In addition, insurance covering medical evacuation is highly recommended. Although several private companies offer evacuation service in the P.R.C., the cost can be extremely high. Tourist travel in China can be extremely strenuous and may be especially debilitating to someone in poor health. Tours often involve walking long distances and up steep hills. Plans should include rest time and avoiding overly full schedules that could lead to exhaustion or illness.
China discourages travel by persons who are ill, pregnant, or of advanced age.
Visa applicants over 60 usually are required to complete a health questionnaire. If medical problems exist, a letter from your physician in the United States explaining treatment and, if relevant, copies of your most recent electrocardiograms would be helpful in case a medical emergency occurs in China. Air pollution in the large cities is often severe, particularly in winter when soft coal is burned in the northern cities. It is common for tourists to become afflicted with respiratory ailments. Visitors are advised not to drink the tapwater in China.