We are all soldiers in the fight against COVID-19. Deployed as conscientious patriots to fight the virus in our homeland, we now face breaking tradition to celebrate the holiday season in ways that we hope will help to keep us all safe and healthy. The surge in the coronavirus disease requires that we meet new challenges – both emotional and logistical – all for the good of the country.
Dr. Francis Collins, Director of the National Institutes of Health, explains the quandary at hand …
“Celebrating holidays alone or with your immediate household members can sound rather dreary. After all, who wants to roast and carve a turkey for just a few people? But, if you look at it another way, the pandemic does offer opportunities to make this holiday a season to remember in new and different ways …
“Making all of these adjustments is a lot to consider when you’re trying to have a good time and there are children and older adults in the mix. That’s why I and my wife Diane decided the best plan for us this holiday season is to stay home in Maryland and forgo our traditional trips to family in Michigan and North Carolina. Not only did we want to reduce the risk of possibly contracting COVID-19 from—or transmitting it to—our faraway loved ones, we want to do everything we can to protect our local friends and co-workers from the coronavirus.”
(Dr. Francis Collins. “Planning Your Holidays During the COVID-19 Pandemic.” NIH Director's Blog. November 12, 2020.)
Travel Preparedness
If you do travel, Keri Althoff, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, recommended researching the precautions airline, train and bus companies are taking and look for reviews from recent customers before booking.
“It will help you know what to expect and come prepared, or make a different decision,” she said.
Dr. Emily Landon, head of infection prevention and control at the University of Chicago Medicine, recommends ensuring everyone limits contact with people outside their household for at least a week before meeting. Getting tested and taking all the right precautions during travel won’t help if someone picked up the virus between the test and their departure.
“What you’re bringing to the table on Thanksgiving is more than just wine or mashed potatoes, you’re bringing all the risk you’ve accumulated during the seven to 14 days before you showed up there,” she said.
General Considerations for Events and Gatherings
What about considerations for events and gatherings during the holidays? For accurate information, this blog consulted the Centers for Disease Control's “Holiday Celebrations and Small Gatherings” recommendations. These considerations are meant to supplement – not replace – any state, local, territorial, or tribal health and safety laws, rules, and regulations with which all gatherings must comply.
(“Holiday Celebrations and Small Gatherings.” Centers for Disease Control. U.S. Department of Health & Human Services. Updated Nov. 11, 2020.)
Celebrating virtually or with members of your own household (who are consistently taking measures to reduce the spread of COVID-19) poses the lowest risk for spread. Your household is anyone who currently lives and shares common spaces in your housing unit (such as your house or apartment). This can include family members, as well as roommates or people who are unrelated to you.
Organizers and attendees of larger events should consider the risk of virus spread based on event size (number of attendees and other factors) and take steps to reduce the possibility of infection, as outlined in the Considerations for Events and Gatherings.
There are * several factors that contribute to the risk of getting and spreading COVID-19 at small in-person gatherings. In combination, these factors will create various amounts of risk:
Community levels of COVID-19
Exposure during travel
Location of the gathering
Duration of the gathering
Number and crowding of people at the gathering
Behaviors of attendees prior to the gathering
Behaviors of attendees during the gathering
* Important details for Small Gatherings of Family and Friends are found at the CDC post. Please access all details here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html
The CDC recommends the following people should NOT ATTEND in-person holiday gatherings:
People with or exposed to COVID-19 (diagnosed, has symptoms, waiting for test results)
People at increased
risk for severe illness (older people with
certain medical conditions)
If you will be hosting a gathering during the holiday season that brings people who live in different households together, follow CDC tips for hosting gatherings. If you will be attending a gathering that someone else is hosting, follow “CDC Considerations for Events and Gatherings.” Below are some general considerations for hosting a gathering that brings together people from different households. Guests should be aware of these considerations and ask their host what mitigation measures will be in place during the gathering. Hosts should consider the following:
Considerations for Hosting or Attending a Gathering
Check the COVID-19 infection rates in areas where attendees live on state, local, territorial, or tribal health department websites. Based on the current status of the pandemic, consider if it is safe to hold or attend the gathering on the proposed date.
Limit the number of attendees as much as possible to allow people from different households to remain at least 6 feet apart at all times. Guests should avoid direct contact, including handshakes and hugs, with others not from their household.
Host outdoor rather than indoor gatherings as much as possible. Even outdoors, require guests to wear masks when not eating or drinking.
Avoid holding gatherings in crowded, poorly ventilated spaces with persons who are not in your household.
Increase ventilation by opening windows and doors to the extent that is safe and feasible based on the weather, or by placing central air and heating on continuous circulation.
