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Giving thanks in age of COVID: Tips for the holidays

Monitor staff
Published: 11/10/2020 8:14:56 AM

Like most things this year, the holiday season will be shaped by COVID-19.

The safety of traveling, holiday shopping, and eating in close quarters all depend on the fickle curve of new cases in the United States.

With less than a month until Thanksgiving, it’s time for big decisions and uncomfortable conversations. Here’s some advice from Michael Calderwood, an expert in infectious diseases at Dartmouth-Hitchcock Medical Center.

Traveling

Is it safe to fly right now?

So, right now we know that multiple areas of the country are experiencing an increase in cases of COVID-19 and the issue is probably less about the flying itself, at least for domestic flights. There haven’t been many cases of documented transmission on the flight. What we know, however, is the time in the airport, particularly in security lines and in the large terminals, that there is a risk, especially if you have more connections with your flights. When we think of high risk, we have been focusing on planes and buses and trains. Probably the safest thing for travel is a personal car just because you’re interacting with fewer people.

What about rest stops?

Rest stops are usually an area where it’s easy to maintain social distancing. You have to think that typically on a holiday travel period, you’re going to have a lot of cars on the road so you may have very crowded bathrooms. That would be an area where you want to think a little bit about if you can maintain that social distancing.

Do you have guidance on how people can make an informed decision about whether or not a specific place is safe to travel to?

So there are many resources that are looking at the data. One that I think has been very helpful is a map that is put out by Harvard that has real-time data on county-level risk. You can really look up and get a sense over the weeks and weeks, what has the activity been in that area?

What we have to realize is that there is no magical number of what is safe. When people are beginning to make decisions about what they’re going to do for the holidays, what we know is that you are best to celebrate with those from your local area. And if we are going into other areas and meeting up with family and friends that are coming from multiple areas that may be at higher risk, that’s going to increase the risk of spread.

Stores are beginning to plan for this. There’s an expectation that holiday gatherings this year are going to be smaller. For instance, and there’s news that stores have really been focused on smaller turkeys, realizing there’s gonna be a lot more smaller gatherings.

You know, when you look at the states, they’re, they’re color-coded. And so there’s kind of green, yellow, orange and red in terms of the level of activity as those colors go up to orange and red, there is a higher risk in traveling to those areas. Increasingly more and more states are falling into that. I would caution people about thinking how they might alter their plans for the holidays, realizing that things, unfortunately, are not getting better, but they’re getting worse. As we head toward Thanksgiving and Christmas, it’s likely that most of us are not going to have the typical holiday celebration that we’re used to.

Activities

Are there any COVID-safe Thanksgiving celebrations you can recommend?

I’ve actually spoken with people who say “we’ve always traveled to other houses so this is our year where we as a family are going to try out new recipes and really create our own tradition at home.” I think one thing that people have begun to think about is how you deliver family recipes to family and neighbors without direct contact. This is a good time to think about those who might be isolated. I think many of us have older neighbors or family that may be more susceptible we can think about if we can deliver meals to them. We’re not going to spend a long time with them but can we at least reach out and let them know we’re thinking about them.

Some people are beginning to think about a modified potluck where people have different parts of the meal and then they deliver those around again, not prolonged contact, but at least sharing some of those recipes. Some people are thinking of virtual dinners, and I think that there are ways to make them fun whether you use it as a time to share photos or to share stories or to play games virtually.

There are others who say “we want to have some level of gathering so we’re going to do small outdoor dinners with family and friends who live in the community.” It’s lower risk because we’re bringing people together from the same area, making that social distancing and trying to do things outside. You can find a way to kind of keep people warm outside whether it be with a heating lamp or a fire or whatever it might be.

Is Black Friday shopping safe?

I think large crowded shopping on Black Friday is about as high risk as it gets.

COVID testing for the holidays:

Is it safe to celebrate together if everyone gets a COVID test beforehand?

We need to be really careful about a false sense of security from testing. We have to be aware that none of the tests have been approved for asymptomatic individuals and there have been concerns about false negatives due to lower viral loads early on in the course of the illness. We’ve learned a lot from recent events, say with the spread of COVID-19 and in the White House. We’ve spent a lot of discussion on the impact of negative test results on human psychology. One point that we keep highlighting is that these tests are not tests of contagiousness. What you’d want to do is thinking about what your family is doing 14 days prior to travel, how much they can isolate to mitigate the risk, and what they’re doing as part of that travel to get from point A to point B.

The testing itself may be part of a strategy, but I don’t think that this is going to be the panacea that folks think it’s going to be. We are going to have plenty of people who are going to have a false negative test.

What kinds of COVID-19 tests should people be taking?

There are lots of tests out there, whether it be in the antigen test or the PCR test. It depends a little bit on what is available in your local area.

So I think that is a really critical point to make it that in New Hampshire, we are increasing testing around contact investigations. As we have more of those cases, we’re beginning to really strain our system.

We have a lot more capacity than we did in the spring but we are currently running machines 24-7, that are not meant to run at that rate. They are beginning to break down and need to be repaired. And so as we get the holidays and people are saying, “well, why can’t I just be tested?” we do need to realize that (testing) is not an endless resource. We are beginning to reach our capacity in what we can do. We really want to focus that testing in the areas where it’s needed which are to test those who are symptomatic.

So the testing may be available, but I worry that if everyone is going to rely on this, then it’s going to really strain our system. It’s not something we’re going to be able to support.

What factors should people weigh when making decisions about whether or not to come together during the holidays?

I think first of all you need to think about who is it you’re bringing together and whether you have people in the family, because of age or illness, that may be at higher risk for severe disease. We really want to encourage those people not to attend in-person holidays. It’s just too high risk at this time. I think you really want to think about if people are coming from areas where there is more local transmission or if people going to areas where there’s more local transmission, where they then may bring things back.

Once you’ve thought about that, you really want to tell people if you’re willing to do this or not willing to do this. You want to keep open lines of dialogue around if anyone is feeling ill. If people are feeling ill, they really should not be joining in the celebrations because it really increases the risk to others.


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