As we continue to navigate these unprecedented times, KCBS Radio is getting the answers to your questions about the coronavirus pandemic. Every morning at 9:20 a.m. Monday-Friday we're doing an "Ask An Expert" segment with a focus on a different aspect of this situation each day, sponsored by Sierra Pacific Financial Advisors.
Today, we discuss summer travel and family vacations during the COVID-19 pandemic with Dr. Lisa Lee, a public health expert with Virginia Tech who specializes in infectious disease epidemiology and public health ethics.
You spent a good chunk of your career at the CDC and I have to ask anybody who's been in the public health game if you could have forseen what this real world reality we're facing would be like? I'm sure you thought about it a lot, but to actually experience it.
I never thought I would. This pandemic is really what infectious disease epidemiologists dread; a respiratory disease that's highly infectious and lethal. This is what we all used in our modeling as the "worst case scenario." So we are definitely in what we thought we would never see in real life. But here we are.
And you also have an interesting background, I think unique among folks we've talked with for this segment, in bio-ethics. You were the Executive Director of President Obama's Bio-Ethics Commission. We are in the middle of something where everything isn't equal, and we're faced with questions about treatment, prevention, messaging. Could you talk about that for a moment?
The thing about ethics is it's such a great partner to science because science and research and public health science tells us what we can do, and ethics really helps us decide what we should do. And in this case, with COVID-19 we rely very heavily on the science; what is safe, what's best. But as you said, we often have things conflict and so we might want to do something and neither option is very good, and when we're stuck with the question of, "what should we do?" And ethics really helps us think through those kinds of decisions. So I'm sure many of your listeners, all of us everyday take these bio-ethics questions and they really come out in a situation like COVID-19.
Yeah these are the hard ones, it's kinda easy to say "this will make that happen" or "that will make this happen" but it's the gray part in between where people are kinda hung up right now.
Sure, sure. It's understandable.
We're going to get to listener questions now, which have been sent in to askus@kcbsradio.com. First one: I am wondering about traveling on a train, such as Amtrak. I am thinking of a trip in California from San Diego to Santa Barbara in October and I've heard a lot of recommendations about flying, but just thinking if train travel is going on presently, and if I need to know a lot in advance of planning such a trip?
Great question. I've gotten lots of questions about travel and very few about the trains so I'm glad a listener is interested in that. I think generally speaking, travel this summer and probably for the foreseeable future is going to require a lot more planning than we've really had to do in the past. By that I mean thinking about your trip from start to finish and remembering the four key things about public health: you want to stay six feet away from each other if at all possible, wear a face mask or covering, not touch your face when you're out and about and to wash your hands frequently. So if you keep those four things in mind when thinking about your trip, you'll have to think about how to be prepared. Have enough masks, have enough cleaning supplies.
So a train, for example, is not unlike any other transportation where we're in a small space with other people that we don't know or are not our family who we've been isolated with. We've got to be careful touching surfaces, we have to ensure that everybody wears a mask if at all possible, that we keep six feet apart. If we're traveling with children we have to really think carefully about, "how are we going to help children maintain physical distance?" And if they're old enough - that is, over two - can keep their mask on their face and not be touching it and taking it on and off. For a train I would think, very similar to any other kind of congregate travel, bring disinfectant wipes with you. Amtrak in particular has a cleaning protocol that they have implemented, as have most major carriers, with enhanced cleaning protocols and limited booking and these kinds of things to try to keep distance and keep things clean. They are also, like many other carriers, requiring face coverings for all customers who can wear them.
I could use some guidance. My husband and I have been debating plans for a trip to another state to see family. I worry about the whole health situation: the airport, the flight, hotels, restaurants, etc. He's less worried about that, but he says there's an ethical reason not to travel these days. Can you discuss that?
