COVID-19 Travel Tips with Global Emergency Medicine Expert Dr. Chris Sidford

By on May 27, 2021
Categories: COVID-19

A webinar hosted by Dowling & Yahnke Wealth Advisors

Dowling & Yahnke Wealth Advisors hosted Dr. Chris Sidford, founder and medical director of Black Bag Global Emergency Medicine, on May 26, 2021 to provide you the most up-to-date information on the pandemic and travel.

During the webinar, Dr. Sidford addressed topics like:

  • Health considerations for national and international travel
  • Vaccinated? What is permitted (or prohibited) while traveling?
  • COVID variants and how that may influence travel destinations
  • What you need to know if you get sick abroad
  • Additional precautions to consider when traveling such as seat location on planes, taxis, and other public transportation
The information contained in this webinar is for information and educational purposes only and represents the views and opinions of the presenter only. This information should not be construed as medical advice. Viewers should consult their own physicians before making any medical decisions. Dowling & Yahnke, LLC and Black Bag are not affiliated with one another.

The below is an audio transcript with time guides. This automatic text capture may not be 100% accurate.

Well, hello and welcome.

My name is Anna Diaz and I’m a principal

and lead advisor with Dowling
and Yahnke Wealth Advisors.

And on behalf of my teammates,
all our colleagues at Dowling and Yahnke,

we’re so glad you joined us
for today’s conversation.

So we’re also excited because we are
in our 30th year anniversary

when Dale Yahnke and our co-founders
founded our firm 30 years ago.

They were pioneers as an independent
wealth advisor and as a fiduciary.

Today, we provide investment management
and financial planning services for over

thirteen hundred clients,
and that’s individuals,

families and organizations, and today
managing over five billion in assets.

We’re also excited because this is
a really interesting conversation.

And as our team chats,

we love hearing what’s going
on in the lives of our clients.

And many of you are asking questions
about returning to travel.

We were excited to partner with Dr.

Chris Stanford of Black Global Emergency
Medicine to talk about travel safety.

So looking forward
to today’s conversation.

Let me tell you a little bit about Dr.

So he’s a board certified physician
in emergency emergency medicine.

With over 30 years of health and medicine

he practiced and cared for over

one hundred four clients and over 150
fifty countries and locations to date,

ranging from the mountains of Patagonia
to ships in the Labrador Sea.

As a US naval officer, Dr.

Sidford served as a faculty member
of the Emergency Medicine Residency

Training Program and provided emergency
medical support for NATO troops during

amphibious operations
in the Arctic Circle.

So providing care in difficult and remote

locations became
the impetus for black bag.

It’s also exciting to share that very

recently black bag was awarded the health
care firm award by Family Wealth Reports,

and actually this is the third year
in a row that they’ve won this award.

So before I turn it over to Dr.

Sidford just a couple of housekeeping
items, so first of all, thank you.

Many of you submitted questions when
you registered for today’s webinar.

We did share those with Dr.

So you’ll be incorporating a lot
of that into his talk today.

However, I also will be incorporating
a Q&A session after he speaks.

So we hope to answer additional questions.

There is a Q&A button
at the bottom of your screen.

Feel free to send
questions as they come up.

And we’ll do our best to cover
as much as we can today.

Again, we’re so glad you’re here.

And with that, doctors in front of me.

Turn it over to you.

Anna, thank you very much.

It’s a pleasure to see you again and
congratulations to you and your team.

I know you had some great news recently

in your neck of the woods,
so thank you very much.

And I’m going to share the screen
now and get us started.

So, again, thank you very much

for that introduction and thank you,
everybody, for joining us.

I’m going to try and share some
of the lessons that we learned as our

organization looks after international
travelers and security teams and so on.

And as we all know,

it’s been a very challenging year
and there’s been a lot of really good news

and bad news and really tough
times to get decent information.

So I’m going to try and share what
we’ve learned in the past year.

And and thank you again for those
of you who submitted questions.

And we’ll get to some of those in the end.

So just as Anna said, I did do some
emergency medicine training program

in Boston and one of the original knife
and gun club training programs and I paid

back a Navy scholarship
in actually San Diego.

San Francisco
helped open up an underground nuclear,

chemical and biological proof
hospital near Mississippi.

And that’s part of the strange trips.

I also got sent to the Arctic Circle
to look after NATO troops.

And this is some of the photographs
that got me started in this line of work.

So this is heading up after 17 hour flight

to begin to train for the
various troops and so on.

And this is pictures of various NATO

leaders and commanders and all the king’s
horses and all the king’s men.

And this is day one, kicking
off the amphibious landing.

And this probably got me
in the first opening up.

No matter what you plan for, you’re
going to see things you don’t expect.

So here we are on our first amphibious day
and two things happen we did not expect.

The first is those people down by the
beach with the red jackets and so on.

That’s Greenpeace have decided they’ve
come all the way up to the Arctic Circle

and straight through the landing,
which I got to say I was not expecting.

And the second bigger issue was that those

half tracks coming up the beach
cut to our communication lines.

So we were sort
of essentially flying blind.

And again, it was a sort
of eye opening experience.

No matter how you train, things happen.

And so you try and train to be
prepared for the unknown.

And that’s how it got started.

As one in ER
and then also in Black Bag.

So I’m going to try and summarize what

we’ve learned and I’m going to try
and present the various aspects depending

upon some, as if you’ve
never heard some discussion.

And some of it is if you’re
vaccinated and some if you’re not.

And how we go forward from here.

So the Clint Eastwood movie,
obviously The Good, Bad and the Ugly.

The good news is that the vaccines are
incredibly effective and half of our

the US population has gotten a single
dose and almost close to 40 percent.

has gotten the second dose.

And the bad news is that for whatever
reason, misinformation, fear,

doubt whatsoever, about a third
of the people don’t plan to get one.

And that’s going to be a really

challenging part of moving forward to get
beyond a pandemic existence walls

and some of the things that contribute
that are things like the various variants

around the world, the one that’s gotten
the most attention and probably one

of the country’s in worse shape is
India because of their variant.

And the variants happen because as
the virus transmits from various people

and cells and so on, it goes
through genetic variations.

And so the variants develop
that are in some way.

They learn to develop new ways to attack

our cells and make us sicker and so on,
and then these become more prevalent.

So this was probably heard of the one
that was in Britain to be one 17 and then

the one that was
in South South Africa and so on.

So these variants are what is keeping us
on our toes and trying to keep us as safe

as we can while we get ready,
while we proceed.

Just a heads up that places like
The New York Times,

I’m assuming the L.A. Times probably does it,
too, but you can log on with your email

and create your own window for the
various places you want to track.

So this is San Diego and I just logged
on and think this is one of the cities.

It’ll give you updates every day

for cases, new cases
and changes and so and gives you some idea

of where you are depending upon
the country that you live.

This is one of the original pictures

from a small diner in China at the very
beginning of the epidemic,

and it brings home one of the points I
want people to try and remember is

that this virus, as we all know,
is incredibly sneaky.

