Just over this past weekend, air travel in the United States hit its highest level since mid-March, raising fears that the spike in holiday travel will likely result in another hospital-crippling surge in coronavirus cases and related deaths.

According to the Transportation Security Administration, more than a million people passed daily through airport security checkpoints Saturday through Monday. Air travel is still down significantly compared to previous years, but top health officials like White House coronavirus advisor Dr. Anthony Fauci are sounding the alarm that the rising number of travelers will have lethal consequences even as vaccine campaigns are being ramped up in states across the country.

Perhaps the effects are already being felt from the increased travel in late December. The United States reported more than 253,000 new cases on Wednesday, bringing the rolling seven-day average up to about 222,600, the highest figure to date in the nearly yearlong pandemic, according to data compiled by Johns Hopkins University. 

The weekly average of daily new cases has climbed by at least 5 percent in forty-seven states, while currently, more than 132,400 are hospitalized nationwide with the virus—yet another record according to COVID Tracking Project data.  

As Americans enter the new year, how will holiday travel shape the coming weeks in January? In order to get that important answer, the National Interest reached out to sixteen medical experts across the country. This is what they foresee.

Dr. Lee Riley, Professor and Chair of the Division of Infectious Disease and Vaccinology at the University of California, Berkeley 

“After every holiday since the pandemic began, we saw a surge in the number of new cases and deaths. Travel contributes to people coming into close contact during travel to facilitate transmission, but more importantly, travel helps spread the virus into new territories free of the virus. When the virus sees these ‘virgin’ populations, it just goes crazy and transmissions explode at multiple places at the same time. When the epidemic occurs at multiple places at the same time, it stresses the already under-resourced health services and personnel. This is why health officials discourage holiday travel.” 

Dr. Kumi Smith, Assistant Professor in the Division of Epidemiology and Community Health at the University of Minnesota

“Any time in the past that social gatherings have been more common—especially if those people are unmasked and/or sharing the same unventilated indoor space for sustained periods of time—it has almost always been followed by a jump in COVID-related hospitalizations and deaths. Fundamentally, an important part of the math underlying transmission is the number of personal contacts that people have. For most people, more travel means more contacts.”

Dr. Matthew Abeln, Physician at Allina Health 

“More people traveling and gathering equals more viral transmission equals more infections equals more deaths—and there is exponential growth without strict public health measures. Traveling around the country and gathering in large groups does not constitute strict public health measures. It’s foolish and lethal. What happens is that our hospitals fill up and people can’t get the care they need. The death rate from COVID went from 1.7 percent to 1.8 percent this fall—it seems purely because hospitals were overwhelmed and couldn’t take care of patients in the best way possible. That’s thousands of preventable COVID-19 deaths. From my perspective as a physician, people running around calling us heroes and then not following public health measures, including severely limiting travel and gatherings, feels very hollow.”

Dr. Daniel J. Van Durme, Chief Medical Officer of the Florida State University COVID Program and Senior Associate Dean for Clinical and Community Affairs 

“We have seen significant spread from smaller family gatherings of just ten to twenty people. Since these are families, they often do not practice (public health-conscious) behaviors of mask-wearing and (social) distancing—so there is spread. When these newly infected people then travel through airports and elsewhere, the (virus) spreads to fellow travelers and they bring it home with them to their own communities.”

Dr. Glen P. Mays, Chair and Professor in the Department of Health Systems, Management and Policy in the Colorado School of Public Health at University of Colorado Anschutz 

“It is possible that increased holiday travel resulted in higher levels of transmission due to increased social interaction and lower levels of compliance with control measures, such as social distancing, mask-wearing, and limiting indoor gatherings, over the past several weeks. If this is true, then the highest levels of cases, hospitalizations, and deaths may still be to come in January. Making matters worse, it appears that the new and more transmissible COVID-19 virus variant has been circulating in the United States during this holiday period. This new variant may also drive up transmissions over the next few weeks and months.”

Dr. Joe K. Gerald, Associate Professor of Public Health Policy and Management at the University of Arizona 

“(There are) two factors: social networks that would not have otherwise come into contact will, in fact, come into contact facilitating transmission across dissimilar groups, then those new infections will be taken back to households that are spending more time together, thereby facilitating spread within them. (It’s) basically a two for one special.”

Dr. Prathit Kulkarni, Assistant Professor of Medicine-Infectious Disease at Baylor College of Medicine 

“Holiday travel can be problematic for a few different reasons. One, groups of people who don’t usually live together might come together without use of masks and physical distancing. This can, of course, lead to increased spread. Two, the travel itself can sometimes be a risk if there are large crowds indoors. And three, if infection is acquired in one geographical area, it can then spread more quickly to different geographical areas because of the travel.”  

Dr. Dean Winslow, Infectious Disease Specialist at Stanford Health Care

“Record numbers of people traveled after getting together in indoor settings, so this could be a ‘perfect storm.’ . . . I am afraid we will continue to see cases rise until at least 75 percent of the U.S. population is immune (by either vaccination or natural infection). Our rollout of vaccines has been very slow in the United States. It is very important we strictly adhere to mask-wearing in public, avoid indoor gatherings, and unnecessary travel in the United States with cases exploding. . . . Just doing the math, this is 14,000 to 21,000 deaths per week.”

Dr. Wes Van Voorhis, Professor of Allergy and Infectious Diseases at the University of Washington School of Medicine and Director of the Center for Emerging and Re-Emerging Infectious Diseases 

“I expect we may see an increase in cases. I think the big events that make this likely are the effects of the Christmas and holiday travel and the effects of increased transmissibility of the UK and/or South African SARS-CoV-2 mutant. Holiday travel may cause cases to rise dramatically because of intermixing of groups outside of their small home-based ‘bubbles’ that probably happened as millions of people traveled over the holiday period. This travel will undoubtedly lead to (often asymptomatic and pre-symptomatic) persons transmitting to the new folks they encountered, especially when not masked (or) social-distanced. … In addition, more travel can spread strains more rapidly that have increased transmissibility, such as the UK and South African mutants.”

Dr. Daniel Bachmann, Emergency Medicine Physician at The Ohio State University Wexner Medical Center 

“Holiday travel is a risk for spread of new COVID-19 cases due to intermixing of individuals outside of their standard ‘bubble’ of people. Close contact with new individuals is a known risk for COVID-19 transmission. Additionally, the type of close contact that typically occurs during holidays, including hugging and prolonged contact (within) six feet from others, is also a risk for COVID-19 transmission.”  

Dr. Cindy Prins, Clinical Associate Professor of Epidemiology at the University of Florida

“When people travel, they are removed from their normal routines, including their routines that may normally protect them from COVID-19. If they travel through crowded airports and on planes or buses, then they will get exposed to many more people than usual. And with the high number of cases in the United States, there’s a high likelihood of them getting exposed to people who are infected. Also, people usually travel over the holiday to visit with others, and those small gatherings can increase the risk of COVID-19 transmission since people may decide to remove their masks and get close to each other. We trust our loved ones, and that trust somehow gets extended to assume that those loved ones are not infected—but there’s no guarantee of that.”  

Dr. Ian Kim, Physician and Professor at the University of California Davis School of Medicine

“Plane trips are among the highest risk things anyone can do. Treat any plane trip as if you’ve been directly exposed to COVID-19 and stay in quarantine for fourteen days after any trip. Reduce your risk of exposure during the plane trip by wearing an N95 mask, unless you have medical reasons not to wear that type of mask. Even then, the fourteen-day quarantine rule should apply.”