I have to be honest with y’all, I’m a little bummed right now.  Why you ask?  At this very moment, I should be preparing to fly to Singapore, getting ready to embark on a cruise through several Asian countries.

I think you can guess why that’s not happening.  Co-vid 19, colloquially known as “coronavirus,” has reached global epidemic status (or panic at least) setting off a domino effect in the global economy and in life and society itself.   With no signs of slowing yet, this outbreak is severely affecting the travel industry.  Especially within the cruise ship sector, people are concerned, rightfully so, that they could be exposed to this “novel” threat.  I mean, we saw first hand what can happen with the Diamond Princess in Japan, and although the show must go on, the cruise I was about to travel on had changed almost all of its itinerary due to certain countries no longer allowing passengers to disembark.

And even though the risk of me, a physician who is regularly up in everyone’s nose and mouth area, contracting the virus is probably lower than say, getting the flu, the thought of being quarantined for any extensive period of time was enough to make me cancel.  It is my literal nightmare to be stuck on a boat, and I want no part of it.  My business and career would also suffer, so for now, nonessential travel is put on hold.  Which sucks.

So instead of frolicking on a boat, I’m here to provide a few tips on staying healthy while you travel along with some facts about the virus (since there’s a ton of misinformation out there).   Because even though the chance of getting Co-Vid 19 is low, it never hurts to protect yourself from all the other grossness out there.  Yes, grossness is a medical term 😉

Trust me, I’m a doctor

Let’s talk some facts.  There’s so much fake news out there, so let’s break it down.

What is Covid-19?

Coronavirus is actually a family of viruses that is quite large, even including types that are common causes of acute nasopharyngitis or the common cold.  This Covid-19 strain in particular is very virulent and mega-contagious, so it has spread throughout China and other parts of the world quite rapidly.  And because it is a newly discovered virus, arising in the latter part of 2019, its unknown state stokes a lot of fear since we don’t have a lot of solid data about it, and there’s no current effective treatment or prevention other than supportive care.

So, what do we know about it?

This virus is thought to be a bat related illness, which should be a surprise to no one, because bats harbor lots of diseases!  Rabies much?  The first reported cases came out of Wuhan, China which is a huge hub of industry at the meeting point of the Han and Yangtze Rivers.  Lots of people travel in and out of this Central Chinese metropolis, which equals opportunity for rapid spread all over.

How is it spread?

This little bugger travels in respiratory droplets via person to person contact, especially if you’re within about 6 feet.  The patient is most infective when they are already symptomatic (although there is also low risk when a person has not had symptoms yet). So, that means if the person a row or two ahead of you on the plane has it and is coughing up a storm, you’re potentially at risk (sorry).

What happens if you get it?

CO-Vid 19 is very closely related to other respiratory borne illness like SARS or MERS and causes a gnarly pneumonia type illness.  This particular type affects the lower pulmonary cells, so you’re probably getting your cough/shortness of breath more quickly than with a cold or flu, sometimes without the prodrome of a sore throat or runny nose.  Elderly people who have other health issues (especially COPD, emphysema, etc) are at the highest risk, but luckily, children aren’t as affected.  It has caused a significant amount of deaths which has helped spur the widespread panic, but the majority of patients recover with supportive care.  We’re not in Ebola status mortality wise.

What symptoms should cause alarm?

There is a 5 day incubation period (2-12 days really) before you may start showing symptoms.  Fever, shortness of breath, cough, malaise, possibly diarrhea — just like the flu or walking PNA, so just because you have these symptoms does not necessarily mean you have it!  Unless you’ve been in direct contact with a person who has recently been to the affected region or has had the disease, it’s super low risk in the US still.  You’re much more likely to have the flu, which has affected millions this year!

So how do we keep safe from Co-Vid 19 and other stuff while traveling (I’m talking norovirus, shigella, measles, etc)?

WASH YOUR HANDS.  This is the most effective way to keep yourself healthy.  It’s a no brainer!  And while hand sanitizer is better than nothing, most of these rapidly contagious diseases are viruses and I’ve got news for you, antibacterial gel may not work.  Wash your hands, use soap count the alphabet.  The act of rubbing and the presence of alcohol does help though, so Purell away, too.

If wearing a mask makes you feel better, go ahead, but it’s probably not preventing much.  A known infected person should be wearing a mask to help prevent spread to others, obviously, as well as covering their cough.   If you choose to wear a mask, get an N95 and have it fitted.  Don’t let it lull you into a false sense of security and make you forget to wash your hands.  Most of these masks are disposable for a reason, so don’t reuse them over and over (think of the bacteria in your mouth staying inside your mask with repeated use, yuck).

Try not to touch your face.  This is the one I struggle with the most.  I demonstrate things to my patients every day by touching my face, so I’m screwed I guess.  But seriously, germs from your hands can easily travel to your mucous membranes of your eyes, nose and mouth, and those are the wide open entrances to Sickville…the less popular sister city of Flavortown™ .

Stay hydrated, have good nutrition, exercise regularly, keep warm and get adequate sleep.  Your body’s immune system is prepared to fight anything, but you gotta have some good tools in the arsenal to win the war.

GET YOUR FLU SHOT.  I cannot stress this enough.  The flu is still so much more prevalent and there’s literally something that can keep you from getting it.  Get all your vaccines!

Avoid sick contacts.  I mean, this is obvious, but not always possible.

Cruise ships are petri dishes for germs and that’s why you always hear about Norovirus and Shigella outbreaks.  There’s common areas like pools, casinos, theaters; common food receptacles and utensils, and let’s face it, the likelihood that your fellow passenger may not be the most clean person is very high.  People are disgusting.

Some cruise lines will spray your hands with sanitizer as you enter any cafeteria or dining area, but I’ve seen people retrieve food with their hands, lean over/under sneeze guards, and take/put things back from their plates.  I actually will use a separate unused fork/spoon rather than the tongs or whatever is provided to grab any food.  I avoid the big cafeteria/buffets when possible, and I try to grab the furthest food item from the outside.  If the buffet has a fresh food option, omelets/carving station, I’ll probably choose that rather than taking the food that may have been prepared hours before (always avoid the fried rice, learning about B. cereus has ruined biryani at buffets for me forever).

Airplanes are also teeming with germs, so a quick wipe down with some cleansing cloths can help, and I literally try not to touch the tray table, headrests with my hands.

My travel med kit: antiemetics, NSAIDs, antipyretics, acid reducers/anti-diarrheal, cortisone cream, antihistamines, and I never travel without some antibiotics just in case.

This is by no means an exhaustive list, and I bet a lot of you have great tips on how to stay healthy when traveling — share if you’d like.  The main thing is to have common sense and continue the habits that keep you in good health at home.