Updated January 10, 2023
Flu season is back with a vengeance, with levels returning to pre-COVID levels. The CDC classified the 2022-2023 flu season as moderate among the general population, and highly severe among children. In regard to what "moderate" means, last year's season saw 31 million reported illnesses, 14 million doctor visits, 360,000 hospitalizations, and 21,000 deaths.
As of the date of this publication, the CDC reports 10 million illnesses, 110,000 hospitalizations, and 6,500 deaths so far. Prevention is essential to protecting yourself and your loved ones.
Although the single best way to avoid the flu is to get vaccinated, it is a myth that you are fully protected with only the vaccine. Avoiding places more likely to contain the flu can mean the difference between staying healthy and catching the flu. Though anyone can get the flu, the elderly and young children are especially vulnerable and may become seriously ill if they catch it.
If you cannot avoid places that can be notorious for germs, there are steps you and your family can take to stay as protected as possible. Here are six public places you should avoid to the extent that you can, along with prevention tips and how to make your home environment more safe from the flu virus.
The flu virus and how it spreads
Viruses are not entirely “alive”–the flu (influenza) virus needs a host to multiply because it cannot on its own. Flu viruses pass through the air and can enter a person’s body through their nose or throat, potentially causing a respiratory infection called the flu. Flu symptoms may be much worse than those of the common cold, and may include body aches, chills, cough, and sore throat, according to the Centers for Disease Control and Prevention (CDC). They also may cause fever and headaches–symptoms that rarely occur with the common cold.
How does the flu virus spread from person to person? Experts believe that flu viruses spread mostly through tiny droplets that become airborne when a person sneezes, coughs, or talks. These small droplets can then land inside the noses and mouths of people nearby. Those who have the flu can spread it to someone else up to about 6 feet away. The flu can also spread (though less often) when someone touches a surface or object containing the flu virus, and then touches their own mouth or nose. The flu virus may “live” or stay on some surfaces for up to 24 hours, says the CDC.
The flu virus can enter a person’s body and only show symptoms after 1-4 days. Therefore, people can spread the flu before knowing they are sick. Most people are contagious during the first 3-4 days after they become sick. However, young children and people with weakened immune systems might even be contagious for a period of 7 days or longer.
Have you wondered why flu season happens in the winter? It might be because viruses have a rubbery coat that is strengthened by cold temperatures, as the NIH reports.
Now that you have read how the flu virus spreads, here are the best (and most simple) ways to prevent the flu from spreading to you and your family, in case you cannot avoid the 6 places mentioned in this article.
Basic flu prevention practices for public indoor places
The following good health habits can go a long way to help prevent the flu and stop germs in their tracks, says the CDC:
- Avoid close contact with those who are sick.
- Stay home if you're sick.
- Cover your mouth and nose, especially when coughing or sneezing.
- Clean your hands (or use a hand sanitizer) to protect yourself from germs.
- Try not to touch you eyes, nose, or mouth, as that is how the virus spreads.
Masking is also a proven way to effectively restrict the spread of droplets containing airborne illnesses. Wear a mask if you're sick, or if you have to be in public places where you risk being near people who are sick.
6 public indoor places to avoid the flu virus
Luckily, the season of holiday shopping ended last week, though trips to the mall to return or exchange gifts can keep shopping malls busy. Many people crowded together means the flu virus can do what it was “born” to do–spread as quickly as possible to as many people as possible. However the end of the holiday season does not mean the end of peak times (such as weekends) when many people visit shopping malls. If possible, it is best to avoid going to crowded, busy malls, because you will likely come into contact with people who are sick (and may not even know it). Even if someone does not appear sick they could still be contagious.
Also, a lot of people means a lot of potential for germs to “live” on surfaces like the register where you would purchase items and sign for them, such as the PIN pad or another electronic payment terminal.
If you cannot avoid being in the mall at a busy time, it is a good idea to take hand sanitizer with you, and use it especially after touching doorknobs, escalator handrails, or other commonly-touched surfaces.
Packed movie theaters or live performances
The opening night of special, much-anticipated movies or packed live performances can be fun to attend, but it could also mean that many people are sitting close together, and the flu virus can spread more easily and quickly (imagine if every seat is filled, and one person has the flu virus).
If you cannot avoid attending a movie on opening night or a special performance you have bought tickets well in advance for, using hand sanitizer, not touching your face (eyes and nose), and wearing a face mask could help a lot to stop the spread of any viruses that come your way. If you sit next to someone who is frequently coughing or sneezing, it may be a good idea to turn away when they do so or wear a face mask to prevent any liquid droplets from entering your nose or mouth or getting on your hands.
If you live in a place where winter has made its mark, with heavy snowstorms and extreme cold temperatures that force you to stay indoors, going on a cruise can be a great escape. However, one consideration is the risk of flu on cruise ships, especially if you or a family member is vulnerable to the flu. The virus can spread rapidly throughout such close quarters, either through droplets in the air or via contaminated surfaces.