This is one person,
the one circled in the yellow

in the middle,
who over the course of a short meal ended

up infecting half the people
in this restaurant from one person.

Nobody had symptoms.

There was one person infected,
had no symptoms.

This ability is still there.

It is greatly changed by the fact that
many of us have already been vaccinated.

But this is what’s still out there.

It’s unbelievable ability to infect and be
contagious for people who don’t know it.

One of the questions we get a lot is what

do we do, indoor outdoor dining and I’ll
try again to break this down

into vaccinated or unvaccinated if you
were unvaccinated for whatever reason,

whether you are, that’s a contradiction or
whether you decide you don’t want to do it

or you’re too young to get one yet
indoor dying, in my view, is is a no no.

There’s just no way for you to take
a mask off inside with other people.

It’s just too, too likely for you
to get sick and get quite sick of it.

Some of the attempts of the at the tent

dining and so on,
unless you’re in with the very same people

in your bubble, those are
still all very risky events.

And I would even go so far as to say

for those of you who are vaccinated,
if you’re vaccinated and you’re living

with only vaccinated people and you want
to go with a group of vaccinated people

to a small restaurant,
I think that’s still a good idea indoors.

If you are going to a large setting,
if you have any kind of underlying

if you want to be safe and cautious,

it’s not time to go indoors yet
because it’s still we still do not know

what the various and what vaccination
does in terms of protection.

And I’ll come back
to that a little bit then.

Some of the super spreader events
from the fall and now even still,

there are still some events that are
pretty serious because kids are not been

vaccinated yet because they’re still
testing which ones are safe for children.

Sporting events were big, scary events,

particularly in New England
where hockey is king.

So they had to shut down a lot
of the tournaments and so on because too

many kids are coming home sick,
a lot of endorsing events or speaking

events or where people can push their
voice out and their and their their song.

But unfortunately,
that carries with it also virus.

And that’s how they get spread.

And probably the number one risk right now
is that people who go to work when they’re

for those of you who’ve been to whatever

type of screening at the door,
when someone does a little thermometer,

a digital thermometer on your forehead,
those are really inaccurate.

And by the time they screen and catch
that fever, it’s probably too late.

Way more people getting
through that screening.

So you really have to be diligent if you
run a business or part of business or have

coworkers, is that if they do not feel
well for any reason,

they need to stay home until they can
confirm that they do or don’t have?

This is just, I thought,

an interesting case from a large church,
one piano player,

and those over two days of playing this
person was an asymptomatic carrier.

And those are the number of people
who got sick from this one person.

And the green numbers are
people who were 30 meters.

So somewhere between 40 and 50 and maybe

as far as 70 feet away
got infected from this one person.

So, again, if you’re unvaccinated

and unmasked, the risks
are really quite serious.

Some clues that you may have heard
of or may not have heard of.

I think we’ve all heard losing taste
or smell, which is really awful.

But there’s also something called parent

knows where you get
your smell starts to come back.

Not only do you get a smell,
but you get a bad smell for good things.

So some of your favorite foods
may smell like rotten eggs.

And these are some clues to having
bad or progressing to cold it.

And the symptoms that people get,

you probably all have had somebody
who’s had it or known of it.

And there’s the typical fever aches,
maybe a cough short of breath or things

like headache, isolated
headache or sore throat, diarrhea.

And so those are still signs of covid.

And for people who have young children or

grandchildren, these are things that,
again, these are triggers to get covid

tests and to make sure
that that’s not what they have.

The symptoms.

You may have also all heard of long covid.

And that’s the unfortunate outcome
for people who are recovered from it.

That may have I think
there’s up to 70 symptoms.

They could have fatigue to sort
of foggy brain and ringing ears.

And this can go on for months and about

one in seven people
who recover from covid.

So this is more sort of a reminder of why

we want to be diligent about being
careful of getting vaccinated.

I’m a big proponent of certain types

of mass, and for those of you who are
unvaccinated, you all know that you still

have to wear them any time you’re
within a certain distance of people.

But even people who are vaccinated with no
underlying conditions,

places like health care settings,
any kind of public transportation,

if you’re going to go on a flight,
you’re going to get on a train.

If you’re going to go visit relatives

in a nursing facility or so on,
a mask is essential.

And the mass that I recommend is difficult
to get and now they’re much easier to get

are called N-ninety fives and their
medical grade three makes a great one.

I’ll show you the next slide.

But the difference is not only does it
filter out 95 percent of particles,

but because N-ninety fives have
electrostatic layer,

it actually has a magnetized attraction
to the small viral particles.

So it’s even more effective.

There’s a couple of
things you should know.

There’s there’s certain brands that have

graphene in it, which was
thought to be antibacterial.

The trouble with the antibacterial is
that actually that material broke off.

So people were

so careful what kind of mask you get.

The gentleman on the right has a couple

of problems with that kind of mask. That’s a
contractors N-ninety five mask.

So the mask itself filters very nicely.

When he breathes in the problem,
he’s got that port,

that box in the middle,
which is actually an exhalation force when

he brings out it go straight
out and there’s no filtration.

So the mask works great for him.

It does not work great for you if you’re
next to him on an airplane or if you’re

standing next to him in line
at the grocery store.

And the other issue for those of you
that are that have beards is you’re

breaking what’s hoped to be
a nice seal against your face.

So you’re making that mask much less

efficient and the chances of breathing
in particles is much higher.

This is great if you’re doing more

compound work or spackling
or something else.

But it’s not very good in terms
of preventing the covid consumer lab.

dot com down left is one
of my favorite sites.

It’s a small yearly fee and it goes
over all sorts of natural supplements.

It has really nice reviews
on the various masks that you can get.

And my two my one favorite is the called

the the three,
and it’s the last to the top left and it’s

a full down three and very
comfortable and ninety five masked.

Whenever you buy any of these masks
N-ninety five even KN-ninety five,

you want to look for the NIOSH
that name up the top left is

the National Institute
of Occupational Safety and Health.

It means that they verified
that that mask is what it says it is.

And to at least tell, you know, what your
body is, it’s very difficult to find.

But now you can go to sites
that carry them critical supplies.

USA buries the 3M and then
GDI Medical on the right.

It’s another very nice,
nice and ninety five.

They’re both very comfortable
and very reliable.

And I think that we’re going to be

with this whole idea and so
on for several months, if not years.

So the idea that you’re traveling without

a mask is probably pretty far
off even if you’re vaccinated.

So I would suggest that you

stockpile put a box of these in your
closet or two and keep them around

for when you have to travel,
even if you’ve been vaccinated.

The L.A. linen mask down below the cloth

masks that have one or two or three layers
can be very effective.

They’re almost as good as the N-ninety five.

And this is one of the highest rated ones

displayed and it’s supposed to be
very comfortable and very effective.

I would still go with the three
and if you can get it.

But these are these are all good choices.

If you have them and you need to use them

on a regular basis, maybe health care,
health care workers in your family or

yourself or you’re volunteering,
you can actually wash that.

