Thanksgiving is over. Many people celebrated with just their household unit, but many others did not. In fact, up to 50 million Americans are traveling over the Thanksgiving weekend, according to the American Automobile Association, or AAA.
The comings and goings of US travelers belie the fact that the Covid-19 pandemic continues to surge. The US reported 2,046 deaths Wednesday — the highest one-day coronavirus death toll the country has reported since early May, Johns Hopkins University data shows. The country also hit a new daily hospitalization record, with 89,954 people currently hospitalized for Covid-19, according to the Covid Tracking Project. This is the 16th straight day that figure set a record for the pandemic, as previously reported by CNN.
We talked to CNN Medical Analyst Dr. Leana Wen about her recommendations on how to keep safe after people return from holiday festivities.
First and foremost, anyone who traveled to visit with family and friends or hosted guests outside their immediate household unit should quarantine, Wen advised.
Taking action to protect others around you will help mitigate the spread of Covid-19, especially with Hanukkah, Christmas, and New Year’s just around the corner.
Many people took a risk and got together with loved ones for Thanksgiving. Why are you recommending that these people quarantine after they return?
Dr. Leana Wen: Coronavirus is surging all across the country, and there are hotspots in so many areas. Anyone who traveled to another part of the country and got together with other people could be at risk for contracting Covid-19. When they return to their home communities, they could spread it — to people in their households and to friends, colleagues and any other people around them.
We are facing an impending calamity. Many hospitals are already at the brink. ICUs are full. We all need to do our part and flatten the curve again. And that means knowing when we are at risk to others around us. If you’ve traveled, and have seen other people, you could pose a risk to your community.
How should you go about assessing your risk?
Wen: There are three things you should consider when assessing your own risk exposure. First, consider who you saw over the holidays. How many guests were there and what were their risks? If you visited elderly parents who have been quarantining themselves, that’s very low risk to you. On the other hand, if you were together with three households, some with teenage children who are in school, and they’ve been at work themselves, and these households haven’t been quarantining, the risk is much higher.
Second, what activities did you do with others? If you only saw people outdoors, spaced at least 6 feet apart, the risk is very low. Time spent indoors is a high risk, particularly if you are in poorly ventilated spaces for long periods of time, and where people are eating and drinking (and therefore don’t have masks on). If you stayed in someone’s house, the risk could be even higher, because the time of exposure was longer.
Third, what kind of exposure did you have during travel? If you drove, the risk will be lower than if you flew. I’m actually less concerned about your risk exposure during the flight than all the other components, like waiting at the airport and boarding the jetway, where there’s the potential of people crowding together in less well-ventilated spaces. If you wore a three-ply surgical mask the whole time, that further reduces risk. Overall, I’m most concerned about the risks of getting together with people.
What does a quarantine look like?
Wen: Good question. By quarantine, I mean that you should act as if you’ve been exposed to someone with coronavirus because you could have. That means you should not be around others as much as possible. Do not go to work. Keep kids out of school. Get groceries delivered. Definitely do not get together with others during this period.
The safest thing to do is to quarantine for 14 days. If you have testing readily available, you could quarantine for at least seven days after the date of return and then get tested.
I recognize that this is asking a lot. For some people, this full protocol may not be necessary, if your risk during travel was truly very low (that is if you saw elderly parents only who were already quarantined and you drove yourself). But if you got together with others who have risk themselves, know that you are now at risk, too.
Please keep in mind just how contagious Covid-19 is, and that nearly 60% of the spread is by people who don’t have symptoms. I am certain that none of us want to inadvertently infect others and increase the level of community spread where we live.
The community I’m going back to is a hotspot itself. Should I still quarantine?
Wen: Yes. Just because the area you’re going back to also has a lot of Covid-19 doesn’t mean that you don’t have a responsibility to try to keep the level from getting higher. Having hospitals overwhelmed affects all of us — not just patients with coronavirus but also patients with cancer and heart disease who may not be able to get the care they need.
What if you have roommates who didn’t travel with you?
Wen: If you normally live at home with other people who didn’t go with you on your travels, you should stay away from them during your quarantine period. Do not spend time in shared spaces. If this can’t be avoided — for example, if you have a shared restroom or kitchen — wear a mask, open the windows, and do not use either space at the same time as others. Remember that they could have risk themselves if they traveled too, so please urge them also to follow the same quarantine protocol.
What should you do if you are staying put, for example, if you’re a college student and the school has let out?
Wen: For some students, they were able to quarantine and then get tested prior to returning home. In that case, they are fine to see their family members — though they must continue to be vigilant and not engage in risky behaviors like seeing their friends indoors. For those who couldn’t, they should quarantine once they return home, following the same procedures as above: ideally 14 days and if not, at least seven days and then take a test.
Will I need to follow all these procedures for Christmas and New Year’s, too?
Wen: Yes. There will almost certainly be an even higher level of coronavirus infection by then, and hospitals will be in an even more dire position. I highly encourage everyone to put off nonessential travel. We are so close to getting a vaccine that will allow us to see one another safely again. Please, let’s get through this winter. Keep up the safeguards that we know to work: Wear a mask. Practice physical distancing. Do not gather indoors. I know it’s very hard, but we can make it through this winter!
CNN Medical Analyst Dr. Leana S. Wen is an emergency physician and a visiting professor at George Washington University Milken Institute School of Public Health. Previously she served as Baltimore’s health commissioner. Follow on Twitter: @DrLeanaWen.