Over the course of the past three weeks — during the time that coronavirus transformed from a scary but faraway problem to a direct threat to grandma’s eldercare facility — my husband and I entered four countries: Ethiopia, Italy, Germany, and the United States. Our experiences transiting through immigration and the various levels of screening were radically different, and more than a little troubling.

I will note before starting this blog that we spent our time exclusively in Italy’s deep south, on the island of Sicily where there are only few cases of coronavirus that we know of. Life in Sicily continues as usual and is not impacted by Italy’s recent draconian restrictions on parts of the north. My husband and I both feel fine and have no reason to think we were in contact with anyone carrying COVID-19

Italy: We entered Italy twice through Palermo — once arriving from the U.S. in mid-February and then 10 days later returning from a jaunt to Ethiopia. On both occasions, health screeners wearing white, head-to-toe medical garb met us at the jetway holding temperature guns. We didn’t need to break stride as we moved through the queue with a quick scan to ensure we did not have a spiked temperature. Both times we were cleared without discussion. We did not see anyone pulled from the queue.

Did this make us feel safer? Remotely. Italians always give the impression that they’re doing their job while pondering a cigarette break or reliving the last soccer match in their minds. But they had the right equipment and the medical suits conveyed a sense of professionalism as they checked us. That’s something.

Ethiopia: Our five-day trip to Ethiopia in late February was initially conceptualized as a fun and crazy runout leveraging the direct flight from Rome — one of the only vestiges of Italy’s five years of poorly administered colonial rule. But by the time the trip happened, “escaping” to Ethiopia was a helpful way to get some distance from Italy’s insidious coronavirus spread.

The Ethiopians at Addis Ababa’s airport responded accordingly. Upon entry, a health worker (not as well dressed as in Italy) took our temperatures and asked our point of departure. When we replied “Italy” his eyes grew wide and he practically recoiled. We were directed to a colleague wearing a white coat, standing behind a long desk stacked with forms. He asked us a few direct questions like “Where in Italy were you?” and “How long have you been there?” He rifled through a stack forms and asked us to fill out two pages of paperwork about our basic life information, our stay in Italy, and our contacts in Ethiopia. After a quick inspection of our work, he nodded and handed us each one small card saying we’d been “checked” that allowed us to proceed through passport control and another that explained simple ways to slow the spread of coronavirus: washing hands, avoiding face touches, etc.

Safety check: Nice job Ethiopia. I don’t know if all that paper went anywhere or if those “checked” cards were very official but at least we felt like someone was watching.

Germany: Our long trip home this past weekend started with a flight from Palermo to Munich. Like in Italy, we were met at the Munich airport by health workers from the Deutches Rotes Kreuz who took our temperatures. Lufthansa had us fill out paperwork similar to what the Ethiopians had distributed accompanied by a one-pager in multiple languages about COVID-19, its impact, and how to mitigate transmission.

How did the Germans do? Despite the Teutonic talent for presenting with extreme efficiency, they did about the same as our Ethiopian friends. Again, I found myself hoping that all that paper was going somewhere useful. Where I had my doubts, I appreciated the efforts.

United States: This was the real test and what we thought would be the gold standard. I’ll admit that I was jumpy and my stomach churned a bit. I really did not want to end a three-week stranger-than-strange sojourn with a quarantine or border block. I steeled myself. Upon arrival, there were no health workers with temperature guns — no matter because I felt fine — but we were met by a diminutive but authority-imbued male TSA representative who asked us, “In the past 14 days, have you traveled to China or Iran?”

Well no, we had not. And that was it. Welcome to America!

That interaction was troubling for a couple of reasons. First of all, because it was barely an interaction. In the middle of a global pandemic that’s spreading like wildfire and with a president who is boasting about how thoroughly we have this under control, I expected SOMETHING.

Second, the randomness of country choices was an issue. Someone traveling these days from the Lombardy region of Italy, where thousands of people are sick, has a much greater chance of carrying the virus than someone from Shanghai or even Beijing. I couldn’t help but think that the choice of country entrants — focusing on the U.S.’ traditional adversaries China and Iran, but not mentioning our long-time allies Italy and South Korea, which deeply equally infected by the virus — was politically motivated.