You need to leave them in in a standing

by themselves for five days, at which time
the virus will died off if you are

exposed, but you can
also recycle them in a

rice cooker.
The recipes are all over the Internet,

but it’s basically there with moisture
without if you put water at the bottom,

you put a towel down and put those in and
one hundred and twenty degrees for about

20 minutes so you can reuse
these mask over and over again.

And I know the CDC came out recently

and said, well, you know, in case
you don’t need to wear them anymore.

I agree that that’s probably
where we’re going to get to.

I think I’m a little premature because we

really don’t know who’s
been vaccinated, who’s not.

And there’s such a cantankerous discussion
about who can or can’t get vaccinated.

I think it was a little early to do that.

There are a couple of the products down
below with their touting a ultraviolet C

lighting that you can use as a wand
or a box of heating oil supplies.

Yes, those do work as a wand.

It doesn’t really work very well unless
this is sort of a smooth, dry surface.

So if you’re going to bring in I’ve seen

people on a plane to bring this and try
and scan their canvas seat, it doesn’t work.

And so really, those
are not that effective.

It’s still you can use a Clorox wipe
if you want to put your keys and your

phone in the box and that’s useful,
then you got to rotate them.

But most of that is a bit of hype.

Or for people who are looking for I’ve had
a number of attorneys,

I have security teams that are covering
embassies where they can’t control

who comes in and out and whether they’re
masked or vaccinated,

there are a number of systems that can
help you clean the air you are in.

And synergise is a dry
hydrogen peroxide system.

It’s the only system that I’m aware

of that’s effective in decreasing virus
in the air while people are in the room.

There are all sorts of systems that you
can turn on when you leave the office.

Let’s say you’re an attorney.

You need to do closings or you have
to have clients come in and you’re

concerned about your health or somebody
elderly or you have suppressed.

These are now in the variety of gyms,
grocery stores, hotels and so on.

The model that the left is a small one.

It’s about twelve hundred dollars.

But it’s a really nice option for comfort
or peace of mind

for you running a business or even some
clients who have a number of workers

in their house and so
on that are nervous about it.

We need to have them install these.

If you’re going to travel,

eye protection has been proven to have
been a benefit and there are different

options you can use, you can put the mask
over your face to face guard.

I’m not a big fan of those
because they’re just so cumbersome.

But there are a number of people

that you’ve flown that that will fly,
those you cannot use.

That in lieu of a mask you have to use both.

But I’m a big fan of the goggles on the
left was available on Amazon for that.

I think it’s 15 or 18 dollars.
It’s form fitting.

It’s meant to be used honestly when you’re

cutting onions,
but they’re very comfortable.

And it’s a nice sort of protection
from your eyes, particularly if you’re

on an airplane or public transportation
or even health care setting.

Couple of risk factors people might want
to know about these e-cigarettes are,

in my mind, are inviting trouble anyway,
but it does multiply your risk of getting

covid or the complications
by a factor of five.

And the other thing which you
may want to tell to your

children themselves are young males,

is that covid does increase erectile
dysfunction about six times more likely

in young patients, which is always
obviously gets their attention.

So whatever means you can
to have them be careful.

This is one of the sort
of discussions that

social distancing,
which we’ve carried around for a number

of months is six feet was
meant to be the prevention.

And I want to explain that it’s
really not a prevention.

It’s a control.

Six Feet is not the same thing.

Where you can’t get it in means as

a population, as students,
as classroom and so on.

It’s meant to slow down the spread.
It does not

stop it.

So a number of people who I’ve had
discussions with over the last year

who say what we’re indoors with six
feet away, what can be the problem?

It doesn’t work that way.

It’s meant to slow down.

And I’ll never forget,

there was a Alabama senator
who mentioned that he met friends.

And the first time he’d been what he would
said, careless outdoors, six feet away.

And one of them was contagious.

And he literally this this gentleman died.

And his last posting was we messed up.

I let my guard down.

So, again, there’s very good news about
the vaccine, but there’s still lots

of reasons to be careful
and cautious about going forward.

So in terms of testing,
no doubt everybody here has had some

experience with testing schools to work
for their own illness or traveling and so

on, and the tests that you need
to understand a little bit

PCR is to test where they that’s the one
where they put the swab of your nose.

It takes maybe one
to three days to get back.

It’s a very sensitive test.

So it tells you if you have the illness.

The trouble with this one is that, say,
for example, you got it on day one and you

may be no longer contagious
by day 10 or 14.

You may still be positive two weeks later.

So if you’ve had experience with having

this keep term positive, it it’s a marker
that you have still illness or virus.

It does not tell you whether
you’re necessarily contagious.

These are the tests that you will be asked
to get before you go back to school before

three days, before you
travel internationally.

And you’ll need to submit will come
back to how you do that and where.

But those are the tests that they
can ask because it’s very sensitive.

The antigen test is
the one that’s very rapid.

It’s not as accurate.

If it is positive, it’s means pretty
accurately that you’re contagious.

That’s very good news.

It’s what they’re using for screening when

we come back, from certain countries
and hotels and events and so on.

The bad news is it’s
not entirely accurate.

If you have symptoms, it’ll catch
about seven out of 10 people have it.

But three out of 10 people who are

contagious will still
have a negative test.

And if there’s no symptoms,
it’s actually six out of 10.

So just something to be aware of because

we’ve all heard cases either the nose one
they had the antigen test.

And obviously a number of people who got

through the screening were sick and then
it turned into a super spread event.

And they just came out recently

with the idea that people who are fully
vaccinated do not need to get tested even

if they’re exposed to known
exposure to covid.

However, if you’re a public health

employee, work in a nursing
home or someone you need to.

This is still sort of a contentious idea

is that if you’ve been fully vaccinated
and somehow exposed or have the illness

with no symptoms,
who you spread the illness.

And that’s a number of people sent
the email questions about that.

And it’s not entirely clear.

The thinking the consensus of the various

news sources I’ve looked at is that
if you have no symptoms and you can

vaccinate, you could still have the virus,
you could still spread it.

But it’s less likely if you have symptoms,
it’s much more likely that you have a high

viral load or more virus in you and more
likely that you can spread this.

And the antibody test,

some of us may have had to see if we
either had proof that we were sick

in the past so that we need that we know
whether or not we need to do or not.

It is decent in terms of determining
in some period of time whether you had

coded within six weeks
of when you were sick.

One thing it doesn’t really tell you is

antibodies translate to having antibodies.

It doesn’t translate to immunity.

So just because you have the antibodies
doesn’t mean that you’re protected.

And while I’m on that,

I also mention the issue that just because
you had covid and you have some of these

other antibodies doesn’t mean that you’re
prevented from getting disease.

So even if you have covid,
it’s always recommended you get at least

one and probably both vaccines,
the RNA, if you can.

So this is sort of this is an L.A.
nightclub that was offering in the cover

charge that they would get
a 10 minute covid engine test.

Again, just to reiterate,
if you’re vaccinated and you’re going

through this as a young,
healthy person, that’s fine.

But if you’re a little bit older,

have comorbidities and so on,
a lot of the people,

about 60 percent of the people who might
be contagious, it will catch a 30 percent.

It will not.

So there’s not an effective
screening for keeping you from safe.

