Last year, the pandemic forced many to dramatically alter their holiday plans. Annual parties were canceled, gift exchanges moved into video chat rooms, outdoor patios transformed into dining rooms and menorah candles were lit with far fewer loved ones gathered around.
Much has changed since then, bringing hope that this holiday season will be different. Vaccines are now widely available to those over age 5, along with booster shots for adults. Stores sell at-home coronavirus tests, most schools have reopened and airports were packed last month with Thanksgiving travelers.
Yet, despite the overall rosier picture, the coronavirus continues to be a risk, especially for those who are unvaccinated, immunocompromised or too young to get the vaccine. Cases are increasing in several states with colder weather and a new variant of the virus has emerged, alarming many health officials.
So, for another holiday season, many Americans are once again weighing the risks and trying to find safe ways to celebrate. While there’s no one-size-fits-all solution, physicians and experts from across the country have some advice to share.
Q: Is it safe to visit Santa in a mall food court?
A: When planning your visit to Santa this season, consider the vaccination status of your child, said Priscilla Sarmiento-Gupana, a pediatrician in the Chicago suburbs.
“Some children will be considered fully vaccinated prior to this fun tradition (meaning two weeks have elapsed since their second dose), but some will not get their second dose in time, or are not even eligible for the vaccine due to their age,” Sarmiento-Gupana wrote in a Facebook chat. “The safest way to visit Santa is in an outdoor setting. If your Santa visit is indoors and your child is not fully vaccinated, the safest way to interact with Santa is while wearing a mask. Don’t forget to maintain space between other families while standing in line to meet him.”
Q: Are extended family gatherings and holiday parties back on this year?
A: Yes, because “gathering and celebrating traditions are so important to reconnect, recharge and build our resiliency,” said Keri Althoff, epidemiologist at the Johns Hopkins Bloomberg School of Public Health. But take precautions in doing so — and be ready to cancel or alter plans if cases in your area increase.
“If you and those you are gathering with are fully vaccinated, enjoy time together reconnecting over a traditional meal. If there are people you plan to gather with who are a mix of vaccinated and unvaccinated, try to keep the gathering small, and perhaps move it outdoors,” said Althoff, suggesting that s’mores could replace turkey. “Build in some flexibility to your gathering plans to increase your strategies to reduce risk if transmissions are increasing in your community. Decline invitations for gatherings that do not match your risk tolerance. Have a plan for how you will leave the gathering if you are uncomfortable with the COVID-19 risk.”
Althoff added: “Many families are also grieving the loss of loved ones to COVID-19 or the concurrent drug overdose epidemic this holiday season. Keep that in mind as you gather with family and friends, and when interacting with strangers during your travels to and from your holiday gatherings.”
Q: As holiday invitations pile up, is party hopping allowed?
A: “I don’t recommend party hopping unless you and your fellow partygoers have been vaccinated against COVID-19 and the incidence of infection is low in your area,” said Sterling Ransone Jr., president of the American Academy of Family Physicians. “There’s one thing we can be sure of: one of the worst gifts you can give or receive this holiday season is COVID-19.”
“You can easily look up the number of local cases, but how do you know who’s been vaccinated? You really can’t be sure,” Ransone said. “So, if you do decide to party hop, it’s important to make sure that you are vaccinated and are consistently practicing proven safety measures like hand-washing, physical distancing and mask-wearing when in close quarters with others.”
Q: Can communal bowls of dip once again grace potluck tables?
A: Definitely avoid chip-and-dip type of foods because there’s a high likelihood of sharing germs, said Shreela Sharma, a professor at the UTHealth School of Public Health.
Viruses can be easily transmitted from hand to hand via serving spoons, so Sharma recommends offering bite-sized appetizers that can be picked up with an attached toothpick or mini skewer, like veggie kebabs. For the main course, continue to minimize sharing by serving wraps, sandwiches, individual size potpies or personal quiches.
“Lastly,” Sharma said, “serving healthy food matters to maintain our immune systems during these difficult times.”
Q: How should you set holiday boundaries with risk takers?
A: First, clearly state the reason behind the decisions you’ve made for you and your family, said Yesenia A. Marroquin, a clinical psychologist at Children’s Hospital of Philadelphia.
“Explain why the choices you’ve made are important to you,” Marroquin said. “This will help anchor you when navigating discussions with relatives who may not share your views. Validate their thoughts and emotions while at the same time remaining firm on your choices. They have every right to experience unpleasant emotions, and you have every right to hold steady in your choices. You do not have to convince them that your choice is ‘the right choice,’ as that may lead to increased defensiveness from both sides.”
