The bad news about the upcoming holiday season is that traditional meals and parties — involving indoor settings, poor ventilation, and prolonged, close contact — are the biggest risk factors for spreading Covid-19. The good news is that there are still plenty of reduced-risk activities for family and friends, according to an informal survey of epidemiologists and other experts.
The favored modifications for holidays like Halloween, Thanksgiving, Hanukkah and Christmas are limiting group size and attempting to take things outdoors. Epidemiologist Marc Lipsitch of Harvard said his family usually has a big Thanksgiving dinner for 16, but this year it’s just the four people in his nuclear family. Julia Marcus, also of Harvard, said she’s skipping a big family dinner but will continue the family tradition of a Thanksgiving hike. Purdue University virologist David Sanders is also not attending a Thanksgiving get-together this year and also advocated an outdoor gathering if possible.
If there’s anything that’s been learned over the seven months of this pandemic, it’s the three c’s of danger: crowds, closed environments, and close contact. Cases are likely to tick up across the country if millions of people combine all three in one night. But that doesn’t mean you should cancel the holidays outright.
Holiday planners also have to think about whether there are vulnerable people in the group, says Sanders. The right question, he says, isn’t whether an activity is safe, but which different alternatives would be safer.
Gathering size is a big factor if you want to avoid spreading the virus. Each additional person increases the risk that someone will bring the virus to the party, and also increases the number of people who might get infected. If you double the size of the party, you roughly quadruple the risk of transmission.
Lipsitch suggested inviting friends for a series of smaller gatherings, hosting outdoors, and moving the meal earlier in the autumn, before the weather gets colder. Time is running out in the north, but afternoons can still be balmy in late October and early November.
Marcus adds that ventilation is an under-appreciated risk reducer. If it’s too cold to hold your small gathering outside, open a window and turn on the heat.
Marcus in particular has been willing to talk about something that’s painfully true but politically incorrect: Asking people not to have any normal social encounters for months on end is brutal. And unnecessary. Because she’s worked in AIDS/HIV, she makes the distinction between an abstinence-only approach to public health and a harm-reduction approach.
Abstinence is how things started in the pandemic, with people advised against venturing out of their homes except for essential trips. Even low-risk activities were discouraged. “That’s obviously unsustainable and has not been a successful model for any other area of public health so I don’t know why it would be now,” she says.
A sustainable approach recognizes that some activities, such as large, indoor gatherings, are high risk, but others are not, such as going to the beach or letting kids play in playgrounds. Restricting the low-risk stuff, or shaming playground and beach users, she says, is leading to distancing fatigue without actually reducing much risk.
“People have social needs and our whole approach to this pandemic may have benefitted from recognizing this up front,” she says. “We have largely failed to do that and the result is people are in great need of social connection.” Many people are looking forward to the holidays as a way to relieve that need.
Marcus says she disagrees with CDC’s decision to put trick-or-treating in the same risk category as indoor haunted houses with people screaming. If the kids aren’t crowded together, and they wear masks, she sees the old Halloween staple as a low risk activity.
Some families may be trying to get everyone tested first, or using a 14-day quarantine before and after a gathering. The experts had a lukewarm response to such complicated approaches — none of them would try it. A 14-day quarantine on either side of a party is asking a lot, and getting the timing of tests right is complex. Just look what happened at the White House Rose Garden gathering a month ago.
While proceeding with the holidays at all this year might seem frivolous, it’s far from it. Pandemic rules have sucked much of the joy from life. Festivities shouldn’t be a casualty. We need them not despite living through a drawn-out pandemic, but because of it.
Bloomberg