It’s an effective screening
for a large population.

So we can track who does or doesn’t have

the illness, for example,
in schools and universities and so on.

A couple of things that our clients carry
and I would suggest is

that if you don’t have one,
it’s a decent household test to have.

Now, is that little O2 stat monitor

it’s about 40, 40, 50 dollars.

You just keep it charged with a USB mini
cord and you put that over your finger.

It’ll tell you what your heart rate
is and tell you how much oxygen.

And I’ve used this with clients
all over the world.

It’s a very useful bit of information,

and particularly for if we’re discussing
if, you know, you have COVID and trying

to figure out how sick you are,
the two things that have recently come out

that if your saturation drops below 92
percent, you should be around 95


or if your heart, your respiratory rate,

the number of times you reap the benefits
of the fall of twenty three,

those are both indicators
that something serious is happening.

It’s time to get to the E.R. Most of you

are probably breathing
around 12 to 16 times.

So it’s actually a big change.

If you were speaking to someone
on the phone and they were breathing

at twenty three times a minute,
you would notice it.

You could say, well, something’s wrong.

So it’s not subtle.

These are these important findings

that that there’s effects on the lungs
of the heart and it’s time to get

to the E.R. And I mentioned the no
exercise rule for some of those

who’ve never had it or may still contract
covid, even if it’s relatively

asymptomatic, it does have effects
on the heart and the lungs.

And while most of us have grown up
in the air where viruses were things you

might exercise through recovery,
it’s important that you don’t overexercise

during a covid recovered
because it does affect heart.

They did they took one hundred college
athletes who had

covid and they found with an MRI analysis
of the heart that 78 of them had

demonstrated effects, decreased
the ability of the heart to pump.

The good news is most of them recovered,
but it’s thought that while the recovery

is not a time for them to overexert
themselves and one of the comparisons

that one of the exercise physiologist made
was it’s like taking a Division One

athlete and turning them
into a Division three athlete.

It can have a very pronounced effect.

And unfortunately,
there have been some very sad stories

of professional athletes who’ve had
either really serious events or have had

a really difficult recovery
coming back from covid.

In terms of treatment, again,
I mentioned this for those of you who may

not have been vaccinated or if you have
comorbidities or you suppressed that,

you still that being sick with this is
still a possibility or you have relatives

overseas, the monoclonal antibodies
are still a fabulous treatment.

But something I would mention,

you can actually you can actually
Google this for where it is here.

There are treatment centers
that will give you supplies.

So you can Google, for example, San Diego,
and it will highlight the various

treatment centers that are giving this out
by giving this out there,

actually administering this
the appropriate patients.

And I would tell you,

it’s a fabulous treatment, but you
need to go before you get really sick.

So if you have a positive diagnosis,

it’s important that you speak to someone,
either your primary care or an infectious

disease doctor on whether you need to go
see them or call one of these centers

and ask them if you fit the criteria
because it’s very effective early on.

It’s not so effective.

Later on,
I’ll mention Luvox and Ivermectin,

because some of us, I’m sure other people
on the phone has relatives or employees

in different parts of the world
where different treatment modalities are

not available for vaccination
is actually a the SSRI.

So it’s an antidepressant.

It’s called a serotonin
uptake inhibitor.

And it actually has a remarkable benefit.

If you have an early diagnosis of covid,

it has a very good effect of keeping many
of the people who take it out

of the hospital from severe covid
and ivermectin and similar

And I mentioned it because people who have

either got to say, for example,
in India or South America,

whether that disease is really ravaging,
these are things that they can get access

to that can help them because
the hospitals are really overrun.

So if you’re vaccinated,
it just came out with a report yesterday

about the breakthrough that thousands
of people who’ve been vaccinated both

sequenced their two weeks,
at least two weeks after the second

in the series, and they’ve
been diagnosed with covid.

So the good news is it’s about somewhere
around one hundred million,

maybe 90 million,
two hundred million who’ve been vaccinated

and they’ve documented ten thousand
breakthrough cases, which means that they’re

COVID positive there vaccinated and somewhere about
a third of them have no symptoms at all.

But those of those 10000 thousand,
about a thousand people end up being

hospitalized and two percent
of those people did die.

So it is still a serious
illness to be taken seriously.

There’s great news about vaccine.

It’s a great comfort,
but it’s not a jail free card.

But so, as you probably know,

Pfizer and Moderna are both getting approval
for the 11 to 17 year old age group.

So they hope that the teenagers will be

able now get vaccinated
and be less concerned.

There’s a lot of people that it’s sort

of speculated that young kids
and teenagers aren’t as susceptible.

They don’t get sick from this.

And while there is some truth to that,
there are unfortunately a number of rather

serious complications for children
and teenagers who get this and so on.

It is something to still
take very seriously.

A second vaccine or a vaccine of either

one of the answers have been shown
to improve long covid symptoms.

So if you know someone who’s struggling
with it and they may not think that it’s

important that they get vaccinated,
it actually does improve.


you may have read recently about this is
another breakthrough case where nine

of the Yankees turned positive
and they’ve all been vaccinated.

They’d all been together.
They get regular antigen testing.

Well, what happened is that it looks like

one they got the Johnson Johnson,
which is not quite as effective.

But fortunately, it seems that there were

a case that they all got positive,
but there were no real symptoms.

So it looks like that may be a relatively

safe place for us to be is if you’re
vaccinated, you turn positive.

Doesn’t seem to serve
for the majority of us.

In terms of the Olympics that some of you

are either going to as athletes,
relatives, families,

coaches or so on that have been a lot
of discussions about the safety of Japan.

Japan is struggling with a rather serious
uptick in terms of cases and mortality,

and unfortunately, they’ve only vaccinated
about four percent of the population.

So I find that a little bit surprising

given the relatively
tightly controlled society.

But that’s the case where they are now.

I’m hoping that they will surround
the Olympic village and travelers

and visitors with people who have
been vaccinated if they can.

But if it is something you’re considering,

feel free to reach out to me
in between after the presentation.

And we can discuss some of the risks

with some of the ways you might be
able to to improve your chances.

So a couple of questions that we get all
the time is if you get if you get covid

versus getting the vaccination,
which is better,

and it turns out that the vaccination is
better than improving your chances, your

immune protection than the illness.

And it’s even better that if you had told

if you go ahead and get at least one
and probably both of the vaccines

and as I mentioned earlier,
that a vaccinated person,

it looks like they can get positive,
they can get it, and it looks like they

may be able to transmit
it to someone else.

But that’s when things are trying
to figure out the most right now.

Estimate as to how long you’re protected.

It’s really not known.

There are all sorts of speculations

between six months to nine
months to maybe a year.

And that’s one of the challenges that we

come into with people who are
not going to get vaccinated.

Are we going to have these pockets

of outbreaks that are going to come where
there’s going to be a big

peaking number of cases and it’s going
to occur is maybe in six or nine months.

And now those who thought they’re

protected because
of vaccination are no longer.

A recent study from the England
in England public health system there

found that there’s some really pretty

encouraging news that a number
of the variants are protected.