Absolutely. Great question. What we have to consider, in addition to pre-planning to make sure we have enough supplies and enough masks for everybody, enough wipes, that we can maintain distance, we do have to think about the state of the pandemic where we are (that is, where we're traveling from) and where we're going (that is, where we're traveling to). So if you're going from a low prevalence area (say rural Montana for example) to a city, the chance of you bringing the virus to the city is lower than your chance of bringing it home from the city. So you really want to be thinking about those kinds of things. The ethical questions are really tough ones. You might really want to see family or really need to see family, but the question really is: can you be a carrier, one of the half or so who are asymptomatic, and bring that to a community or to a family member? So those require careful consideration. Not so much a factual one, but an ethical question.
Testing is obviously not perfect because there's a lag time and so on, but would you advise people having that ethical question to go get COVID-19 testing before going?
That's a great question. I think part of what we would suggest is, if testing is available, go ahead and get tested. If you have a negative test and you're going to see a family member who might be at risk and you don't want to take the virus there, then you have to make sure you stay unexposed for two weeks prior to your journey. So you can get a test, plan ahead, then make sure you stay unexposed - that is, you don't go out without a mask, you don't get within six feet of people you don't know - and then you can go visit that person and you have a better chance of not carrying the virus with you.
Is it safer to fly or drive?
Good question. I think the key here is that the less you have to interact with people who aren't in your "bubble" so to speak, reduce that as much as possible. So plane travel: once you're on the plane it's pretty safe, it's just getting to the airport, standing in line, waiting close to people. I would say driving your own vehicle is probably the way to go. That said, if you do drive in your own car, be sure to buckle your seatbelt and don't use your phone.
We had to cancel our April trip to Hawaii. Since then, the 14-day quarantine period there has been renewed month after month. Once this quarantine lifts, how much lapsed time would be a good amount to wait before thinking of rescheduling our trip to Hawaii? We are seniors in our 60s.
If the travel isn't essential, at this point I would say that it's probably best to wait until we can get a vaccine or until we have this epidemic under control. The two week quarantine is so people don't come from other places and bring the virus to the islands, and I think that makes a lot of sense. Some other countries are doing that as well. I would wait until there's no more spread in Hawaii. If possible, wait until we have the vaccine.
Are there any real standards for how to clean an airplane or a hotel room or a shuttle bus or a rental car?
So there are standards for products that will decontaminate and I think the guidance has been to all of these public accommodations, whether they're cars or hotels or planes, is to use an EPA-approved cleaner or disinfectant and then to really think about all the commonly touched surfaces. So high traffic surfaces like doorknobs and faucets and toilet levers and these kinds of things. Most hotels and airlines have a cleaning protocol and if I were going to travel, before I booked in a hotel or with a carrier I would ask them for their cleaning protocol. They should be able to supply that to any customer.
I'm far more worried about being on the plane than in the airport, where I assume there will be very few people and it'll be easy to keep my distance. What about the circulation of all the air on the airplane?
Yeah, that worry is interesting. It's actually the reverse, to be worried about. The air circulation in the plane itself is very much external air. It's probably the safest air flow anywhere, better even than in a building for example, it uses a lot of external air once you're in the air. The risk for flying is really being within six feet of a lot of people, many of whom likely, if they have the infection, don't know it. So think about things like standing in line to turn in your luggage, standing in the security line, waiting for the restroom, things like boarding the plane and de-planing. These are all times where we get close to each other and that's where the real risk is. In an airplane the air is probably safer than pretty much anywhere, it's really your proximity to other people. So if you have the middle seats empty and you're able to keep your six feet distance from folks, the plane itself is less risky than the transport and the actual time in the airport.
I had to cancel my three-week trip to Europe for this July that involved visiting four different countries, one of which now has a mandatory 14 day quarantine. When would it be a good timeframe to start thinking about re-planning this trip, as I have credit vouchers that need to be used within a year's time? Any forecasts? Also, what about crowded public transit systems like subways and commuter trains overseas?
I would definitely avoid any crowded anything at this point. You want to try to be in situations where you can have a distance of at least six feet if not more and face coverings required. And many subway systems and transport systems are requiring face coverings, but they're not 100%. So the other thing about traveling overseas is every country has different rules, every airline has different rules so again, in terms of planning, it's going to take a lot to be thinking about where you're going, what the requirements are for each country, each transportation system, etc.
