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Safe Travel in the Post-Pandemic Era. What you need to know to enjoy your trip in good health.

As travel slowly returns to the new normal it’s important to continue to employ many of the health safety policies developed during the pandemic and re-emphasize older health policies that you might be unaware of in order to keep you safe while traveling.

A good planning strategy is key to staying healthy on any trip that takes you far from home, especially if your plans involve public transportation or mingling with large groups of people.

Be prepared: 

Keep hand sanitizer and disinfectant wipes with you. Frequent hand washing and hand sanitizing will help prevent colds, flu, and nasty gastrointestinal illnesses. Don’t spend your hard-earned vacation on the toilet with diarrhea. Don’t forget to wipe down your phone, computer, earbuds, wallet, or any frequently touched items with disinfectant wipes after use. Wipe down armrests on planes and buses. They’re the germiest part of the seat.

Avoid risky foods. Don’t risk eating highly perishable foods from locations with slow turnover: Skip the prepackaged sushi or salad at the gas station! Focus on cooked foods that are served hot. They’re less likely to be contaminated.To avoid food poisoning, fast food items need to be thrown out after 2 hours at room temperature. This includes drinks other than water! While food from street vendors is tempting, it puts you at higher risk for food poisoning than conventional restaurants. Avoid buffets, especially if everyone uses the same serving utensils. Bring along some non-perishable snacks and bottled water especially if you have food allergies or intolerances. Keep a card describing any special dietary requirements and an action plan for what to do if you have a reaction.

Eat regular meals as much as possible. An irregular eating schedule plus dehydration from travel are a recipe for constipation and stomach cramps.

When using public transportation, travel as directly as possible. A direct flight limits the number of people you’re exposed to on the plane as well as in the airport. Direct flights are also more eco-friendly.  

Nausea from motion sickness is a common problem. Avoid traveling on an empty stomach because you will be more prone to nausea if you’re hungry. Eat light meals and avoid greasy foods that can make you feel sick. Staying hydrated is also key to preventing nausea.  Wear sunglasses if you’re traveling during the day. Squinting in the sun can make motion sickness worse and even cause headaches. If you can, look out the front of your vehicle and gaze at the horizon rather than looking out the side or at your phone. Don’t attempt to read in the car, but do listen to music, a podcast, or audiobook. Distraction improves nausea. You’re less likely to be motion sick if you’re driving. Getting plenty of fresh air on your face combats nausea too.

Ginger is the best natural anti-nausea remedy. Bring ginger candy or chews on all your travels. Most brands of ginger ale contain very little ginger. If you have severe motion sickness, consider taking a preventative medication like Dramamine (Dimenhydrinate) or Bonine (Meclizine) according to package directions. (Do not take this if you plan to drive or need to do something requiring coordination in the next several hours! Also, do not mix these drugs with alcohol, weed, or other antihistamines) Check with your doctor to see if one of these medications is right for you. Some people get relief from wearing an anti-nausea band, or massaging the acupressure points that interrupt the nausea reflex. If you’re on a cruise ship, book a cabin on a lower deck near the middle of the ship. Spend time on deck where you can see the horizon and get fresh air. 

Stay hydrated. Travel in airplanes is very dehydrating. Many people also avoid drinking water while on the road so they don’t have to stop to pee, however, you should stop and stretch at least every 3 hours to prevent sleepiness behind the wheel and DVTs as mentioned below. Be sure to sip plenty of water during your trip. 

On long trips that require you to sit still for more than 4 hours, whether you travel on the road or in the air, you need to take steps to prevent deep vein thrombosis (DVT)  which are blood clots that can form in the limbs if you’re too still for too long. These DVTs can break off and cause devastating consequences in the lungs. Be sure to get up, move around and stretch at least every 2 to 3 hours while traveling. Did you know that people of all ages can develop DVTs while traveling and that people on birth control pills and those wearing a cast are at increased risk? Click here to find out if you are at increased risk, signs, and symptoms.

Travel when well-rested. When possible, get extra sleep prior to travel. Avoid driving late at night or extremely early in the morning. Even if you’re wide awake, you’re more likely to encounter other drivers who are impaired in the wee hours. Driving while sleepy is as dangerous as driving drunk.  It’s more difficult to find safe places to stop for needed breaks when traveling after dark. 

