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Maia Majumder hasn’t had much time to think about a vacation lately.
For much of 2020, the computational epidemiologist has spent most of her time studying the coronavirus as part of the Computational Health Informatics Program run by Boston Children's Hospital and Harvard Medical School, trying to model the behavior of the virus since it first emerged in China. On Jan. 24, Majumder and colleague Kenneth Mandl became some of the first researchers to publish an estimate of the R0 for the coronavirus, or the average number of people infected by one infectious person, back when it was still believed to be mostly isolated in Wuhan.
But if she were to pause and take a much-deserved break after all these months thinking about COVID-19, what might that look like? Given what she knows about the virus and its transmissibility, would she be comfortable flying somewhere? Would she drive instead? Would she stay in a hotel?
“I wouldn't get on a plane right now for a vacation, but I would take up to a two-hour drive in our family car and go camping at a secluded site where I could ensure that my family would be adequately distanced from other people,” Majumder told BuzzFeed News.
“I'd also be comfortable with renting a single-family cabin that had been cleaned between reservations using COVID-19–compliant protocols, ideally with a few days between the cleaning and check-in,” she added. “In both cases, I would pack groceries with us and would avoid any activities that might bring us within 6 feet of non-family members.”
As Americans swelter through a sticky summer wearing masks, many are also feeling in desperate need of a change of scenery after months of mostly confining themselves to their homes. But with large swaths of the country now seeing dramatic and deadly surges in the virus — including in popular vacation destination states such as Florida, California, and Texas — how safe is it to take a trip? And what summer activities are less risky than others?
To try to get a better picture, BuzzFeed News asked Majumder and half a dozen other scientists and doctors across North America about their summer plans and what things they would feel comfortable doing amid the pandemic. Having previously sought their advice on whether it was OK to visit parks and beaches (in short: yes, but with precautions), these experts weighed in on whether they would get on a plane or visit a pool or dine outdoors.
While most of the experts we spoke to were much too busy amid the pandemic to travel or take time off, there were things they all agreed on: wearing masks, social distancing, washing hands, and being outdoors as much as possible, say, on a camping trip with those in your quarantine bubble.
But their responses also varied greatly. That hints at a more obvious truth: Everyone’s situation is different and each person needs to make their own decisions about how best to assess and reduce the risks for their families and others, based on both where they live and where they plan on traveling to.
“There’s no activity that’s absolutely safe or risky,” said Amesh Adalja, infectious diseases physician and senior scholar at the Johns Hopkins Center for Health Security. “It’s all part of a risk calculus and you have to think about what value you’re placing on activities and how to adjudicate between the two.
“I think it’s going to be very difficult for some people [to make those decisions], especially those at higher risk for complications,” he said. “I think it’s something we as Americans haven’t done for a very long time, such as before the measles vaccine.
“There’s no black or white answer,” he said. “It’s lots of shades of gray.”
What are your summer plans? Are you going on a vacation? What does that look like?
AARON GLATT, doctor at New York’s Mount Sinai South Nassau hospital and a spokesperson for the Infectious Diseases Society of America (IDSA): I think there are lots of things to do that are safe. I’ve just been too busy to go. Maybe I’ll have some time in August.
SUSAN KLINE, a professor of medicine with the University of Minnesota’s Division of Infectious Diseases and International Medicine and another IDSA spokesperson: Yeah, I did take a vacation. I got back from a two-week summer vacation a little over a week ago. We decided to drive instead of flying. We were going to visit a family member. Instead of flying, we did a road trip … We were also very cautious. If we were going into a public space inside a building we would always wear a mask. If we were in close contact with other people we would wear masks and we washed our hands carefully
GERARDO CHOWELL, professor of epidemiology at Georgia State University’s School of Public Health: No vacation this year at all. There’s no point, and being an expert and trying to advise the public, we are not taking any vacation. It’s a very simple summer for us this year. We're grateful we have some green areas around our house here in Decatur, Georgia, and we go out for walks almost every day. But that’s it. We’re not going anywhere because the risk is very real, now more than ever.
ADALJA: I’m probably the worst vacation taker. I’m less likely to take it because of the coronavirus, not because I’m scared but because I don’t want to get behind on my research.
