Paging Dr. Frischer: Covid-19 and the Holidays

The holidays are fast approaching. Every day I hear these questions: “My kids are coming home for the holidays. How do we handle this?” “I want to spend time with my family and friends over the holidays. What should we do to make that safe?” As if this year hasn’t been challenging enough. What is the best way to celebrate during a pandemic?

 

The easy response is that there is no easy response. Let’s be clear. This rotten pandemic is far from over. Daily new cases and hospitalizations are at an all-time high. Sharing the holidays often involves travel, and every form of travel carries some risk.

 

Members of your family and close friends are not automatically part of your pod. Your loved ones bring the exposure of their own pod along with them. Are you ready to suddenly accept a higher level of risk simply because the calendar tells us that it happens to be November?

 

Let’s evaluate your own particular level of acceptable risk. What risk factors do you have? Age? Obesity? Diabetes? Are you a cancer survivor? What are the risk factors of every other member of your pod? Start speaking with loved ones now. Express your concerns and listen to them. Remember that your goal is to protect everyone’s health.

 

Let’s get creative. You can absolutely take steps to minimize these risks. What about quarantining and testing in advance? You might all agree to get tested before gathering, and only convene if everyone tests negative. This doesn’t entirely remove the risk. Note that those in the early stages of infection can test negative but still be infectious later, or that one might be exposed after taking the test but prior to the gathering. These lags have been blamed for many outbreaks. Ideally, everyone would quarantine for a full 14 days and then be tested.

 

Let’s recognize that there is no such thing as a perfectly safe way for groups to gather. COVID-19 is a highly contagious virus. Consider this:

  • Outdoors is better than indoors in a big way. The virus spreads when we are exposed to respiratory droplets. These large droplets are unlikely to travel further than six feet (unless the infected person is, for example, running, singing, coughing, or sneezing). It is easier to stay distanced outdoors, since particles dissipate fairly quickly. In an enclosed space, particularly one that is poorly ventilated, particles can build up and potentially endanger anyone in the room, even those who are more than six feet away. If there will be an indoor gathering, do your best to replicate the advantages of the outdoors. Choose as large a space as possible. Open windows and doors to increase multidirectional air circulation.

  • Keep in mind that, just by breathing, an infected person is constantly exhaling those tiny particles. Wearing a mask reduces the number of droplets and aerosols. Wearing a mask at all times is far safer than no mask at all, and wearing that mask as much as possible is second best.

  • Keep the group small. Each addition of a new pod increases the odds of the virus being present, and the carrier may very well be asymptomatic. California health officials suggest that we restrict gatherings to no more than three households.

  • Consider cutting back on the number of food courses and variety, in order to minimize both the amount of time spent together, and the amount of time spent mask-free. Say your goodbyes in two hours or less, as the length of time directly increases the chances of exposure.

 

My advice is to find your own level of comfort. Faced with the potential emotional minefield and prospect of a holiday meal filled with restrictions, testing, and quarantine, some family members will choose to not be physically together this year. Everyone will need to work hard to understand and respect one another’s decisions. If you do get together for the holidays, work out the rules ahead of time, so that there is no new territory to navigate once everyone has gathered.

 

Thinking outside the box is the best way to survive 2020. I have attended a Zoom bridal shower, wedding, and funeral. This may be the year to be creative and gather for a Zoom Thanksgiving, Christmas or Hanukah. Perhaps your virtual gathering will involve dining, streaming a movie, or playing an online game. Perhaps you will organize a family recipe swap so that everyone can be enjoying your aunt’s famous mashed potatoes. Perhaps you will drop off favorite foods to older relatives.

 

Needless to say, avoid hugs, kisses, and handshakes like…well…the plague. Whatever you do, I urge you to carefully think it through, communicate clearly with everyone involved, and to have safe and loving holidays.

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