Travel in the middle of a global pandemic presents challenges, with each activity carrying its own level of risk for coronavirus.
Joseph Khabbaza, a pulmonary and critical care physician at the Cleveland Clinic, said some of the biggest questions he's getting relate to travel activities.
Khabbaza, who treats coronavirus patients, said the primary path of transmission is contacts with respiratory droplets produced by infected people. Face masks, physical distancing, frequent hand-washing and cleaning and disinfecting of surfaces have become standard across the travel sector.
"Every industry has interventions in place to make things safer," he said.
The Cleveland Clinic has been helping United Airlines develop its coronavirus mitigation policies, including mandatory face masks, touchless kiosks and physical distancing.
"Companies are bringing in outside health experts," Khabbaza said. "That can be a little bit reassuring."
Khabbaza, who's taking a 500-mile road trip with his family to Long Island, New York, offered his thoughts on the relative risks of different travel activities and best practices.
In spite of all the precautions now in place, Khabbaza said flying offers the most potential for exposure to the coronavirus, because of the nature of how planes are configured.
"Once you’re in the cabin, you don’t know who’s on the plane," he said. "You’re in relative closer proximity to people you don’t know."
Still, he said, flying is safer than it was earlier in the pandemic because of the changes airlines have made.
"It is as safe as they can make it," Khabbaza said.
In addition to spacing and sanitizing, he said face masks add an extra layer of protection from the virus. Most U.S. carriers now require passengers to wear them.
Coronavirus: Does your airline require you to wear a face mask?
Trains and buses
Surface transportation presents similar challenges to those in aviation, Khabbaza said.
"Distancing isn’t always possible to the extent you’d like," he said. "That’s not going to go away as long as the virus is around."
Like the airlines, Amtrak and intercity bus operators like Greyhound and Peter Pan Line are requiring passengers to wear face masks. They're promoting physical distancing when possible and cleaning and disinfecting high-touch surfaces more often.
Though cruise ships were some of the original hot spots for the coronavirus, Khabbaza said when they resume sailing, their risk will be lower with precautions cruise companies are putting in place, as long as passengers and crew members adhere to them.
"It involves buy-in from everyone," he said.
Cruise ship passengers can stay separate from other groups on the ship by staying in their own rooms. Common areas of the ship offer space for distancing, and outdoor activities are inherently less risky for disease transmission, Khabbaza said.
The elimination of buffet food service, a move under consideration by multiple cruise lines, would remove a point of potential transmission not only for the coronavirus, but also for the foodborne illnesses that have long plagued cruise ship operations, Khabbaza noted.
'Hygiene is the new luxury': How cruise ship design could evolve to ward against outbreaks
As some of the nation's larger theme parks reopen, such as those run by Universal and Disney, Khabbaza said the biggest risk may come from the travel it takes to reach them. The coronavirus is having a different impact across the country, with some states seeing a decline in infections and others an increase.
Otherwise, he said theme parks are at the safer end of the spectrum. Why? Theme parks are universally implementing changes that include social distancing, mandatory face masks, the increased availability of hand sanitizer and the increased disinfection of high-contact surfaces.
Theme parks are also mostly outdoors, posing a lower risk than enclosed spaces. They're also limiting the number of visitors who can enter.
"Less people is definitely better than more people," Khabbaza said.
Life after coronavirus: When Six Flags reopens post-pandemic, guests will need to book and pay in advance
Walt Disney World: July 11 reopening date set for Magic Kingdom, Animal Kingdom
Khabbaza said to take precautions every time you step out of the car, whether for gas, food or a rest break.
He recommends using hand sanitizer every time you pump gas, and resist the temptation to use your phone while you're doing it.
"Even locally, that’s a very important practice," he said.
How to road trip safely during a pandemic: Tips for navigating rest stops, gas stations and hotels
With adults or older children, Khabbaza said it should be safe to visit convenience stores and sit down to eat.
"If you’re traveling with young kids, that changes it a bit," he said. "Kids run around and touch stuff."
With younger kids, he said take them to the restroom and then back to the car to eat. That minimizes their exposure to surfaces and items where infected droplets may have fallen.
RVs come roaring back: More turning to RVs, motor homes to escape COVID-19 – and get away from it all
Hotels have increased their cleaning and disinfecting procedures for high-touch surfaces and common areas, as well as encouraged physical distancing. They've encouraged online check-in and automatic checkout to eliminate face-to-face interactions. They've sealed items in rooms, such as coffee cups and glassware, and have eliminated mini-bars.
Hotels, resorts announce new cleaning programs: Here's what they look like
Khabbaza said it's not a bad idea to bring your own disinfectant wipes to use on surfaces in the room.
The risk of coronavirus from housekeeping should be relatively low he said, though housekeeping staff are going from room to room.
"If they carry the virus, potentially the risk is they could bring it to your room," he said.
Preventing coronavirus while on the road: Here's how to sanitize your hotel room
Camping is probably the safest activity, Khabbaza said. It's outdoors, and you're likely to stay with your own family or social group. Some campgrounds remain closed, though, including those in national parks. Check before you go.
Considering a camping trip this summer? Tips to make sure your gear is good to go
Need a social distancing-friendly activity? Use this time to improve your outdoor skills
This article originally appeared on USA TODAY: Rating the coronavirus risk factor for common travel activities