The end of the year is sneaking up, and people are weighing travel plans to join friends and family for the holidays — all against the backdrop of asurge of the deadly pandemic.

Gathering with others — probably the most universal holiday tradition — has never required so much meticulous forethought.

Should you travel for the holidays in 2020? What precautions will make it safer? Who will be there and how careful have they been?
The US Centers for Disease Control and Prevention says that travel increases the chances of contracting and spreading Covid-19, and health officials are reminding people that clusters are emerging from gatherings of family and friends.

“We’ve seen a great deal of community spread from household gatherings,” said Alex Azar, US Health and Human Services Secretary, on October 19.

Azar said people need to use common sense and assess the circumstances in the community to determine if they should have gatherings over the holidays.

CNN spoke with medical experts on how to reduce the risks around holiday travel and when you really should skip it altogether.
Should you travel for the holidays this year?
“I think the threshold for travel at this time should still be higher than before the pandemic,” says Dr. Henry Wu, director of Emory TravelWell Center and associate professor of infectious diseases at Emory University School of Medicine in Atlanta.

“If you do choose to travel, try to keep gatherings small and take precautions,” such as wearing a mask and practicing social distancing and good hand hygiene, Wu said.

Traveling is fine if you’re willing to be cautious, follow the rules and adapt easily to changes of plan, says Dr. Richard Dawood, a travel medicine specialist and director at Fleet Street Clinic in London. The United Kingdom is experiencing a rapid increase in coronavirus cases this fall.

“Probably not, if you are anxious or vulnerable,” he says.

Who should skip it?
People who are especially vulnerable to severe Covid-19 illness are safest staying home.

“Are you older, are you frail, do you have chronic underlying illnesses?” are the questions to ask, says Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

People who are considering meeting up with vulnerable relatives or friends should really weigh the implications of introducing illness to them, Wu said.

“There are well-documented Covid-19 clusters associated with family gatherings, including ones that resulted in deaths,” he said.

Are some locations safer than others?
Gatherings are likely safer in areas around the world where infections remain low, although the standard precautions still apply.

For example, it may be possible to have a “relatively normal” Thanksgiving gathering in parts of the United States where infections are very low, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“But in other areas of the country … you’d better hold off and maybe just have immediate family,” Fauci told CNN’s Chris Cuomo in early October. As always, wear masks and keep gatherings small to reduce the risk of infection.

“I’d like to say that everything is going to be great by Thanksgiving, but honestly … I’m not so sure it is,” he said.

The Centers for Disease Control and Prevention reminds people that the risk of infection increases when you travel from or to communities with high numbers and rate of disease.

Does testing provide protection?
Testing can help catch coronavirus infections before travel, Wu said,”but testing is not foolproof.”
“It can be falsely negative, or just miss infections you are still incubating,” he said. “You could certainly also get infected during travel and potentially infect others after that.”

Testing can offer “a level of reassurance if the people who are attending are negative at the time they were tested,” Schaffner said. “You still have to be cautious.”

Would a vaccine make travel safe?
Even if a vaccine becomes available in time for the holidays, it’s likely to provide partial protection much like the flu vaccine, says Schaffner.

If it’s 70% effective, then three people out of every 10 won’t be protected, plus a sizable percentage of the population won’t have been vaccinated yet.

It’s not a “suit of armor,” he says, and the other standard precautions would still apply.

What’s the safest way to get there?
Driving generally allows travelers more control of their interactions with other people than flying or other forms of communal transportation, the experts say.

“Your own vehicle, or a private jet!” is the safest way to travel, Dawood says.

Minimizing contact when you get out of the car is key, Schaffner says. Mask up when you’re outside the vehicle, make very few, very brief stops and opt for drive-thru food over going inside a restaurant.

With air travel, “you’re more at the mercy of what’s happening around you,” Schaffner said. Still, wearing masks, good hand hygiene and maintaining as much social distance as possible is important.

Should you stay with family?
Schaffner sees hotels as offering more control of your environment than staying in a relative’s home, provided you avoid close encounters in elevators and other public areas and skip restaurant dining in favor of takeout or room service.

Whether you choose to stay in someone’s home “has a lot to do with who’s the relative and how careful have they been,” Schaffner said.

Anytime you’re gathering in close contact with friends or relatives, it’s important to discuss these things in detail beforehand: Is anyone at elevated risk for severe disease? What kinds of precautions and risks are guests and hosts taking day to day?

Schaffner knows people who have stayed in the homes of friends or relatives after carefully quarantining for a couple of weeks before visiting or receiving guests. That’s the kind of safety measure that’s good to consider and agree upon in advance.

Wu doesn’t have a strict answer on whether staying with friends and family or in a hotel is safer. A number of factors come into play, he says, including your ability to safely distance. For stays in the same house with other people, “consider if the family you are visiting has been able to isolate and take precautions,” he says.

Can you safely gather with people outside your household?
Even if you do stay in a hotel, chances are good that you’ll want to gather with other households to celebrate the holiday season.

Schaffner has been to relatives’ homes during the pandemic and they’ve been to his, but they’ve stayed far apart and worn masks and only stayed together for a couple of hours, he says.

Food is served, but they sit at the far ends of the dining room table and take their masks off only to eat and drink.

“It is prudent to keep the mask on during a family gathering, especially if indoors and you (or others) have risk factors for severe illness,” Wu said. Gathering outdoors is preferable, whenever possible.

In the United Kingdom, many areas have officially restricted the size of gatherings to control the spread of the virus.

“The ‘rule of six’ shows no sign of letting up, restricting gatherings to groups of six, but people are finding innovative ways to meet while respecting the rules, including ‘drive-by’ weddings, and setting a rota of events through the day,” Dawood says.

Small, outdoor, socially distanced gatherings are safest.

“Large groups, especially if coming from different households or geographic locations, could increase the risk of infection,” Wu said.

The very safest option? “Get a small turkey and stay at home,” Schaffner says.

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