- Traveling for the holidays during the coronavirus pandemic will pose some degree of risk no matter what your plans are.
- That risk will vary based on where you’re going, who you’re seeing, and what you’re doing.
- Insider spoke with four public health experts about questions to consider when planning holiday travel during the pandemic.
- Visit Insider’s homepage for more stories.
As the holiday season approaches, many Americans have now gone months without seeing family and friends.
Some may choose to gather safely if they’re able, but any social activity or travel comes with some degree of risk. The risk of transmission increases if you’re coming from or going to an area with a high infection rate, and the risk of someone getting seriously ill goes up if you’re seeing elderly family members or those with preexisting conditions.
“These are not easy decisions, but unfortunately, they’re the kind of decisions that we have to make these days,” Matthew Fox, DSc, MPH, professor of epidemiology at Boston University, told Insider.
Insider spoke with four public health experts about holiday travel during the pandemic. Here are six questions they recommend you consider before finalizing your plans.
Do you know what going home entails?
The first question to consider is: Do you want to go home? Conversely, does your family (or whoever you’re planning to visit) want you there?
It’s a question you’d ask any year, but it carries a different weight during a pandemic, when you have to consider risks you are taking on your health and the health of others, Amesh Adalja, MD, a senior scholar at the Johns Hopkins University Center for Health Security, told Insider.
This year, Adalja recommended, make sure that all parties involved in your holiday plans are aware of the risks at hand and the level of transparency required to keep everyone safe. If you’re not willing to have a conversation about who you’re seeing and the possible exposures you might bring to the table, going home might not be worth it.
“With any activity right now in the middle of the pandemic, whoever you socially interact with, you should try and ideally match the risk tolerance on both sides and make whatever compromises that you might need to make,” Adalja said.
What is the risk level in the areas where you’re traveling to and from?
If you decide you do want to travel, you should consider the risk levels in the areas you’re traveling to and from. You can get an idea of the infection risk in your state or county based on two figures: the basic reproduction number and recent case counts.
The basic reproduction number, also known as R0 (pronounced R-naught), is the average number of people a patient is expected to infect in a population that has no immunity. An R0 greater than 1 (noted in red on this graph) could be a signal to avoid traveling to or from that area, as it signals the virus is spreading quickly.
Jennifer Kertanis, MPH, president of the National Association of County and City Health Officials, told Insider that she looks at recent case counts per 100,000 residents to get a sense of community spread.
“I think that’s probably one of the better metrics because it speaks more to what is your likelihood of encountering someone with COVID in these states,” Kertanis said. “Is that one in 100,000? Is it 10 in 100,000?”
Many states have implemented travel restrictions on areas where case rates are high, so Kertanis recommended checking your state’s department of health website to plan ahead for requirements to quarantine upon your arrival or return.
Can you drive there in one trip?
Driving alone or with people in your household is the safest way to limit potential exposure while traveling, Kertanis said.
“That’s your safest route because you’re not being exposed to others as you would be in a train or a plane where you don’t know who might sit next to you,” Kertanis said. “You don’t know if they’re asymptomatic but positive.”
If you need to visit a rest stop or hotel, make sure to wear a mask, avoid lingering in common spaces, and wash your hands thoroughly when you leave.
It’s possible to take a plane or train safely if you’re properly prepared with PPE, hand sanitizer, and wipes for surfaces. Air travel may be safer than you’d expect, as planes have state-of-the-art filtration systems and strict requirements to wear masks, but there’s still a chance of infection in airport lines and eateries.
What risk do you pose to others?
It’s important to understand the risk you carry based on your everyday contacts before you visit people outside of that bubble. Consider how many people you interact with indoors versus outdoors, with or without a mask, and if you’re having extended interactions with them, Fox said.
You should ask the same questions of the people you’re planning to visit so you understand the risk they may pose to you.
Health care workers and college students pose extra risks due to increased exposure in hospital and communal living environments, respectively. Adalja said that as a physician who takes care of COVID-19 patients, he’s probably in the highest risk category for exposure.
You can minimize the risk you pose to others by limiting who you see in the weeks before your visit, or by wearing a mask around your loved ones who may be at a higher risk of getting sick because they’re elderly or have preexisting conditions.
“Particularly if you’re going to visit elderly parents or grandparents, I would urge real caution with that,” Marcus Plescia, MD, MPH, chief medical officer of the Association of State and Territorial Health Officials, told Insider. “You wouldn’t want to be the cause of somebody becoming ill who might really suffer significantly or even die from the infection.”
What will you do during your visit?
Large, indoor holiday dinners with people who live outside of your household are rated “higher risk” according to the Centers for Disease Control and Prevention’s Thanksgiving advisory. But there are a few lower risk alternatives to a traditional Thanksgiving meal.
Having a smaller dinner with your household or bubble, with loved ones tuning in virtually, is the safest way to celebrate. If your local climate permits, you could also gather with a slightly larger group outdoors and maintain a moderate level of risk.
Now is a good time to create new outdoor holiday traditions, like a Thanksgiving hike or family snowball fight.
If you’re seeing family for a longer period of time and can work in a 14-day quarantine before the holiday meal, it would be safe to have a small gathering indoors. But keep in mind that quarantining before a flight is essentially useless, as you could be exposed to the virus en route.
Adalja said you should also consider how many people you’re seeing — whether it’s family, friends, or both — if you choose to go home. Visiting with old friends at local bars and restaurants might’ve been fun in years past, but remember that expanding your bubble increases your risk of getting or spreading COVID-19.
Can you get tested before you go?
Testing is not a substitute for wearing a mask or social distancing, but it can provide some peace of mind before you hit the road.
“If you can demonstrate that you are not infected before you travel, that is obviously helpful, but it is only indicative of your infection status as of that moment,” Fox said. “You could have been infected in the period just before you test or during the period that you’re traveling.”
Adalja said that if you’re using a test to guide your decision to travel, you should get the test as close to your travel date as possible. It is also wise to get tested five to seven days after your return if you think you could’ve been exposed.