We’re protected from those
parents with vaccinations.

So in your mind, there are a few people
that ask various questions about

the different
illnesses that they may have or relatives,

and I just mentioned some of the reasons
why someone may be compromised.

Steroids, cancers and so on.

Things that you may know, smoking is
a reason that you may be suppressed.

And it means that for those people who can

get the vaccine, they’re not
nearly as successful in terms

of a immunological response, particularly
the first dose is not that helpful.

And the second one is really important,
whereas someone who doesn’t have this kind

of illness may be somewhere around 60 or
80 percent with the first vaccine and up

to 90 the second someone who’s
immunocompromised may be closer to 10 or

15 percent on the first one
and maybe 50 percent on the second.

And there’s a this is one of the reasons
why it’s kind of kept with trying to be

careful about trying to wear masks and so
on, being aware of the other people

in and around you, your household,
your relatives and so on.

So in terms of traveling, some
of the things to keep in mind is that.

There’s going to be a need for some sort
of verification that you’ve either been

vaccinated or you’ve had a negative test,
and there’s lots of different people

who are putting their stake in this,
the Department of Homeland Security,

the World Health Organization, it’s not
going to be a global or national effort.

So what you’ll find is if you’re thinking

of traveling, it’s going to be
it’s going to be a combination.

It’s going to be the airline.

It’s going to be the hotel.

It may be the resort
and maybe the travel agency.

They’re all going to have different

criteria for when and what
kind of proof they require.

And some of them are digital passports.

So, for example,
the Excelsior passes by IBM

and New York State is going to use
a suit to get into public events.

The International Air Transportation
Association represents about hundred

airlines worldwide and they have
a digital health passport.

So there are different
airlines verifies one.

Even dating apps are starting
to have ways to verify your

vaccination status for dating.

And I won’t tell you that a month ago is

down in the Bahamas and you’ll
find it’s kind of a mishmash.

So everybody has a different claim.

And I would tell you that when you travel,

you want to bring up some
type of back up.

So bring literally a photocopy of your

vaccination, bring a digital passport,
and that applies even to your passport.

Bring a cup of coffee with you because

everybody seems to have a different
thing that they require.

And you don’t want to be stuck because
your app doesn’t open up for sale somehow

or it doesn’t upload
your images and so on.

So the other question I give you for those

of you who are traveling is that these
tests, they’re going to require either you

you’re going to need
a picture before you go.

We require some antigen tests
a couple of days after you get there.

And depending how long you are,
they may do them every five days

and they may require the US government
required tests for you to come back.

And all of these tests,

if you’re in certain countries,
they know they have you.

They can be a hundred fifty dollars

a test, some of them very nice, very
accurate to come to your hotel and so on.

But but it’s a it’s an expensive venture
to keep in mind if you’re thinking

of traveling, for example,
with a large family of kids.

So like I said before,

they’re not quite out of jail yet,
particularly for not vaccinating.

There’s still lots
of reasons to be careful.

Just a couple of things about where you
travel and how you do,

if you’re going to be traveling
in a in a taxi, for example,

so you don’t know the status or
the vaccination status of the driver.

I would suggest you wear a mask.

Whether you want to wear
eye protection is up to you.

But even if you’re vaccinated,
is the best way to keep a barrier between

you is to actually open
up the windows opposite.

So the passenger window in front of you
and then the person across the street.

So it creates a wind barrier between
you is the best way to travel.

In terms of traveling by plane,

I actually consider that the plane itself
is not the risky area for people

who a number of questions on where they’re
going and what countries and hotels

the risk when you’re in a plane is
probably the lowest of the trip.

The risk when you’re in the airport,

when you’re in public transportation,
because when you’re trying to get

something to eat,
probably the high risk areas.

So this is a flight that went
to Ireland early in twenty twenty.

All those seats are empty.

So those positive cases have that plane
came positive just from one person.

And this is some of the people were

wearing masks and some of them
were not wearing masks and so on.

The good news is that there is HEPA

filters, that high efficiency filters,
there’s a rapid turnover.

There depends on the airline for how
much it is, but it’s very effective.

So the rates before vaccination

with masks, when you had a middle seat
that was empty, it’s about one in eight

thousand that you would get covid
even following the protocols.

And it’s a middle seat
for folks about half that.

The good news is that because so many

people are getting vaccinated,
those right.

Those numbers will improve dramatically
until we if they do take off the mask

mandate, then it’s going
to go the other way.

It’s going to be much more serious because

now they’ll be so much more free,
the air that’s not filtered.

So some advice that I tend to tell people.

I mean, I think most people are very

careful about being clean around
the public restrooms and so on.

And that’s still the case.

It’s still the case.

Even though there’s not a high

transmission from contact surfaces,
it’s still important to clean wipe down

the trays and the buttons and things,
even the air vents that you might not

think of and keep your hand
and hand sanitizers and so on.

A couple other things.
I mean, the food isn’t very good anymore

anyway, but I would recommend
you do not eat during the day.

They bring the food in between

because that’s when everybody
has a message you want to eat.

When everybody put their mask back on,

put the vent right over your
head and leave it on full.

You have to bring extra clothing
because it gets chilly.

That’s fine.

But these are some
of the ways to help improve.

And again, this is not the risky area
when you’re thinking about the various

countries and so on,
it’s more of where you’re going and how

and what kind of location
you’re going to be.

So, again, this is the Bahamas
is one of the places we went.

So your resources, when you want to figure

out what’s required,
the U.S. embassy for that country will

have resources very specific
for what the country needs.

The other one that I’m a big fan of is

the International Air
Transportation Association.

So you can click on the country you’re
going to and you can register your name

and your email and they’ll tell
you everything that’s required.

And it’ll also send you updates up
to the trip that you’re going to.

So it’s a very useful website.

Evacuation insurance. I won’t go too deep,

but I would tell
I can’t tell you the number of events

where I’ve been asked to try and help
evacuate somebody from across the globe

who just didn’t think something
medical or traumatic would happen.

And unfortunately, they just do.

And now they’re in a foreign country.

They need the better definitive care.

There are a number of great policies
and carriers out there before COVID in the

Travel Guard International S.O.S. They’re
all great carriers, Redpoint and so on.

And again, I’m happy to speak to anybody

on here who’s trying to figure out
which carriers they want to use and why.

So my contact information will
be later on in the presentation.

But covid through a wrench in that,

because in the beginning,
when people so sick,

the evacuation policies didn’t apply
to covid, because one of the exclusion

criteria for your policy is if you put
the crew at risk, they can’t fly you.

So a number of this is one

of the companies that came out and said,
we will fly you if you’re covid positive,

because the issue you have to think about
when you’re traveling internationally is,

one, not only could you get sick with it,
but to what if they don’t let you back

in a country and you have to go
to their health care system.

And that is a real challenge to some

of the countries that going to go back a
little bit as one of the ones that does.

And you can also get,

I think is one of the few ones
you get a policy after you leave.

But again, I’m happy to discuss those

kinds of details with people
trying to make decisions about it.

And this is a good example.

