With vaccines for COVID-19 widely available—including for children five and up—and international borders open for the vaccinated, this holiday season was poised to be closer to the pre-pandemic standard than at any time since the virus made itself known in March 2020. However, increasing COVID-19 cases and the emergence of the Omicron variant reminds us that it is still important to remain vigilant.
Daniel Caplivski, MD, Director of the Travel Medicine Program at Mount Sinai, and Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains how to protect yourself and your loved ones while travelling this holiday season and why getting the flu shot should factor into your plans.
Now that vaccines are readily available, is it safe to travel this holiday season?
I think it’s safer than last year because we have an additional layer of protection for the people who are getting vaccinated and receiving boosters. And certainly, for those who have not yet gotten vaccinated, the winter holidays are a good motivation to do so.
However, there is some uncertainty as we are facing the Omicron variant which we are still learning a lot about. The good news is that the COVID-19 vaccines are highly effective at preventing severe illness, hospitalization, and death. It is likely that we will learn about breakthrough infections with the Omicron variant, but it’s encouraging that we have these vaccines available, including booster doses. We are in a very privileged position.
How high is the risk of contracting the virus from other passengers?
It’s a little hard to put an exact number on the risk, but there are a few variables.
One of the variables is if you, and the people in your family, are vaccinated. When you and your party are vaccinated and you are adhering to the Centers for Disease Control and Prevention (CDC) guidelines as well as masking while travelling and practicing standard hand hygiene, it goes a long way to decreasing the risk of contracting COVID-19.
And while you are travelling there are other things you can do to mitigate the risk. Doing your best to social distance if in a crowded airport, train, or bus station. If you are having a snack or meal, try to stagger your eating to a different time than whoever is sitting next to you. Keep your mask on while they are eating and then eat when they are masked. That’s the ideal timing and will help reduce your risk.
What happens when you get to your destination is a very important factor in terms of your risk of contracting COVID-19. Families will be gathering around a table where everybody is unmasked and enjoying a meal. There may be people who are coming from different parts of the country, and there may be some variability in vaccination. This situation might actually be more of an issue because for most of the time you are travelling, you will have to be masked.
In a post on how to gather safely during the holiday season, Mount Sinai infectious disease expert Krystina Woods, MD, explains how to mitigate the risk of contracting COVID-19 while visiting family and friends. It provides excellent advice for how to prevent the spread of the virus.
Would you recommend wearing a higher quality mask when traveling?
If you have access to better masks, that’s a good idea. The transmission of COVID-19 seems to happen mostly through larger droplets. However, there are certain scenarios when there are smaller aerosols generated—like a cough or sneeze—and that can lead to transmission, especially if you are in a tighter space, like on a packed airline flight. In that scenario, you would want a little more protection.
One solution is to wear an N95 or its international equivalent (the KN95 or KF94). Or you can use the double masking technique, which involves wearing a disposable surgical mask underneath a cloth mask. This gives the mask a better seal on the face by decreasing the amount of space around the mask and lessens the likelihood of transmission.
Looking back to spring 2020, high-quality N95 masks were in short supply, so they were only recommended for health care workers who were at most risk. But now, there’s been increased availability of KN95 and KF94 masks that are for use by the general public. You can upgrade to these types of masks while travelling—just make sure the masks are legitimate. The CDC has advice on how to identify counterfeit masks.
Should I change my travel plans due to the Omicron variant?
If you are fully vaccinated, including a booster, then the health risks associated with travel may not be so different than they were before we knew about this variant. However, we are still gathering information on that front.
The variable that is harder to predict is whether or not we will see further travel restrictions that might disrupt travel —such as additional testing requirements or the imposition of self-isolation periods. If you are travelling internationally, it will be important to monitor what is happening via the U.S. State Department and the CDC’s travel health site as more stringent guidelines may change the way you look at your upcoming plans.
I am traveling internationally and will need a negative test before returning to the U.S. Are there activities that I should avoid while I am away?
If you’re hoping to avoid getting stuck in an international destination, try to steer clear of unmasked situations, particularly those where you are indoors and in close proximity to others. The best case scenario would be to head to a destination where you can eat outdoors and where there is spacing in between you and others who are not in your party. And if you are indoors, wear a mask.
Additionally, there is variability in case rates both domestically and internationally. One precaution you will want to take is to monitor the infection rate at your destination.
What should you do to protect yourself once you return?
Individuals who are returning from international flights will need to present a negative test regardless of vaccine status. But regardless of whether you are travelling 50 miles or 500 miles away, we should all have a heightened awareness about symptoms. We want to make sure that we are not inadvertently playing down symptoms of COVID-19—even if we are vaccinated. The same applies for kids returning to school, especially if they’re not vaccinated.
You have to monitor yourself and not assume that a little cough is just a cold because it could be something more. COVID-19 is still with us. We should still be aware of that even with mild symptoms could actually be the virus—especially if you’re vaccinated. So, pay attention to how you are feeling.
Are there any additional behaviors that the public should be aware of when they’re traveling during the holidays?
Getting people vaccinated is still on the to-do list. While a large number are vaccinated against COVID-19, there are many who are not. I hope that the holiday travel season will motivate some of those people to get vaccinated. And even though last year was a mild flu year, we don’t know what this year has in store, so people should get their flu shot as well as their COVID-19 vaccine.
Additionally, people who are vaccinated but immunocompromised should make sure that they get their booster before they enter crowded settings like airports and airplanes.
For everyone else, continue to do the things that we have been practicing for the past 18 months. Wear a mask, practice social distancing, and exercise proper hand hygiene. I think all of those continue to be important.