Q: What should a host do when a guest shows up with a stuffy nose or a stomachache?
A: “Take some time now to have conversations with your friends and family about how to keep each other safe and healthy this year, so there are no surprises,” said Kelley M. Boston, an infection prevention and control expert at Infection Prevention & Management Associates.
Boston continued: “Think about your family’s risk and comfort level in advance, and communicate what you need to your guests — whether it’s asking relatives to wear a mask inside to protect those who are at higher risk, or letting people know that if anyone has respiratory or gastrointestinal symptoms that you’re asking them to stay home until they are healthy, and you’ll celebrate together at a later date.”
Once you set those rules, Boston said to stick to them, even if that means gently asking a sick guest to leave.
Q: What special precautions should be taken around high-risk relatives like those in cancer treatment?
A: Most of our families include high-risk relatives, including those with cancer, but also older individuals and those with chronic medical conditions, said Craig Bunnell, the Dana-Farber Cancer Institute chief medical officer.
“We want to protect those we love and who are most vulnerable,” Bunnell said. “Getting vaccinated is the greatest gift we could give those individuals — the gift of protection, ours and theirs. Beyond that, limiting their contact with unvaccinated individuals or those with symptoms, wearing masks and sitting at least six feet apart when eating are additional, effective measures we can take to protect each other, and especially our most vulnerable loved ones.”
Q: Should holiday hosts insist their guests get a booster shot before showing up?
A: It’s a great idea to ask people who are eligible to get a booster shot to do so at least a couple of weeks before traveling, said Akiko Iwasaki, a viral immunologist at Yale University.
“A booster shot will elevate the immune responses to block infection and transmission, and prevent severe diseases in the susceptible individuals,” Iwasaki said. “Another good strategy for an extended family gathering is to have the guests take a rapid COVID test just before the event. This adds one more layer of safety, especially if elderly or immunocompromised people will be present.”
Q: Is it necessary for those who are vaccinated to get tested for the coronavirus if no one is showing symptoms?
A: It’s understandable that even vaccinated families may want to test before a get-together, particularly if there are members who are immunocompromised or if multiple households are gathering, said Jillian Oft, an infectious-disease specialist with Cedars-Sinai Medical Group.
“Testing should be performed one to three days prior” to a gathering, Oft said. “Rapid tests can be ready within 24 hours, but if people are traveling from a significant distance, they may need to test two or three days in advance to ensure timely results. It’s important to consider your goal for testing and how you would act on the results. Discuss in advance and be respectful of others if you get a positive result.”
Q: Is it safe for unvaccinated kids to fly over the holidays?
A: If the adults traveling with those children are fully vaccinated, this represents only a small risk, said Emily Oster, an economist at Brown who studies health economics.
“It’s not zero — there are no zero risks — but airplane and airports have not been sources of significant COVID spread, and if all adults are vaccinated you’re well protected against serious illness,” Oster said.
She suggested taking these precautions:
Anyone who can be vaccinated should be vaccinated, and those who are high-risk should get a booster shot if they are able to do so.
Get a rapid test before and after traveling.
And wear masks while on the airplane and in the airport.
Q: How risky is it to go to an indoor performance of “The Nutcracker” in an area with a low vaccination rate and no mask mandates?
The risk level depends on a few other things, such as how prevalent coronavirus is in a community, the venue size and its ventilation system, said Kristin Moffitt, a pediatric infectious-disease expert at Boston Children’s Hospital.
“County-level COVID-19 transmission rates can be checked on the CDC website and are described as low, moderate, substantial or high,” Moffitt explained. “Low to moderate rates would make this a low risk event, in general. But even in settings of moderate or high transmission, the risk for a fully vaccinated and masked individual remains low.”
Moffitt added that in addition to assessing your own risk of severe illness, you should also consider whom you will be spending time with in the days after the event and their risk levels.
Q: Has the pandemic become an issue like politics and or religion that’s best avoided at gatherings of those with differing viewpoints?
A: Not at all, said Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development.
“Right now, refusing to get vaccinated against COVID-19 has become a leading cause of death in America,” Hotez said. “We’ve lost more than 100,000 unvaccinated Americans to COVID despite the widespread availability of vaccines. It’s death by anti-science aggression. So while there is no question that refusing COVID vaccinations is split along a partisan divide, it is still essential to try to convince your loved one or friend to get vaccinated. It is the only way to ensure they won’t go to the hospital or die. So pushing someone to get vaccinated is an active of love, pure and simple. Remember, it’s not you politicizing vaccines and refusing to get vaccinated, but it is your job to try and uncouple the anti-science from the politics.”