It’s hard to believe, but here we are preparing to embark on our third COVID winter, and just like the two COVID winters before it, there are a lot of unknowns ahead. This winter will be unique from the two previous ones in that it will be the first during which there will be almost no pandemic precautions in place, such as mandatory masking on airplanes. And just as we enter the busy holiday travel season, COVID is now circulating alongside other viruses that were more muted the first two years of the pandemic, namely flu and respiratory syncytial virus (RSV), which are experiencing a resurgence this fall.
“We’re all familiar with winter being a time of increased risk of respiratory virus going around. This year it’s expected to be worse, and one reason is COVID. But the other two reasons are influenza and RSV, which are poised to have a lot of increased activity,” says Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis Children’s Hospital.
Blumberg notes that because of the COVID precautions we had been taking over the past two years, including social distancing and masking, the U.S. experienced decreased rates of non-COVID respiratory viral infections the previous two winters, and unfortunately, “that has led to people being more susceptible to infection [now],” says Blumberg.
That means we have pivoted once again into new and uncharted public health territory, a potential “triple threat” as some have deemed it.
“This is one of the first winters we’re going through with these normal viruses and COVID at the same time. A lot of us are honed in on how are our hospital systems going to do? How this winter plays out will tell us a lot [about] whether we’re in this emergency phase of the pandemic or we’re moving towards something else,” says Dr. Katelyn Jetelina, an epidemiologist who is the director of population health analytics at the Meadows Mental Health Policy Institute and author of the newsletter “Your Local Epidemiologist.”
This fall and winter are also gearing to be the busiest holiday travel season since 2019, with the number of air travelers passing through Transportation Security Administration (TSA) airport screening checkpoints reaching the highest levels they have been since the start of the pandemic—occasionally surpassing prepandemic levels.
For those heading into the holiday travel fray, the current scenario presents two sets of issues. First, there is the concern about getting sick before or during a trip, not just with COVID but with any number of viruses. This could affect the journey on several levels, from forcing a cancellation to forcing a traveler to spend their vacation time stuck inside or not feeling well. Second, there is the concern about getting others sick. The holidays are a time when many travelers reunite with friends and family and, just as during the past two holiday seasons, infectious disease experts remain most concerned about the risk to vulnerable populations, including the elderly and those who are immunocompromised.
The good news is, we have a lot of tools at our disposal to combat transmission, many of which we amassed during the past two and a half years. We can also set up our immune systems for success ahead of the holiday travel season. The U.S. Centers for Disease Control and Prevention (CDC) offers these tips for how to improve our bodies’ natural defenses.
How to enhance your immunity
- Make healthy eating decisions: Limit saturated fats, cholesterol, salt, and sugars.
- Exercise and reduce your stress: Physical activity has numerous health benefits and can also boost immunity by reducing stress and anxiety.
- Get a good night’s sleep: The CDC reports that “sleep loss can negatively affect different parts of the immune system,” which can “lead to the development of a wide variety of disorders.”
- Avoid smoking and excessive alcohol consumption: Both of these activities can weaken the body’s ability to fight disease.
Physical activity helps to reduce stress and boost immunity, according to the CDC.
How to stay healthy this holiday season
In addition to helping our immune system do its job, here are the actions that travelers can take this holiday travel season to improve their chances of healthy getaways and gatherings.
Get your flu shot and COVID booster
With the United States currently “experiencing a resurgence in the circulation of non-COVID-19 respiratory viruses,” according to a November 4 health alert issued by the CDC, the agency is strongly encouraging that everyone get their flu and updated COVID vaccines.
“Both the yearly influenza vaccine and updated COVID-19 vaccine is essential to make sure you and your family are protected. I want to underline that with the holidays around the corner, vaccination is your best protection against infection,” stated Dr. José Romero, director of the CDC National Center for Immunization and Respiratory Diseases, during a November 4 media briefing about the current uptick in respiratory disease.
