DOs answer patients’ FAQ on celebrating the holidays safely during COVID-19

With the holidays right around the corner, millions of Americans are grappling with the reality that COVID-19 may prevent them from gathering safely with their families this year.

Richard Bryce, DO, a family physician and the chief medical officer at Community Health and Social Services Center in Detroit, says he has received many questions from patients about family holiday gatherings. As COVID cases skyrocket at a record pace, he is recommending that patients avoid gathering with those outside their household, in line with the CDC’s latest recommendation.

“There is nobody who wants to have Thanksgiving more than I do, so the fact that I’m having to say that is painful,” Dr. Bryce said. “I definitely hear where people are coming from as they try to figure out ways to make this work, but we’ve just got to get past this. I’d rather us all do this the right way than have a lot more people get really sick.”

In her role as a public health official, Jacqueline A. Watson, DO, MBA, the chief of staff for the Washington, D.C., Department of Health, has fielded many similar questions and given similar answers.

As many DOs across the country face the same set of questions from patients about the upcoming holiday season, The DO asked Drs. Bryce and Watson to give answers to common questions about celebrating safely during COVID-19. They also provided advice for ways that families can get creative to stay as safe as possible if they do choose to gather.

Is there any safe way to gather for Thanksgiving and the holidays this year?

Dr. Bryce: “With the rates of infections spiking so rapidly, and given the risk of bringing together family members from different households, that would kind of be like the perfect storm. Yes, most people don’t get very sick from this, but the ones that do get sick unfortunately get really, really sick. As much as it saddens me, there’s really not a fully safe way to have large group gatherings inside a home, for Thanksgiving or the rest of the holidays.”

“We’ve definitely learned to do some things virtually through Zoom or similar apps, which is pretty awesome. The software is much better than it used to be, so that would be my recommendation to be safe this year.”

If you’re going to see family, what are some precautions you can take to ensure it’s as safe as possible, for both you and them?

Dr. Watson: “When meeting in person it’s best to keep it small, preferably no more than 10 people, with everyone wearing masks properly (securely over nose and mouth), and following strict social distancing guidelines — yes, that’s a must, even with your family and loved ones.

“Generally, outdoors is safer than indoors and it is recommended that you only take your mask off when intaking food or drink. If meeting indoors, in addition to keeping masks securely on, and sitting six feet apart, consider cracking the windows and leaving entrance doors open — only if safe to do so — to improve airflow. When it’s time to eat, avoid buffet-style serving. Consider having a designated person serve the food to prevent communal sharing and guests touching the same utensils.

“Lastly, do your research. Know the COVID-19 transmission rates in your home state and the state that you are traveling to and abide by its rules. Most state and local health departments have information posted on their website, or you can visit the CDC website to stay informed.”

If you have been strictly quarantining, then test negative for COVID-19, then go to see family (who all did the same), would you, in theory, be as risk-free as possible?

Dr. Watson: “The PCR COVID test, which is really the gold standard diagnostic test, represents what your status is at that point and time. It’s a snapshot of the day it is taken. If you quarantine for two weeks (meaning truly quarantine, no work, no social activities with anyone outside of your household), and get a PCR test at the end of your quarantine (and are negative), then yes, you have reduced your risk.”

Dr. Bryce: “The only problem with reducing risk that way is that sometimes an active infection still has room to grow before you would test positive. Testing can be helpful, but if you have 20-30 people together who all tested negative before Thanksgiving, there’s still a possibility that somebody could be positive, even with a negative test.”

What if you or a family member you’re visiting have recovered from COVID-19 within the last few months? Can you assume that you are at a relatively lower risk?

Dr. Watson: “There is still so much we are learning about this new virus. Current data suggests that re-infection within 90 days after an initial confirmed COVID-19 infection is uncommon. However, we cannot assume that any given person is immune. Mask-wearing, social distancing, hand hygiene and staying home if sick are critically important and should be followed regardless of anyone’s history of COVID-19 infection.”

Is it possible to travel safely via train or plane right now?

Dr. Watson: “Air and train travel puts you in spaces and places that bring you into close contact with people and frequently touched surfaces, which can make social distancing virtually impossible. So, to be safe, consistently wear a mask, cover your mouth and nose, avoid touching your face, and wash your hands frequently or use hand sanitizer with 60% alcohol after touching common surfaces. Also stay six feet apart from people not in your party whenever possible.

“Once you have boarded your flight or train, consider wiping down frequently touched surfaces near you before settling into your seat. Remember that travel begins once you leave your home, so carefully consider how you will get to and from the airport and take the necessary safety and hygiene precautions to mitigate risks.”

What would your final argument be to patients who are set on visiting family this year?

Dr. Bryce: “I heard one doctor say, ‘I’m going to sacrifice this year because I want to make sure we get a Thanksgiving 2021,’ and that’s how I feel about it, too. This is so tough, and I feel for everybody.

“But we are so close to the vaccine. If we can just hang on a little bit longer and do what we’re supposed to do, then we can really decrease the risk of death and hospitalizations for so many people and hopefully celebrate safely next year.”

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DC health chief of staff advises DOs on public health