With Thanksgiving and winter holidays around the corner, travelers are gearing up for busy airports and hectic trips to see family and friends. But the coronavirus threat that kept many home the last two holiday seasons isn’t gone, and it’s joined by more respiratory illnesses like the flu and respiratory syncytial virus that are sending people to the hospital this year.
“Covid is still floating around, RSV’s floating around, influenza’s increasing,” said Abinash Virk, an infectious disease specialist at the Mayo Clinic in Minnesota. “All three of them, particularly in frail people or immune-compromised people, are really nasty.”
Michelle Barron, senior medical director of infection prevention at UC Health in Colorado, said this time of year often brings norovirus outbreaks as well.
“People have been talking about the ‘tripledemic’” — referring to covid, flu and RSV, a common virus that usually causes mild, cold-like symptoms — “I’m like no, this is just the season of grossness,” she said.
Unlike last holiday season, masks are no longer required on planes or other forms of transportation. But travelers may still want to take extra precautions to avoid bringing germs along on their trip — especially if they’re planning to see grandparents, new babies or other at-risk friends and family. Health experts say people should take precautions to protect the most vulnerable people they plan to spend time with.
“At the end of the day, people want to enjoy themselves, people want to gather and they want to travel and they should,” Barron said. “But you don’t want to be sick on your vacation.”
Stay up to date on vaccines
New omicron-specific boosters are available for people age 5 and older, and kids as young as 6 months can get their primary course of the vaccine. The Centers for Disease Control and Prevention recommends people 5 and older get an updated booster if it’s been at least two months since their last vaccine dose.
Flu shots are available for people age 6 months and older.
“If people have not had a flu vaccine, now is the time to get one,” said Kris Bryant, a pediatric infectious-disease specialist at Norton Children’s Hospital in Louisville and a member of the American Academy of Pediatrics Committee on Infectious Diseases.
There is no vaccine available yet to prevent RSV, which can be particularly severe in young children, older adults and immunocompromised people.
Be cautious leading up to a trip
Virk said she’s told her own family members to start being cautious a week before they visit grandparents. That means avoiding potentially risky behavior like eating at restaurants indoors, going unmasked in crowded indoor spaces or gathering with large groups of people inside.
Barron said a week is “probably really, really cautious.”
“Most things you worry about, especially right now, about three days is when it’s going to hit you,” she said.
Mask while traveling
You don’t legally have to wear a mask most places anymore. But, experts say, it’s still a good idea — especially if you’re trying to avoid getting sick and spreading illness to others.
Bryant acknowledged that masking is a choice now more than a mandate; it’s a choice she made when visiting her newborn grandchild after she’d been working and attending a meeting.
“If people are going into crowded environments where they don’t always have the choice to step away from somebody who’s coughing, they can absolutely choose to wear a mask to protect themselves and to protect the others in their family who may be vulnerable,” she said.
Virk said she would “definitely” wear a mask if she were not able to separate herself from crowds.
The kinds of high-quality masks that are recommended to protect against the coronavirus, like an N95 or KN95, “will also protect against influenza and RSV as well,” said Jessica Tuan, an infectious diseases doctor at Yale Medicine.
“If you’re wearing a mask, don’t feel uncomfortable being the only one doing it,” she said.
Wash and wash and wash your hands
You probably perfected your hand-washing routine in the early days of the pandemic — and then, perhaps, let it slide after the CDC said the coronavirus primarily spreads in small particles or droplets from person to person.
But good hand-hygiene remains important, especially as multiple viruses circulate, experts said. As a reminder, the washing should last “at least 20 seconds,” Tuan said.
“Hand-washing is very important and I know we’ve heard a lot about that during the pandemic,” said Bryant, who also said people should be careful to clean their hands before holding a baby. “But RSV is in nasal secretions. If those nasal secretions get on a surface, they can live there. They can be spread that way.”
The CDC says that RSV can survive “for many hours” on hard surfaces and for shorter amounts of time on soft surfaces, including hands.
Even beyond the high-profile triple threat of the season, Barron said washing your hands should be a priority to protect against “dirt and other things that are easily communicable.”
“It is a huge way to transmit all sorts of things and it’s really gross if you really thought about all the stuff that touches seats and handles and doorknobs,” she said.
Test (more than once) before gathering
Virk recommends testing for coronavirus three days before traveling and on the day of travel as a precaution. The Food and Drug Administration advises repeat, or serial, testing with home antigen tests “to reduce the risk an infection may be missed” with a false negative result.
Barron warns that while repeat testing may improve the sensitivity of home tests, they still aren’t foolproof.
“No test is 100 percent,” she said.
As a rule, if someone has any symptoms, they should test, Virk said.
The CDC says people should stay home for at least five days and isolate if they test positive for coronavirus. Without symptoms or with improving symptoms, isolation can end after Day 5. People who have moderate or worse illness should isolate through Day 10.
People who test positive should wear a mask through Day 10, the agency says. And until Day 11, they should avoid being around people who are more susceptible to serious illness from the virus.
While there is no rapid home test for flu or RSV, experts say it’s good to know what you’re dealing with if you are sick.
“Particularly if someone is immune-compromised and they know it’s influenza or they know it’s covid, there are treatments,” Virk said.
Know when to bow out
Bryant said it might have been common before the pandemic for someone who had mild cold symptoms to show up to a gathering and get everyone sick.
“We’ve learned not to do that,” she said. “People who get sick, even with mild cold symptoms, should stay home and stay away from babies.”
Tuan said travelers might want to reconsider visiting family who are moderately to severely immunocompromised, or very young kids who might not have robust immune systems yet.
“If you are immune-compromised, travel on a need-to-go basis,” she said.
Barron agreed that someone who is feeling unwell should avoid gatherings. If that isn’t an option, they should wear a mask, stay apart from other people or stick to outdoor activities.
“Be responsible that if you do get sick, have that Plan B,” she said.