How to Stay Safe at In-Person Events in a Pandemic

As we work our way through 2022, we’ve noticed a lot of confusion and questions about business travel and events, especially as in-person events resume. Different nations, states, and locales all have different rules and regulations about what is and is not permitted, and many folks have questions about how to best keep themselves safe as COVID-19 and other diseases continue to spread.

Our goal with this article is to help you make informed decisions about traveling during a pandemic so that you can safely attend events and conferences while protecting yourself and those you care about at a risk level comfortable for you.

This post was last updated July 29, 2022.

Disclaimers and Disclosures

First, let’s start off with some important points. We are not medical professionals, and you should almost always heed the advice of your primary healthcare provider. If your doctor tells you to do something, it’s generally a good idea to do it.

Whatever rules and regulations are in effect in the areas you’re traveling to, respect them as the bare minimum. If a convention center asks visitors to wear a mask, do so. If an event requires vaccination, make sure you’re vaccinated and you have proof of it. It’s never a bad idea to have a digital copy of your vaccination status.

Situation Analysis

With those two key points out of the way, let’s discuss where things stand. COVID-19 is an airborne, aerosol disease; if you think about it like cigarette smoke, any place where you’d be breathing in a lot of smoke if the people around you were smoking would be a place where risk levels would be higher.

Currently, there are several major variants of COVID-19 to be concerned about, largely in the Omicron family – BA.2, BA.4, and BA.5. As of the time of this update, the Omicron BA.5 family is the dominant variant and has roughly the same probability of causing severe illness as all its predecessors, but is substantially more infectious.

There is also another pandemic occurring, that of MA001 orthopoxvirus (commonly called monkeypox) which can also be spread through the air. The World Health Organization has declared both COVID-19 and monkeypox to be public health emergencies of immediate concern.

Risk Analysis

The first question to ask yourself is straightforward: what level of risk can you tolerate? If you or someone you live with has a history of heart or lung disease, has other medical conditions that lead to an immunocompromised state (more vulnerable to disease), or are unvaccinated (such as children under 4) then you would probably have a very low tolerance for risk.

If you and all the people you live with are fully vaccinated and boosted within the last 3 months, are otherwise healthy, and under the age of 50, then your tolerance for risk might be higher. You might be willing to endure a moderate infection; the probability of severe, life-threatening disease for a fully-vaccinated person is very low, though the risk of Long COVID is approximately 20% per exposure to COVID.

Second, if the venue you’re visiting has good COVID wastewater data, examine that data in the days leading up to travel. If the data shows very low incidences of COVID RNA in wastewater, the inherent risk of a venue may be somewhat lower. If a region has high levels of COVID RNA in wastewater, an outbreak is likely occurring and your risk levels at that location are higher.

Risk Mitigation Methods

There are four primary ways to mitigate the hazards of COVID-19: vaccination, wearing a mask, testing, and good ventilation. Let’s review each of these quickly so we’re sharing common definitions.

Vaccination means being vaccinated by one of the known effective vaccines, such as Pfizer/BioNTech, Moderna, AstraZeneca, or Johnson & Johnson/Janssen, plus receiving at least one booster dose 3 months or less before the conference or event. All vaccines’ effectiveness wane over time; for any kind of situation where risk levels are elevated, such as conferences and events, travel should occur within 3 months of the most recent booster dose. You should consider your risk higher for every month after the 3 month window.

Wearing a mask means wearing a secure, airtight covering over your nose and mouth that filters the air of particles containing the SARS-CoV-2 virus (the virus responsible for COVID-19). Masks provide different levels of protection; the generally accepted safe mask for use is a mask with a safety rating such as N95/P95 (or higher) in the USA, KF94 in South Korea, KN95 in China, and FFP2 in the EU. The highest level of protection comes from masks with designations such as N100/P100 in the USA, KP100 in China, and P3 in the EU.

