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A Public Health Expert Unpacks The Risks And Necessary Precautions For Anyone Considering A Road Trip

Like it or not, there are a lot of people hitting the road right now. With international travel pretty much cut off for the foreseeable future, Americans — stir crazy from months in quarantine — are taking to the highways. Some of these folks are visiting loved ones who’ve been isolated for months. Others are hitting up National Parks or BLM land to get away from crowded cities. Others still are traveling the roads to go and help the relief efforts in areas with spiking outbreaks of COVID-19.

Whether or not you think people should be moving around the country is almost beside the point right now. People are. In fact, many are doing so with an aggressive lack of care. And though every decision to travel is different, the more information you have straight from scientists the more pragmatic you’re likely to be.

To help add insight and outline the risks for anyone considering a road trip (think three-hour jaunts and microadventures), we spoke with Karl E. Minges, Ph.D., MPH. Minges is an assistant professor and the chair of Health Administration and Policy at the University of New Haven and a thought leader in the systems-based health community. To help you make travel decisions that will positively affect your community, we asked Minges about how to prepare for a manageable road trip, what to do on the road, and how to proceed when you arrive in a new destination. We also touched on mask use and reuse, disinfecting gas station toilets, and where to get reliable COVID-19 numbers.

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What’s your overall view of the safety of doing a road trip when it comes to contact points, for instance? It’s pretty much impossible to be completely “contact-free” but how can we be safe out there?

I mean, I think what you’re saying is backed by data. There’s a study that looks at a sub-sample of people across the United States based on mobility. People enroll in the study and they tap into their cell phones. That gives the researchers a sample of people and how they move. What they’ve shown is that basically people are almost, state-by-state, at their pre-pandemic level of travel, in terms of mobility. So people are putting on more and more miles on their cars and traveling further and further.

There was a huge drop off in travel when everything was shut down and now it’s picked up to almost the pre-pandemic levels. Why that’s scary is because infection rates are also increasing in most states of the United States. And so that’s something I’m fearful of because I think there’s going to be a rapid risk of increasing infection rates with increasing travel.

However, that doesn’t mean that the two are correlated because there’s a lot of states, like Connecticut for example, that are actually seeing declines in the number of cases, hospitalizations, and mortality rates. Not every state is following the same trend line. So to correlate mobility and travel with rising infection rates isn’t necessarily true or a fair correlation. I think there’s a lot more that’s going on behind the scenes.

So, I’m seeing a lot of fellow travel writers out on the open road right now. Should I be worried about them?

The research is showing us that the more stops people make for a road trip, the less likely they are to engage in public health guidelines in terms of preventing COVID. So for example, they’re going to be less likely to engage in wearing face masks, washing hands, proper hand hygiene, maintaining social distance.

So, the longer people are traveling on their road trip, the less likely they are to engage in those important guidelines for reducing the risk of transfusion of COVID. But people can still be vigilant. To be completely contact-free is possible, but very hard.

I even actually just took a road trip to visit family in Pennsylvania, which was about an eight-hour drive. It’s hard to go to use restrooms, things like that, and not engage with people at all. You really have to time it or travel at unusual times of the day or at night to circumvent a lot of contact with individuals.

Travel is precarious because people are traveling from all over the place. Some people will be from states that have 30 percent net positivity rates to states that are declining in terms of positivity rates. So there’s a lot of variation. But the point is, is that you never know where people are traveling from or what protocols they could be following.

We observed on our road trip that even if it doesn’t say you have to wear a mask in a convenience store in Western Pennsylvania, probably half of the people — anecdotally — were actually wearing face masks. But, that’s an order based on what the governor’s protocols are right now.

What would be the main thing that you would look for in deciding whether or not to go somewhere?

Oh, you definitely have a look at the COVID transmission rate. What’s the net positivity? What’s the number of new cases that are being indicated per day? And in Connecticut, we are now quarantining travelers from about 16 states that have high COVID rates. And I would not be traveling to any of those places.

Given the news about the White House defanging the CDC from getting and releasing correct numbers on COVID, where is a good source for you to find the best numbers? The New York Times? The CDC still? State health authorities?

