Talking holiday travel with U of M

The holiday season historically is a popular time to travel in the U.S. Although many Americans won’t celebrate the holidays as usual this year due to the COVID-19 pandemic, a recent survey indicates that 80% of respondents plan to take a road trip for November and December holidays, and one in five will fly. 

Jill Foster, MD, a professor of pediatrics in the University of Minnesota Medical School and pediatric infectious diseases physician with M Health Fairview, explains how to stay safe when traveling for the holidays this year.

Q: What should people consider if they’re thinking about traveling this holiday season?
Dr. Foster: There are two ends of the spectrum — you can either isolate yourself in your home and do nothing risky or you can just throw caution to the wind and enjoy your holiday as if it were still 2019. Where you fall between those two extremes should be based on:

1. medical/vulnerability aspects of the people involved, 
2. the baseline level of COVID-19 in the community for all the geographies involved, 
3. and, your tolerance of risk and ability to creatively problem-solve around the risk.

People need to really think through whether or not putting vulnerable people at risk – older relatives, someone with diabetes, someone getting chemotherapy – is worth the negative implications. Needing family time around the holidays is natural. After how difficult 2020 has been, people are really feeling a need to be with family even more. I encourage people, though, to think ahead to 2021. What do you think you will regret from what you did now? 

Q: What should people do to prepare before traveling for the holidays?
Dr. Foster: Testing is a two-edged sword. It's great at identifying who is infected and likely to be infectious, but if the test is wrong, then you get a false sense of security and drop precautions. No test is perfect, but tests are particularly fraught with false negatives in people without symptoms and if done too early. A two-week quarantine is good, but only if the person in quarantine truly has no potential exposures during that two week period — no sneaking out for a cup of coffee or a quick trip to the gym. This is where trust comes in — trust that other humans are going to do exactly what they say they are going to do and trust in testing technology and the ability of facial coverings and hand sanitizers alone to protect you. 

Q: If visiting friends and family, how should everyone prepare to see each other in-person?
Dr. Foster: The safest way to see family and friends is to create a holiday bubble and plan ahead. People need to be able to have frank discussions about what will be the rules of the road. You may want to identify key family members to plan the holidays this year for better buy-in from other family members and to build a united front. 

In colder weather climates, the best precautions are still physical distancing of at least six feet of separation when possible, mask-wearing except when eating, good handwashing and consideration of ventilation. In warm climates where the majority of interactions can be outside, groups that are meeting during the holidays should consider proper physical distancing and facial coverings when spending prolonged time together.

Q: What are some steps that can be taken to create a safer environment while gathering with friends and family?
Dr. Foster: The family’s most favorite house for the gathering may not be the best one for air exchange, so make sure you spend time to talk about the location in advance. When you’ve nailed down the location, there are plenty of ways to be creative. Design a set of customized masks for people to create a bond and while practicing safety measures. Unless the temperatures are prohibitively cold, move your party outside with fire pits and patio heaters — similarly seen at restaurants — and have people dress accordingly. Plug-in portable HEPA filters will also help air exchange indoors, but it is another thing that may lead to a sense of false security. 

And, just because you're gathering doesn't mean you have to spend as much time with each other as you usually do. Limit the amount of time you spend together and avoid letting other people into the bubble that may not be a priority — that friend from high school who drops by every year can see you safely in 2021.

Also, remember to consider younger children and toddlers when deciding on housing arrangements since they aren't known for following physical distancing and hygiene practices.

Q: What should people consider when thinking about taking a personal vacation for the holidays that doesn’t involve visiting loved ones?
Dr. Foster: With cases rising all across the U.S. and some parts of the world, this might not be the year to travel. If you do travel, prepare your “armor” for the transit (facial coverings and hand sanitizer) and minimize your exposures where you can. Most importantly, think about conditions on the ground. What is the level of community spread where you are going, how close will you be to other people not in your party, and what is the availability of specialized health care for patients with COVID-19 at your location in case you get sick because your preventative measures were not enough?

Jill Foster, MD, is a professor of pediatrics in the University of Minnesota Medical School and pediatric infectious diseases physician with M Health Fairview. Her expertise is in prevention and treatment of viral diseases, and in mobilizing public health and healthcare systems in the areas of prevention and screening. 

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