MELISSA MILLER, director of the clinical microbiology and molecular microbiology laboratories at the UNC School of Medicine and chair of the American Society for Microbiology (ASM) Clinical and Public Health committee: [I’m] overseeing COVID testing at the hospital; no summer plans as I cannot be gone for very long nor risk being quarantined at home and unable to go to work. My days off are staycations only. … My answers will be skewed because I cannot be away from the laboratory nor risk getting quarantined at home and not able to go to work.
If everyone would social distance as much as possible and always wear a mask when they can’t we could interrupt transmission and get back to “normal” sooner. I prefer to restrict myself now and reward myself later when this is all over with a vacation to be remembered!
Would you feel comfortable getting on a plane and flying right now? Is it safe?
KLINE: I am not very comfortable getting on a plane still. My biggest concern is once you’re on a plane with a large number people, usually it’s in tight quarters and you’re all sharing the air, so I do think that’s the highest-risk situation: indoor spaces with a relatively large number of people in a relatively small space, plus add in you’re often sitting very close to people and you can’t control who you sit next to and you have no idea if they have any symptoms.
ROSIE REDFIELD, microbiologist at the University of British Columbia’s Department of Zoology: One of the big issues for anything you might choose to do that involves other people is what is the level of infection in others you’re going to be interacting with. If it’s in the local community, then you know what it is in your community and you can make an educated decision, but on a plane you’ve got people coming from all over and you don’t have any control.
I’d still be quite cautious about getting on a plane and I’d sure as hell wear a mask and I’d do my best to pick an airline that’s actually enforcing the requirements to wear masks because I’ve seen some disturbing stories about how they don’t have any way to enforce it. I’d absolutely wear a mask in an airport, on an airplane, and I’d minimize the amount of time standing in contact with others. I wouldn’t stand in a line until I had to. I’d turn the overhead vent up on the plane to keep the air moving.
MILLER: I will not be getting on a plane unnecessarily. I separate my decisions into necessary risks and unnecessary risks. Traveling on a plane for pleasure is an unnecessary risk for me.
ADALJA: I do think it’s something that can be done safely. Many airports, many airlines, have put in place safeguards to decrease the risk of transmission. I’d tell people there are simple steps you can take to decrease the risk of transmission. Many planes are not full anymore so that makes it easier. But other important things are handwashing, avoiding congregated spaces at airports like food courts, and wearing face coverings.
GLATT: I would feel safe on a plane if I had a good reason to go, but at this point in time when so many places in the US and across the world are seeing infections soar, it’s safer in my areas so I’d probably just go somewhere nearby.
It’s not so much the plane, it’s the places you’re going to. I wouldn’t be afraid to go on a plane. My son just went on a plane.
CHOWELL: Yes. With the proper precautions and safety, yes. In fact my wife had to do that. She happened to be in Chile when the pandemic hit so she got stranded in Chile for three months and finally three weeks ago she was able to fly back to Miami and then Atlanta. She was able to get a great face mask, she got an N95, and she got a face shield, and she put herself into quarantine.
I could travel by plane with the proper precautions and face shield but I wouldn't enjoy it for a vacation. It wouldn’t be something I'd enjoy, flying somewhere, particularly a long flight. I think we’d prefer to stay put and maintain the levels of stress at a minimum and stay home as much as possible.
Would driving or taking a train be preferable to flying (bearing in mind that for longer trips, you’d need to make stops in gas stations, restaurants, motels, etc.)?
GLATT: I wouldn’t be worried about that. I’d be more concerned about traffic accidents. If you drive 1,500 miles, that’s a risk in and of itself. I think both [flying and driving] can be done safely. But you have to weigh the risks and benefits.
ADALJA: The transmission doesn’t occur with fleeting contact, and transmission from surface to surface is secondary to person-to-person. I’m not worried about acquiring the virus at a gas station. Many hotels have changed their operations to minimize the risk.
KLINE: We drove our own car [on our vacation] because we thought it better to drive in a private vehicle rather than an airplane. Where we could, instead of staying in hotels, we camped because we thought that was safer. … I felt really safe on the road trip. I think you can control your own movements better on a road trip than on an airplane.
