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Overseas Security Advisory Council
Bureau of Diplomatic Security
U.S. Department of State

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State Department Discontinues Global Level 4 Health Advisory


On March 19, the U.S. Department of State issued a Global Level 4 Health Advisory because of the COVID-19 pandemic. The Advisory urged U.S. citizens to avoid all international travel and, in countries where commercial departure options remained available, recommended an immediate return to the United States or preparation to remain abroad for an indefinite period. On August 6, the Department rescinded the Global Level 4 Health Advisory, reverting to individual Travel Advisory levels based on local travel conditions, and adding portions to each based on the COVID situation at the local level.

The Global Health Advisory

On March 11, the Director-General of the World Health Organization declared a pandemic of COVID-19, a disease caused by the novel coronavirus first found in Wuhan, China, in December 2019. The declaration came as worldwide case number topped 100,000 in over 100 countries. The number topped 14,000 in the United States alone on March 19, and it became clear that international travel was becoming increasingly untenable, with border closures and airline cancellations mounting. The U.S. Centers for Disease Control & Prevention (CDC) issued a Level 3 Travel Health Notice, indicating widespread ongoing transmission of the virus, and the Department of State followed suit, issuing a Global Level 4 Health Advisory.

This is the first time the Department has issued a Travel Advisory to supersede individual country levels. The Travel Advisory system has been in place since January 2019, when the Department first assigned specific levels of risk to each location around the world—usually based on a country, but occasionally on a portion of thereof. Among other risk factors contributing to that risk level is health risk. All travel advisories at or above a level 2 must have a reason for being so; the Department calls this reason an “indicator.” For the first year of the system’s operation, that health risk factor (known as the “H Indicator”) brought traveler attention to locations where there were heightened risk of diseases, poor medical infrastructure, and other health concerns. The H Indicator was the less common of the indicators the Department used to determine risk level—far less common, for instance, than the C (Crime) or T (Terrorism) Indicators.

At first, when the novel coronavirus was only found in China, the Department used the Advisory system as it had originally been developed, adding an H Indicator and language about the virus only to the China Travel Advisory for the first time on January 27. That initial report raised the Travel Advisory level for China from 2 to 3, and to 4 for Hubei Province, home to Wuhan. Within three days, however, the Department raised China’s level nationwide to 4, indicating travelers should not go to China and should leave the country if possible, due to health-security issues. Over the next six weeks, the Department issued similar Level 4 guidance based on the “H Indicator” for Iran on February 26, and Mongolia on March 18. Iran’s health-security issue was the spread of the disease, while Mongolia’s was based a lack of departure options for U.S. travelers in-country. By March 19, it became clear the Mongolia was not the outlier for transportation issues, and the Department issued the Global Health Advisory, superseding every other Travel Advisory Level.

Back to Normal?

Between March 19 and August 6, the Global Level 4 Health Advisory superseded all other State Department Travel Advisories, effectively adding an “H Indicator” to every country’s advisory and bumping each to a Level 4. Once the CDC removed its blanket Level 3 Travel Health Notice, the Department viewed it as a prudent time to remove its blanked Level 4 Advisory and revert to individual, locally based Advisories once again. Travelers will see the Global Health Advisory no longer appears on the Department’s travel website, though there is still a tab for COVID-related travel issues, both on that site and on each U.S. Embassy website around the world. But they will also see additional COVID-related language inserted in each Advisory, reflecting conditions in country. The advisories will contain one of the following four sentences to reflect those conditions:

  • Travelers to [Country] may experience border closures, airport closures, travel prohibitions, stay at home orders, business closures, and other emergency conditions within [country] due to COVID-19.
  • [Country] has lifted stay at home orders, and resumed some transportation options, and businesses operations.
  • [Country] has resumed most transportation options, (including airport operations and re-opening of borders) and business operations (including day cares and schools). Other improved conditions have been reported within [country].
  • [Country] is no longer impacted by restrictions due to COVID-19.

Private-sector security managers should continue to consider the totality of the situation in any location—including organizational risk tolerance, footprint, and capabilities—rather than relying solely on any one assessment such as a Travel Advisory or Diplomacy Strong level. Security managers can also note that all of the State Department ratings reflected in the 2020 OSAC Crime & Safety Reports for Crime, Terrorism, and Political Violence remain unchanged as of the date of this report’s publication.

Further Information

For further information on the Travel Advisory system or for an update on the security situation anywhere in the world, contact OSAC’s Research & Analysis Unit and consider the following resources:


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