The CDC’s update came only a couple of weeks after President Joe Biden issued a plea to the American public on October 25 to avoid a repeat of the past two pandemic winters, during which we experienced a rise in COVID infections, hospitalizations, and deaths. He urged Americans to make sure they are up to date on their COVID vaccinations, including the recently released Omicron bivalent booster.
The president noted that only a little more than 20 million Americans had received the latest bivalent COVID booster—less than 10 percent of those who are eligible.
Infectious disease experts recommend using a high-quality mask—like this Powecom KN95—when traveling.
Mask up while traveling
On April 18, 2022, a federal ruling in Florida struck down the country’s national transportation mask mandate and since that time, masks are no longer required on trains, airplanes, or in airports and other transport hubs. But for those who want to protect themselves from viruses that might be circulating on the plane, at the airport, or in any common spaces, infectious disease experts recommend continuing to mask up.
“I’ve traveled and hardly anybody is masking on planes, and I just don’t understand it,” says Dr. Blumberg. “You don’t know who you are going to be sitting next to on a plane. You don’t know if that mild cough is allergies or if they are coming down with COVID, RSV, or influenza. You just don’t know. And then you’re going to be sitting next to them for a while.”
Blumberg notes that over the past three years, he has had only one upper respiratory tract infection even though he’s a pediatrician who sees sick children. He attributes that in large part to wearing a high-quality mask such as an N-95.
“I’ve been really pleased with that. I don’t like to get sick,” adds Blumberg. “That’s why I think it’s more important than ever for people who really do want to stay healthy and decrease their risk—they should continue to mask.”
For its part, the CDC continues to recommend that everyone age two and older continue to wear a mask in indoor public transportation settings.
Reduce your risks (and the risks you pose to others) prior to travel
As of November 11, more than 2,100 Americans are still dying each week from COVID-19, according to Johns Hopkins University. “The vast majority are older and vaccinated, but not up to date. As an epidemiologist, I refuse to accept this as the ‘new normal,’” Dr. Jetelina wrote in one of her recent newsletters.
If you want to improve your chances of getting out the door in good health and protecting vulnerable friends or family at your holiday gatherings, one way to do so is to be extra vigilant in the days and weeks leading up to departure.
Dr. Jetelina emphasizes that when it comes to holiday travel, she is “laser focused on those 65-plus. If we’re going to go see grandpa, we’re going to be extra careful that week before. Meaning we’re wearing masks everywhere, we will do cadence antigen testing, [we’re] trying to do anything to break that transmission chain for those older folks. And that’s not just [for] COVID. That’s flu, too, that’s RSV as well.”
Use those at-home COVID tests
The holidays are a good time to dig out those stockpiles of COVID home tests (but make sure they’re not expired). Epidemiologists advise using them before heading out and bringing some with you during your travels. While they are certainly not foolproof, they offer an added tool in our COVID detection toolbox. Dr. Jetelina recommends testing two days before departure and again on the morning of any event or gathering, such as Thanksgiving dinner.
Eating and gathering outside—if possible—is another way to reduce risk.
Embrace the great outdoors
Fresh air and ventilation continue to be our friends when we are hoping to reduce transmission risk. Prior to travel, epidemiologists recommend either avoiding crowded indoor spaces altogether or masking up while inside, for instance when heading to the grocery store. If the weather is conducive to hosting meals or celebrations outdoors, this is another way to reduce risk.
Be flexible with your travel plans
Despite all our best efforts, there is the possibility that we will get sick before, during, or after our travels. That means we need to be prepared to cancel or alter our plans at the last minute. It’s better to make peace with this possibility and have built-in safeguards for it than to blindly hope for the best.
Have a contingency plan in place for whatever the fallout may be for any cancellation, as well as a plan for if you get stuck in your destination for several extra days with COVID or a nasty flu. Depending on the complexity of the trip, look into options like adding Cancel For Any Reason coverage to your travel insurance plan so that you can recoup some of your losses if you need to cancel at the last minute due to illness. All of the major U.S. airlines are still without flight change fees for all but their Basic Economy fares, so if you need to cancel, you can bank the money you spent on flights as future flight credits for a redo when you or the others in your crew are feeling better.