MILLER: I would limit my travel to driving with only my family that lives with me and likely stay within my state. Careful planning of gas stops, bathroom breaks, and food would be a priority for me. I would not plan to stay in multiple hotels while driving to my destination, so my trip would likely be limited to destinations within a day drive from home.
CHOWELL: Yes, I think driving would be safer definitely than going to the airport and spending time on the plane in a confined setting with people you don't know. The chances of someone in the plane being a carrier of the virus is not negligible. If you drive with your bubble, I think you are completely safe. But if that drive will entail a few stops and even staying in a few hotels along the way, that will increase the risk. You could take care of yourself by wearing a good face mask. If you have to stay overnight in a couple of hotels that’s increasing the risk of contracting the virus. There are a few variables involved in that process. It’s tricky. You can try to sanitize everything but that would be a chore.
Would you rent an Airbnb with a small group of friends or family? Would you do anything extra when you arrive, such as opening windows or cleaning surfaces?
REDFIELD: I’d be quite comfortable renting an Airbnb — but with a small group of friends? That depends. Are they coming from communities where infections are really low? Is it you and your buddies from your community or you and your buddy from Nebraska and your uncle from Seattle? I’d be cautious.
Getting together outdoors for a bit where you’re not jammed together, that’s one thing. But sharing an apartment or bathroom and breathing each other’s air? I’d worry about that.
If you’re at that Airbnb or cabin with friends or extended family, keep the windows open.
KLINE: An Airbnb is similar to a hotel room. I think there are certain high-risk surfaces that I’d disinfect like kitchen countertops, handles, anything in the bathroom, sinks, toilets — those sort of high touch surfaces I'd wipe down with a disinfectant. Same thing with tables. I’d assume whoever was there could’ve had corona and could have contaminated high-touch surfaces
MILLER: No. As there are at-risk people in my circle or their contacts, I have chosen to only cohabitate with my immediate family. If staying at a rental, I would clean surfaces and check with the renter on their policies related to time between renters and cleaning practices.
GLATT: I would feel comfortable in [either a hotel or Airbnb] if they were clean and taken care of. I would feel comfortable in either.
[On cleaning], it would depend on a lot of factors. Was somebody else just there? Am I waving goodbye as they leave? Was the house just cleaned? I don’t think you need to go crazy. It depends on the policies. I know some hotels don’t re-rent the room for 24 hours, for example. If that was the case, I wouldn’t be concerned. I don’t think that’s a major mechanism of transmission.
CHOWELL: I would definitely have to do some work disinfecting most of the common surfaces in that place. I’d make sure it’s well ventilated, disinfecting surfaces in the restroom, kitchen. We’d try to limit our contact with surfaces there and try to use that place only to sleep there. It wouldn't hurt to do some more cleaning when you arrive to have some piece of mind.
ADALJA: You have to remember that transmission from surfaces is a secondary route. It’s not as important as person-to-person. That being said, I know Airbnb is putting in protocols to have residences cleaned thoroughly between guests. I’m pretty confident. If you’re uncomfortable, you can always re-wipe them down. Transmission from these surfaces are secondary issues and the virus does not remain on these surfaces for that long. If you’re worried, you can always use normal disinfectant on these surfaces.
If you were going on a trip with friends or family, should you get tested before you leave? When you return? Both?
ADALJA: I would not recommend people that aren’t symptomatic get tested. We have a major testing backlog and we need to prioritize symptomatic people getting tested. If you don’t have symptoms, you shouldn’t be tested unless you’re part of a contact tracing scheme and you’ve been instructed to seek a test.
Remember, the result is also only a moment in time. So it’s not something I would recommend people do.
MILLER: Neither. There are not enough tests to warrant testing asymptomatic individuals prior to or upon returning from traveling. I would self-monitor for symptoms and get tested if symptoms developed.
CHOWELL: Yes, testing would be a way to minimize bringing the virus to other people. Getting a test soon before your departure would be a good idea if you can do that.
It also depends on how many days you’re going to spend there with people you’re visiting because the test may be negative if you're still early in the infection process and you may become infectious a day or two later. You’re not guaranteed you won’t develop symptoms later on. It’s not bullet proof. But it would be a good idea if you can do that. It’s a way to catch asymptomatic people.
You should maybe also get one when you come back if possible, particularly if you were mingling with strangers.
