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The 'Tripledemic' Holiday: How to Fly More Safely (Hint: Wear a Mask)

Tariro Mzezewa Tue, December 20, 2022 at 5:06 AM PST




A third year of pandemic holiday travel is upon us, but this year instead of just thinking about how to stay safe from the coronavirus, people are also worrying about how to avoid the flu and respiratory syncytial virus, or RSV, the so-called tripledemic.


What’s also different this year is that there is no federal mandate to wear masks on public transportation. And even though cases of the coronavirus have been ticking up, there is no suggestion that mandates will be reinstated. The Centers for Disease Control and Prevention and the Transportation Security Administration suggest that it’s a good idea to mask up, but are not requiring travelers to do so.

“CDC recommends properly wearing a high-quality mask or respirator over the nose and mouth in indoor areas of public transportation (such as airplanes, trains, buses, ferries) and transportation hubs (such as airports, stations and seaports),” the CDC says on its website. With the number of people flying tracking close to 2019 levels — the TSA screened more than 4.5 million people over the past weekend — here are some steps you can take to stay safer as you travel during the holidays.

Should I wear a mask on the plane, even though it’s not required? You should “absolutely” be wearing masks while traveling, public health researchers, infectious disease doctors and air-filtration experts said. Even though planes have great filtration systems, you’ll likely be on crowded planes with other travelers for extended periods of time, increasing the chances of exposure, said Saskia Popescu, an infectious disease public health researcher and assistant professor at the Schar School of Policy and Government at George Mason University. “Now compound this with rapidly rising numbers of COVID, influenza, RSV and seasonal respiratory viruses,” she said. “I would highly recommend if you’re traveling in a plane, train, bus or boat, you wear a mask.”


Do I need to keep a mask on elsewhere? Dr. Linsey Marr, a professor of civil and environmental engineering at Virginia Tech and an expert on airborne transmission of viruses said: “If you have a vacation coming up, and it’s really important to you that you want to be well and you want to be able to spend time with your loved ones or do some activity that you’ve been looking forward to all year, and you don’t want to be laid up in bed sick or potentially getting other people sick, then definitely wear a mask when you’re traveling.” She added: “Not just on the plane, but in the airports, on buses, transit and everywhere else that you’re going in between.” Even if you’re not traveling, experts say that while it’s no longer required, it’s a good idea to mask up anywhere you will be around a lot of people in a confined space. Popescu said she recently began to develop nonspecific symptoms, including a sore throat. It turned out that she had COVID and she had caught it while flying home from a work trip. “I can personally say that it’s those moments you perceive as lower risk or let your guard down that can result in exposure,” she said.

I know

masking avoids spreading the coronavirus, but what about the flu and RSV? Masking prevents the spread of all kinds of germs and is “the best tool we have to prevent the spread of those surging respiratory viruses, from COVID to influenza to RSV,” Popescu said. Marr said that the flu and RSV transmit “at least partly” in the same way as COVID-19. Traveling over the holidays is a good time to remember the “three C’s” we first started hearing about in 2020 — closed spaces with poor ventilation, crowded places and close-contact situations — and to wear a mask in each of these situations.

Should I wear a specific kind of mask when traveling? Even though wearing a mask is most effective at stopping the spread of a virus when the infected person is wearing it, masking to protect yourself from disease is still beneficial, especially if you’re using a high-quality mask. “If you’re going to bother wearing a mask at this point, I think you should get a high-quality one,” said Marr. That generally means an N95, KN95 or KF94, she added. “Those are going to be much more effective than a cloth mask or surgical mask.” These are widely available, affordable and you can wear the same one until you notice that it’s dirty, the straps are getting loose or if it is damaged.

Do I have to take a COVID test before and after I travel? If you’re traveling within the U.S. or to the U.S. from abroad, you’re not required to take a test, but the CDC and medical authorities say it’s a good idea. “Consider getting tested with a viral test as close to the time of departure as possible (no more than three days) before travel,” the CDC says. If you test positive, they say, you should delay your travel. If you’re traveling and plan to interact with people without a mask, even more reason to test before your flight and for a few days after you land,” Popescu said. “How much you test is really about your risk profile and preference.” You should consider things like how much you’re interacting with others, whether you’ll be with vulnerable people and if you’ll be unmasked. “Overall, I recommend testing before you leave and a couple of times during your trip,” Popescu said.

What about being vaccinated? U.S. citizens and immigrants do not need to be vaccinated to fly within the U.S. or to the U.S. from abroad. Non-U.S. citizens and non-U.S. immigrants traveling to the U.S. by air are required to show proof of being fully vaccinated against COVID-19. Only limited exceptions apply. If you are not fully vaccinated and are allowed to travel to the United States by air through an exception, you will be required to sign an attestation before you board your flight stating you meet the exception. Depending on the type of exception, you may also have to state you have arranged to take certain protective measures. Also, all travelers have to give their contact information to airlines to help with contact tracing, if necessary.

Is it too late to get a booster? Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System, and Aaron Milstone, a pediatric infectious diseases specialist at Johns Hopkins Children’s Center, both said that it is “never too late” to get an updated COVID booster. “Most data suggest that a full immune response to a vaccine dose can take 14 days, but some of our early data showed that people can generate an antibody response in a few days,” said Milstone. “You might be more protected in a few weeks, but there can be some benefit as soon as a few days after, so get an early holiday present by getting the boost.” Camins said that because there isn’t great data on this aspect of boosters, it’s possible that the booster could reach efficacy before the 14-day mark. And, he said, with vaccines in plentiful supply it’s easy to get jabbed quickly. “If you make an appointment today it would work,” he said.

Is

there anything else I can do to prepare safely for my trip? The experts suggest thinking about why you’re traveling and perhaps taking extra precautions. “We’re at the point where for most people these diseases are not a personal threat if you’re healthy. At the same time, at the holidays we’re often gathering with family, and visiting with more vulnerable people and older family members in particular,” said Marr. Marr’s nuclear family will be spending the holidays with her elderly parents, so in an effort to minimize the chances of spreading any illness to them, her family unit will be taking more precautions, like not visiting crowded indoor spaces before their trip. “We probably won’t go out to any restaurants in that week leading up to it just to make sure to minimize our chances of picking up a virus and bringing it to them,” she said. The flu and seasonal respiratory viruses like RSV are also spread more easily through contaminated items and hands, “so hand hygiene and cleaning/disinfection of high-touch surfaces is an important strategy,” Popescu said. “Also, a good reminder to avoid touching your face.”

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