• 9 Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
• 10 Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany.
• 11 Institute for Urology and Reproductive Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 12 Department of Intensive Care, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 13 Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 14 Department of Internal Medicine No. 1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 15 Department of Forensic Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 16 Department of Statistics, University of Oxford, Oxford, United Kingdom.
• 17 Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
• 18 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
• 19 Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom.
• 20 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• PMID: 33035307
• PMCID: PMC7665333
• DOI: 10.1093/cid/ciaa1535

Background: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking.

Methods: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020.

Results: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47).

Conclusions: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.

Keywords: COVID-19; Russia; SARS-CoV-2; cohort; mortality risk factors.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

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Healthcare in Moscow – Personal and Family Medicine

Emergency : 112 or 103

Obstetric & gynecologic : +7 495 620-41-70

About medical services in Moscow

Moscow polyclinic

Emergency medical care is provided free to all foreign nationals in case of life-threatening conditions that require immediate medical treatment. You will be given first aid and emergency surgery when necessary in all public health care facilities. Any further treatment will be free only to people with a Compulsory Medical Insurance, or you will need to pay for medical services. Public health care is provided in federal and local care facilities. These include 1. Urban polyclinics with specialists in different areas that offer general medical care. 2. Ambulatory and hospitals that provide a full range of services, including emergency care. 3. Emergency stations opened 24 hours a day, can be visited in a case of a non-life-threatening injury. It is often hard to find English-speaking staff in state facilities, except the largest city hospitals, so you will need a Russian-speaking interpreter to accompany your visit to a free doctor or hospital. If medical assistance is required, the insurance company should be contacted before visiting a medical facility for treatment, except emergency cases. Make sure that you have enough money to pay any necessary fees that may be charged.

Insurance in Russia

Travelers need to arrange private travel insurance before the journey. You would need the insurance when applying for the Russian visa. If you arrange the insurance outside Russia, it is important to make sure the insurer is licensed in Russia. Only licensed companies may be accepted under Russian law. Holders of a temporary residence permit or permanent residence permit (valid for three and five years respectively) should apply for «Compulsory Medical Policy». It covers state healthcare only. An employer usually deals with this. The issued health card is shown whenever medical attention is required. Compulsory Medical Policyholders can get basic health care, such as emergencies, consultations with doctors, necessary scans and tests free. For more complex healthcare every person (both Russian and foreign nationals) must pay extra, or take out additional medical insurance. Clearly, you will have to be prepared to wait in a queue to see a specialist in a public health care facility (Compulsory Medical Policyholders can set an appointment using EMIAS site or ATM). In case you are a UK citizen, free, limited medical treatment in state hospitals will be provided as a part of a reciprocal agreement between Russia and UK.

Some of the major Russian insurance companies are:

Ingosstrakh , Allianz , Reso , Sogaz , AlfaStrakhovanie . We recommend to avoid  Rosgosstrakh company due to high volume of denials.

Moscow pharmacies

A.v.e pharmacy in Moscow

Pharmacies can be found in many places around the city, many of them work 24 hours a day. Pharmaceutical kiosks operate in almost every big supermarket. However, only few have English-speaking staff, so it is advised that you know the generic (chemical) name of the medicines you think you are going to need. Many medications can be purchased here over the counter that would only be available by prescription in your home country.

Dental care in Moscow

Dentamix clinic in Moscow

Dental care is usually paid separately by both Russian and expatriate patients, and fees are often quite high. Dentists are well trained and educated. In most places, dental care is available 24 hours a day.

Moscow clinics

«OAO Medicina» clinic

It is standard practice for expats to visit private clinics and hospitals for check-ups, routine health care, and dental care, and only use public services in case of an emergency. Insurance companies can usually provide details of clinics and hospitals in the area speak English (or the language required) and would be the best to use. Investigate whether there are any emergency services or numbers, or any requirements to register with them. Providing copies of medical records is also advised.

Moscow hosts some Western medical clinics that can look after all of your family’s health needs. While most Russian state hospitals are not up to Western standards, Russian doctors are very good.

Some of the main Moscow private medical clinics are:

American Medical Center, European Medical Center , Intermed Center American Clinic ,  Medsi , Atlas Medical Center , OAO Medicina .

Several Russian hospitals in Moscow have special arrangements with GlavUPDK (foreign diplomatic corps administration in Moscow) and accept foreigners for checkups and treatments at more moderate prices that the Western medical clinics.

Medical emergency in Moscow

Moscow ambulance vehicle

In a case of a medical emergency, dial 112 and ask for the ambulance service (skoraya pomoshch). Staff on these lines most certainly will speak English, still it is always better to ask a Russian speaker to explain the problem and the exact location.

Ambulances come with a doctor and, depending on the case, immediate first aid treatment may be provided. If necessary, the patient is taken to the nearest emergency room or hospital, or to a private hospital if the holder’s insurance policy requires it.

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‘Kashchenko’: Moscow’s most famous psychiatric hospital

As Moscow grew, the Preobrazhenskaya Hospital (the first psychiatric clinic) couldn’t treat all the arriving patients anymore. This fact made local psychiatrists quite concerned. They asked Nikolai Alexeyev, the city mayor, for help. In 1889, he organized fundraising to solve this problem. At first, the mayor only wanted to expand the Preobrazhenskaya Hospital, but then, he decided that Moscow needed a second clinic with 300 new beds.

