By Katia Hetter, CNN
Americans entered Memorial Day weekend with the United States at five times the level of COVID-19 infection compared with this time last year. Cases continue to rise in most parts of the country, driven by the very contagious BA.2.12.1 subvariant. At the same time, many more people are returning to pre-pandemic activities.
Should people reevaluate their summer travel plans, given the rise in coronavirus cases? What precautions should they take? What about those with underlying medical conditions — and what’s the advice for families with children under 5, who are still not yet eligible for vaccination?
To answer these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and the mother of two young children.
CNN: COVID cases are on the rise again. Does that mean people should cancel their summer travel plans?
Dr. Leana Wen: Not necessarily. There may be some people who want to reevaluate their travel plans, and everyone should think through contingencies — but I don’t think that most people should have to cancel their summer travel.
Throughout the pandemic, I’ve given advice based on people’s risk factors for severe disease as well as their tolerance of risk. Those who are generally healthy, and vaccinated and boosted, are at low risk for severe illness due to COVID-19. It’s reasonable for many people to say that, given their low risk, they are fine resuming pre-pandemic activities and are not going to restrict their travel or other activities. Yes, there is still a small chance they could become very ill, and long-term symptoms from the coronavirus infection remain possible, but many people are concluding that they will assume that risk because the value of travel and all other pre-pandemic activities is so high to them.
On the other hand, there will be many people who are still choosing to be cautious. The good news is that there are also many more tools available to them that were not before in the early stages of the pandemic. There are antiviral pills, for example, that reduce the chance of severe illness even further. And, of course, making sure that they are vaccinated and up to date on boosters also lowers the risk of both severe illness and symptomatic infection.
CNN: What are some factors people should consider in deciding to postpone travel?
Wen: The most important is your own medical risk for severe illness due to COVID-19. I’d advise speaking with your physician to better assess your individual circumstance. This is not to say that people with underlying medical conditions shouldn’t travel, but rather that they should know what their risk is and then weigh that risk against the value they’d derive from the trip.
Another factor is whether you recently had COVID-19. Chances of reinfection are low if you were infected within the past three months. On the other hand, if you were infected back in 2020 and never vaccinated, you really should get the vaccine for optimal protection. And those who are not boosted but eligible for boosters should also get the booster now.
Consider, too, what your plan would be if you were to contract COVID-19 while traveling. Will you be going to a country that has good medical care? Can you access the treatments you need in that location, including antiviral pills, monoclonal antibodies and remdesivir? I’d also recommend talking with your physician beforehand to find out what treatments you are eligible for if you were in your home country. Will you be able to access the same treatments readily at your destination? Will your health insurance cover the cost of treatment?
COVID-19 infection level could also be a guide. The US Centers for Disease Control and Prevention has a list of countries by risk level. I think you could consult this guide as you plan your trip, but keep in mind that circumstances are fluid, and a country that was low risk a month ago could be higher risk now and vice versa.
Finally, think through the inconvenience factor of what happens if you end up testing positive while traveling. If the COVID-19 level in the country you’re going to is high, and you engage in higher-risk activities like dining indoors and going to crowded bars, there is a chance you could get the coronavirus. The United States still requires pre-departure testing before international travel. If you were to test positive, do you have the resources to isolate for the required number of days? Will this be a major inconvenience — do you need to come back for work or family responsibilities? If so, that could weigh in favor of postponing your trip. Which reminds me — travel insurance is a very good idea, given the many uncertainties travelers are faced with. Make sure to check the insurance policy carefully, as not all insurance plans cover COVID-19-related disruptions.
CNN: What precautions can people take during travel?
Wen: Making sure you are vaccinated and up to date with boosters is a big one. If you are immunocompromised, ask your doctor if you are eligible to take Evusheld, the preventive antibody that gives you an additional level of protection.
Another key protective measure is wearing a mask. Most airlines and airports no longer require masks, but remember that it’s always an option available to you. One-way masking with a well-fitting, high-quality mask — such as N95, KN95 or KF94 — is very effective at protecting the mask wearer.
I’d recommend continuing to mask in crowded indoor settings, especially if the area you’re in has high COVID-19 levels and/or you are around people who are coming from other places that have high levels. That includes while flying. If you don’t want to mask during your entire flight, wear a mask during the highest-risk settings — for example, you could take off your mask to eat but mask while standing in the security line and during boarding and deplaning. (Onboard air is circulated and filtered during flight but usually not during boarding or deplaning or when the plane is sitting on the runway.)
Also be aware of gatherings. Events that have some distancing, good ventilation and requirements for vaccination and same-day testing will be safer than those that don’t. Again, this is not to say that you need to avoid every indoor event, but rather to be aware of the risk. If you do attend a higher-risk event, make sure you take a same-day rapid test before visiting vulnerable loved ones.
CNN: Will parents and caregivers of children under 5 have some relief soon? Will their kids be vaccinated in time for summer travel?
Wen: I hope so! I’m very much looking forward to having my own two little kids vaccinated when the vaccine is authorized for them. The US Food and Drug Administration and the CDC are due to discuss the vaccine for young kids this month. By the end of June, families with young kids could be getting them their first doses.
Families should decide for themselves whether they want to wait on travel until these kids are vaccinated. That decision, again, depends on tolerance of risk and the value of the activity.
Overall, we are at a very different point in the pandemic than we were this time last year. We have many more tools at our disposal to help protect us from the worst effects of COVID-19. Particularly because this virus looks like it will be with us for the foreseeable future, we need to be mindful of the risks, while also resuming parts of our lives that are important for our overall emotional health and well-being.
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