REDFIELD: In general, the more testing we can do the better. That applies at an individual level and at a community population level. So absolutely, but it has to be — I’m seeing scary things about how long it’s taking to get results. The communities where infections are very low, it’s pretty easy to get tested and get results back quickly. In higher-hit areas, it’s harder to get tested. There’s a backlog and you might have to wait a week or two to get results. The test isn’t going to be a lot of use if you have to wait weeks, during which time you might have become infected.
Would you go on a camping trip?
CHOWELL: Actually, we have thought about that. I think that could be a low-risk activity as long as when you get there you make sure everything in the cabin is disinfected. But yes, getting away from people, getting into the woods and mountains, a place where you’ll be socially isolated from others, be alone and have a chance to enjoy nature — that would be a nice thing to do and overall pretty low risk. As long as you don't have to drive a long way to get there. If it’s a short trip, it’s probably better.
KLINE: I think camping is quite safe because campsites naturally space people apart. The only potential problem again is if you have to use the public restroom so I’d minimize the time hanging out in public restrooms and wear a mask when you have to go in one. Wash your hands too. The other thing we did was carry a lot of alcohol hand rub with us.
REDFIELD: It depends on who I am camping with. Camping with a family is the best thing of all. You’re mostly outdoors. The tents are well spread apart. I think that’s gotta be the safest thing you can do. Plus, it’s nice being outdoors if you’ve been stuck in the house.
MILLER: Yes, with my immediate family or another family that is social distancing. I would still remain distanced at the campsite from those not in my immediate family.
How comfortable would you be swimming at an outdoor pool? Should you wear a mask there?
REDFIELD: If it’s an outdoor pool, if there’s a breeze, if it’s in an area with a reasonably low level of infections, sure, absolutely. Outdoor activities are much safer because of the ventilation and people can spread out. When you’re outdoors, the air you breathe out mixes with the outdoor air and it goes up and out. It gets diluted and there’s almost always some sort of breeze. So whatever you and the people around you are breathing out is being carried away. So I’d be much more comfortable in an outdoor pool.
If it’s so full you can only bounce up and down and you’re surrounded by people, I’d be more worried, but if you can swim laps you’re fine.
You wouldn’t want to hang out in a crowded locker room or anything.
ADALJA: I would be comfortable in a swimming pool. This is not a waterborne virus. There’s no risk of contracting the virus in the pool. The risk is people congregating around the pool. You still need to social distance on the pool deck and if you can’t, you might need to wear a mask. Make sure you’re still washing your hands. Avoid congregating at the concession stand. It’s the people. It’s not the swimming pool.
MILLER: While time in the pool might be safely enjoyed, I am concerned about the number of people at the location. This is an unnecessary risk for me. We bought an inflatable pool for our backyard to get our pool fix.
GLATT: I think social distancing at the pool is more important than anything else. The pool itself is not dangerous, but what else are you doing? Sitting around with other people and not wearing masks? That’s more of a risk.
CHOWELL: I am not sure about that one. It depends on how many people are visiting that pool at the time you are there. If it’s a popular place, I don't think it’s a good idea, particularly if you’re going to run into people in the dressing room, in the restrooms, where you may cross people you don’t know. That is what brings up the risk of running into someone who is positive. I don’t feel comfortable doing that for myself and my family.
KLINE: I would not. I wouldn’t feel real safe. You don’t know who has been in the water. You don’t know if they’ve been infected with coronavirus. I might wade in the water but I don’t think I would dive under or submerge my head. I don’t think I’d sit in a hot tub with steam coming out because they could be higher-risk situations where you might be exposed to the virus.
Would you visit a public museum?
MILLER: No, this is an unnecessary risk for me.
KLINE: That wouldn't be my choice for things to do right now because it’s an indoor space. You’d get a lot of people in a larger space but I don’t know how well they’d do social distancing. It’s indoors, there’s concerns about crowding, not knowing how good the ventilation system is, and having to be there a long time. A visit to a museum is not like a quick dash into a convenience store. You’re there for an hour or two.
REDFIELD: I guess a lot of places and things are opening, but they’re restricting how many people can come in and they’re wearing masks. If I were going to a museum in a destination city where people were coming from all over, like New York, then I’d wear a mask, especially because you’re probably going to be there for a while. You’re not just in and out. I would also make sure the mask fits well — that the air goes through the mask and not just around it.
