Walkers, campers and anyone else eager to escape could “simply explode in the open. And there may not be the same thoughtful approach” to preventing exposure, explains Dr. Sorana Segal-Maurer, director of Dr. James J. Rahal, Jr. Department of Infectious Diseases in the New York-Presbyterian Queens Health Care System.

“I’m a little nervous that their guard might be a little down,” she added.

The crowds in the open were so great around Remembrance Day weekend, that parks from Southern California to North Carolina had to close early after they hit capacity.

Last year, the Centers for Disease Control and Prevention announced an increase in Lyme and other tick-borne diseases, with seven additional bacteria identified in the U.S. in the last two decades, while the “lone star potato” expanded its footprint beyond southeast to northern state and middle west.

But neglecting basic steps that reduce the risk of ticks and vector-borne diseases to focus solely on preventing Covid-19 is just one of the dangers. Another possibility is to confuse the symptoms if you start to feel sick.

Lyme disease and Covid-19: a story of similar symptoms

The warning signs for tick-borne diseases “are very similar to the severity we saw with Covid-19, and that is that there is fever, muscle aches, headaches, severe fatigue,” says Dr. Segal-Maurer.

She believes the unique difference is that breathing problems are common in patients with coronavirus, but not in those infected with tick-borne diseases. Yet even that difference is ready for debate.

“Pulmonary involvement, even to the point of death, has been documented in a series of tick-borne infections,” Dr. Steven Phillips of the Bay Area Lyme Foundation told CNN. “Although severe lung involvement with vector infections is relatively uncommon, nonspecific lung problems, such as shortness of breath, are extremely common.”

Even if you follow the advice of Covid-19, listening to bite avoidance tips is just as important. Dr. Segal-Maurer describes a “realistic” scenario if you’re on a crowded hiking trail: “You’re all going to push yourself into the vegetation … you’re just going to deviate a little from the trail.”

Ticks “hang from the very top of grass or leaves or vegetation. They have these little deposits that … shake a little. There, when you rub them, they get caught.”

Last month, Pennsylvania Health Secretary Dr. Rachel Levine announced an increase in emergency room visits in recent months “associated” with tick bites. “Some symptoms of Lyme disease, such as fever, chills and headaches, are similar to the symptoms of COVID-19,” Dr Levine said in a statement, repeating what other experts say..

Go outside – but responsibly

Dr. Segal-Maurer says healthcare professionals should always ask patients about their travels and other activities. “You have to cover all your bases … we don’t want to be blinded.”

Patients should in turn ask about both options.

And when it comes to tick protection, she says, “You need to use DEET. It has to be 30%. You have to be careful where you walk. Then you have to do a body examination when you get back inside.”

Dr. Phillips prefers permethrin, which he says is stronger, but “can only be sprayed on clothing, not skin, and should be left to dry overnight before wearing.”

Other tips include putting a hat in bright clothes to make it easier to spot ticks, putting socks over your pants, and choosing long-sleeved shirts to prevent ticks from getting close to your skin.

It is, of course, an additional wearing of a mask to fight the spread of coronavirus.

Still, even with the added hassle of a safer summer vacation, Dr. Segal-Mauer encourages people to move outside this summer because he believes “it’s been traumatic for months. I think it’s great outside.”