Flying, Boosters, and Hugging Friends and Family: Public Health Tips for Holiday Travel 

Holiday travel season is almost here – coinciding with a rise in new COVID-19 variants that suggest a winter coronavirus surge is possible. Dominican University of California public health professor Dr. Michaela George offers holiday travel safety tips for those visiting family and friends this season.

The good news: Hugging is OK (but stay home if you are sick and get your booster and flu shots).

Dr. George, who earned an MPH with a concentration in Epidemiology from Boston University School of Public Health and a PhD in Epidemiology from the University of California, Berkeley, is an assistant professor in Dominican’s Global Public Health (GPH) and Physician Assistant (PA) programs. Since the beginning of the pandemic, Dr. George and her GPH colleagues Dr. Patti Culross and Dr. Brett Bayles in the School of Health and Natural Sciences have served as media sources on issues related to COVID-19. Their commentary has appeared in The New York Times, the San Francisco Chronicle, VICE, The Mercury News, The Houston Chronicle, The Marin Independent Journal, and KTVU.

I will be flying domestically this holiday season, what precautions should I take at the airport? Should I wear a mask in the terminal? Should I use hand sanitizer?

These are personal choices. The more precautions you take, the safer you will be  – not just from COVID but from the common cold or flu too. Personally, I choose to wear a mask while I am inside at the airport, on the plane, in a cab, etc. I travel with hand sanitizer and wash my hands regularly. I don’t want to show up to Thanksgiving dinner with the sniffles or a cough, so I protect myself and my family by traveling as safely as possible. I would also consider who I am flying to see (an elderly grandparent, a sick relative) and where I will see them (at a dinner party inside or on a beach). 

Once on board, should I wear a mask on the plane? If I am wearing a mask, does it have to be a N-95 (and why)? Should I bring wipes to clean tray tables and arm rests (does that make a difference)?

Again, I choose to wear a mask on the plane because it is my way of protecting myself and my family, not just from COVID, but from all the other germs out there. I find that talking and eating are more comfortable when I wear a KN95  – these masks fit my face the best. However, when I know I will be in a mask for a long period of time, I bring extras in case one gets uncomfortable, or a strap breaks, or something like that. KN95 are safer than cloth masks. In terms of wiping down the arm rests, tray table, etc., COVID is not a fomite  – which means it does not stay on inanimate objects, it’s airborne. Planes clean and recycle the air at the same intensity as hospitals. So, it’s very unlikely that you would get COVID from the tray table on a plane. That being said, there are plenty of germs on your seat and surrounding surfaces. If it makes you feel more comfortable, wiping your area down before a long flight might help keep you healthy. 

I am planning to travel overseas this holiday season, are there any extra precautions I should be taking? 

With longer flights, you may be more likely to get mask fatigue. Bring a few extra ones to change out and give your face/ears a rest on those long flights. I would also recommend researching the COVID restrictions in the country you are traveling to and be sure you are prepared when you get there. If most of your activities are inside, then bringing masks and hand sanitizer would be recommended. However, if you are lucky enough to head somewhere warm and you plan on spending time outside, then you are at a decreased risk of COVID once you get to your destination.

I am traveling to visit family this holiday season. I will not be flying. What precautions should I take in advance?

If you are sick, be ready to cancel your plans. There are still other illnesses we need to worry about – everything from the common cold to the flu. If you have symptoms, treat them and stay home. 

What precautions should I take if I am traveling with an unvaccinated infant or young child?

Same precautions that you would take in your daily life. If you can travel by car, great! And if you are feeling sick, stay home. 

If I start having symptoms such as a sore throat, a cough or a fever, how will I know if I have a cold, the flu, or COVID? 

You can always take an at-home COVID test or a PCR test to confirm or rule out COVID. Your doctor will help you determine if your symptoms are due to the flu or the common cold.

Should I get tested either before or after I travel - even if I am feeling fine?

If you are asymptomatic, then there is no need to test.

How long after a positive COVID result is it safe to travel?

When you are no longer symptomatic, then you are less likely to transmit COVID to others. But this is true for most infectious diseases. If you feel sick, stay home. 

Where can I get information that will let me know if I am heading to an area with high COVID rates? What sources can I trust?