For better sleep, bring earplugs, a sleep mask, and if you have the space, a good pillow. Wear multiple layers of clothing, especially if you will be traveling between different weather regions. Public transportation can be either unreasonably cold or hot. Wear loose-fitting clothes and reasonably comfortable shoes. 

I don’t usually recommend taking medications to make you sleep, because many of these drugs either decrease the quality of sleep or have side effects. However, if you plan a vacation in a timezone more than 3 hours earlier than yours, it may be worthwhile to take 1 to 3mg of melatonin an hour before bedtime. Taking melatonin for the first few days of your trip can help you fall asleep so you have less jetlag. If you vacation in a destination 3 or more hours later than home, you might need melatonin when you get back. Ask your doctor if this is right for you.

Spend time outside, especially in the morning to help regulate your sleep cycle. Avoid napping the first day in a new time zone so you fall asleep more easily, and practice good sleep habits.

Be aware of home remedies for minor illnesses so you can treat symptoms before they get out of hand. Mild upper respiratory infections, allergies, diarrhea. constipation, stomach aches, sunburn, and minor injuries can be taken care of without a doctor’s visit. 

Pack wisely. Make a list of all the items you will need on your trip. Every travel kit should contain a pain reliever/fever reducer like Naproxen, an antihistamine like Benadryl or Zyrtec for allergic reactions and stings, a 1% hydrocortisone cream for rashes, an antiseptic ointment for minor wounds,  sunscreen, eye lubricating drops as well as all your prescription medications, and OTC meds you need on a regular basis. Don’t forget period supplies if needed. If you wear contact lenses be sure to bring all of your supplies as well as a pair of glasses and an extra pair of lenses. Remember your toothbrush, floss, and paste.

Keep your travel kit in your carry-on bag or in the car with you. The trunk might be too hot or cold for some items. 

Whether you’re flying or just taking a road trip through the mountains, you may experience mild to severe ear pain and stuffiness as you change elevation. If you have congestion from a cold or allergies the pain can be severe and last longer. Try yawning, drinking water, or chewing sugar-free gum to unblock your ears. If they’re still blocked, you can try plugging your nose with your fingers and GENTLY blowing out. A squeaky popping noise is a normal sign that your eustachian tube (the tube between your ear and throat) has opened up. Do not continue to blow if you experience pain. If you still have symptoms, try drinking a warm liquid like tea. Alternating between downward dog and upward dog yoga positions can be helpful too. Hold downward dog as long as it is comfortable for you. For more on treating upper respiratory symptoms see this article.

Bring your insurance cards and a copy of your immunizations, medications, and medical conditions. Wear any medical alert bracelets you have and make sure your travel companions are aware of your medical conditions. Scope out the medical situation in the area you will travel to so you can quickly access the medical system if needed. Note where hospitals and urgent cares are near your destination. 

You can always call your doctor for advice while traveling, and sometimes a telemedicine appointment can be scheduled. If you forget to pack a  medication that has been prescribed to you, you can often have your doctor call a refill into a pharmacy near you. (Be sure to have the phone number of the pharmacy ready when you call.) Unfortunately, if you forgot a controlled substance like an ADD medicine on your trip out of state, you’re out of luck.

Don’t travel sick-get a doctor’s note Many airlines and hotels will offer a refund or credit for a missed trip due to illness. The pandemic has taught us to be patient and put off gratification when it’s the wise thing to do, hopefully not just when we’re forced to. You will enjoy your trip much more if you reschedule it when you’re well.

Keep a mask handy even if there are no mask mandates. COVID-19 is far from the only infection that can ruin a vacation. You will be breathing the same air as many others who might have the flu or just a rotten cold. It’s never wrong to wear a mask to protect yourself even if they aren’t required. 

Consider wearing a mask on public transportation, especially buses, subways, rideshares, ships, and trains even when not required. Airplanes have highly filtered fairly germ-free air, so you are at less risk of catching something from a sick person at the other end of the plane, but if the person next to you is ill, you are still likely to get sick. If possible, reserve seating in advance so you can sit with people in your travel group. The aisle seat is the germiest because you’re exposed to people walking by.

Greater acceptance of mask-wearing on crowded public transportation and at crowded events should remain the norm but only be required when epidemic levels of disease transmission are present. Masking in medical facilities is the exception. It is always a good practice.

