Since COVID-19 spread around the world, infection rates and the numbers of hospitalizations and deaths rise and fall on unexpected rhythms. America appears to be near the end of a brutal “fourth wave” of the disease. Despite vaccinations, worry persists that as people move inside for the holidays and winter, infections could soar again. Also, millions of Americans still have not been vaccinated.

One way the United States is similar to the rest of the world is that the locations that will be hard hit by the pandemic are difficult to forecast. At this writing, Europe is in the midst of a deadly wave. Germany and the United Kingdom have been particularly hard hit. Germany just reached a new all-time high in infections. Parts of the country probably will be shut down. U.K. Prime Minister Boris Johnson has warned he may soon shutter parts of that nation as the National Health Service battles to curb a new spread.

In the United States, it appears that the recent rise in infections may not be over. The Northeast largely dodged the most recent national surge. Yet, NBC News recently reported that Vermont and New Hampshire “have had two of the largest increases in the U.S., respectively rising by 60 percent and 56 percent, the data showed.” Unvaccinated people have been the primary trigger.

From time to time, the Centers for Disease Control and Prevention (CDC) issues warnings about individual countries its research finds are dangerous to visit because of the spread of the virus in each. These recommendations do not have any predictable pace. When the agency finds sharp increases in infections, the country can be added to the list.

The CDC has four levels of COVID-19 risk, officially called Travel Health Notice levels. They are meant to “better differentiate countries with severe outbreak situations from countries [where the disease is] sustained, but controlled.” The levels run from 1, which is very low, to 4, which is a very high level of risk.

The CDC added four countries to its list on November 15. Each of these has a risk level of 4, and the advice is that if people have to visit them at all, they need to be fully vaccinated.

The newly added countries are Guernsey, Hungary, Iceland and the Czech Republic

Click here to see which states have the most cases of COVID-19.

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