Again, when I looked after

three families that rented very nice
to go to Croatia during the pandemic.

So there are ways to travel safely,
even if you’re not vaccinated,

but you have to be very careful
about the environment you control.

So in this case, it was a
large part of yacht.

And we’ve done all the screening.

We’ve done all the coverage testing,
all the current testing sites.

We’re going to be all the way up and down

the coast of Malaysia where the medical
facilities there and so on.

So this is some of the things that you

need to sort of think about
when you’re over there.

And then I’m going to share this is

the other things that happen
that just happen when you travel.

So I’m going to throw this out as a video,
and this is one of our clients in there.

And I’m warning the boy who gets
injured in this, it was perfectly fine.

But this just does raise the kind

of harrowing experiences
that you have when you travel.

So that’s him in the yellow shirt

and he takes a quick turn around


he’s fine.

But, you know, sometimes.


so, again, he’s fine,
but he did get knocked out.

He was down on the water and we now have

to figure out a way and where to go
and take him in in a foreign country where

we don’t speak the language
in the middle of a global pandemic.

For those of those of you who speak,

who are considering travel,
these are some of the things I don’t want

to scare you,
but at least need to be aware.

And that’s things like evacuation
services on in this case.

We literally I mean,
I spoke to the treating team I walked

the family through the various medical

some dramatic issues that that they are
because they went to a trauma center,

they took a quick look and then
they put them out in the courtyard.

Health care is very different
in different countries.

So some of the things need to you
want to think about when you travel.


and that’s it for now,
so open up the questions

and stop screen share.

Thank you, Chris,
that was very interesting and as you

as you know, we’ve had a series
of conversations through this pandemic.

We had a couple of conversations with Dr.

Erica Saphire, at the La Jolla Institute of Immunology when we were kind of into it.

And so it’s now really great to get
your perspective where we are today.

And definitely as we talk to our clients,
there’s there’s an interest and there’s

a hope that we’re getting to close
to the end of this tunnel.

We still have some somewhere to go.

And you made that clear.

We want to make sure we’re thinking
through some of these travel dynamics.

So questions have come in.

Can I pose a couple of these to here?

OK, great.

Some we’ve got two that are kind
of geographically specific.

So regarding that India variant,

and there’s a 30 to 50 percent higher
mortality rate affecting the young.

Can you share some thoughts on

how is that changing the perspective
of children being impacted by covid?

So I think it’s the the children issue is

I think it sort of reinforces the idea
that we shouldn’t ignore children because

they’re young,
because they get coronaviruses normally as

kids and because they’re young
and healthy and the complications of.

So I think it’s changing the focus
that we need to address them.

We need to do this.

Type of studies are actually already
well underway, if proven very effective.

In fact, it’s more effective
for teenagers than it is for adults.

And the studies now are going on for I
believe it’s six months to 11 years old.

So I think what it’s reinforce the idea is

that we have something to help prevent
some of the very serious complications.

They are rare.

It’s nowhere near the same
impact it is for adults.

But it is a reminder that we should not
ignore this age group,

even though I have teenagers,
even though they may want to ignore it.

Medically speaking,
there are ways to be careful about it

and conversations to have
with them about the risks.

It makes sense, makes sense.
Very good.

So we also have a couple of guests
who are intending to travel to Africa

and so later this summer and the fall,

which has also some dynamics
going on in the country.

Can you share some of your thoughts

on on specifically what’s going
on in Africa and maybe thoughts

that travelers heading that direction
should be thinking about?


So we have a number of clients
who are traveling to Africa as well.

And I think it’s a matter of where you
going and how you’re getting there.

And I don’t mean that you have to go
incredibly high end travel,

but it’s more of a what kind
of exposure are you going to be in?

Are you going to be in small hotels?

Are you planning to go
into large public events?

Are you going to be in the bazaar
or you’re going out on safari?

And are you going to be well controlled?

Well, maintain well-established
travel organizations.

There are a number I would tell anybody

who’s going there are a number
of evacuation policies are very good.

And it’s not to say that it’s going to be
something awful,

but you want to have the idea that if
something happens,

somebody has has a reason to come
look for you or get you out of it.

Redpoint is one of the ones I use
a lot of TravelGuard like I said.

It means that you can be in safe
places where they do look into

how clean the air is or
how well they’re tested.

In terms of it,
if you’re going to get into public

markets, if you’re going to get
into places like the Congo and so on,

that a little riskier that that,
I would say would not be is a good idea.

And maybe the summer, obviously,

for a variety of reasons, not
to mention that there’s probably more

to the virus if they’re not testing as
thoroughly as they could or should.

But there’s obviously other other
issues like volcano and so on.


there’s risk in everywhere you go,
but you can walk through the various steps

you go and consider
the risks and the exposures.

So what kind of hotels?
What kind of staff?

And this is something there’s some very

good safari organizations that can walk
you through what they do, where and why

do they do they include things
like flying doctors and so on.

So there are ways to do it,
but there are risks.

And as I mentioned to you before we
started our session earlier is that one

of the articles, The New York Times was
speaking to epidemiologists and they

interviewed a number of epidemiologists,
the various questions of people we asked

here, what about going to this country,
about this country

and the range of what people do who are
infectious disease and epidemiologists?

It’s all this study was unbelievable from
some people said, well, of course we go.

And other people said, no way,
we’re not taking our kids on this.

So these are general advice
and it is a matter of comfort.

So that’s why I sort of look
at every step and who’s going.

I didn’t mention that.
But who in your team is at risk?

Is anybody immunocompromised?

Has everybody vaccinated?

I, quite frankly,
would not take on vaccine.

I wouldn’t go unvaccinated really.

I’m not sure I’d go anywhere
right now except maybe the Caribbean.

But even then,
you can really get into issues.

Not only can you get sick, you get
really sick and then you can’t get back.

So that’s my bottom line is
at the very least, get vaccinated.

And if you’re thinking of taking small

kids, then you need to be in a very
controlled bubble of your own.

So there’s not an exposure for them.

Again, thank you.

We have also a couple of guests

who who are connected to schools
thinking about school.

And so a question like my address
addressed a few in this group.

So this particular school they’re testing

every two weeks, is that good enough
to catch someone who has the virus?

Maybe you can walk through some

of that positive results window
a little bit more.

Well, so there’s two questions
there in that question.

There’s the individual, you as a family
and you as your child is one issue.

And then there’s the bigger
issue of the school.

And so speaking for you as an individual,

you start with do we have good
are my children wearing the kind of deal?

And that’s probably the most important
handwashing and so on,

because there are a number of studies
about even not very good mass in people

who were contagious
with covid before vaccines.

The mass, a really very
effective and schools.

We’ve been very surprised
in the last year.

I personally am one of those people.

I thought there would be a terrible

outbreak of children
from going back to school.

The other risk,
and that is that the exposure to be

adults, the teachers and so on,
and that that is still a problem.

But us sending your kids back to if
they’re they’re careful about the message,

they’re careful about
their social circles.

For example, a number of the outbreaks

in universities and prep schools and so
on didn’t come from going to class.

