Alan Frischer, MD, MPH
Travel During a Pandemic
My wife and I had an amazing vacation booked for February. February sure does seem like a long time from now, so of course by then travel will be no problem…right? Well, I had put the odds of taking this trip at a lot less than 50-50, and just this morning the decision was made for me: the tour company cancelled the trip. Next February, you’ll find me hanging around the office instead.
Travel increases the chance of contracting COVID-19, and of spreading infection. Staying home is certainly the least risky action at this time. When will it be safe to plan vacations again? It depends on where and how, and the answer is constantly changing.
Of course, not all travel is for exploring new places and having new adventures. What about visiting family or friends? The dangers of travel are multiplied if you or your loved ones have COVID-19 risk factors (including age, obesity, diabetes, and other conditions). Keep in mind that merely because you share blood ties or a long history, even close family or friends are not in your pod. You have not been isolating together. The safest way to form a new pod is for both parties to quarantine for 14 days, and to test negative.
If you do travel, I urge you to practice all of the new-normal pandemic precautions. Wash your hands often with soap and water or hand sanitizer. Avoid touching your eyes, nose and mouth. Keep at least six feet between you and others. Wear a face covering in public. Pick up food at drive-throughs or use curbside service.
At this time, many countries with low COVID-19 infection rates are not welcoming Americans. With 177 countries reporting cases (note that Antarctica is the only continent without a single case!), the U.S. Department of State has finally lifted the general do-not-travel warning. Instead, it has issued individual warnings by country. Before you travel, check travel.state.gov for the latest State Department information.
Domestically, each of our 50 states has its own rules and travel restrictions. As with international travel, this is a rapidly changing, fluid situation. Make sure that you are well versed in the most current rules for your destination.
So, what is the safest way to travel?
The CDC maintains that the risk of air travel is relatively low. However, spending time in security lines and airport terminals makes it very difficult to avoid coming into close contact with other people and with frequently touched surfaces. The good news is that even with a severe reduction in the number of flights, many are only 50% to 60% filled. (Still, other flights are nearly fully booked and distancing becomes impossible.) In-flight food and drink service has largely been eliminated. Recirculated cabin air appears to be less of a danger. All international jetliners are equipped with High Efficiency Particulate Air (HEPA) filters, similar to those found in hospital operating rooms. Cabin air is circulated vertically from ceiling to floor, and refreshed every two to three minutes. Between flights, airplane cabins are scrubbed down with anti-microbial disinfectants. (Note that not all domestic flights are HEPA-equipped.)
Those traveling on a bus or train find it very difficult to avoid coming into close contact with other people and with frequently touched surfaces. When possible, avoid busses and trains at this time.
Automobile travel usually requires stops along the way for gas, food, and bathroom breaks, putting the traveller in close contact with other people and surfaces. Any kind of a car service or rideshare exposes us to contact with the driver and surfaces. Renting a car certainly poses fewer risks then taking public transit, but I would advise wiping down and ventilating any rental.
RV travel has seen a huge increase in demand, and does mitigate some risks. However, there may still be stops for gas, food, and campgrounds, all involving contact with people and surfaces.
Are hotel rooms safe? What about vacation rentals? As states lift their stay-at-home orders, restrictions on hotels are starting to ease. The bigger chains promise heightened safety protocols, including contact-less check-in and more rigorous cleaning practices. Nonetheless, some travelers choose to bring their own cleaning supplies. It is unclear at this point how safe hotel stays are, but practicing all of the usual precautions - hand washing, face masks and distancing - will increase your level of safety.
Most cruise lines have put operations on hold, although a handful are resuming with amended itineraries and enhanced health protocols.
Travel has never been so complicated. Unfortunately, we will still be living in a pandemic for quite some time. If you do plan to travel, please do so as safely as possible. Bon voyage!