My guess is that your travel vouchers might expire in a year but if we don't have a vaccine and the coronavirus is still circulating as it is now, it might be worth asking about getting that extended.
I have terminal lung cancer. How do I balance if it's safe enough to take a life's dream trip to London and Rome and enjoy life's last moments and risk getting COVID, or staying put and staying safe but no travel?
That's a tough question. I think obviously a person with terminal lung cancer is at very high risk for severe complications from COVID-19. Anyone with any kind of lung problems are really at the highest risk. It really has to be about whether the life's dream and what that might mean is a very individual decision. I will say it's a very high risk trip.
I'm wondering about unaccompanied minors on planes: are they allowing that now at age 9, and is that high risk?
There is not a federal instruction to airlines about how to manage this. Each airline, each airport has different rules and guidance. So you'll really need to check for that particular airline and the airport, make sure you check both. In terms of is it safe, a 9-year-old accompanied by a flight attendant or what have you, if you can trust that that child can actually maintain a distance, use wipes and follow instructions, that might be okay. But you really want to make sure that you check with the airline first and then the airport so you know what to do with an unaccompanied minor.
I hear a lot about how children seem to be less susceptible to the coronavirus. We're a couple in good health in our 40's, two children under age 6. Do you think a beach vacation somewhere where we stay in a condo and stick to ourselves on the beach makes sense?
You're right, kids are not less susceptible for the infection but if they get the infection they're less likely to have dire consequences. Now that said, there are children who have died and if your child has an underlying condition, you really need to take that into account because people with underlying conditions are especially at risk for pretty fire outcomes if they get COVID-19. In terms of a beach vacation, I think that the key here is when you travel with kids, you've gotta know your own kids. Can they keep six feet from others? Will they be able to manage a mask at the beach if they are closer than six feet to others? If you're at a beach and you can stay six feet away from other folks, that might be okay. But again it takes a lot of planning. You're going to have to plan for what kind of cleaning materials, masks etc that you need to bring and plan ahead.
My family is really eager to go to Disneyland when they reopen next month. I'm a little bit worried about being around that many people even if they are wearing masks and keeping their distance. Am I overthinking this?
I think that's a healthy worry. I think if there's not a compelling reason to go as soon as it opens, I would wait and see. One of the things about this virus is, we are still very early in the game here. We haven't even had a year's experience with this virus, so we're not really sure how it's going to act over the summer, we're not really sure the details of how it's going to wane, if it's going to wane, if we're going to have a rebound. So we really need to be careful. I'd wait and see.
We had longstanding plans to travel to the Midwest in our RV. We're very self-contained and we feel quite safe traveling this way. But as this thing plays out, we're starting to worry about how we might be received in other places.
Oh boy, that is such a great question. The self-contained travel in an RV is absolutely the way to go if you're going to really think about summer travel. I think the more you can plan ahead and stay to yourself, keep your distance, the better. And an RV really is a great way to do that. In terms of the reception in other places, it's really something to think about with the state of the epidemic where you are and the state of the epidemic where you're going. If you're coming from a big city and going to a place where they haven't had much infection, that is something to consider.
Do you have any advice on the best way to clean a hotel room? We obviously can't do a full scrub down, but are there certain things we should focus on or maybe some surfaces we should avoid altogether?
I think firstly when you're making reservations for your hotel and when you check in, ask to see their cleaning protocol. Every hotel who has a cleaning protocol between guests will be able to show you that, because they have to train their employees to do it. So I would ask for that, and the things you want to look for are the obvious things; the linens are changed, etc. But also, that there's disinfection between guests. You can bring your own disinfectant wipes and wipe down commonly touched surfaces like doorknobs, like sink handles, the spigot, the surfaces that you or your family will touch. And importantly, you might want to ask for a room that hasn't had a guest for a day or two because any virus on surfaces, whether it's on porous surfaces or hard surfaces, they don't last very long on the surface. So if you can get a room that's been empty for 24-48 hours, even if there was something left behind, it'll be safer.