Holiday Travel During COVID-19
Concern over safe traveling during the COVID-19 pandemic is making many think twice about getting together with family or a winter getaway during the upcoming holiday season.
The simplest questions about traveling for the holidays are also the most important to consider: are you sick, are you or a family member at increased risk for severe illness from COVID-19, is the area you plan to visit experiencing a spike in cases?
If the answer to any of those questions is yes, the Centers for Disease Control (CDC) says don’t go.
Melissa Perry, ScD, MHS, chair of the George Washington University Department of Environmental and Occupational Health in the Milken Institute School of Public Health, agrees that there is a lot to consider before traveling.
“These are hard questions,” Perry says. “Even a month ago they were easier, but with what has been happening in the past six few weeks, it’s much harder now.” For her part, Perry says, the answer to the question whether it’s safe to travel is “it all depends.”
The national two-week trend of COVID-19 cases ending on Nov. 8 showed an increase of more than 55%. Pandemic-related deaths increased by 17.5% over that same period, according to the CDC. With cold and flu season ramping up, the CDC and health care professionals nationwide are urging that everyone six months or older receive a flu shot this year. The university has even added influenza vaccination as a requirement for campus access.
“In medicine, we do a lot of risk/benefit analysis, and that's what I encourage people to do on anything,” says Michael Knight, MD, MSHP, assistant professor of medicine at the GW School of Medicine and Health Sciences. “Staying at home is still generally the right thing to do, but there are benefits of going home for the holidays. Maintaining healthy connections, seeing loved ones that you may not have been able to see during this time” might outweigh potential risks.
If you’ve decided that you have to get away for the holidays, say Knight and Perry, with a little due diligence it’s possible to minimize your risk.
Look Before You Leave
Before heading out on a holiday trip, Knight and Perry suggest checking the Washington, D.C., list of high-risk states. Visitors to Washington, D.C., not including Maryland and Virginia residents, are required to have a negative COVID-19 test within 3-5 days of arrival. District residents returning to the city are required to either limit daily activities and self-monitor for 14 days upon arrival, or limit daily activities until they get tested for COVID-19 and receive a negative result with 72 hours after their return. Those traveling from high-risk states after essential travel or arriving in the District for essential travel are required to self-monitor for symptoms of COVID-19 for 14 days and, if they show signs or experience symptoms of COVID-19, they should self-quarantine and seek medical advice or testing.
“A two-week quarantine prior to traveling, with a COVID-19 test at the beginning of that quarantine, is the best way to ensure that you are not infected upon arrival,” says Lynn Goldman, MD, MPH, the Michael and Lori Milken Dean at Milken SPH.
The problem with testing around the time of departure, she adds, is that “even if you test negative, you could still be exposed but just not yet positive, and the results may not come back before your departure date. And if you are positive, you really should not go.”
Depending upon how you travel, says Perry, people should consider quarantining once they arrive at their destination as well, in the event of exposure en route, and the same advice applies after your return trip.
“The idea of quarantining before travel is determining whether you are infected and just asymptomatic, so you don’t bring the virus home,” Knight explains. “It’s not really for you, it’s about protecting other people. For me, my parents are older and at a higher risk, so I likely would want to be certain I wasn’t COVID positive.
“I think the biggest consideration when we asked the question ‘is it safe to go home,’” says Knight, “is ‘where is home?’ ”
Many areas of the country are experiencing very different rates of infection. The CDC posts 7-day data tracking for all 50 states, the District and all U.S. territories. For those traveling abroad, the CDC offers COVID-19 Travel Recommendations by Destination.
Planes, Trains or Automobiles
It’s also important to consider your mode of transportation this holiday season. Airports, bus stations, train stations and rest stops are all places travelers can be exposed to the virus in the air and on surfaces due to more contact with other people. Social distancing is difficult on crowded planes, trains and buses, so Perry suggests checking with these carriers regarding their seating and cleaning policies before booking a ticket. Many in the travel industry are posting their COVID-19 prevention plans so look for specific details about what these companies are doing to keep customers protected while traveling.
Is the business community up to the challenge?
“The travel and hospitality industry has taken a huge hit during the pandemic, and in order to reopen and continue operating they have had to adopt some vigilant health and safety practices,” she says.
Traveling by car may offer the lowest potential for exposure, she adds, as drivers and passengers are isolated from the public for the bulk of their trip. However, stops along the way for gas, food, or bathroom breaks offer opportunities for close contact with other people and frequently touched surfaces.
“You could limit going to public places, such as restaurants and stores,” she explains. If you did need to take a break on the road, Perry adds, “The safest option is to bring your own food. If you don’t bring your own food, use drive-through, delivery, take-out and curb-side pick-up options. Ideally you could sit outside to eat and wear a mask if you have to go indoors.”
On the Road
Once you are on your way, the same public health protocols in place since the pandemic took hold last spring offer the best line of defense against contracting or spreading the virus. The CDC recommends travelers wear masks, keeping the nose and mouth covered at all times, in public settings. Whenever possible maintain at least 6 feet of physical distance (about two arms’ length) from anyone who is not part of your household. Handwashing with soap and water for at least 20 seconds is advised not only after using the bathroom, but also after you have been in a public space. And if soap and water isn’t available, using a hand sanitizer containing at least 60% alcohol is the next best thing.
Perry also recommends using disinfecting wipes whenever possible on high-touch surfaces — including metal, plastic and even cardboard — such as gas station pump handles and ATM machines.
“I would advise having some gloves on hand for gas pumping or, if you don’t have them, washing your hands or using hand sanitizer afterward is a good idea,” she adds.
If you happen to get sick on your trip, Knight and Perry agree that you shouldn’t cut your trip short and head home. “First and foremost, don’t travel if you are having any kind of health symptoms,” says Perry. “Stay home.” Common symptoms of COVID-19 include fever, cough, breathing trouble, sore throat, muscle pain and loss of taste or smell. While most people develop only mild symptoms, the severity of the symptoms has little bearing on the ability to transmit the virus.
Even if it’s just a cold or a flu, that illness could put you at greater risk of contracting the virus, as well as experiencing more severe symptoms. “Call your provider and describe your symptoms,” Perry says. “They will advise you on how to seek testing and further care.”
“We understand how to prevent transmitting this virus,” she adds. “Don’t travel or go out when you’re sick, maintain physical distances, wear a face covering, and wash your hands. Studies have already shown that when everyone does these things, virus transmission rates go down. We’re all in this together.”