As holiday season gets underway, here’s how to protect yourself and your family from respiratory viruses

With Thanksgiving just days away, people across the United States are finalizing travel plans or racing through grocery stores in search of the perfect turkey, but there’s another plan to consider ahead of the holiday season: how to stay healthy and avoid the mix of seasonal viruses in circulation.

Flu cases continue to pick up in most parts of the country, particularly the South and the West, according to data from the US Centers for Disease Control and Prevention.

Covid-19 and respiratory syncytial virus are also spreading as many Americans hit the road and take to the skies this week, noted Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco — and they’ll be touching common surfaces that may be contaminated and sharing air with infected people.

“A lot of people are going to be traveling at record numbers for Thanksgiving and the holiday period,” he said. “That means that risk is going to be mixed in from all around the country.”

While navigating a sea of strangers may seem intimidating for the health-conscious, experts say there are a number of familiar precautions you can take to keep from catching an illness from fellow travelers or out-of-town visitors this year.

‘Don’t let your guard down’

Some Americans have continued to wear masks well into 2023, but many cast the practice aside as local jurisdictions eased Covid-19 guidelines. However, Chin-Hong said that wearing a mask on public transport and at the airport is still one of the best things you can do to prevent the spread of disease.

“I know we think about masking as something that people do when they don’t want to get [sick], but if you have mild symptoms, wearing a mask is actually going to prevent other people from getting what you have, even if it’s a common cold,” he said.

Masking is also key in areas with limited ventilation and airflow, such as the stuffy jet bridges that passengers stand in while waiting to board a flight. Chin-Hong adds that masks should also be worn on flights, even if there is good ventilation, as an added layer of protection from people who are coughing and sneezing.

When it comes to Thanksgiving dinner or meeting up with old friends, try to avoid gathering in crowded spaces, Chin-Hong recommends.

“The hole-in-the-wall bar is going to be a little bit riskier,” he said. “But if you sit by the window, that’s going to be less risky.”

Handwashing is also a good habit to practice during the holidays, Chin-Hong said. If soap and water aren’t available, a hand sanitizer with at least 60% alcohol can kill many germs, according to the CDC. It’s also a good rule of thumb to avoid touching your eyes, nose and mouth to avoid spreading germs.

In theory, Chin-Hong said, the only way to make sure you don’t pick up a virus while traveling for the holidays is to not travel at all, but that’s not a reality for most Americans. About 55 million people are expected to travel between the Wednesday before Thanksgiving and the Sunday after the holiday, AAA forecasts. Nearly 3 million people are expected to hit airports nationwide on the Sunday after Thanksgiving alone, according to the Transportation Security Administration.

Not everyone will be flying, however. A majority of Americans — more than 49 million — will be driving to their destinations. Chin-Hong said some people may see this as a safer alternative to milling about an airport or sitting on an airplane, but a car is still an enclosed space.

“People let their guard down because they know somebody, but of course, the virus doesn’t care if you’re related to the person,” he said. “I got Covid last Thanksgiving, and it was from a relative. They were visiting, and I let my guard down. I didn’t think of them as a stranger on the street.”

Chin-Hong said many Americans have become nonchalant about circulating viruses. In fact, about three-quarters of adults say they are “not too worried” or “not at all worried” about getting Covid-19 over the holidays, according to a new survey from KFF, and two-thirds say they are not worried about spreading the virus to people close to them.

If you’re worried about spreading a virus, Chin-Hong said that testing — whether for Covid-19, the flu or RSV — is a good option that should be utilized more often, especially if you’re headed to visit young, elderly or at-risk relatives, such as those with compromised immune systems or pregnant people.

“It’s hard to go by symptoms alone,” he said. “Getting a test is an important way to distinguish what’s happening, particularly for flu and Covid. It’s important for those at risk, because you can get early therapy that can shorten the course [of the virus] or prevent hospitalization.”

Vaccines are available

For the first time, there are vaccines available to protect against Covid-19, influenza and RSV, and now is the time for everyone eligible to get vaccinated, experts stress.

Everyone 6 months and older should get Covid-19 and flu shots, the CDC recommends. Both are available now at retail pharmacy chains like CVS and Walgreens, and you can even get them at the same time.

Ideally, Chin-Hong said, very young children should have gotten their flu shot last month. Even if parents have not received their own flu shot, at the very least, they should get their child vaccinated.

“Kids actually have a very high rate of doing poorly with flu,” he said.

RSV is another dangerous virus for young children and infants. Nirsevimab, marketed as Beyfortus, is a long-acting monoclonal antibody injection to protect infants against severe illness related to RSV.

Although doses are in short supply, the CDC announced Thursday that more than 77,000 additional doses will be distributed “immediately” to doctor’s offices and hospitals.

For people 60 and older, there are also two vaccines for RSV, and the CDC is encouraging people to get them as soon as possible. The vaccines are also available at pharmacy chains and other retailers, and at local health clinics.

Staying up to date on vaccinations can help take a load off hospitals, many of which were overwhelmed with RSV, flu and Covid-19 last year, Chin-Hong said.

Make sure you have cold and flu medications like acetaminophen and ibuprofen, “particularly for kids,” he said, because many of those medications were in short supply due to overwhelming demand last winter.

‘It’s good to be humble’

In most parts of the country, seasonal flu activity is increasing once again after taking a backseat during the Covid-19 pandemic. According to the CDC, flu-like activity was high in Puerto Rico and several Southern US states for the week ending November 11, with Louisiana reporting very high flu activity. During this week, 3.5% of health care visits were due to respiratory illness that included fever plus a cough or sore throat.

Meanwhile, Western states like Alaska, New Mexico, California and Texas are seeing more cases, according to CDC data.

More than a third of US adults and nearly a third of children have gotten their flu shot this year, the CDC said. By comparison, about 14% of adults and 5% of children have gotten the new Covid-19 vaccine, and about 14% of older adults 60 and up have gotten the new RSV vaccine.

Overall, outpatient visits for flu-like illness are lower than they were at this time last year but higher than in the previous four seasons. Covid-19 hospital admissions, emergency department visits, and test positivity are all trending down, CDC data shows. For the week ending November 11, the percentage of Covid-related emergency department visits was 1.4%, or just over 16,200 people – similar to rates seen throughout this month and last month.

The last time we saw a “significant” spike in flu activity was about a year ago, Chin-Hong notes, “so a lot of immunity has gone away, whereas we’ve had successive waves of Covid,” in the past year, he said.

Even though Covid-19 is trending down at the moment, it’s still a virus to keep in mind, since it continues to cause serious illness and death, Chin-Hong said, noting that he expects to see another spike in the new year.

“There are things that we can’t always predict, and I think it’s good to be humble about all of these viruses and how they work and when they peak,” he said.

CNN’s Deidre McPhillips contributed to this report.

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