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Three years into the pandemic, the question of how to approach travel — whether for fun or necessity — remains as confusing as ever. With winter, traditionally a vacation high season, around the corner, we asked infectious disease experts about the measures they’re taking and the advice they have for others.
Recognize that risk exists. Calculating risk can be complex, says Dr. Susy Hota, medical director of infection prevention and control at the University Health Network in Toronto. Take precautions (like the ones below), but understand you could be exposed anywhere, and even with your best efforts you might end up getting infected. Dr. Hota travelled to Alberta with her kids in July, while cases were still relatively high, so they centred their plans on small family visits, outdoor activities and patio dining.
Don’t delay boosters. Make sure you’re caught up on COVID vaccinations, including the Omicron-targeted bivalent vaccine. The current recommendation for a booster is to wait six months since your last dose or COVID-19 illness, but Dr. Hota says you can get boosted as early as three months later.
Tara Moriarty, an infectious disease researcher at the University of Toronto and co-founder of the grassroots organization COVID-19 Resources Canada, worries that many Canadians haven’t gotten their fourth doses. “We’re seeing a ton of reinfections,” she says, “(and) a lot of people who have not previously been infected are now getting infected because they don’t realize the fourth dose is important.”
Mask up (even if it’s optional). As of Oct. 1, people aren’t required to mask when travelling within or to Canada, but they absolutely still should, experts say. Dr. Howard Njoo, Canada’s deputy chief public health officer, explains that the country’s public health agency is encouraging Canadians to “practise enhanced health precautions,” especially when travelling. That includes masking on planes, trains and buses.
Dr. Njoo has travelled during the pandemic, including to the World Health Organization headquarters in Geneva, and tells the Star he remains careful: “I follow local public health advice on when I should wear a mask — but will also do so, even if not required, if I am in closed and crowded spaces.” Given Omicron’s infectiousness, Dr. Hota says that “cloth masks won’t cut it.” Go for a well-fitting, medical-grade mask (like an N95 respirator), with at least three layers and no gaps for air leakage.
Be aware of air quality. Ventilation systems vary among planes, but most do a decent job of filtration and recirculation — that is, when they’re in the air. When planes are on the tarmac, the ventilation is switched off to avoid sucking fuel fumes into the cabin, explains Colin Furness, an epidemiologist and assistant professor at the University of Toronto’s Faculty of Information.
Furness hasn’t flown during the pandemic, but he still advises others on how to do it more safely. For example, if you must unmask to have a snack or sip a drink, do it while the plane is in the air (when the ventilation is on), and while others next to you have their masks on.
Pack rapid tests. Although rapid antigen tests (RATs) aren’t foolproof — they can give false negatives — they can still be helpful as one tool in your arsenal. You can test methodically before and while travelling with others, especially if visiting more vulnerable people. Don’t just follow the box instructions either. Public health guidelines since February 2022 suggest you go higher up your nose “until you hit resistance,” and also swab the inner cheeks, tongue and back of your throat for more accurate results. “A rapid test result is just part of the story,” says Dr. Hota, who recommends factoring in any exposure risks, any symptoms and how they’re progressing.
Consider your accommodations. In a hotel room, steps you can take to improve air quality include opening windows (if possible) and bringing your own HEPA filtration unit. For a recent conference in Chicago, Furness says his wife packed a small unit in her suitcase, and after check-in, let it run for 30 minutes before unmasking. In addition to opening a window to draw in fresh air, you can also turn on the bathroom extractor fan if there is one, says Moriarty.
Even better, say the experts, are accommodations that don’t have shared air, such as motel rooms that open to the street; stand-alone cottages or cabins; and resort villas separated from others.
Have contingency plans. For peace of mind, invest in travel insurance. Dr. Hota also recommends travelling when it’s less busy for you personally, so if you do happen to pick up something, you can work recovery time into your schedule. If you’re travelling with others, Moriarty suggests having a separate space where someone can go if infected, or at least have a plan in place if that happens.
Recognize that even with good intentions, behaviours tend to change on holiday as people relax and enjoy themselves. “I don’t think any of this is about judgment,” says Dr. Hota. “It’s about trying to do the right thing for yourself and those around you.”
Clarification — Oct. 28, 2022: This article has been updated to note that when turning on a hotel’s bathroom extractor fan to improve air quality, experts recommend also opening a window at the same time, so fresh air is being drawn in from outside.
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