It came from the covid parties.

It came from taking your
mask off on the weekends.

It came from breaking out of your circle,
which is understandable.

These are kids.
Those is a really challenging time

for them in terms of getting back
to the school and screening.

I mean, they can’t they can’t.

Unfortunately, if the covid testing,
if the testing were really rapid

and really inexpensive,
they could literally do it every day.

You can go to school,
but it would cost to be exposed here.

Some of the schools are actually now

testing the sewage because you can check
a suit from one dorm and screen the entire

sewage to find any
evidence of covid vaccine.

And then you go through
and check out the individuals.

So there are ways of doing larger

screening and then fine tuning
to where it may come.

We know that there is a tremendous mental

health burden for kids who do
not socially interact.

Also for adults, but also for kids.

So while honestly, I have two college kids
and both of them said

we’re not going back, this remote
learning is a terrible waste.

They’re going back in the fall.

And I think now with the
combination of vaccines.

And so I think it’s appropriate

if you have children who are younger than,
say, 18 and aren’t eligible yet,

it looks like maybe October they may be
getting, but maybe as early as September.

I think there’s ways of safely doing it

and balancing the idea that they
need to get among their friends.

We are all having discussions about
the safety of our kids and what they do,

what they do with their friends
when they take their masks off.

What happens when teenagers drink?

I mean, it’s just, you know,

it’s things we’ve all dealt with and now
they have to think of things like covid.

So it’s a complicated discussion.

It is we’re entering a new chapter

and there’s a there’s an impetus
for kids to get back in school.

And what would that look like
and what does that mean?


send my contact out for the people who are

asking these individual questions,
if you want to chat about it in greater

detail, I’m happy to set up a call
because these are tough choices, so.

Thank you, thank you for that question,

yes, to remind us a couple of guests
who said questions,

we will also again post his contact
information at the end of the session.

So you’ll see that one more time.

So let me ask another question here.

So there are
some commentary about the impact

on the lungs for a patient so someone
could read a news article and a couple

of people did
of the X-ray image of a lung of a covered

patient and that the scars look
worse than a lifelong smoker.

Do you believe with mild to no symptoms,

covid patients have lung damages
like those who had severe symptoms.

Well, I think so, yes,
there are clearly rather pronounced

effects in relative,
relatively asymptomatic patients.

I know that I think that the severity

of the effects is somewhat comparable
to the severity of the symptoms.

So if you were somebody who was

on a ventilator, you were
in intensive care setting for weeks.

We know there was a lot of damage
to a lot of effects in your lungs.

But we also know that there was really

some rather surprising effects
or have very few symptoms.

And I would tell you from the E.R.,
when I was mentioning the saturation

that we used to have people,
they came in with a saturation in the 80s.

That was an indication in many ways either
get extra oxygen,

even consider a ventilator, be very,
very serious interventions.

Now, there are people who would come

in the door with 40 or 50 percent
readings we’ve honestly never seen.

It’s a very strange effect where things
like you have to turn a patient over,

put them on their stomach, and it’s
just such an unusual illness and so on.

So to answer your question, we know
that there are effects in the lungs.

I was just actually listening to a lecture

about things like nitrous oxide and
various other

naturopathic solutions and things that may
be considered for scarring and long term.

But the answer is yes,
there can be very pronounced scarring.

Could it be worse than smoking?

I haven’t seen that comparison made.

It would depend on the degree of smoking

and the and the how long
you’ve smoked and so on.

But they’re different.

So one is an inflammation and one
is a chemical inflammation.

So I haven’t seen it.

But I’m sure that there are unfortunately

similarities in how severe and how
much effect, how effective you may be.

OK, thank you.
Thank you.

OK, so we have

a couple of travelers who are hoping
to cruise and the next coming months or

year, how do you feel about cruises
and that particular travel?

Well, I’m not I’m not a big fan
of the cruise ship medical support.

I you know, I’ve had my.

I wouldn’t say run ins,
but I’ve certainly had patients that we’ve

dealt with and I’ve had patients who have
been sick and literally dropped off

in the port in Greece, said,
you’re too sick for us.

You’re in a hospital.
See you later.

I think it’s a large volume business.

And so in the short term,
while we’re figuring out are they ever

going to be able to say, well,
we want everybody vaccinated?

I don’t think so.
I think they’re probably one

of the industries that say
we’ll take your word for it.

I don’t want to be on that ship with.

I guarantee you people will get

the screening or no screening,
will have the illness and there will be

outbreaks, no guarantee
it’s going to happen.

What I would say is if if you’re a big fan
of it and there are some unbelievable

figures available, is that could you find
a way to find the smaller ships,

the 40 guests, 50 guests,
where they have better control

of the staff and better
control of the travelers?

If you’re if you’re a diehard traveler,

the other one is know give
it a couple of months.

If they start opening,
I believe it is the fall that they’re

planning on getting
shipped out back and see.

I wouldn’t I wouldn’t be in the first wave
travels for a couple of months,

and I hate to say it,
but we will see what the numbers.

We’ll see what cases.
We’ll see what happens.

There are too many areas in the world

that are raging
covid locations like South America,

like India and so on,
that with international travel being so

easy, it’s hard to imagine that there will
not be people who get through

the screening and be on that ship
and then like we did in the fall.

What happens if you’re on it?

How do you get off?

Because then the places where you’re going

to remember what they did with the ship,
they said, well, nobody can get off.

I can’t imagine a worse place to be than
to be stuck on a ship and then say, well,

you know, the port doesn’t want you or
the Bahamas doesn’t want you or whatever

beautiful place to visit
does not want sick patients.

That’s my caution.

OK, thank you.

So a couple more questions around

the India variant, because that’s one
that’s that’s front and center right now.

If if it does become more dominant

globally, will it be
safe to travel even with

the current vaccines?

What are your thoughts there?

Well, that’s a great question.

And that’s that’s probably the most recent

headlines is around those very,
very issues we already know.

Whereas, for example, in England,

the B 17 was that was the new kid
in the block because three,

maybe six months ago where it started
to show up in England and it was again,

oh, my gosh, it’s more transmissible,
it’s more sick and so on.

That was a big concern.
And now it looks like in the last week or

two, the Indian variant
is actually doing the same

thing the B 117 it’s now and 40
percent of the new cases in England.

The good news is so far is

that the initial studies and they just
came out in England

or Health or Ministry of Health came out
and said it looks like the vaccinations

are protective against
almost all the variants.

So the one thing we know that the variance

advantage is when I mentioned
the monoclonal antibodies that Regeneron.

So we know that those are not as effective
against the variants,

but it looks like the variants,
the vaccine so far are protective.

And I will also add to that that they’re
already Moderna I know is already working

on a booster shot
specific to the variants.

I think Pfizer may be doing the same or

they’re considering a surge
to boost your immunity.


a year ago I would never have imagined we

would have this many vaccine
options be disaffected.

So this really amazingly good news.

The bad news is we’re having trouble
getting it to all those who need it.


it’s a very good question.