The CDC and WHO are trusted sources for general results. However, I would also check the local health departments websites to give me a sense of what the local precautions and community spread is like before I get there. I would stay away from Facebook and other social media outlets.

How long after a positive COVID result is it safe to travel?

When you are no longer symptomatic, then you are less likely to transmit COVID to others. But this is true for most infectious diseases. If you feel sick, stay home.

Is it OK to hug my family or shake hands with guests when we meet?

HA!! Yes  – humans need physical touch! Hugging is ok. However, if you are sick, then you should be prepared to stay home. Depending on your guest’s comfort level, hosting some of the party outside will decrease the risk of spreading germs. You can also be open with everyone at the party and set rules to make everyone feel comfortable. I usually go with the lowest common denominator, that way everyone will feel informed and more comfortable.

 At family gatherings, will it be safe to interact with elderly family members? Should I wear a mask? Should they wear a mask? Do we need to be socially distant? 

If grandparents would rather stay outside, or would prefer if others stay masked, then it's best to keep everyone comfortable. If you are sick, stay home!

How many different households of vaccinated people is it safe to socialize with indoors?

There is no magic number. And safety depends on multiple factors – is anyone sick? What are their daily risk factors? Employment - do they work at the grocery store or at home? Are there lots of kids in the mix? Are they sick? Do they wear masks at school? Safety is cumulative - the more precautions you take, the safer you will be. 

My child is coming home from college in the U.S. What precautions should we take at family gatherings?

Monitor symptoms, if you are feeling sick, stay home. If your child is not feeling well and exhibiting symptoms, do your best to isolate them until they have a negative COVID test. Call their doctor. If you can keep your gathering small, especially away from immunocompromised or elderly family members, that would be safer too.

My child is coming home from an overseas trip. Do we need to take any additional precautions based on the region my child was visiting? 

Same as above  –  also take into consideration their lifestyle while they were away from home. Do they live by themselves? Do they spend a majority of their time indoors/outdoors? If they are at an increased risk in their lives away from home, stay quarantined during the holidays (keep things small) may be a good idea.

What precautions should I take when staying in a hotel?

Make sure you know and understand the local COVID precautions and be ready to be masked while indoors in common spaces if required. Personally, if I was in a hotel that was enclosed and, in a place where COVID rates are increasing, then I would choose to wear a mask in the lobby and common areas. However, if I was in a warm environment with very little COVID, then I would feel more comfortable walking around without my mask.

I tested positive for COVID but do not have any symptoms, should I isolate?

Depends on why you tested  – if you didn’t have any symptoms, then why did you test? For example, if you were testing to clear yourself from a known exposure (5-7 days previously), and then you get a positive result, you may be at the beginning of your illness, therefore isolating would be smart (and cautious). I would also recommend getting a PCR test to confirm. However, with no symptoms, you are likely less contagious than if you are coughing and sneezing. 

What does isolation mean? 

From the CDC website: Isolation separates sick people with a contagious disease from people who are not sick. Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick. 

How long in advance of travel should I get the newest COVID booster?

This depends on how you felt with previous boosters. If you were very sick after your previous shots, then be prepared to get your booster a few weeks before travel. However, if you haven’t suffered from fever or chills or headaches (etc.) previously, then you should get the booster a week or so before traveling. With that being said, there isn’t a benefit to waiting for your booster. The only time recommendation I am aware of is 60 days after your last positive test for COVID. Therefore, if you have recently had COVID, you may have to wait to get your booster. 

What should I be more concerned about – catching the flu or COVID? 

BOTH! I don’t want to get sick  – with the common cold, a cough, nothing. Good thing you can protect yourself from most of wintertime sicknesses in the same way - proper hand hygiene, mask wearing, staying outside or away from crowds, etc. 

Can I get my flu shot and COVID booster at the same time? 

You can get the flu shot and booster on the same day in the same arm. No need to space them out. I suggest getting your flu shot ASAP, before flu season. Most results from the Southern hemisphere show we may be in for a really bad flu season. I already got my flu shot!

I have already had several COVID boosters. Why do I need this latest booster?

The latest booster is formulated differently than the previous ones. This booster is designed to be more effective against Omicron strains of COVID.

I have only had one COVID dose. Will this new booster still be effective?

Yes.