By: Katie E. Golden, MD
If you’re reading this, you have so far survived a worldwide pandemic, raging forest fires and non-stop hurricanes, endless zoom calls, the death of Alex Trebek, and the painful viewing of the first presidential debate. I don’t know about you, but after everything we have been through this year, I don’t want to be brought down by a case of COVID from my weird Aunt Judy over the holidays. So in this month’s installment of The Golden Hour, I am providing some guidance on how you can stay safe this holiday season amidst an unprecedented number of COVID cases. Now, more than ever, our behavior and social distancing practices will determine how well our country survives the coming month. And we didn’t come this far just to miss out on 2021 and its promise of widespread vaccine-induced immunity. And the release of the new Top Gun sequel starring Tom Cruise AND Val Kilmer.
Before your visit
The safest approach to the holidays this year is to stay home, limit in-person gatherings to your immediate household, and maximize use of virtual celebrations. Your next best strategy is to wear a hazmat suit. (No, I kid, don’t do that. They are suffocating and unflattering anyway.) If you are planning to travel or attend a holiday gathering, however, there are some simple but necessary precautions you should take to keep yourself and your loved ones safe.
DO NOT travel or attend a social gathering if . . .
- You have been exposed to someone with a confirmed case of COVID in the 14 days preceding your date of travel or the event (I highly recommend you download the SlowCOVIDNC app, which enables easy contact tracing and will notify you if you have been exposed)
- You have ANY symptoms of COVID
- You are immunocompromised, or at high risk for severe illness (age over 65, chronic medical conditions such as heart, lung, or kidney disease)
- These conditions apply regardless of your own testing results (false negative tests are still common, and you can learn about the pitfalls of testing here)
- If you are traveling or gathering with people outside your household, get tested first.
- If you plan to travel to a different city, county, or state, research the current case numbers here and cancel any trips to hot spots.
- Pay attention to local travel restrictions (many states are effectively enforcing quarantining after travel, and the punishment for violating these policies can be significant).
- If you are gathering with others for a meal, like Thanksgiving, set safety expectations ahead of time. Ensure other attendees are following social distancing practices before the event, and establish a plan for minimizing everyone’s risk (see holiday-specific guidelines below).
- If you plan to see an older or higher risk family member, take the extra precaution to quarantine for the 14 days prior to your travel to minimize the chance of being an asymptomatic carrier who transmits the virus to your loved one.
- Get your flu shot! While data is still preliminary, we are learning that co-infection of COVID and flu is much more deadly than COVID alone.
During your visit
If you must travel this holiday season, we all know extreme caution should be paid to the guidelines that have been emphasized all year: wear a mask, stay 6 feet apart whenever possible, wash your hands frequently, and limit surface contact.
While gathering with family and friends, however, there are some extra considerations to keep in mind to stay safe:
- Remember that your risk of contracting the virus is dose-dependent. Do whatever you can to limit both the number of people in attendance and the duration of the event. There’s never been a better excuse to eat and run. Or to take that second piece of pumpkin pie to go.
- Keep the celebration outdoors whenever possible. Build a fire, put on a thick sweater, and be grateful you don’t live in Maine. If you must be inside, open windows and keep the space well ventilated.
- If you are not actively eating or drinking, keep your mask on. (I know, these moments can seem few and far between over the holidays)
- Limit the sharing of utensils, glassware, and dishware whenever possible. Many groups are resorting to a ‘bring your own’ strategy for both food and utensils this year.
- We have learned that singing and shouting increases the dispersal of respiratory particles, so maybe cancel the karaoke and Christmas caroling, avoid bringing up politics with family, and if your quarterback gets sacked on 3rd down in the 4th quarter of a tied game, just look away. Serenity now, friends.
- No, drinking extra alcohol does not kill the virus. But you know what can feel a lot like COVID? A bad hangover. Congratulations, that extra martini just bought you a nasal swab and 14 day quarantine.
After your visit
Given the higher risk of viral transmission that comes with travel, it is advised that you quarantine and limit human interaction for the 14 days following your trip. If you develop any COVID symptoms in that time, get tested, and immediately notify the people to who you may have exposed. Again, download the app, which will make this process easy (and unanimous).
If you test positive for COVID . . .
- You have to isolate (which is different than quarantining, which is the protocol when you have been exposed but are not sick)
- If you are asymptomatic, your isolation period ends 10 days after the date of your positive test
- If you are symptomatic, you can end isolation when all three of the following conditions are met:
- It has been over 10 days since symptom onset
- You have been fever-free for 24 hours (without the use of fever-lowering medications such as Tylenol or Ibuprofen)
- Your symptoms have significantly improved (with the exception of the loss of taste and smell, which may persist well beyond the resolution of infection)
Please be safe this season. I know that we are all fatigued by the impact of social distancing on our lives, and nothing is more welcome after a tough year than meaningful time with loved ones and joyous holiday celebrations. This is the time, however, that we need to be extra vigilant about the risk of infection. Save lives. Save tastebuds. Let’s all enjoy the holidays the same way we enjoy eggnog – responsibly.