I think it’s a lot of people’s
minds to see if that.

so a couple who wanted a little more

elaboration, if you could, Chris,
on the 50, 30, 20 rule you referenced

and you mentioned it to be very careful
exercising, is that the same?

Can you explain that?
I went a little unfamiliar with it so that

when you talk to yourself,
you know, you’re tired.

So what was that recommendation is is the
first week you go to 50 percent capacity.

So if you’re whatever kind of distance or
speed or so and you’re going to 50 percent

of that for a week
and the symptoms you’re looking for,

are you having chest pain
or you’re lightheaded?

Are you short of breath?

If you don’t,
you go up 30 percent the next week

and then you go to the final
20 percent, the third week.

So over the course of two weeks somewhere,

what you want to do is a progression
you don’t want to start out.

I’m sick whenever I get a cold,
I just run by marathon,

I run by six miles whatever, and I
work myself through it all semester.

And that’s actually there’s truth
to that for general viruses.

You raise your body temperature,
it helps eliminate the virus.

That’s not the case here because we’re
worried about whether you have

asymptomatic effects on your lungs or
your heart you may not know about.

And that’s where your symptoms
of shortness of breath may come in.

So sorry about rushing through that.

One of the things we’re elaborating

on that,
OK, so we have so many really appreciated

the insight on traveling on an airplane
and people have already been traveling or

they’re wanting to do
longer travel on airplanes.

And some of the data you shared
showed some interesting points about not

having people in the middle seats
and the benefit of all that.

The planes are full.
I mean, you’re saying planes are.


that’s what it is up to.

And clearly, the airlines aren’t aren’t
aren’t buying into that that benefit. But

if seats are full,
individuals are asking,

is it better to sit on a window seat or
an aisle? Is there a preference,

a recommendation you have there
if it is a pretty full flight?

So I hate to say this,
but if if you have the option,

you’d be surprised,
I would if you’re I don’t think it’s going

to make a difference
for a seat or an aisle.

I mean, I guess the aisle is maybe

more air, but then you’re also exposed
to the people walking up and down.

I haven’t seen anything documenting it.

What I would say is, if you’re going to do

something, if if I don’t know,
the airlines are crazy these days,

you can’t get a basic seat anymore without
paying 30 to 50 dollars for every flight

because you want to put your
legs two inches further.

If you add all that up,
if you’re if you’re going to go and you

have the means is think about first class
because they’re the spacing is better and

some of them have some very nice deals up
until the flight leaves,

that this is changing because obviously
the tickets are going up in every year.

But that’s that’s why I
have not seen anything.

See, just one seat to the other.

I would tell you that if you’re vaccinated
and you’re wearing a ninety five mask,

again, I’m happy to help people figure
out where, but I think you’re OK to go

if you’re not vaccinated.

I mean, I travel a couple of times about

it and but is facing was much
better than it is now so.

There’s a little bit of risk there,

again, if you go through an airport,
that’s where you wonder,

you see the people sitting
in the in the waiting room,

they’ve got the mask over the top of the
head and they’ve got their noses out.

Those are the areas where I think are
much higher risk than the actual plane.

And the big one is where do you meet?

Where do you take your
mask off is the big issue.

And some items take a mask off
first couple of times like this.

OK, OK, great.

So if you want to create a list,
a short list based on what we know today,

crest of the the no go travel place,
these are places that you would just say,

gosh, I really would not go
there at this moment in time.

Maybe you’d put India on that list,
maybe right now.

What other places would you put on that
very high concern locations?

I still think England
is a bit of an unknown.

I think Europe is a bit of unknown.

They have a couple of countries
that are really struggling.

And and

I kind of keep coming back to this.

But the issue is how how well can you
control your your entry and exit

from where you’re going
and where you’re going to be?

So if you’re on a private yacht off
the coast, you’re in good shape.

If you’re in a public hotel and you have
to go through the public hospitals,

if you get sick, if you’re
in London, then I’m not as comfortable.

I know they’re headed in a better

direction, but there are some
really serious outbreaks.

I would put India on there.

I would put I’m looking for.

But the Seychelles is not a large number,
but percentage wise, it’s having.

Terrible outbreak.

Four of the countries have have either

needed to or been rewarded with
indignation from different countries.

And I know the Seychelles, for example,
I think they got their vaccination.

I won’t say which country
because I can’t remember.

I thought it was
China Chinese version of the U.S.

and for some reason, they have not
it wasn’t very effective.

And they have a very high number

of recurrent cases in spite
of very high vaccination rate.

South America, Brazil,
I would not go to there.

There are places
in the Manaus is the country or

the county where
so many people have the illness originally

that they thought they were actually
through the through the pandemic.

There were not very many vaccinations,
but because the variants had come through

in a second wave, many of the people got
sick and they’re completely overwhelmed.

There are parts of South America,

they’re probably fine,
but I would stay away from Brazil.

And I think, again,

there are certain sites you can go into
and look at where the numbers are going.

Japan has a very,
very low vaccination rate.

Japan high on that list.

You know, New Zealand, if you can
get in, is probably very good.

Australia is better and even some of the

Southeast Asia and so on.

What happens if you get sick?

What happens if you turn positive?
Where are you?

And that’s already an issue,
medically speaking, anyway.

If you get sick or if you’re in these

countries, it’s an issue I
have for many of our clients.

If you turn into a patient,
you’re just another patient.

And and there are different priorities.
I don’t care where you fluent.

You don’t care you are because the care

they have to take care
of in front of them.


Mexico, by the way,

I’m going to throw Mexico out only
for a couple of different reasons.

Like I said, I do work a lot with
former Secret Service FBI teams.

Mexico is always a quandary.

And one of the reasons is you have
to consider security risk where you go.

Mexico is probably the highest
in terms of your personal risk.

And the security security teams that I

work with do not or will not go to Mexico,
mostly because they cannot one that can’t

carry a weapon usually and they
don’t trust the local police.

And I know a lot of people that go,
I have relatives that go.

It is not that reliable
and there are a lot of very random

ATM hold ups where they come point,

they take things, they take
three thousand out of your ATM.

There are ways you should figure out
who is who is screening the driver to your

resorts and even being
at high end resorts.

Mexico is a bit of a wild card
for me as well.

Thank you.
OK, that’s helpful insight for our guests.

Well, Chris, thank you
for for giving us the time on Q&A.

There was a fair amount
of questions, comments.

It’s great to go through
those to our guests.

I know we’re a little bit over on time,
but we hope that that additional

space to go through your
additional questions was helpful.

If there are additional questions
that we did not get to.

Please feel free to reach
out to your team.

We will do our best to answer them.

And then, as Chris mentioned,
he’s very willing to answer them.

And so you’ll see in just a minute or
two here the contact information for Dr.


And and again, he was kindly willing
to to respond to many of those questions.

Thank you to all of you for joining us.

We hope this was productive
use of your time.

We know there are some
interest of traveling.

We want to make sure where does it safely

and and as informed as possible
on behalf of our team.

We appreciate it.

And we’ll hope to see you
in our next conversation.

Thanks so much, everybody.
Thank you.

Wonderful job.
Thank you.


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