CHOWELL: With a face mask, yes, probably. I would be fine doing that. But it would be a short visit. It would not take longer than 45 minutes. And it would have to be wearing a mask and at a museum where they are limiting the number of visitors and they’ve put in place protocols to ensure social distancing.
ADALJA: I would. You have just to remember to be mindful of other people and social distance and washing your hands a lot. But yes, I wouldn’t have a problem visiting a museum.
GLATT: I think all of these are the same type of question. Are there going to be opportunities for you to be masked or social distanced? Or are there going to be pile-ons where everyone is packed in tight? The critical factor isn’t if somebody else breathed this air 15 minutes ago. It’s, are they on top of me?
Have you visited an outdoor restaurant or bar? Did you feel safe?
ADALJA: I’m in Pittsburgh. They do have outdoor dining and I’ve been there. I avoid the crowded areas. I try to maintain my distance from other people and I’m mindful of washing my hands frequently. I don’t pull up my mask each time the server comes because they are usually wearing one.
KLINE: On our road trip we did because you have to eat. We did only dine at outdoor restaurants or do takeout and eat it outdoors and in our hotel roms. We didn’t dine at indoor dining establishments. Being outside, if you can sit at least 6 feet away from other diners it’s much safer than dining inside a restaurant. I do think it’s best to wear the mask. Not while eating but at other times.
CHOWELL: I don’t feel comfortable doing outdoor dining yet. We have been doing takeouts. Most of the restaurants around here are delivery. We are having our food at home but not going out to restaurants.
I would feel a lot more comfortable if you find a place where you can dine outside with the proper precautions and protocols. I would feel fine doing that. But I have to say we haven’t gone out to dinner or lunch at any place.
GLATT: I have done takeout but I think if it’s socially distanced and the tables are far enough apart it’s a reasonable thing to do. It’s about individuals’ risk factors. If somebody is older or has medical issues then they should be more cautious than someone who is a healthy 25-year-old. What might be healthy for them is not appropriate for others. You need to look at all the risks and not just one factor.
REDFIELD: I’d be pretty comfortable. I wouldn't want to sort of cozy up at the bar to a bunch of other people. I’d like people to keep their distance at the bar, but you’re outdoors and that’s so much safer than being indoors.
MILLER: Absolutely not. We have limited ourselves to occasional takeout from restaurants that appear to have good practices. A bar is out of the question; it is clear there is a high risk associated with visiting a bar. You cannot social distance or keep a mask on.
When you return from a trip, what does it mean to “quarantine” on return? Can you not leave your home at all?
REDFIELD: To really quarantine, the strict ruling means you have to stay home and somebody does your shopping for you. But of course it’s very convenient and people will stretch that because they think they feel OK. Fourteen days is this arbitrary cutoff and you have to be being tested because any infection can be asymptomatic.
GLATT: If they’re in self quarantine they’re supposed to stay home. They can go outside but they shouldn't be around other people or in supermarkets. They can go outside and take a walk but they shouldn’t be with other people.
ADALJA: You’re supposed to have no interaction with other people for two weeks. Obviously, I don’t know how well this can be enforced, but that’s what the technical recommendation is. I don’t know how compliant people are going to be, but maybe that will actually discourage people from going to those hot spots because then they’ll have a difficult time when they arrive back.
CHOWELL: You should stay inside your house. If you want to take a breath of fresh air, right outside your house I'd consider it valid as long as you're wearing a mask and not talking to a neighbor. You shouldn’t go to the supermarket or any public setting at all. That’s the definition of quarantine.
If only half your family goes, those folks should be isolated in an independent room where you provide food and that individual is isolated for two weeks. That's what we did here [with my wife] and it worked relatively well. ...
We have right now at home, my mother in law. She’s a high-risk person so we can't afford any type of risk of bringing the virus.
My daughter tells me, “Oh, my best friend is now in Florida visiting her grandparents,” and I’m like, “Oh wow, that’s interesting.” That’s very surprising behavior. And her parents are well-educated people, too. And that’s the behavior of many Americans in this country. They have this mentality of I want to have my vacation somehow and obviously that is contributing to the rise of the number of new cases.