If you’re considering holiday travel, but are increasingly worried about the rising number of Covid-19 cases across the country, you’re not alone. Health officials agree that the uptick in the cases reflect more people getting together more often – increasingly indoors.
While the lowest risk is to remain at home and celebrate only with those living in your household, you may be experiencing pandemic fatigue. The sense of isolation and months without seeing loved ones takes an emotional toll. So, do you stay or do you go?
It's a hard decision, and it’s important to know the risks and weigh them against the benefits of face-to-face connection. It’s all about lowering risk, not eliminating it. And everyone’s risk is different, depending on a variety of factors.
Ask yourself these seven questions when considering holiday travel:
Are you or the people you will be visiting with at increased risk for severe illness?
While everyone is vulnerable to contracting Covid-19, some are more likely than others to become severely ill – like older adults and anyone with a chronic medical condition, including diabetes, heart disease, obesity, cancer or breathing problems (like asthma).
Do you live in a “hot spot” or traveling to one?
Travel restrictions and protocols for local and state government may be in place either at your home, or where you’re traveling to. There may be testing or quarantine requirements upon arrival. Check with the county health departments where you live, and where you are going. Be aware and prepare to be flexible, as policies might change during your travels.
Do you plan to fly or drive?
Whether you choose to drive or fly, your risk is most affected by whether you and those around you take the right precautions – like mask-wearing and social distancing from those outside your household. Airports, bus and train stations, and rest stops are all places where you can be exposed to the virus.
While some people worry about the air quality on a plane, that's actually a low-risk issue, with the highest risk coming from being around other travelers. Car travel can be low risk, with limited stops and take-along snacks. But if your drive is long and you need to stay overnight, you’re again around other travelers and more frequently-touched surfaces. Either way, aim to travel at non-peak times, to reduce the number of people around you.
Plan ahead for your travel needs, and make sure to bring a mask for all family members (over age 2), hand sanitizer and some snacks.
Should you get a test before you go?
Testing can provide mental comfort and reassurance that you are not currently carrying Covid-19. But these tests are not 100 percent accurate, and results can depend on when you might have been exposed and how long the virus has been incubating. Ideally, aim to self-isolate for five to seven days afterwards. But it’s still important to get a test if you think you might have been exposed, or live in an area with a recent increase in cases. Another way, although harder, to reduce risk without a test is to self-isolate for 14 days before your trip. This is especially important if higher-risk people will be under the same roof.
How small is a “small group” for indoor activities?
While public health officials, including the CDC and WHO, do not provide a specific “cut-off” for a total number, it’s well known that the greater the number of people, the greater the risk for spreading the virus. And while mask wearing, and a 6-foot distance is recommended as a baseline, risk is lower for the fewest number of people (10 people has been mandated in some areas to lower risk) from the same local area, remaining 6 feet apart, wearing masks, and not sharing food or objects.
How can you lower your risk at a holiday dinner?
An outdoor holiday gathering puts you at lower risk. However, while it might be possible to do this in colder weather using outdoor heat lamps or a fire-pit, most people don’t have those options and will wind up inside.
If this is you, keep the windows open, ideally for cross-ventilation to circulate fresh air into the home. Aim for a buffet style, with seating spread out to maintain social distancing. Wear your mask when not eating. And wash your hands (or use hand sanitizer) frequently, while limiting physical contact. Remember the four basics of risk evaluation:
-Duration of the gathering
-Number of people attending
-Locations attendees are coming from
-Behaviors of the attendees
Are you willing to self-isolate for 14 days after returning?
After your return home, it’s a good idea to stay at home for 14 days to protect others around you. While you might feel well and have no symptoms, it’s possible for you to have been exposed during your trip and spread the virus to others. You might pose a risk to other family members, friends, and your community.
Madelyn Fernstrom, Ph.D. is NBC News' health editor. Follow her on Twitter @drfernstrom.