Omicron and holiday travel: how to strategize

NEW YORK — Taylor Allen wanted to be a responsible traveler, but she was finding it difficult.

Late last week at least seven people Allen knew in Brooklyn posted on Instagram that they’d tested positive for the coronavirus. She had not seen any of them in person. But after developing an intense headache and runny nose on Friday, she canceled her Saturday morning flight to Jacksonville, Florida, where she was planning to see her parents and grandparents.

Two at-home tests — one Friday and one Saturday — came back negative. But Allen, 22, who is fully vaccinated but not yet boosted, wanted more official assurance before she rebooked her trip. On Sunday evening, long after her scheduled appointment at an urgent care clinic in Crown Heights, an employee told her and the 30 or so other people waiting for tests in the bitter cold that they’d have to come back at 8 a.m.

“I really don’t want to put anyone in danger,” said Allen, who left the clinic with plans to return again the next day.

Even as the number of coronavirus cases is skyrocketing in some parts of the country, largely driven by the omicron variant, the holiday travel rush appears unstoppable. On Friday, Los Angeles International Airport reported its busiest day since early 2020, and on Sunday, 2.1 million people passed through airports in the United States, nearly twice as many as at this time last year.

For those who are determined to keep their travel plans, figuring out how to do so responsibly has never been more confusing. Part of the problem is that testing has been hard to obtain in a timely way, particularly in hard-hit cities like New York.

Another key challenge is that many people plan to stay in a house with fully vaccinated friends and family.

Now, they are learning that vaccination is far from a guarantee that they won’t infect one another. So what can travelers do?

Get a booster

Only 1 in 6 Americans have received a booster, according to the Centers for Disease Control and Prevention. Fully vaccinated individuals without a booster are at least twice as likely to test positive as those who received a booster.

If you plan to travel over the coming weeks and months, and you’re already fully vaccinated, one of the best ways to be a responsible traveler is to get a booster, said Jeffrey Kahn, the director of the Johns Hopkins Berman Institute of Bioethics.

In terms of timing, the data show that the optimal immune response comes about two weeks after the booster, according to Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at the Columbia University Mailman School of Public Health in New York. But many will see some protection within a few days, other experts noted, so getting a third shot today could still benefit those traveling over the holidays.

Consider the worst-case scenario

When deciding what’s responsible in terms of holiday travel, Kelly Hills, a co-founder of Rogue Bioethics, a consulting firm in Boston, advises thinking about “moral injury” and asking whether you are mentally prepared for the consequences if you infect a vulnerable person.

That doesn’t have to translate into canceling plans, but it may encourage you to wear an N95 instead of a homemade mask on a plane or to take a test even though it’s a hassle. If you are indoors, unmasked around many people in the days leading up to the trip, you may also want to pay extra to book a separate house or motel room, rather than staying with family or friends.

“‘I don’t want to be a spreader’— that should be the motto today,” said Leonard J. Marcus, the co-director of the National Preparedness Leadership Initiative at Harvard University and the director of an initiative focused on public health on flights.

Marcus said that though he’s not aware of any data suggesting children are likely to become infected on planes, he advises parents not to fly with unvaccinated children — if possible — until more is known about omicron.

Test as close to the gathering as possible

Many pharmacies and online retailers have sold out of at-home tests. The White House is planning to make 500 million free at-home tests available, but that won’t happen until January. For those who do manage to get a kit, use it as close to your departure date as possible, several experts said.

“The closer you are to the event, the better and more accurate it will be,” said Dr. Lin H. Chen, a professor at Harvard Medical School and the director of the Mount Auburn Hospital Travel Medicine Center in Cambridge, Massachusetts.

Chen suggested taking an at-home antigen test the day of the gathering. (If a person tests positive at any point, she advised not going to the event and getting a PCR test for confirmation.) If people are staying in a house together for an extended period, testing periodically throughout their stay is advisable, Chen said. This is particularly important if someone is not vaccinated or boosted, or has been exposed to someone who has tested positive, other experts noted.

Yes, everyone is confused

Hills, the bioethicist, said that it’s understandable that many people are confused by having to make what should be public health decisions.

“We should be getting more guidance,” she said, noting that many state and federal agencies offer different advice.

At the testing site in Brooklyn, several travelers echoed this point and lamented that public health authorities were not making what they considered responsible travel — getting tested before visiting family — easier.

Compounding these frustrations, some travelers said, is the sense that the burden is on them to figure out what is socially responsible and epidemiologically safe and then to convince their family and friends of the policies they have come up with. One woman, who declined to use her name because she didn’t want her family to identify her, said she no longer feels comfortable flying with her 2- and 3-year-old children after learning over Thanksgiving that her own family members would fly even if they tested positive.

Rather than fight with them about what’s appropriate or worry that the people sitting next to her share her family’s approach — and could infect her or her children, leading them to infect her father — she is going to stay home this Christmas.