We are entering our third holiday season in the COVID-19 pandemic. While holiday traditions may stay the same year to year, how we are monitoring whether COVID-19 is a risk in our communities has changed greatly since the first year of the pandemic. This causes me concern as both an infectious disease epidemiologist and history buff because I know that history tends to repeat itself. We experienced COVID-19 surges around the holidays the last two years in the United States. In November 2020, we were in the thick of the Alpha variant surge, and at the end of November 2021 we were watching for the arrival of Omicron which quickly resulted in a surge across the country.
However, unlike the last two years, we may not be able to see a surge coming this holiday season because the case-based surveillance metrics that we used previously are no longer reliable since most cases now go unreported due to widespread use of at-home antigen tests.
Fortunately, our collective immunity has increased over the last two years due to vaccination and prior infection. However, both forms of immunity provide short-lived protection against infection that wanes after 2-6 months. Getting reinfected with the virus still poses significant short-term and long-term risks including hospitalizations, Long COVID, and even death. The latest subvariants, BQ.1 and BQ.1.1, are more infectious than BA.5 and are immune evasive, while it does not appear they cause more severe disease.
While many people are so done with this pandemic, or hopeful that we can simply return to how we celebrated the holidays before the pandemic, unfortunately we are not there yet. When making holiday plans, it is important to think of the most vulnerable person you will be celebrating with - that elderly parent, newborn child, or loved one who is receiving medical treatment and needs our help to be better protected.
In addition to the vulnerable members of our families and community, our healthcare systems lack available beds and are already grappling with the convergence of flu and respiratory syncytial virus (RSV). With COVID-19, these triple threats are flooding hospitals with patients in some regions of the U.S. and straining overworked healthcare workers.
Here are 5 things you can do this holiday season to help protect against COVID-19:
1. Get a bivalent COVID-19 vaccine.
2. Limit the number of people you interact with indoors for 3-5 days prior to your holiday gathering to reduce the chances you could become infected and spread the virus.
3. Have everyone attending your gathering take a rapid antigen test the morning of the get together. Any positive result will prevent attendees at your gathering from being exposed.
4. Isolate if you test positive. Do not attend any gathering if you have even mild COVID-19 symptoms until you test negative with either a PCR or two rapid tests taken 48 hours apart.
5. Hold gatherings outdoors or open windows and doors to improve ventilation if you live in a part of the country where this is feasible.
Let’s all do our part this holiday season and take actions to protect the most vulnerable in our circles, and show how thankful we are to our healthcare workers by helping to keep everyone healthy and out of the hospital.