If you have already planned travel on a cruise and decide to go, the CDC recommends that if you have not already received the flu vaccine, that you get vaccinated at least two weeks prior. You may also want to check the state department’s travel advisory website for any safety warnings about your destination, including public health information about any outbreaks of diseases. While on the cruise and during the time at your destination, you should follow the same basic care practices like washing your hands frequently and sanitizing common areas with wipes as much as possible.
Daycare (childcare) centers
Flu is especially serious when it comes to children, as they (especially those 5 years or younger) are at a higher risk for complications related to the flu, according to the CDC. The CDC says that the best way to protect your child from the flu is to get them vaccinated every year.
The seriousness of contracting the flu may affect your decision of whether or not to send your child to a childcare or daycare center during the winter season. Imagine several children together, especially infants and toddlers, who often use their hands to wipe their noses, touch their eyes, and then play with toys and touch other children, who in turn do the same. The flu virus can easily spread among them and cause infections, especially as their immune systems are still building up.
It may not be practical to avoid sending your child to daycare. In that case, you can check with the center about their flu/sickness policies, and whether children who have a fever or other flu symptoms are sent home or can continue to stay. Licensed childcare providers may be required to give a notice of an outbreak. You should also check with the center about the measures they take to promote good hygiene, such as if toys and surfaces are properly sanitized and whether staff and other children are immunized. HealthyChildren.org has more information about reducing the spread of illness in childcare and questions you should ask the staff.
People think of airplanes as enclosed spaces where sickness easily spreads–and for good reason. You may have heard about the flu and Emirates flight 203 that landed in New York City from Dubai in September 2018: the CDC initially said 100 people reported being ill. The passengers were briefly quarantined and 11 were hospitalized, with tests confirming flu and common respiratory viruses. Because you may be seated near an infectious person for a long time (especially if they are sitting right next to you and are visibly sick), it may be best to avoid air travel if you can help it or are especially vulnerable.
However, avoiding air travel may not be possible. In the case where you must fly, it is a good idea to use hand sanitizer frequently, wipe down your tray table and the surfaces around you with sanitizing wipes, and use restrooms on the ground as much as possible, so you do not have to use airplane restrooms as much (it could be the place with the most germs).
Common public surfaces/places that have the most germs:
This section is not one specific place, yet describes public surfaces that are notorious for having the most germs.
- Shopping carts
- Pens used to sign at store checkout or at a restaurant
- Self-checkout terminals at the grocery store
- Door knobs and handles
- Handles and other surfaces on public transportation
It is important to sanitize these types of public surfaces as much as possible (shopping carts, ATMs, etc.) and then use hand sanitizer afterward. You can also bring your own pen to use at the register.
If you can avoid the above six public places (they may have a higher chance of containing the flu virus) and follow best practices whenever you cannot, you will have taken a critical step to prevent getting the flu.
How to protect your home from the flu virus
What about preventing the spread of flu within your own home, especially if a family member has already become sick? There are steps you can take to create a safer, healthier environment to prevent flu viruses from contaminating the air, as well as household surfaces and linen.
One step you can take is to provide enough air circulation within your home to help keep viruses out. The American Lung Association reports that research has shown the air flow and ventilation can affect how sickness spreads throughout the air, and that the more stagnant the air is, the more likely it is for diseases to spread.
Basic health practices
Good habits as recommended by the CDC become critical inside the home–steps like washing hands frequently, having family members who are sick cover their mouth when sneezing or coughing, not sharing utensils, and not touching your eyes, nose and mouth with unwashed hands can help prevent the spread of germs.
It is important to clean and disinfect surfaces and objects within your home that are often touched, as flu viruses can live on surfaces for up to 24 hours; some studies have shown this number to be up to 48 hours. However, flu viruses outside of living cells are relatively fragile and so cleaning and disinfecting surfaces is enough to remove them. It is really important to use disinfecting wipes on electronic devices like computers and cell phones, if they can withstand the liquids involved.
Wash linen frequently
If you are caring for someone who is sick at home with the flu, you may want to wash linen like bedding and towels often to get rid of germs.
Some air purifiers claim to destroy viruses with UV light or through other methods like Photochemical Oxidation (PCO). Yet there are no standardized methods to evaluate these claims. However, third-party data has shown that the Molekule air purifier, which uses Photo Electrochemical Oxidation (PECO) technology, can remove viruses from the air to provide safer, cleaner air to breathe. Of course, the use of an air purifier must be supplemented by the basic prevention methods discussed above.
The CDC expects an elevated level of flu activity this season to continue for weeks. Try as you may, it could be impossible to avoid places that are notorious to have the most germs, and in this case, flu viruses. Daily life in a modern society often requires people to be in close contact with each other in settings like school and work. However, some good habits and awareness of places to avoid as much as possible can go a long way in protecting you and your family.