Should you mask up on a holiday flight? Here's what health experts say

This holiday season, travel is up — and so are rates for viral infections. It’s not just COVID-19 that public health officials are worried about. Rates of influenza, the common cold and respiratory syncytial virus (RSV) are also putting a strain on health care facilities. 

And, while there are vaccines for both COVID-19 and the flu, there isn’t one for RSV. RSV symptoms include a decreased appetite, runny nose, coughing, sneezing, wheezing and fever — and it can cause more serious health problems in those ages 65 and older, or 2 and under.

Even if you’re not in a high-risk group or aren’t worried about getting COVID-19, you may want to consider decreasing your odds of getting (and spreading) one or more of these viruses, according to public health officials and experts. 

“Everybody needs to think about protection — getting one of these (viruses) doesn’t give you immunity against the other things,” says Dr. Peter Chin-Hong, UC San Francisco professor of medicine. “Who wants to get sick right now? This is the year that everyone wants to get back together.”

“Sure, you might want to catch up on season five of The Crown or whatever, but it’s really tough to just sit on your couch feeling miserable,” he adds. 

So, how can you avoid getting sick while traveling this year? We got some advice from Chin-Hong and others. 

Should we be traveling at all?

Chin-Hong is. 

“I’m not holding back — I’m not walling myself off at home,”  he said. “I think we have enough tools and combinations of tools to navigate the situation.” 

He’s had a flu vaccine and the COVD-19 vaccine and latest booster. And he’ll be wearing a mask. “I don’t want a cold. I don’t want to get sick,” he said. “I’m trying to have as normal a holiday period as possible.”

There are benefits to waiting until later, though, including the potential for fewer crowds, less viral exposure and less expensive prices.

Should I wear a mask at the airport?

Masks are still required in health care settings in California, but they aren’t required on public transportation. Still, the U.S. Centers for Disease Control and Prevention recommends wearing a mask in any indoor public transportation setting, as well as during international travel and in transportation hubs that serve international travelers. 

“Regardless of vaccination status, people should wear well-fitting N95 or KN95 masks indoors and in crowded outdoor settings,” according to Dr. Shoshana Ungerleider, public health advocate and host of TED Health. “This includes both in airports and on airplanes.”

If you actually want to enjoy your trip without any cold symptoms at all, you’ll lower your risk by wearing a mask. “We’re not in the 2020 era where it’s just one game in town — it’s multiple things,” Chin-Hong says. 

“Masks can prevent transmission of COVID, flu, RSV, and other respiratory viruses all at once,” a dozen Bay Area health officials said in a statement this week.

If you really hate masks, Chin-Hong recommends wearing one in the areas with the most risk for infection: in the TSA line, while boarding the plane, and getting off the plane.

Are there any times when it would be considered safer to take the mask off?

“Maybe you don’t want to wear the mask all the time — and who wants to?” Chin-Hong says. “We’re all so tired of it.” He recommends wearing it whenever you’re in a crowd. 

Airplane ventilation is higher when you’re actually in flight, so that would be the time to take your mask off. Keeping it on, however, will reduce your risk of infection not just from COVID-19 but the other viruses circulating right now, too. 

OK, but which mask should I wear?

N95 masks can filter out at least 95% of airborne particles, according to the CDC. Research has also shown a similar effectiveness for genuine KN95 masks. 

“The N95 is the gold standard but it’s super uncomfortable and leaves lines on your face the longer you wear it,” says Chin-Hong, who prefers wearing a KN95 because it is nearly equal in protection, is more comfortable and comes in more colors. 

The next best mask is a tightly sealed surgical mask. Wearing a cloth mask over a surgical mask makes the protection greater, but a cloth mask alone doesn’t do much, Chin-Hong says. (A cloth mask, he adds, may still provide some protection against viruses transmitted primarily through droplets — the flu, common cold and RSV.) COVID-19 can remain in the air for up to three hours. 

Still, the CDC says “any mask is better than no mask.” If wearing a cloth mask only, the CDC recommends they be multilayered, made out of a tightly woven,  breathable fabric, have a nose wire, and fit snugly over the mouth, chin and nose. The fabric should block light when held up to a light source.

“The best mask is the one that you’ll consistently wear,” Chin-Hong says. 

Do I need to wear a mask when I’m traveling to visit family and friends?

“It depends on who you are and the company you keep, meaning who you live with and who you’re going to come back home to,” Chin-Hong says.

He explained that there’s a continuous spectrum of risk. While he recommends everyone get vaccinated and boosted against COVID-19, it is especially important for those who are ages 65 and older or who are immunocompromised. The same goes for the flu shot. 

If you’re boosted and aren’t in a high risk category, you may feel more comfortable visiting friends without wearing a mask. But, if you live with or plan to visit an unvaccinated and/or elderly relative, he said, that’s a good reason to wear a mask while traveling. 

Should I still carry hand sanitizer?

Chin-Hong said that keeping your hands clean is important, so go ahead and bring that fruity scented hand sanitizer with you. To help stop the spread of germs and viruses, we should continue to wash our hands and disinfect surfaces. 

“Washing hands is an easy thing for people to remember,” Chin-Hong said. “Who wants dirty, smelly hands anyway?”

What about testing? Should I take a test before or after I travel? 

“Ideally, you should do a COVID rapid test at home right before you travel but, regardless of results, stay home if you have any cold-like symptoms or aren't feeling well,” Ungerleider says.

The CDC also recommends testing before and after travel. U.S. households are eligible for another round of free at-home rapid tests — the fourth round of free tests issued by the government this year. Orders can be made through COVIDtests.gov and are expected to begin shipping next week. (For help placing an order, call 1-800-232-0233.) 

Chin-Hong says you should absolutely take a test if you have any symptoms, including allergy-like symptoms like sneezing or if you have a scratchy throat. The other time to test is when you know you’ve spent time with someone who is positive for COVID-19. Even if you don’t have any symptoms, he said, take a test three to five days afterward. 

What if I test positive or have symptoms?

It’s “simple,” Chin-Hong says: “If you have symptoms or if you are sick, don’t travel — particularly if you have a fever.”