Friday, April 9, 2021

Stay Safe & Healthy in United States

North AmericaUnited StatesStay Safe & Healthy in United States

Stay Safe in United States

Crime

Big headline-grabbing crimes and slightly unfavourable statistics give the United States a reputation for crime. However, there are few visitors who have problems; common sense precautions and vigilance are enough to avoid problems. Crime in the inner cities is mostly related to gangs and drugs, as well as violent altercations. Avoid these situations and you will be fine. Urban tourist areas are heavily policed and are safe from all but minor crimes.

Rural crime in America is rare and very local, occurring mainly in very poor and troubled communities that are very easy to avoid.

In urban areas there are usually homeless people who may aggressively demand money. If you feel harassed, say “no” firmly and leave.

Illegal immigration and drug trafficking, as well as harsh treatment by the authorities, make the Mexican border unsavoury. The official border crossings are safe to use.

Police

American police are generally polite, professional and honest. When in uniform, they are also more formal, cautious and cold than, for example, Latin American police, especially in large cities. If you are stopped by traffic police, you should remain calm, be polite and cooperative, avoid sudden movements and indicate what you are doing if you need to take out your handbag or wallet to show your ID. It is especially important to appear calm and cooperative if you are not white, as People of Color in the U.S. are much more likely to be victims of police harassment and violence than white people. Turn on the vehicle’s interior lights and keep your hands on the steering wheel to make it clear that you are not a threat; do not get out of the vehicle until you are asked to do so. Generally, the driver of the vehicle should speak to the officer when they approach.

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Do not offer a police officer a bribe in any form. American police culture categorically rejects bribes, and the mere suggestion would most likely lead to your immediate arrest. If you have to pay a fine, do not try to pay the officer; he may refer you to the appropriate police station, court or authority. Most minor traffic offences can be paid by post. Increasingly, fines can be paid online or by phone within minutes of receiving the ticket, though often for a fee of a few dollars. Instructions are often printed on the ticket.

There are three types of police officers you are most likely to encounter: State police/patrols on state highways, deputy sheriffs employed by county governments in rural areas, and police officers employed by city or municipal governments in urban areas. There are also smaller police departments, such as transit or airport police, who patrol public transportation, and university or “campus” police, who patrol universities. Federal police officers are usually only found at or near federal facilities, such as ports of entry, national parks and government offices. If you encounter them elsewhere, it is usually because they are investigating specific allegations of federal crimes.

Emergency services

If you dial 9-1-1 from any phone, you can reach the emergency services (police, fire, ambulance, etc.). Any US phone, “active” or not, should be able to dial 911 when connected to the network, and these calls are always free. Unless you are calling from a mobile phone or internet phone, the operator should be able to locate you through the phone you are using, even if you say nothing. Modern mobile phones send a GPS location of your position to within a few metres within seconds of dialling 911. If you dial 911 and leave a line open, all three emergency services will arrive within five minutes in most populated areas. Response times may be longer in sparsely populated areas or along motorways.

On any GSM mobile phone (the standard technology in most countries of the world, including Europe) you can also dial 112, which is the standard emergency number on GSM networks worldwide. US GSM operators (AT&T, T-Mobile and smaller regional operators) automatically forward 112 calls to 911.

As in most countries, misuse of the emergency number will result in at least a call back from the authorities, and at most an arrest. If you call 9-1-1 by mistake (e.g. if an error in dialling the international prefix 011- results in a “9-1-1, what is your emergency?” response), stay on the line long enough to explain to the dispatcher that you dialled the wrong number. Even then, an agent may show up.

Border Patrol

The United States Border Patrol works near the Canadian and Mexican borders, as well as in southern coastal areas like the Florida Keys. They can check immigration status and enforce immigration laws in “border areas” – generally within 40 miles of Canada and 75 miles of Mexico (although the law allows 100 miles from any border, including the ocean and Great Lakes). Near Canada, they tend to be more low-key and generally focus their efforts on buses and long-distance trains. In the south, systematic vehicle checks or stopping on the road with a friendly “Papers, please…” are much more likely. They usually do not specifically target tourists.

Foreigners must always carry their passport, visa and residence card (or green card). If you are found near the border without these documents, you may be detained until your status is checked or even fined. If your documents are in order, you will usually not be questioned. In most states (Arizona is a notable exception), police and other local authorities are not allowed to question you about your immigration status or ask for your passport or visa unless you are arrested and charged with a crime, and then only for the purpose of liaising with your embassy. After September 11, 2001, some statistics have shown that Muslims or people believed to be Muslims are disproportionately screened at airports, despite claims that passengers are selected at random. A minority of law enforcement officers may express racist or ethnocentric sentiments.

