Americans Abroad Ask Whether to Stay, and Risk Infection, or Fly Home, and Risk Infection

WASHINGTON — The travel plan was as exhausting as it was risky for the 77-year-old cancer survivor wondering how to leave self-isolation in Ecuador and return home to New Hampshire without catching the coronavirus.

“It’s not for the faint of heart and promises to be very grueling, but we wanted to gauge interest,” the American Embassy in Quito, Ecuador, wrote in a notice last month to Americans looking to get back to the United States as the deadly pandemic spread.

It was a nonstarter for Bob Rand, who remains in Ecuador with an immune system already compromised from previous rounds of chemotherapy to treat Stage 4 cancer. He makes annual trips there to visit a son working in Quito.

But it turned out to be the last U.S. government flight out of Ecuador, leaving few, if any, options available for American citizens trying to avoid becoming sick.

The March 29 itinerary called for Mr. Rand and other travelers to take a C-130 military cargo plane to Panama, where they would remain onboard for a 12-hour layover. They would have no food or water, except what they carried in the single 50-pound bag each passenger was allowed to bring.

From Panama, they would fly to a naval base in Norfolk, Va., and passengers would have to find their own transportation the rest of the way home.

For Mr. Rand, that meant booking a commercial flight or renting a car for the trip back to North Hampton, N.H. — almost certainly coming into contact with people who had not spent weeks in isolation, as he had.

“But at the end of the day, you’ll be back in the United States and will have a great story to tell,” the embassy said in its notice.

Mr. Rand does not regret passing up the cargo flight. “That would have been tough on me,” he said this week in a telephone interview.

But a month later, and with coronavirus cases doubling by the week in Ecuador, Mr. Rand now wonders whether he would be better off taking one of a dwindling number of weekly commercial flights to the United States — even if it means interacting with strangers who ultimately could infect him.

“I think I’d rather be home surrounded by doctors than be sick down here,” he said.

Those who had assumed they could stay overseas, and wait for the pandemic to ebb, now face an unnerving choice: Either stick it out, and prepare for the possibility they will be infected with the virus and treated in foreign hospitals, or chance catching it on the way back to the United States.

The State Department is winding down government-organized flights that have so far brought home 65,000 Americans from across the world. Some continue in limited numbers, in areas like the Indian subcontinent and Africa, but “these flights will not go on forever,” Ian Brownlee, a deputy assistant secretary of state, told reporters on Wednesday.

The department is also helping commercial airlines cut through foreign regulations that have restricted flights during the pandemic. At least four flights carrying Americans to the United States left Peru over the last week, officials said, after diplomats lobbied the government in Lima to ease its closed borders.

But there still are at least 17,000 American citizens or legal residents abroad who have indicated they need help and, at this point, the State Department is urging them to take any available flights out.

Dr. William Walters, the State Department’s deputy chief medical officer, said the risk of catching the virus was nearly as high on the government-sponsored flights as it was on commercial airlines. What will make a difference in Americans’ health, he said, is where they will be able to get medical treatment.

“You can come back to the United States where you are a citizen and you have access to health care and you have access to an infrastructure that is still intact,” Dr. Walters said.

But by hunkering down, in developing countries in particular, where the virus has yet to peak, “you will be an American citizen in a foreign country that didn’t have great infrastructure to begin with,” he said. “And now you have less rights and less access to less infrastructure.”

Mr. Brownlee warned that commercial flights to the United States also might end in the coming days — making it all the more urgent for Americans to grab any opportunities “while they exist.”

More than half of the Americans the State Department has helped so far were departing from countries in Central and South America; an additional 4,000 are still seeking assistance, Mr. Brownlee said.

Hundreds of thousands of Americans live in Brazil, Mr. Brownlee said, but there are now fewer than a dozen flights to the United States each week. The number of commercial flights from Honduras, Guatemala and Ecuador have also decreased in recent days.

The death toll in Ecuador during the outbreak was 15 times higher than the official number of coronavirus deaths reported by the government, according to an analysis by The New York Times. The numbers suggest that the South American country is suffering one of the worst outbreaks in the world.

The State Department so far has helped more than 3,500 Americans leave Ecuador, including more than 110 this week. But Mr. Rand so far has been unable to book a seat.

As he considers where he might receive medical treatment should he need it, Mr. Rand has grown increasingly anxious. Most well-equipped private hospitals in Quito are not treating coronavirus patients, he said, and the public hospitals are already overextended.

He is now hoping to fly out on a United Airlines flight next week that will route him from Quito through Houston for an overnight layover, and then to Chicago, before he arrives in Boston — ironically, as many transfers as the trip on the U.S. military cargo plane.

But at least he will be back in the United States. “Things could get tricky here,” said Mr. Rand, who has been in self-isolation in Ecuador with his son and a small group of friends since March 16. “I’m beginning to think, ‘Uh-oh.’”

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