I currently live in Ontario where the coronavirus situation doesn't seem to be improving that quickly. Meanwhile, my parents live on Vancouver Island where things seem to be more or less taken care of (for now). I haven't seen them since Christmas and want nothing more than to visit later this summer for a week or so, but would that be irresponsible? I don't want to be the cause of a new outbreak in their tiny rural community! —Myles
As we adjust to the indefinite reality of life during a pandemic, a lot of people are wondering about travel. Initially, the messaging was very clear on staying home unless there’s an essential reason to be out and about.
But new daily cases of COVID-19 in some places, including B.C., are almost down to single digits. And airlines are slowly reopening routes. Air Canada recently announced a list of “destinations for safe travel” including more domestic flights and routes to some U.S. locations, such as New York, Washington D.C., Los Angeles, San Francisco, Boston, and Chicago.
Does that mean it’s safe to travel?
I should first disclose that I recently flew from Toronto to my hometown Vancouver, where I’m lucky enough to have a place to quarantine. (My family lives here and tenants who rent a floor of their house recently moved out.)
But I struggled to make that decision. I wanted to see my parents and friends and be in a place with more outdoor space, but I didn’t want to put anyone at risk, especially coming from a city with more cases. In the end, the fact that I have access to my own living quarters and can stay for an extended period of time, working remotely, sealed my decision to come.
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According to the Centers for Disease Control and Prevention, the risk of infection on an airplane is low because viruses and germs don’t spread easily and because of the way air is filtered on a plane. However, people should still be vigilant about keeping their hands clean and avoiding touching their face.
Dr. Abraar Karan, an internal medicine physician at Harvard Medical School, said although there haven’t been many COVID-19 outbreaks linked to planes, there are still risks because you’re in close proximity to other people. Even though there is ventilation, you are breathing the same air, and you could end up sitting near someone who is infected.
“If you have somebody that’s coughing or sneezing or even turns and starts talking at you, let’s say without a mask on, or even with a mask on, you’re not completely protected.”
He said cloth masks have more efficacy in blocking transmission when the wearer is infected, but are less effective at protecting the wearer from transmission, particularly via small droplets. Karan said flight attendants, who interact with large numbers of people, are also potential vectors of disease.
Dr. Martha Fulford, associate professor and infectious diseases specialist at McMaster University, said her main message about flying is to keep your hands clean.
The virus “doesn’t jump from a seat or a door handle to your nose or eyes. You have to transport it there with your hands,” she said.
She said one of the main challenges with flying would be if people were “crammed in like sardines” and unable to physically distance. (For what it’s worth, my flight to Vancouver wasn’t full—I had a whole row to myself, and no one was behind or in front of me.)
Fulford said if you’re sick, or if the person you want to visit is immunocompromised, or you’re an essential worker who is exposed to people with COVID-19, you should avoid travelling. But if you’re in a low-risk category, she said she doesn’t see the problem with going on a trip within Canada right now, so long as it’s allowed.
“One of the things I would like is if we actually had a better idea where the cases are,” she said. For example, she said in Ontario, both Hamilton and Kingston have very few cases of community transmission—so you’d be low risk if you were going from there to another location.
The Ontario government told the CBC it won’t give a detailed breakdown of where the province’s hot spots are located.
“That’s highly unfortunate because you could target your interventions,” Fulford said.
Karan said he would advise against any unnecessary travelling right now, even to locations that are reopening.
“You really want to have a sustained downwards transition in cases for multiple weeks. Most places have not really met that guideline,” he said, referring to U.S. states that have started getting people back to work, despite the public health advice against it.
Before you go anywhere, check to see what the local public health guidelines are, and make sure you’ll be able to abide by them.
Some U.S. states are requiring visitors to quarantine for 14 days when they arrive, especially if they are coming from a hot spot. In Canada, New Brunswick, Newfoundland and Labrador, Quebec, Prince Edward Island, and Nova Scotia have restricted inbound travel. Nova Scotia and Newfoundland require all visitors to self-isolate for 14 days.
In the absence of a hard rule about quarantining, Fulford said she would self-monitor for any symptoms upon arrival and avoid closed and/or crowded spaces. She said if you’re going to get symptoms, you’d typically notice them within seven days, but it could take longer. If you decide to get tested, keep in mind that it could take several days for the virus to show up in your body.
If you’re visiting people who are high risk, such as a parent over the age of 70 with a health condition, the safest option is to get your own place and visit with them while maintaining physical distance, Fulford said.
On the other hand, “if I want to visit my mother or my parents and they’re in their 60s and extremely healthy with no comorbidities, that’s probably an extremely reasonable thing to do.”
But Karan said to be mindful that if you’re staying with relatives, the risk increases the more you socialize with people outside of your home. He said the lowest risk option is to stick to hotels, avoid lots of people and restaurants, and stay outdoors.
As for going to a rural community, Karan said because they are less dense, the spread is probably going to be slower. But he said you should still follow the same rules around physical distancing, wear masks when near people, and wash your hands.
Keep in mind that many rural communities have expressed concerns about the potential for their healthcare systems to be overwhelmed by the introduction of COVID-19, so visitors may not be well-received.
However, Fulford noted that camping, hiking, and going to cottages are probably the safest vacations right now, because they allow for easy distancing.
“I think people need to be allowed to go on vacation,” she said. “It’s sort of a balance of risk and benefit. The longer we keep people locked down and isolated, the more long-term health and mental health issues we’re going to have.”
The verdict: It’s complicated and depends on a number of factors, including the transmission rates at your starting point and destination, how full flights are, and the risk category of the people you’re visiting. The safest bet is to avoid unnecessary travel. If you go, wash your hands, wear a mask, and monitor yourself for symptoms upon arrival. If necessary, find your own accommodations and quarantine for 14 days.
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