Natural disasters

The United States is a vast country with great geographical diversity, and parts of it are occasionally affected by natural disasters: Hurricanes and tropical storms from June to November in the South (including Florida), blizzards (a special and common type are “Nor’easters”) in New England and areas near the Great Lakes and the Rocky Mountains, tornadoes especially in the Great Plains and the Midwest, earthquakes in California and Alaska, flooding in parts of the Midwest, and wildfires in late summer and early autumn in Texas and on the West Coast, especially in California. More details can be found in the respective regions.

Because tornadoes are so common between the Rockies and the Appalachians, this area has been named “Tornado Alley”. The San Andreas Fault is a tectonic plate boundary that runs through California, a region prone to earthquakes. Hawaii has several active volcanoes, but they generally do not pose a threat to life and limb. The last major eruption on the American mainland was Mount St. Helens in 1980.

In the event of a natural disaster, local, state or federal authorities can issue a warning via the Emergency Alert System. This system is characterised by a very distinctive electronic scream followed by a dial tone-like tone before each message. It cancels AM/FM radio broadcasts as well as television systems. Smartphones sold since about 2011 often receive an alert based on the phone’s current location (depending on the phone’s settings, this may include a loud warning tone). Coast Guard weather is broadcast on marine VHF radio for mariners; a separate system (seven frequencies around 161 MHz) provides conditions on land. Special “weather radios” are able to monitor the frequency even in standby mode and provide warnings when deadly storms (such as tornadoes or hurricanes) are brewing. In most tornado-prone areas, a siren system sounds when a tornado warning is issued. When you hear the siren, seek shelter immediately.

Gays and lesbians

In general, the United States is a safe destination for gays and lesbians, although homosexuality is not as accepted overall as it is in Australia, New Zealand, Canada or Western Europe. Most Americans have a live-and-let-live attitude to sexuality, but there are important exceptions. It is generally not a problem to be open about your sexual orientation, although you may receive unwanted attention or comments in some situations. Attitudes to homosexuality vary widely, even in areas known for their tolerance or intolerance. Acceptance is most widespread in the country’s major cities, as well as in small towns, suburbs and college towns, particularly on the Pacific Coast, in the Northeast and in Hawaii, with acceptance in these areas generally comparable to that in Western Europe. Homophobia and anti-gay violence can be encountered anywhere, including in some suburban and rural areas in the southeast and interior west, but the likelihood of it happening to you is low.

Gay-friendly destinations where openly gay couples are common include New York’s Chelsea neighbourhood, Rochester in Western New York, Boystown in Chicago, Capitol Hill in Seattle, Castro Street in San Francisco, Dupont Circle in Washington, D.C., South Beach in Miami Beach, Midtown in Atlanta and West Hollywood in Los Angeles. Outside of gay neighbourhoods, many major cities are also gay-friendly, especially in the Northeast and on the West Coast. A growing number of beach towns are known to be gay-friendly, including Fire Island, Key West, Asheville, Provincetown, Ogunquit, Rehoboth Beach, Saugatuck and parts of Asbury Park. Other smaller towns have neighbourhoods where gay people congregate and many have resource centres for LGBT people.

Legally, same-sex relationships are treated the same as heterosexual relationships. If you are married to a same-sex person, you may still encounter some difficulties in more conservative parts of the country, but recent Supreme Court rulings have made it clear that no state or federal agency may treat your marriage differently from others. Some states still allow businesses to refuse service to gays and lesbians; sexual orientation is not yet a nationally protected category the way race and gender are. Some businesses specifically advertise that they are LGBT-friendly by displaying symbols (usually a rainbow flag) on their facades. In some larger cities, there are alternative monthly or weekly publications that provide information and listings of places or events specifically for the LGBT communities.

Men who plan to be sexually active should be aware of the increased risk of HIV and other infections in the United States. A gay man in the United States has a 44 times higher risk of getting HIV than a heterosexual man, and a 46 times higher risk of getting syphilis. This risk increases dramatically for men who are prone to one-night stands and other risky behaviours. In a nation where 0.5% of the population is infected with HIV, unprotected sex is a very real risk. Precautions, including safe sex, are strongly recommended during your stay. Most cities have affordable or free centres for STI testing and treatment, although opening hours can be limited and waiting times long. Family planning clinics are often an affordable alternative. The lifelong consequences of HIV or other STIs are not covered by many insurance policies. It can be very expensive to seek treatment elsewhere, as the US medical system is private and operates largely on a for-profit basis.