I would actually go to Johns Hopkins. They have a tremendous resource for tracking COVID that pools all kinds of data. They’ve really been a leader in the COVID transmission tracking.

Any of those other sources you mentioned are also valuable. It just sort of depends on where you want to go for your news. I’ve actually steered away from the CDC in general, and I have advised my students, friends, and colleagues to do that as well. Ultimately, the CDC is a political organization because its leaders are appointed by the federal government. So I think using third party sources is probably better.

So once you figure out if it’s realistically safe to travel somewhere, what would you say are the most important things to have in the car?

  • You definitely need to make sure you have hand sanitizer, in case you do go into locations that don’t have active sinks.
  • You want to make sure that you have several cotton masks. You should really only use it once and then wash it. If you have surgical masks, make sure you have a bag to dispose of them properly.
  • You would want to be sure to stock up on items from your home so you can limit the number of times that you have to stop. So for example, pack sandwiches and have bottles of water with you.

Can I ask for clarification there? So, I’ve heard you should only wear your mask once and then wash it. What does “wear once” mean? Because for some people they might see that as, “Well, I went to the grocery store and back. That was ‘once.’ Or I wore it all day and that was ‘once.'” What’s the sweet spot there?

Anytime you’re in a public setting and potentially breathing in potential aerosols that could contain COVID — so basically anytime you’re in a place where you see people who are walking around and you cannot practice the social distancing — then you would dispose of the mask immediately after that point.

I do understand that that is not common practice because masks are expensive, especially surgical masks, and they’re hard to get ahold of. And now they’re saying that because of the recent COVID outbreaks in the South and West of the United States to reduce your reliance on surgical masks and instead continue to use cloth masks.

And in terms of the surgical masks, think about it as your surgeon, right? They wear the mask during one procedure. They take it off and throw it away. They don’t use it for multiple patients.

And so they’re not meant to withstand months of use. They are disposable in that way. So definitely get some cloth masks, several of them.

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Okay, so we’ve packed our car with sandwiches, water, and our hygiene kit. We’re on the road and running low on gas. How would you go about dealing with that situation safely?

So far as pumping the gas, I would use gloves because, again, people are traveling perhaps from states that have high levels of COVID transmissions. If they don’t have gloves at your disposal, use a napkin or something like that to access the gas nozzle.

In terms of using the restroom, I always have a Ziploc bag full of Clorox wipes because they don’t sell them in small, convenient packaging. Or at least, I haven’t seen any. So I think having a Ziploc bag of wipes is valuable to bring with you anywhere, especially if you’re going to use a restroom on the road. You don’t know if the frequency with which these rest stops are cleaned, especially given our economic circumstances. There are perhaps people being laid off who typically do that kind of work.

Do you think full-service gas stations are going to make a comeback because it will lower contact points?

No, I don’t think that. That’s a lot of pressure to put on a gas station for extra salaries for employees that they don’t want to pay for. But interestingly, when we stopped in New Jersey, which is a full-service state, the guy pumping the gas there didn’t have a mask on. And I was like, “Eh…” I thought, “you’re interacting with people all the time. If you’re outside, you’re within that six-foot window, so it’s very possible that someone rolls down their window and they sneeze on you or cough or something and you could be exposed to the virus that way.”

Being aware of what gas station attendants, as well as convenience store clerks, are doing in terms of practicing appropriate risk reduction methods is very important. Maybe don’t stop there if they’re not wearing masks or wearing gloves or are not behind a clear plexiglass shield. Being mindful of those kinds of things around you and who you’re engaging with is important.

In that circumstance that we ran into, we just rolled down the window very slightly and just kind of slipped out the credit card and made sure to sanitize the credit card front and back when we got it back.

Let’s say we need to do stop for food. The likelihood of a restaurant being open seems slim at the moment, given that a lot of stuff is shutting down again. So a grocery store is more likely your stop. What’s the etiquette you follow?

So far as going anywhere where you’re going to interface with the public, do it at the odd time. Go early in the morning. Go late in the evening. So during the weekday when fewer people are likely to be there. Minimize the risk of exposing yourself to someone that has COVID. I think that’s really important and safe advice to follow.

