We’re in a strange place in the pandemic where increasingly people think it is ok to travel while infectious with Covid-19. It is not ok to travel when you are sick and that was true before the pandemic, even though CDC advice used to say that it generally is ok for many people.

I was surprised that even a meaningful number of presumably Covid-cautious people think traveling-with-Covid is now ok. “[O]ne in four people who follow a cautious doctor who writes frequently about Covid..think that a known symptomatic Covid case should still go to a terminal and get on a flight.”

If you were in this situation (spouse w/ Covid, rapid test +; mild symptoms), tix to fly home tonight (1 hour flight), would you have:
1) Stayed in Palm Springs until neg (5-8d)
2) Flown home, w/ tight N95
3) Nixed flight, rent car, drove home (9hrs); masked; windows open.(8/23)

— Bob Wachter (@Bob_Wachter) May 9, 2022

But wait, it turns out that masking requirements lead to a sense of security that causes symptomatic Covid patients to feel it’s ok to travel. Eliminating masking rules caused this cautious doctor not to do so. No mask rules = less Covid spread. Go figure.

Had mask rules still been in place, he would have traveled, thinking that everyone was protected (which gives the average mask worn by travelers way too much credit). But since mask rules have been vacated, he deemed travel-with-Covid to be ill-advised.

Interestingly, we still might have done it if the airline masking requirement was in place. But since it wasn’t, we knew that most people sitting near her would be maskless.
We chose Option 3: the 9-hour drive. (10/23)
(Note to self: this is a very big state.)

— Bob Wachter (@Bob_Wachter) May 9, 2022

There’s a lot embedded here about where we are socially with regards to the pandemic and what our embedded beliefs are about risks and what we owe other people.

It seems to me that it’s generally safe to go about normal life at the moment because vaccines plus boosters remain strongly protective against the bad outcomes we care about, that if we do get sick there’s a cure that not enough people are taking (Paxlovid, though FDA advice is undermining treatment in cases where Paxlovid is ending too early). It’s still advisable for some people to wear good masks, and fortunately with mask rules no longer in place you can wear N95 or even P100 masks with valves now.