Travel can often be stressful. Holiday travel is always stressful. Add in flights full of sneezing, coughing passengers during a pandemic — and no, it’s not over — and you’ve got a really difficult holiday travel season to navigate.

Some 53 million people were predicted to travel during Thanksgiving this year, reaching near pre-pandemic levels of travel. Full flights meant higher threat of spread of illnesses. There is always a risk of getting sick while traveling, but COVID-19 requires an extra layer of protection compared to flights before the pandemic began.

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Dr. Steven Gilchrist

“Realistically, we will all be exposed to certain viruses and bacteria,” said Dr. Steven Gilchrist, a family medicine physician at Novant Health Steelecroft Primary Care. “The key is looking at ways to decrease the rate of transmission.”

In order to keep yourself safe in the coming weeks, Gilchrist offered up a few tips, including how to handle holiday parties.

Stay up to date on all your vaccinations

“The No. 1 thing that will help prevent virus and disease transmission is staying up to date on all of your vaccinations, including the flu shot,” Gilchrist said. “Vaccinations will give you the best chance to fight off any viruses and bacteria.”

This includes the COVID-19 vaccine and booster if you are eligible. Gilchrist recommends that the immunocompromised, high risk, and essential workers receive booster shots before traveling for the holidays.

Navigating airports and planes

The federal government is still requiring travelers 2 years old and older to wear masks in airports and on planes. Your clothes can potentially carry germs around, so Gilchrist also recommends wearing comfortable clothes to the airport that you can change out of quickly when you leave.

Wipes and hand sanitizer are a must

“Anytime I go on an airplane, I make certain that I at least carry a wet wipe, Clorox or Lysol wipe to gently wipe down the seating area,” Gilchrist said. Even pre-COVID, he made sure to clean his seat. He recommended also wiping down the tray table.

Hand sanitizer and proper handwashing remain key strategies. “As a physician, we are in the room with sick patients every day. But take note how many times we wash or sanitize our hands,” Gilchrist said. “On average, most physicians wash or sanitize our hands two or three times while we are in the room, which also decreases the rate of transmission.”

Avoid touching your face – and touching things in general

“One of the reasons toddlers get more infections is that they touch everything and then touch their ears, eyes and mouth,” Gilchrist said.

As much as you wash your hands or use hand sanitizer, you can still get germs on your hand from touching a door handle or sink faucet. Because there are so many ways for bacteria or viruses to get into the body, Gilchrist recommends trying not touch your face.

Also, “I’m recommending that people try to use cards as much as possible instead of cash to prevent the exchange of germs,” Gilchrist said. Cash goes through many different hands, while a card will likely only be handled by you, decreasing the amount of outside germs you are directly exposed to.

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Getting vaccinated is the best protection.

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Get enough sleep before the flight

Sleep is one of the best things you can do to help strengthen your immune system, Gilchrist said. Lack of sleep can disrupt your circadian rhythm – the 24-hour internal clock we all have running in our bodies. Throwing that off can cause a chemical imbalance, forcing your immune system to work harder than it needs to.

“We aren’t machines. We have to think about our bodies and immune systems like electric cars,” Gilchrist said. “Just like electric cars, we have to recharge ourselves and sleep is one of the best ways to do that.”

Avoid snacking on the plane

“I recommend eating before you get on the plane. But, if you have to eat on the plane or have a medical condition that requires you to eat, I say eat fast and try to minimize the risk or the exposure by removing your mask quickly, eating your food and then remasking.”

Stay hydrated

“Our bodies are 70 to 80% water. When you have a fever, you lose about 10% of your water weight,” Gilchrist said. “Your body then starts to work harder to replace those cells damaged from the fever, and you need healthy cells to have a healthy immune system.”

Try to bypass the latte or soda and buy a bottle of water at the airport to bring with you on the plane. If you prefer a more eco-friendly option, bring an empty water bottle and fill it up at the airport. Having water on the plane with you will encourage you to drink more since it’s readily available.

Be mindful when gathering in groups

He supports gatherings – as long as those involved are vaccinated.

“We have to remember that we’re still in a pandemic. I don’t recommend gathering if you’re not fully vaccinated. I think that this is an opportunity for the virus to increase in frequency, so we’re asking people who aren’t fully vaccinated to not gather in large crowds.”

He emphasized the importance of proper hand-washing and recommended that any nonvaccinated individuals mask when in large groups, such as parties or family gatherings.

“COVID-19 and the delta variant has now become a disease of the unvaccinated. If you’re fully vaccinated and you would like to get with your loved ones, I think that that setting is OK.

“I don’t recommend that the unvaccinated attend large parties. This can be very dangerous. If they have to be in a large crowd, they should wear a mask and social distance.”

Around the immunocompromised

“If your immunocompromised family members are vaccinated, they should be OK. The only thing that they need to be aware of is making sure that they have their booster. We still recommend social distancing a little bit, but the vaccine is a lifesaver.”

Besides COVID

Gilchrist said many patients come in requesting a prescription Z-Pak, an antibiotic that helps treat bacterial infections, to help fight off any future colds. “Antibody therapy is not always the best treatment, because 90% or more of colds are from viruses,” Gilchrist said.

Some air travelers resort to amino acids, vitamins and supplements to try and build up their immune systems. Gilchrist advised simply sticking to a multivitamin, if anything, because taking a combination of vitamins and supplements can actually complicate matters and hinder your immune system.