October 26th: COVID-19 and Holidays
As with many folks, the holiday season is a wonderful time of year. However, this year - as with most things - the joy may be dampened. We unfortunately must face this reality and take steps to ensure a safe and happy-as-possible season.
First, a few housekeeping points: The pandemic frustration in all of us asks, "How long must we keep doing this? I thought we had to just flatten the curve?!" The answer is, we did flatten the curve to some extent. The goal was to prevent hospitals from getting overwhelmed as people became infected and required hospitalization. However, as areas are opening up and restrictions are lifted, people are once again becoming infected in even larger numbers than before. We have better testing in some areas, but not all. We have better treatments, but which have modest success at best. Hospitals are starting to see a rise in COVID-19 admissions again, and we do not have the resources to handle a surge if it becomes like the first. We're already starting to see it - El Paso, TX is seeing such a sharp rise in cases and admissions that Governor Abbott has had to order emergency measures - increased supplies, airlifts to other hospitals, and more. Make no mistake: this is not over. Most places still do not have enough PPE or staffing. It’s not about fear. It’s about public health and safety.
Now with that out of the way...let's talk about holiday celebrations! Several of these points are taken from infectious disease researcher Laurel Bristow, a.k.a. @kinggutterbaby on Instagram (if you don't follow her, you should - she does video versions of these discussions in her stories and she's brilliant. She has often influenced my own essays).
HALLOWEEN: We can still do Halloween this year, provided we take precautions! 1. Masks and social distancing are still a must. No ifs/ands/buts. In the northeast, we're used to wearing jackets over costumes. A mask is no different. 2. How do we socially distance trick-or-treating? That would vary from neighborhood-to-neighborhoood (it would be wonderful to see some coordination at a higher level, but that's not always the case). If streets are blocked off, then families are advised to spread out on the street to maintain distance. If not, maintaining the 6-foot distance behind other families on the sidewalk will be necessary. 3. Handing out candy: This needs to be socially distanced, too. Either a table where kids can pick up candy, or some sort of delivery system. Exposure has been redefined as >15 minutes cumulatively over a 24-hour period. Now, hopefully none of the kids or adults in your neighborhood have been infected, but we just don't know. So maintain that gap. 4. Eating candy! Easily the best part. But how to go about it safely? 4a. All candy should be prepackaged/sealed this year. There are ways to make homemade food with precautions, but really, better to err on the side of caution. 4b. There will be lots of hands touching the candy this year, and while fomite spread is not that common, we don't want to take chances - wait until you get home to dive into the candy. 4c. If desired, you can clean it in a number of ways - wipe it down with Clorox wipes (remember, it should all be sealed anyway), or wash it all in a bowl. I know this seems silly. But it's worth not spreading COVID-19, especially if there are vulnerable people around.
THANKSGIVING AND WINTER HOLIDAYS This is less fun. You should start thinking about preparations for this now. If you want to spend time with your loved ones for the holidays, you'll have to try and blend your pods/bubbles - quarantine (staying at home, avoiding other people and exposures) for two weeks and then come together and combine your bubbles. However, that is not always realistic for college students, depending on their break lengths. There is something to be said for quarantining for a week and then getting tested, if that is possible and testing is available (but that is not infallible).
This is not the year for large gatherings. The big family reunions will almost inevitably lead to spread - unless you live in a mansion and don't want to actually eat together, there is no way to maintain adequate distancing and obviously you cannot wear masks while eating delicious stuffing and mashed potatoes.
While sheltering the vulnerable is not a viable strategy by itself, it does remain that too many of my patients, elderly/vulnerable or not, have been people who were otherwise careful and then got exposed to someone who was less careful. Take advantage of technology - phones and video chatting are going to be the anchor of our holiday celebrations this year.
It should be noted that I won't be seeing my parents or in-laws this year - for one, I'm working, but even if I wasn't working on the holidays themselves, my exposure is pretty significant even with proper PPE, and not having the time to quarantine with my schedule, I do not want to take the chance. I don't say this for pity, I just want to state that I am not above such caution.
Hopefully by this time next year we can be better prepared for larger gatherings, but this year, with the pandemic still very much in full swing, we do not want to cause a post-holiday surge, which could land us back in the the same position we were earlier this year. Please take precautions. Please continue to wear masks and physically distance. Please don't shame others for taking precautions, either - this is about public health, and safety in our community. We need to look out for each other.