With the current Omicron variants, cloth and surgical masks are substantially less effective. Masks also protect you against other pathogens like influenza, monkeypox, and the common cold.

Testing means using rapid antigen tests regularly and frequently during an event to determine if you’re contagious. Rapid tests do not detect the presence of COVID-19; they detect whether or not you have enough virus in your body to be contagious and thus dangerous to people around you. To keep your fellow attendees safe, be sure to test every morning before you head to the conference show floor. If you’re contagious, don’t attend.

Upon your return home, test yourself and again 3-5 days afterward to ensure you didn’t pick up COVID-19 and bring it home with you as the worst souvenir ever.

Good ventilation means that wherever you are traveling, the air is exchanged with outside air or filtered through HEPA air filters. If you have the opportunity to do so, check out the hotel, convention center, and airline for what kinds of air filtration are in effect. For example, most modern jet aircraft use HEPA air filters in their ventilation systems to reduce disease and other airborne hazards. When your plane is in flight (not on the ground), these systems clean the air around you.

Ventilation is also part of your personal choices; imagine everyone around you was smoking cigarettes. For reducing risk, imagine how much smoke you’d be breathing in and try to put yourself in situations where it would be minimal, such as eating outdoors rather than inside.

Choosing a Risk Mitigation Strategy

Because of different situations and circumstances, there’s no one answer as to what level of risk you should be comfortable with, beyond the required minimum wherever you’re traveling. However, we can broadly group a few different risk mitigation methods together to help form some basic strategies you can choose from, based on your needs.

As a reminder, always adhere to at least whatever the rules and regulations are of the place you’re traveling to!

High risk: Vaccination only

The least safe strategy is a vaccination-only strategy, where you otherwise take no precautions to reduce your risk. If you and everyone in your household agree that this level of risk is acceptable, then all you’d need is to be fully vaccinated plus a current booster.

Moderate risk: Vaccination plus general masking

A moderate risk strategy would encompass vaccination and remaining masked with an N95 or better mask any time you’re not eating or drinking. Keep your mask on otherwise, and your relative level of risk would be moderate. There’s still a chance you’ll be infected especially in a dining area where a lot of people tend to be concentrated and unmasked.

Low risk: Vaccination plus full masking

A low-risk strategy would encompass vaccination and remaining masked at all times with an N95 or better mask. You’d eat or drink in your hotel room or outdoors away from others so that you’re not breathing the same air as a large group of people. Remember the cigarette analogy; where could you eat or drink where you wouldn’t smell more than the occasional whiff of smoke if the people around you were all smoking?

After Travel

After you’re done traveling, be sure you have enough rapid antigen tests so that you can test for up to 3 days. Many state and local governments have free tests available. You’ll want to test on the day of your return, 3 days after that, and 3 days after that, whether or not you show any symptoms. A key thing to remember is that for fully vaccinated individuals, symptoms show up BEFORE you’re contagious, so if you exhibit any symptoms of illness, be sure to isolate yourself from others in your household while you await rapid test results. If you do show symptoms of illness, test on the day you feel them plus every day after for 5 days. Remove yourself from isolation only after you test negative twice in a row.

Here is how to get your free tests in the USA: https://www.covid.gov/tests

Expert Perspective: Dr. Angela Rasmussen

What does one of the world’s leading experts on virology do when she travels? In a Twitter thread, Dr. Angela Rasmussen, Principal Investigator at the Vaccine and Infectious Disease Organization (VIDO-InterVac), offered her perspective:

Lots of anecdotes about people getting COVID at in-person conferences. I went to one last week in Boston and next week I am going to one in Portugal. Both require negative testing for international travel.

Here’s how I plan to not get COVID.

Vaccination. I’ve had 4 doses of COVID vaccine. 1 J&J in the US, 3 Pfizers in Canada (issues with international transfer of my vaccine records so I had to get fully vaccinated here for my Canadian vaccine SMART card). Last dose January 2022. #VaccinesWork

But there’s still a lot of Omicron around and it is antigenically different enough that it can still cause breakthroughs so I’ll use additional precautions.