The trouble is that politics don’t stop global pandemic. Well informed and articulated public health responses do.

A footnote, upon entering Seattle’s ghost-town Sea-Tac airport a day later, we were never temperature checked, never stopped, never asked anything. I realize that we had entered on a domestic flight but many people fly internationally to Seattle with domestic stops; we are in the upper left so it’s hard to get here directly.

And so we entered the belly of the American coronavirus beast without a sound and slinked off to our own beds for the first time in a long time, happy but more than slightly unsettled.

I’ve worked in the field of global health for almost two decades. I’ve observed maternal health programs in Ethiopia and learned about digital health initiatives in Tanzania, and I’ve spent years documenting work in disaster zones like post-earthquake Haiti, tsunami-swept Japan, and drought-devastated Kenya.

But Italy was not intended to be that kind of trip. My husband Mark and I spend more than a month in Italy each year. We are both Italian-American and we use these trips to study Italian and dive deep into a particular city while working remotely with our offices in Seattle. This year we stuck our pin in Palermo, Sicily, a city known for its fantastic street food, amazing opera, and dark mafia past.

When we left for Palermo in mid-February, coronavirus — or COVID-19 — was mainly a Chinese problem. There were just a handful of cases reported in Italy, all in and around the town of Codogno, which is far away in the northern province of Lombardy. When we entered the airport, earnest-looking health workers aimed temperature guns at our foreheads and we were declared safe to enter.

For us, Palermo was love at first sight. It’s gorgeous and enchanting. Our first week went swimmingly as we coped with the usual light-hearted challenges of jet lag, getting into the groove of Italian classes, and figuring out which local market has the best cheeses and produce.

Ten days later, it was a different story. There were more than 600 cases of COVID-19 in Italy, mostly concentrated in the northern provinces of Lombardy and Veneto, but also a smattering of cases in Rome and even a case in Palermo. Wide swathes of the north were in what’s called the “red zone” where schools were cancelled, people were told to work from home, and life was on lockdown.

The Italian media, never known for its restraint, was in a full-blown panic and ramping up public anxiety. Political infighting started almost immediately, with Prime Minister Giuseppe Conte appealing for calm and his political opponents alleging he’d botched the public health response. Italian prosecutors launched an investigation into a Codogno hospital that allegedly mishandled the case of the man thought to be Italy’s “patient zero” by repeatedly failing to test him for COVID-19 — and allowing him to be in contact with more than a dozen people in the interim.

In the meantime, we fled to an unexpectedly safer place — Ethiopia — for a few days of rest and sightseeing. The perspective of being in a new location made us realize that we had to go home. The decision-making matrix was difficult and predicated on shifting and incomplete information.

We are not fearful for our health; both Mark and I are relatively young and healthy. But we are fearful of staying long enough that we’ll get stuck in Italy, blocked out by a travel restriction, or quarantined once we go home. The worst-case scenario would be getting sick in a foreign country or becoming a health risk to people at home.

But things are constantly changing. At this writing, there are more than 3000 confirmed cases of coronoavirus in Italy and 100+ deaths. At the same time, our home state has emerged as a US hotspot with 28 cases and 10 deaths in Washington. This includes the first death in the U.S. at a hospital in Kirkland, where an entire retirement community is under lockdown.

With a global virus, there’s nowhere that’s safe. It’s all about getting the best information possible, mitigating risks, and being prepared. We feel like we’re better prepared to do all of that from Seattle — where we have networks and known medical providers — instead of Palermo.

There’s not much to like about coronavirus, but I do appreciate that it’s making people think about public health rather than strictly personal health. This is a virus that preys on our connections, challenges our established behaviors, and forces us to consider how our actions impact others. For example, we’re considering whether or not we should self-quarantine when we return home to protect our friends and neighbors — just in case.

This all assumes we can make the trip home. Delta Airlines and American Airlines recently announced that they are stopping flights in and out of parts of northern Italy to the U.S. Our flight is scheduled for Friday and we’re hoping to get out before additional travel restrictions are imposed.

Wish us luck.

When La Vita Bella Turns Ugly was originally published in American refugee in Italy on Medium, where people are continuing the conversation by highlighting and responding to this story.