The Alexeyev Psychiatric Clinical Hospital.

A commission of psychiatrists and city officials, headed by Alexeyev, decided to build the new clinic on the territory of the former Beketov manor. In the middle of the 19th century, merchant Kanatchikov bought these lands and named them ‘Kanatchikova dacha’, which then stuck to the hospital itself.

N. A. Alekseyev, 1880s.

Famous psychiatrist Viktor Butske designed the plan of the future clinic: it had to be a complex of distant two-floor pavilions joined with warm passages for doctors. This complex had a ‘U’-shape and was divided into two halves - for men and women. The departments were located at the sides of the central administrative building. This plan left a lot of free space on the territory, as Butske understood that the complex would, most likely, be expanded later.

Viktor Butske, the plan developer and first head of the Alexeyev hospital.

The construction began in 1890. The first half of the red and white brick complex started operating in 1894 and, in two years, the second was opened. In the following several years, the clinic was expanded with extra departments (for example, for chronically ailing people). It’s remarkable that practically all the money for the building was donated by rich Muscovites encouraged by Nikolai Alexeyev. The mayor, meanwhile, was shot and killed in 1893. Experts then found out that his killer had a mental disorder… And the new hospital was named in honor of Alexeyev.

The administrative building of the hospital, 1913.

When the first half was opened, Viktor Butske became the head of the hospital. He was a supporter of the ‘no-restraint’ system. That’s why straitjackets were never used in Alexeyev Hospital - the doctors wrapped aggressive patients into wet bed sheets to calm them down. Butske understood that the atmosphere mattered. Each department had its own garden. All the wards were well-furnished, except the ones for the violent. He made sure all the staff respected the ill and were kind to them. At first, the hospital used some isolation rooms and kept window screens in the wards for violent patients, but these measures had disappeared completely by 1903.

A living room in the women’s ward, 1904-1906.

As the number of patients grew, Butske had decided to let some of them live and work out of the clinic and organized the system of patronage. In 1900, he started to relocate some patients into families living in the villages near Moscow (for example, Troparyovo and Belyayevo, which are now parts of the city). Of course, the hospital staff kept supervising such patients. Butske knew that the patronage would do well: while he worked at the Preobrazhenskaya hospital, a friend of his was declared to have an incurable mental disorder. The doctor put his friend with a peasant family and it helped a lot to fight the illness.

The pool room in the department for the chronically ailing, 1904-1906.

Butske was replaced by another remarkable psychiatrist named Pyotr Kashchenko in 1904. The new hospital head kept developing the ideas of the ‘no-restraint’ system. The patients were also allowed to receive visitors. One of the doctors remembered that Leo Tolstoy once came to see someone there. Kashchenko did his best to destigmatize the patients with mental disorders and to socialize them. He already had some experience of applying work therapy and, in 1905, a new building for workshops and entertainment was built for the hospital.

The sewing workshop room in the women’s ward, 1904-1906

When the Russian Revolution of 1905 started, Kashchenko organised medical brigades to help injured revolutionaries. At the time, he was too respected to be punished for his political views. The Soviet administration then honored the doctor for his deeds: In 1922, they renamed the Alexeyev Hospital after Kashchenko, though he had left for St. Petersburg in 1907. Unfortunately, during the Soviet period, people were still afraid of psychiatric hospitals (because of repressions) and of people with mental disorders, so the name of the great doctor received negative associations.

Pyotr Kashchenko.

During World War II, Kashchenko Hospital also received soldiers with craniocerebral injuries. Due to medication shortage, they were often treated with electroshock therapy - a notorious method that causes scientific disputes, though its efficacy is proven.

In the Soviet era, the hospital admitted some famous people. Joseph Brodsky spent some time there between 1963-1964 to undergo a psychiatric examination. The poet didn’t have an official job and was accused of “social parasitism”. Brodsky insisted that writing poetry was real work, but the court didn’t agree. The friends of the poet hoped the examination would save him from punishment, but it didn’t: In March 1964, Brodsky was condemned to compulsory labor In the Arkhangelsk area (990 km north-east of Moscow) and, later, had to emigrate. In the Kaschenko Hospital, Brodsky wrote a dark and hopeless poem titled ‘Novy God na Kanatchikovoy Dache’ (“New Year at Kanatchikova Dacha”).

Joseph Brodsky, 1972.

Famous Soviet bard and singer Vladimir Vysotsky also spent some time at the Kashchenko Hospital to treat his alcoholism. He described the life of the patients in a humorous song called ‘A letter to the editors office of ‘Obvious-Incredible’ TV program from an insane asylum - Kanatchikova Dacha’. There is an interesting detail: Vysotsky sings that the chief doctor named Margulis finally banned watching TV at the hospital. This is a fictional character. The real chief doctor at the time was Valentin Morkovkin, who later complained that he had done a lot for Soviet psychiatry (he had published many scientific works), but had finally become known as a doctor who tried to help Vysotsky.

Vladimir Vysotsky, 1978.

In 1994, the hospital was renamed back to the ‘Alexeyev Psychiatric Clinical Hospital’. Nowadays, it has numerous departments, branch clinics and even a radio station called ‘Zazerkalye’ (“Through the Looking Glass”) and runs psychiatric education courses. The primary principles of freedom and respect are still kept there. And even though the hospital’s name has changed, the people still commonly call it ‘Kashchenko’.

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