That means wearing a KN95 or N95 respirator in public places most of the time when I am not eating, drinking, or giving my talk. Especially important at the airport, in taxis, on trains, etc.

On the plane, I’ll turn up the fan in my seat. Airplanes in flight have great HEPA filtration, so increasing airflow at my seat will reduce my exposure risk. I do sometimes eat/drink in flight & on this trip I lucked out with an upgrade, but will only remove the mask briefly for that.

When going to cafes/bars/restaurants/places to eat or drink I will look at capacity, crowding, and outdoor dining options. Will avoid crowded or packed indoor spaces. When outdoor isn’t an option, I’ll look for larger indoor spaces with lots of open windows/ventilation.

Won’t use the hotel gym and will instead work out by going for a run or just walking around Lisbon (which I normally do anyway when visiting new cities). Bonus: provides more opportunities to check out outdoor bars/cafes/restaurants.

This is a clinical microbiology conference so there’s a requirement for vaccination and/or testing. That will further help reduce exposure risk, as vaccinated people are less likely to get infected with omicron and less likely to transmit onwards. Note I said LESS likely.

My default greeting will not be hugging people. I’ll shake hands but will also regularly sanitize and wash them because that’s good hygiene practice anyway.

Travel and in-person meetings are not without risk. I might still get COVID despite my precautions. But this is not a choice solely between lockdowns and let ‘er rip. I can take steps to greatly *reduce* my risk, to protect myself and others around me as much as possible.

This doesn’t have to be as hard as some make it out to be. Risk reduction is additive and by layering on as many precautions as possible, I can significantly reduce the likelihood of exposure and infection. I will do that as I resume getting back out into the world.

I’m going to add three things here based on some feedback:

I will use rapid tests periodically during the trip, including those required for travel (I’m connecting through the US, which requires it), but my other precautions are not contingent on the results.

In other words, I’ll take those precautions regardless. The rapid tests will help me determine if I need to isolate, which I would immediately do if I test positive. I’ll also immediately do that if I develop symptoms even if I’m negative on a rapid test.

I feel comfortable traveling in part because I know my own risk level (and my spouse, who is coming with) & we don’t live with anyone at high risk (elderly, immunocompromised, etc). Your Mileage May Vary (YMMV) but it’s important to assess the risk of your household, not just what you can tolerate.

We have a plan for what to do if we test positive. Our medical plan covers travel & sometimes we purchase supplementary medical insurance in case we get sick or have an accident. This is generally pretty affordable and it’s wise whenever you travel for any reason.

We always ensure we have adequate coverage in case of any kind of medical emergency. And the credit card I used to book the tickets covers unexpected non-medical expenses related to medical emergencies while traveling, like flight changes & extra hotel costs.

COVID or not, it’s *always* a good idea to make sure you are covered in case of an emergency while traveling abroad. If we test positive while abroad, we’ll rely on this coverage to ensure we isolate properly, without endangering others & in line with public health requirements.

Because SARS-CoV-2 is an infectious virus, that means that your actions can impact & cause harm to others. So the key to traveling during the pandemic is to make sure you have lots of options. Choose the options that keep both yourself & those around you as safe as possible.

Travel Is As Safe As You Make It

Two years into the pandemic, we now know much more about COVID-19 – how it works, how it spreads, and how to slow it down or stop it. We have a toolkit of effective ways to reduce our risk – testing, ventilation, masking, and vaccination. With these tools, used properly, our risks of becoming ill can be safely reduced while still allowing us to travel and attend conferences and events. The days of all-or-nothing choices are largely behind us; choose the level of risk you’re willing to tolerate as the world slowly marches back to the way things were before 2020.

Again, we’re not doctors. We wanted to share some of the steps that we will be taking to stay safe so that we can see you in person again. We’re excited to start getting back on the road to see you at events!

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