Drugs

In general, drug laws in the USA can be quite strict: even possession or transport of small amounts can lead to imprisonment or deportation and should be avoided by travellers. However, laws and attitudes regarding the most commonly available drug, marijuana, vary greatly from state to state. States such as Louisiana and Florida impose heavy fines and long prison sentences, while other states have largely decriminalised marijuana use. Eighteen states currently allow the medical use of marijuana, with individuals able to obtain medical marijuana with a doctor’s prescription and a ‘medical marijuana card’. In some states, especially West Coast cities, medical marijuana dispensaries are so commonplace that they seem almost ordinary. Colorado, Washington, Oregon and Alaska allow limited recreational use of marijuana, as does the District of Columbia, although the status of legalisation in that state is currently uncertain due to the District’s unique federal status. Under no circumstances should you transport marijuana or other drugs that are illegal under federal law across state lines, onto (some) Indian reservations, onto federal land (such as federal agency buildings, military bases, post offices, etc.), or internationally, as this is considered drug trafficking and can be punishable by a lengthy prison sentence. Even if you transport it on a direct flight or by mail between places where marijuana is legal or tolerated, such as between the US and the Netherlands or between Washington State and Colorado, it is still illegal under US federal law. In some countries, trace amounts of marijuana residue, poppy seeds or legal drugs containing certain substances such as codeine purchased in the US are punishable under US drug laws. Even drugs such as marijuana that were consumed in the United States before leaving the country may be punishable if detected in your system upon arrival in another country, even if no drugs or drug paraphernalia were found on you or in your luggage.

Prostitution

Prostitution is illegal except in licensed brothels in rural Nevada. Tolerance varies widely from state to state. Police officers can pose as prostitutes to catch and arrest anyone offering sex for pay.

Pistols

It is true: the United States has a strong gun culture, and many Americans (though by no means all) own firearms. Gun ownership is regulated by each state, and although these regulations (obtaining the necessary permits, types of weapons allowed) vary considerably from state to state and sometimes from city to city within a state, the United States is generally considered to have a lenient attitude towards gun ownership, especially compared to Europe and Asia.

Although US citizens have a constitutionally guaranteed right to own and carry firearms, non-immigrant aliens who have been in America for less than 180 days cannot legally possess a firearm or ammunition unless they entered the country specifically to hunt or shoot, or possess a valid hunting licence issued by the state in which they are shooting. Participation in a recognised shooting competition also counts. Any other activity is strictly prohibited.

WARNING: Persons who have renounced U.S. citizenship may not possess firearms or ammunition, even for sporting purposes.

Your chances of being shot are very slim, but remember that :

  • In urban areas, a civilian carrying an openly visible firearm is generally rare and therefore potentially more of a concern than in rural areas. However, since “open carry” is allowed in many states, you may encounter someone with a holstered firearm. Many states also have “concealed carry” laws that allow the possession of a firearm concealed in clothing or in a vehicle. Remember that people with a permit to carry a firearm, whether open or concealed, are usually not criminals and will not harm you.
  • Hunting is popular in rural America. Using marked trails should be safe, but if you go off the beaten track, try to find out if and where hunting is taking place. If so, wear bright colours (especially bright orange) to be easily visible to hunters. You can also put brightly coloured waistcoats on the dogs you take with you. If you want to hunt, get the necessary permits and check the local regulations.
  • Target shooting is a popular sport. Many shooting ranges welcome tourists and offer a variety of firearms to rent and shoot on the range. Many have a “two-person minimum” rule and consider it dangerous to rent firearms to individuals.
  • The legal carrying of firearms for protection by people hiking, exploring or camping in the wilderness is on the rise due to a small number of high-profile incidents on well-known trails. This is a controversial issue in the hiking/camping community, with strong arguments on both sides. In general, legal gun ownership does not increase the danger to bystanders. People who carry guns may have military or police training and be quite willing to help others in an emergency.

Racism

Compared to many European and Asian countries, the United States is, at least publicly, a racially tolerant country. The US Constitution, in conjunction with state and federal legislation and case law, prohibits racial discrimination in a wide range of public areas, such as employment, admission to universities and the provision of services by retail businesses. However, the Constitution also guarantees freedom of speech, so it is still possible to hear racist remarks even in very public forums.

Yet most Americans are tolerant of other races, or at least pretend to be, and it is rare to be openly attacked by random people simply because of your race. The country occasionally goes through periods of heightened hostility towards racial minorities or immigrants (including currently, in 2016), but the general trend is one of tolerance and acceptance.

Stay Healthy in United States

Disease

As a highly industrialised nation, the United States is largely free of most of the serious communicable diseases found in many developing countries; however, HIV rates are higher than in Canada and Western Europe, with an infection rate of about 0.5% in the total population.

