Welcome to December.
The holidays are upon us — Advent started on Sunday, Hanukkah begins on Thursday evening, and New Year’s Eve is only 26 days away.
Personally, this holiday season I have (already) been to see The Nutcracker four times.
I also attended Allegheny College’s Dance & Movement Studies Department’s Cookies & Milk show (twice) on Sunday. And I was at a holiday party on Saturday. Before the end of the year, I have to — get my daughter to her annual physical and get her to the hair salon to get her bangs trimmed, get my son to a vaccination appointment (he needs his second meningococcal shot), celebrate Hanukkah with our pod/chosen family, attend the Allegheny College choir concert,1 and visit with my parents to celebrate Christmas. Not to mention get all of my grades turned in and work for the year completed!
It is a busy season. Full of friends, food, and festivities (a few chores and lots of grading).
With the holiday season upon us — the number of COVID, influenza, and RSV cases is also increasing (but case counts are NOT nearly as high as last year). Additionally, norovirus (the bug/pathogen that causes most cases of vomiting and diarrhea) is surging around the country.
In the midst of all that happens at this time of the year and an increase in illnesses across the country (and around the world), many people have asked me what my family is doing to stay healthy this season, especially since we are so busy (with holiday and non-holiday activities).
Below is a list of what we are (and in some cases are not) doing…
Our goal is to have a happy and healthy holiday season.
First things first — we are stocking up on all things necessary to get through an illness. We have ordered more COVID tests (you can get four MORE for free — order now). We have also stocked our medicine cabinet, which includes ibuprofen, kleenexes, gloves, masks, and disinfecting cleaner.
We are all up-to-date on our vaccines.
We are practicing good hygiene — washing our hands after we use the bathroom, when we get home from school/work/activities, and before we eat. We sneeze into our elbows and cover our coughs. We also bring fresh air into our home whenever possible (the weather has been somewhat cooperative).
We are also balancing risks and benefits. We recognize that illnesses will spread and we will likely get sick (COVID, flu, RSV, the common cold) this season. We are balancing living our lives and enjoying this time of year with the reality that diseases are spreading. From a practical standpoint, this means —
We are NOT masking all of the time. Instead, we will mask in crazy-crowded spaces where the risk is high. Places where we are likely to mask — public transportation, crowded jetways or airports, a crowded waiting room at our physician’s office, or in our home if one of us is sick. We might also mask if we are out and about a few days before a big trip or a big performance, just to be sure we do not get sick before something of importance.
If someone in our inner circle (a close family member or friend) was at high risk for severe COVID or influenza, our masking behaviors would likely change and we might be a little more cautious this holiday season. It is important to point out that even those at most risk for severe COVID are experiencing amazing protection from the COVID vaccine/boosters. The death rate among individuals 65+ (who are most at risk for severe COVID) is 1.3-2.5 times HIGHER among those who are unvaccinated compared to those who are vaccinated.
Vaccines are preventing death, even among those who are most at risk.We are NOT doing asymptomatic testing.2 Two reasons why we are not testing asymptomatically before every holiday gathering — first, the science. Research shows that a single rapid/at-home COVID test will detect ~10% of COVID cases among asymptomatic individuals (I’ve read other reports that it may be as high as 30%, but that is still really low). The accuracy of the test goes up (to ~75%) if and only if an individual quarantines and tests three times in 48 hours.
Nine times out of ten testing at home on the day of a party or event will result in a FALSE NEGATIVE. Meaning your test will be negative when in fact you do have COVID. In order to get more accurate results, individuals need to start testing 48 hours beforehand and quarantine themselves so that there is no additional risk. Quarantining is not possible for those of us who need to go to work or kids who need to be in school. Sure — you could mask. But this only reduces your exposure to viruses; a mask does not prevent all exposure.
(Let me be clear…) The science does NOT support testing once before an event or day of celebration to identify asymptomatic individuals.
Additionally, COVID tests are expensive (~$12 per test). It would cost my family of four $48 to test each of us once. To be blunt, we cannot afford to spend $48 more before every event, especially when we know that the tests can only detect 10% of asymptomatic cases. And if we were to quarantine and all test three times in 48 hours before an event or celebration, it would cost us upwards of $150. And still 25% of the time we would get FALSE negative results.
We cannot afford to do repeat testing if we are all asymptomatic.
And let’s not forget that influenza, RSV, the common cold, and strep throat are also circulating. You may not have COVID, but could be infected with something else. We do not live in a single-illness world. Flu still kills 1000s of people each year; so does RSV. A negative result on an at-home COVID test does not provide safe, guaranteed passage to a healthy holiday season.We will stay home if one of us is sick. And we should all agree to this — stay home when you are sick. Give yourself time to rest and recover and break the chain of infection. Protect others.
You are most contagious (with any disease) when you have symptoms.
And while you can spread COVID in (up to) 48 hours before your symptoms begin, we are most contagious when you have symptoms.
There is always risk.
We layer our prevention efforts to reduce that risk. We agree to stay home when sick, mask in high-risk situations, and all agree to get vaccinated to prevent severe illness.
At the end of the day, I want to have a healthy holiday season AND I want to spend time with friends and family. I want to go to a Christmas Eve service. I want to spend New Year’s Eve with friends.
Being healthy this holiday is about balance. While there are risks of disease spread throughout the holidays, there are also significant health effects associated with being lonely and not enjoying the people, traditions, and celebrations that come with the holidays.
This is NOT a pass to be reckless.
But it is worth saying out loud, that we cannot quarantine, mask, and take at-home COVID tests for eternity. Balance is needed — COVID is not going away (neither is flu, RSV, norovirus). So we need to recognize that we can take steps to prevent the spread of disease (or severe symptoms), but we cannot build fortified walls that will 100% of the time prevent illness.
We need to BOTH recognize what can be done to prevent the spread of infectious diseases AND build community, celebrate with family, and enjoy this holiday season.
We are communal beings and we need one another to survive.
This holiday season I am looking forward to being with my people. I am looking forward to our traditions — Hanukkah with our pod family, Christmas Eve service with my family, and our annual New Year’s get-together. I’m looking forward to eating at a nice restaurant and cuddling up at home with a book (I need to finish The Covenant of Water).
I will stay home if I get sick (or someone else in our house does).
I am up-to-date on my vaccines.
I will take other steps to prevent the spread of disease (or protect myself) as the situation warrants.
Unfortunately, there are no step-by-step instructions to perfectly prevent getting sick during this holiday season. However, we each can take steps to reduce our risk of getting sick.
The greatest gift we can give to each other and our communities this holiday season is the gift of staying home when you are sick.
To stop the spread of disease from person to person.
Gift your friends and family a promise that you’ll stay home if you are sick.
And ask that they give you the same gift in return!
Questions? Worried about a specific situation? Please ask…
And please share this list with your friends and family —
Local friends, be sure to check out the choir concert this Saturday!
I received some of the meanest comments ever on my Thanksgiving post for not recommending asymptomatic testing before Thanksgiving dinner. Here is my reasoning for not conducting them or recommending them to others.
Thanks for another excellent article. It's a useful guideline for best practices for the holidays.
I have had 4 vaccines and Covid once. I hear alot of these new vaccines killing people and I'm afraid to get the new one. Your thoughts?