For additional information on increasing ventilation, visit CDC’s information on Cleaning and Disinfecting Your Home.
Winter weather can be cold, wet, and unpredictable. Inclement weather makes it difficult to increase ventilation by opening windows or to hold an event outdoors.
If setting up outdoor seating under a pop-up open air tent, ensure guests are still seated with physical distancing in mind. Enclosed 4-wall tents will have less air circulation than open air tents. If outdoor temperature or weather forces you to put up the tent sidewalls, consider leaving one or more sides open or rolling up the bottom 12” of each sidewall to enhance ventilation while still providing a wind break.
Require guests to wear masks. At gatherings that include persons of different households, everyone should always wear a mask that covers both the mouth and nose, except when eating or drinking. It is also important to stay at least 6 feet away from people who are not in your household at all times.
Encourage guests to avoid singing or shouting, especially indoors. Keep music levels down so people don’t have to shout or speak loudly to be heard.
Encourage attendees to wash their hands often with soap and water for at least 20 seconds. If soap and water are not readily available, use hand sanitizer that contains at least 60% alcohol.
Provide guests information about any COVID-19 safety guidelines and steps that will be in place at the gathering to prevent the spread of the virus.
Provide and/or encourage attendees to bring supplies to help everyone to stay healthy. These include extra masks (do not share or swap with others), hand sanitizer that contains at least 60% alcohol, and tissues. Stock bathrooms with enough hand soap and single use towels.
Limit contact with commonly touched surfaces or shared items such as serving utensils.
Clean and disinfect commonly touched surfaces and any shared items between use when feasible. Use EPA-approved disinfectants.
Use touchless garbage cans if available. Use gloves when removing garbage bags or handling and disposing of trash. Wash hands after removing gloves.
Plan ahead and ask guests to avoid contact with people outside of their households for 14 days before the gathering.
Treat pets as you would other human family members – do not let pets interact with people outside the household.
The more of these prevention measures that you put in place, the safer your gathering will be. No one measure is enough to prevent the spread of COVID-19.
Lower risk activities
Having a small dinner with only people who live in your household
Preparing traditional family recipes for family and neighbors, especially those at higher risk of severe illness from COVID-19, and delivering them in a way that doesn’t involve contact with others
Having a virtual dinner and sharing recipes with friends and family
Shopping online rather than in person on the day after Thanksgiving or the next Monday
Watching sports events, parades, and movies from home
Moderate risk activities
Having a small outdoor dinner with family and friends who live in your community
Lower your risk by following CDC’s recommendations on hosting gatherings or cook-outs.
Visiting pumpkin patches or orchards where people use hand sanitizer before touching pumpkins or picking apples, wearing masks is encouraged or enforced, and people are able to maintain social distancing
Attending a small outdoor sports events with safety precautions in place
Higher risk activities
Avoid these higher risk activities to help prevent the spread of the virus that causes COVID-19:
Going shopping in crowded stores just before, on, or after Thanksgiving
Participating or being a spectator at a crowded race
Attending crowded parades
Attending large indoor gatherings with people from outside of your household
Using alcohol or drugs that may alter judgment and make it more difficult to practice COVID-19 safety measures.
After the Celebration
After the event, if you feel that you were in close contact with many people from different households or that you may have been exposed to the COVID-19 virus, take extra precautions for 14 days. Stay at home as much as possible, avoid being around people at increased risk of severe illness with COVID-19, and consider getting tested for COVID-19. While you are waiting for the results of a COVID-19 test, stay at home and follow safety measures.
If you develop symptoms of COVID-19 or you test positive for COVID-19, immediately contact the host and other guests who attended the event. This can help reduce the spread of COVID-19 by ensuring that others get tested or stay home and away from others, if needed.
This blog entry is not meant to supplant or replace information from local, state, and federal sources. I encourage everyone to research further in order to plan safe holiday celebrations. Again, the CDC source is https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html. You should access it as more information is available there.
It is possible to celebrate safely. Our mission in 2020 is to make major adjustments to our holiday traditions in order to protect Grandma, Grandpa and other vulnerable relatives. If you’ve ever been looking for an excuse to get out of a family holiday, this is your year to take a step back. Think long and hard about what’s right for you and your loved ones. Planning is crucial.
“COVID-19 is not the gift we want to give at the holidays. The thing I tell people about this is that we all feel the fatigue and a desire for things to be normal, but normal is not safe right now.”
– Kelly Cawcutt, MD, assistant professor in the Department of Internal Medicine at the University of Nebraska Medical Center
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