Rabies and Lyme disease are two infectious diseases that are important to know about. Human cases of rabies are quite rare in the United States, although the disease is more common in the eastern parts of the country. Rabies can be transmitted through animal bites; if you are bitten by a mammal, seek medical attention as soon as possible – if you wait until you have symptoms of rabies, you will almost certainly die (in the entire history of medicine, there are only a handful of documented cases of rabies patients who survived after symptoms appeared, but if you get vaccinated before symptoms appear, you have a very good chance of surviving unharmed). Bats and other small wild animals are particularly susceptible to transmission of the rabies virus. If you are bitten, especially if you cannot identify the animal and even if it is a “simple scratch”, see a doctor as soon as possible.

Lyme disease is transmitted by the deer tick, which is common in the forests and open fields of many rural areas. There have been cases of Lyme disease in every state, but the vast majority have been reported in the Northeast, Mid-Atlantic states and Great Lakes states like Wisconsin, Minnesota and Illinois. If you are going outdoors, it is a good idea to apply an effective deer tick repellent to exposed skin areas. If you develop flu-like symptoms after hiking in forested areas, be sure to get tested for Lyme disease, as it is often confused with other illnesses and early treatment is usually very effective.

Other diseases endemic to the USA but of far less concern are Hantaviral Pulmonary Syndrome (in the western regions), Rocky Mountain Spotted Fever (mainly in the Rocky Mountain region), West Nile Virus (in all regions) and Eastern and Western Equine Encephalitis (mainly in the Midwest region).

These diseases are exceptionally rare and the medical system in the US is quite capable of treating them when necessary.

For the latest travel health information for the United States, including tips and recommendations, visit the Centers for Disease Control and Prevention‘s website for the United States.

Due to the high volume of travel to and from the US and the fact that diaspora communities from almost every country in the world are present in the US, the US is somewhat more likely than other places to experience “imported” cases of pandemics, as in the case of the 2014 Ebola outbreak, where there were some cases in the US.

Health care

American health care is generally top-notch, but can be very expensive. Most Americans have private health insurance. The largest government health programme, Medicare, is mainly for the elderly. Medicaid is a broadly similar programme for the poor. Travellers should ensure that their travel insurance is valid for the United States. Because of the high cost, some “global” insurance policies do not specifically cover the United States. Long-term visitors to the US (e.g. on a work or student visa) are usually required to purchase private health insurance as part of their visa requirement. Many Americans receive health insurance through their employer as part of their benefits package. If you are considering working in the US, check with your employer to see if such an arrangement is possible for you.

For the patient, public (20%), private for-profit (20%) and private not-for-profit (60%) hospitals in the US are generally indistinguishable. Public hospitals in inner cities may be more crowded and less well maintained, but overall the costs and level of service are the same in all types of hospitals. No hospital can turn away a life-threatening emergency. Private hospitals can only stabilise these patients before sending them to a nearby public hospital, which usually acts as a regional centre for 24-hour emergency treatment.

In a life-threatening emergency, call 911 to have an ambulance take you to the nearest hospital emergency room, or in less urgent situations, go to the hospital yourself and register at the emergency room desk. Charges for ambulances usually range from a few hundred to a few thousand dollars, and although they will never refuse to transport you in an emergency, you will be billed for the cost of the ambulance later. Emergency rooms treat patients regardless of their ability to pay, although their services are not free. Expect to pay at least $500 for a visit, plus the cost of certain services or medications administered to you. Avoid going to the emergency room for non-urgent care without an appointment; they are 3-4 times more expensive than other options and your non-urgent condition means you will have to wait for hours or even days. Most urban areas also have small urgent care centres (also called urgent care) for conditions that do not require a visit to the emergency department (e.g. superficial cuts). Their opening hours can be limited; only a few are open at night.

Walk-in clinics can provide routine medical care; to find one, look in the Yellow Pages under “Clinics”, or call a larger hospital and ask. Patients see a doctor or nurse practitioner without an appointment (but often with some waiting time). They are usually very open about fees and always accept credit cards. Make sure the staff member knows you will be paying “out of pocket”; if they assume insurance will pay, they may inflate the bill with unnecessary extras.

There are dentists all over the country. They usually explain the fees over the phone, and most accept credit cards. Health insurance does not usually cover dental care; you need to take out separate dental insurance for this.

Government-supported clinics offering free or low-cost testing and treatment for sexually transmitted diseases are widely available. Local health offices provide further details. Many county clinics also offer primary health care services; however, these services are for low-income residents, not foreign travellers. Planned Parenthood (1-800-230-7526) is a private organisation with clinics and centres throughout the country that provides birth control and other reproductive health services for women and men.

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