Speaking of Wellness: Coping With Covid-19 During the Holidays

Something great happened in late October. My 11-year-old granddaughter, for whom vaccinations had not yet been approved, wanted to spend the night with us, and we were able to make it happen without risking anyone’s health. My wife bought rapid Covid tests at our local drugstore, and when our granddaughter came over, we swabbed our nostrils and waited for the results. In 15 minutes, the three of us found ourselves to be Covid-free, so the fun could begin.

Granted, the rapid antigen test we used isn’t perfect, but it was sensitive enough to the presence of the virus that causes Covid to make us feel comfortable being together indoors and without masks (that was before the introduction of the new Omicron variant, however; more on that below). Such home screening wasn’t available last year. Moreover, my granddaughter had received her weekly PCR test at school three days before her visit with us. The PCR test for Covid is generally more accurate than the antigen test.

Changes for the better

A number of other things besides at-home testing have also changed for the better since last year, even though we remain in the midst of the pandemic:

• We have the vaccines.
• We can now vaccinate children ages 5 to 11 in time for Christmas and New Year’s.
• We have more companies manufacturing rapid antigen tests, so the price (currently around $10 to $12 each) will come down and availability will go up. Furthermore, results from the even more sensitive (but expensive) PCR test (done at a testing center or at home) typically come back in a couple of days, compared to last year when it often took up to a week or more.
• Many colleges and universities are controlling virus outbreaks by mandating immunizations and non-pharmacologic interventions such as mask-wearing, so there’s much less risk of students coming home for the holiday break with the virus in tow.
• We understand the transmission of the virus much better than we did before. Initially, we believed that the main mode of transmission was via droplets. These are heavy particles expelled from your mouth and nose that fall to the ground within six feet. Thus, we thought people were safe indoors as long as they remained more than six feet apart. Now we know that in addition to droplets, the virus can be carried in the air in tiny particles called aerosols. In fact, airborne transmission is one of the main ways the virus that causes Covid spreads. The upshot: Outdoors is safer than we thought because of the dilution factor—the enormous volume of air. The risk is actually quite small outside unless you spend more than 15 minutes in close proximity with someone, both unmasked. But indoors, there’s typically not enough air circulating to sufficiently dilute the virus, which means that indoor get-togethers are far riskier than we first knew.

Not everything is better, however. This holiday season a couple of things are even worse.

For one, the summer surge this year was much worse than the 2020 summer surge because the Delta variant of the virus is twice as transmissible as the preceding version. And the summer surge occurred much later this year. Cases crested in September instead of July, and while they came down, they have been rising steadily in much of the country as of early December. This means we’re celebrating the holidays with rising cases of Delta.

Second, we’re all experiencing Covid fatigue, which has led many people to get lax in their Covid safety practices, including mask-wearing. And this comes at the time when cold weather is sending people indoors, where the virus spreads so easily.

And now there’s Omicron. While we know very little about how impactful this variant will be, it adds another element of concern over the holidays—and has made my own holiday planning a bit more stringent, as I note below.

6 important measures

Still, even with those snags, you can have a quite safe holiday season by taking these six precautionary steps:

1. Don’t get together indoors with anyone who isn’t fully vaccinated, with the exception of children under 5 for whom vaccination is still not approved. According to the current CDC definition, a person is considered fully vaccinated two weeks after receiving a second dose of the Pfizer or Moderna vaccine or one dose of the Johnson & Johnson vaccine. I also recommend that any prospective guest who meets the criteria for a booster dose get the shot before the festivities. (You are a candidate for a booster shot if you are 18 or older and had your second dose of the Pfizer or Moderna vaccine at least six months before or the Johnson & Johnson vaccine at least two months before; as of December 9, older teens, ages 16 to 17, are now eligible for a Pfizer booster.)
2. Anyone who is not boosted, as well as children under age 5, should do an antigen test the day of the gathering. For an extra layer of protection, have them get both a PCR test 72 hours before and an antigen test the day of the event. As an alternative to the PCR test, they can get an antigen test both the day before and day of the event. Those precautions don’t provide an absolute guarantee, but if every unboosted person and unvaccinated child tests negative, you can be pretty sure that Covid is not going to spread.
3. Make clear that no guests should attend if they have even the slightest of symptoms. Yes, maybe it’s “just allergies,” but they should stay home anyway.
4. Place one or more air purifiers with HEPA filters in your home. HEPA stands for “high efficiency particulate air,” meaning the filter removes some matter from the air, including much of the coronavirus. It’s not 100-percent perfect, but as part of the “Swiss-cheese defense” in which every slice of cheese covers up some holes of the other slices, it adds another layer of safety. Two good sources for information on air purifiers and buying recommendations are Consumer Reports and The New York Times.
5. Keep some windows open, even if only a crack, to allow fresh air to circulate.
6. Do your celebrating at home where you can generally best control the environment, compared to gathering at a restaurant or event venue. If that’s not feasible, however, and you want to book a private event somewhere (perhaps your home is not spacious enough to comfortably seat everyone), make sure that the venue has a professional filtration system and that staff are masked and vaccinated and follow all Covid safety protocols.

Take these steps, and your toasts to a happy, healthy new year are likely to ring true. Here’s to you and yours for a safe and healthy holiday season.