Wear a mask when you must travel while sick. Catching a cold while vacationing at a theme park or resort is so common that it’s a cliché. Even if you think you just have allergies or have a negative test, wear a mask in public if you have symptoms. No one wants to breathe in your cough and sneeze.

As much as possible, keep a physical distance from others. I hope that greater social distancing becomes the new standard. Throughout history, plagues and epidemics have been fueled by overcrowding. 

Consider traveling at times when crowds are less and eating out when restaurants are less busy. Consider taking the stairs instead of a crowded elevator. Give others space when you’re standing in line.

If you plan to travel outside the US or to a US territory, read on for important additional information. 

Foreign travel requires detailed advanced planning. The CDC destinations page can give you specific up-to-date vital information about your travel destination. You need to know what immunizations, preventive medications, treatments for common illnesses in the area, insect and wildlife precautions, food safety measures, and COVID precautions are necessary for your trip. Failing to check these things out well in advance could ruin your trip or even prevent you from traveling!

Check the CDC travel site at least one month prior to travel. Some medications and vaccines needed for travel have to be given a week or two prior to travel and require a doctor or travel clinic visit. Did you know that travelers to India need to start taking Malaria prevention medicine at least a week before travel and they need to have a Typhoid vaccine at least 2 weeks prior to their trip? Don’t wait until the last minute to schedule your travel medicine appointment! Call at least a month in advance.

Update and carry documentation of all your vaccines. COVID-19 isn’t the only vaccine document you need. Did you know that you need to get a Yellow Fever vaccine from a Yellow Fever vaccination clinic before you travel to Nigeria where the disease is endemic? If you aren’t vaccinated prior to going there, you could be detained there for 10 days until your vaccine takes effect!

If you have a medical condition, or If you are visiting several countries (like on a cruise ship) you may need to see a clinician who specializes in travel medicine. It’s a good idea to carry a document from your doctor or travel clinic with a description of your condition and any medicines you take as well as an emergency action plan. For example, If you have a food allergy, wear a Medic Alert bracelet and carry a card describing your allergens (preferably in English and the language of the place you will be visiting) as well as your emergency action plan including doses of medications that need to be administered in emergency situations.

Make sure you bring enough of your prescription medications to last the whole trip. All prescription medications must be in their original containers with the pharmacy label. Your name on the medication should match your passport. Your doctor cannot prescribe in another country. Did you know that counterfeit medications are common in many foreign countries?

If you need over-the-counter medications, keep them in their original containers and make sure they are legal in your destination country. Did you know that decongestants that contain pseudoephedrine (like Sudafed) are illegal in Japan? 

Bring your insurance cards and check prior to your trip to see if you have any medical coverage in other countries, and consider travel health insurance if not. Did you know that you can get help from the US Embassy if you need medical care in a foreign country?

Insects can carry diseases that are uncommon in the US. Bring a DEET-containing insect repellent as well as clothing and netting to protect yourself in regions with insect-borne diseases. Precautions should be taken very seriously as some of these diseases have no cure.  Did you know that you need to take special precautions to avoid mosquito bites in Indonesia, Taiwan, and many parts of southern Asia so you aren’t infected with Dengue fever which is nicknamed “Breakbone Fever” because of the severe muscle and joint pain it causes?

Make sure you know if you need to take food and water precautions at your destination. It’s wise to avoid salads, raw meat and egg dishes, (ceviche, sashimi, Caesar salad), local fresh fruit, and dishes served cold because they are more likely to cause food poisoning.  Many destinations lack clean drinking water. Food that is contaminated with local water can make you very sick. You may need to pack specific medicines in case you get sick on vacation. Did you know that if you travel to Mexico you need to avoid drinking tap water, (bottled is OK) drinking beverages from soda fountains, drinking beverages with ice, eating local fruit, and brushing your teeth with tap water in order to prevent travelers’ diarrhea?

Check the CDC travel site again just prior to your trip because health safety conditions can change rapidly as we have learned during the COVID-19 pandemic. 

I hope these tips help you have a safe and exciting adventure. Enjoy the journey!

This information is intended for people 13 years old and up. Please check with your doctor to see if this information is appropriate for you.

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