Then in terms of best practices, here in Connecticut — and this is not uniform — they clean the carts for you. There’s someone there who has a clean cart ready to give you. So in the absence of that, it would be valuable to bring your own wipes in a Ziploc bag and clean the grocery cart.

So far, evidence hasn’t shown that you should be disinfecting and cleaning every single grocery item that you buy. It will be valuable to have gloves on. Of course, you should have your face mask on. And then use wipes and proceed from there.

There’s going to be people that are much younger that don’t have as many risk factors for really extreme symptoms. So they may practice this differently. They may not wear gloves. For example, I don’t wear gloves when I go out because COVID transmission is really more aerosol-based than living on the surface of a product. I know that. But for anyone who’s vulnerable, you have to be as vigilant as you possibly can to reduce the risk of transmission, and that might mean wearing gloves too.

So you arrive at your destination, what would your routine be for when you actually arrive? Do you completely clean your car out, top to bottom? New clothes? Disinfectant shower?

Odds are you have not been visiting a hospital or a place where there’s going to be a significant number of people with COVID. So I don’t think it’s necessary that you kind of wash your clothes, jump in the shower, or sanitize your whole car.

The number one thing I would do if visiting someone is to make sure that the people you’re visiting have no symptoms. It’s also important to make sure that they’ve been in isolation or quarantining to a reasonable extent.

Two, I would engage with them what they’re comfortable with and conform to how they’ve been isolating. There’s going to be the level of risks that you’re going to have to negotiate. This all should really be determined before the trip. Who are you visiting and what is their level of exposure before you take that trip?

In terms of public health protocols once you arrive, sanitize your hands, wear a mask, and maintain a distance of six feet. It may be uncomfortable or awkward, especially in an indoor setting. But if that’s what’s going to prevent the spread and you haven’t been tested or you are uncomfortable with their isolation, or lack thereof, or potential exposure points, then engage in the mask-wearing and glove-wearing.

So let’s say you have to stay in a hotel, what would you look for when you went into a hotel for cleanliness and safety?

That’s a tough question. I would avoid hotels, to be honest. But if you have to, you just want to make sure that you can get as clear of a sense of the cleanliness of visibility as possible.

Do your due diligence. Is the front clerk wearing a face mask? What their cleaning protocols? How do they assure that the room that you are in is clean? How long do they allow the room to aerate or be vacant before the next guest arrives? Is there a time for the virus to die?

If you want to go to an extra degree of precaution, you can even bring one of those Clorox sprays. They’ve been pretty effective in killing the virus. If you are feeling uncomfortable, you can go the extra step and you can disinfect the bathroom too. And if that makes you more comfortable, then I think that’s a fine practice to do. It’s certainly not going to hurt.

On the flip side of that, you can go camping. The same sort of rules apply. Keep your distance. Wear a mask if you’re around people. I mean, it’s camping. The whole point is to be away from people.

Exactly. I think camping is a great alternative to traditional hotels and places like amusement parks and things like that. It’s a good alternative.

There are still places that aren’t testing unless you show symptoms. Would you recommend getting tested before and after you travel?

Well, we know that approximately 30 percent of people who get COVID are asymptomatic and you can actually be infectious when you’re pre-symptomatic even if you become symptomatic. Plus, you’re infectious post-symptomatic up to 14 days later. So there’s a tremendous risk there.

So far as traveling, I think if you have to travel to visit people that have had a positive COVID test — or you’re visiting a state that has a high net positivity — then it wouldn’t be bad advice to get tested when you come home.

So far as testing beforehand, if you’re coming from a state, again, that has high positivity rates, I would say you get tested. If I was going to be accepting a guest from one of the highly hit states at the moment, then I would also ask to be tested before visiting. The test is very quick and easy. It’s generally 24 to 48 hours you get a response. Some places are rapid testing, which is where you just sort of sit in your car and get your results in an hour. Then some states have very long lines and it’s tedious.

The bottom line is that if you feel like you’ve been exposed in any way to COVID, you should get tested. If you visit family in a rural part of the state where there’s very low rates or the risk of infection is very low plus you’ve both been isolated and practicing proper prevention guidelines, then I don’t think a test is that necessary.

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