Just in time for the holidays, the first known cases of Omicron variant appeared in the bay area in early December and we already find ourselves in the midst of an explosion of cases over the last few weeks. The lines for COVID tests and booster doses seem to be growing longer by the hour as many scramble to book appointments or re-arrange Christmas plans.
As of Friday, December 17th, more than 73% of new cases in the country were caused by Omicron, which has overtaken delta as the dominant coronavirus in the US. Companies are revising their return-to-office plans, many colleges are planning to go virtual for the first few weeks of January classes to allow returning students to self-isolate after their travels, and big sports leagues are rethinking their calendars.
With this week one of the largest travel weeks of the year, many planned family get-togethers will be for the first time in a long time. These Omicron developments are causing many to frustratingly find themselves revisiting the feelings and questions of last year’s holidays. How can we still safely get together?
As has been true for the last two years, there is no ‘right’ answer. In many ways, the worries are the same – for our elderly and immunocompromised loved ones, even with booster doses, we must be cautious. On Monday, Moderna announced its booster provides protection against Omicron. Pfizer made a similar announcement earlier in the month. But with the increased contagiousness of the Omicron variant, breakthrough infections are on the rise, even in those who are boosted. And while data is still being collected on the severity of Omicron variant infections in those who are boosted, we do see some, albeit much fewer, severe cases from breakthrough infections, particularly in the elderly and immunocompromised.
Many of our recommendations remain the same. You may find it helpful to revisit our article from last year on how family can more safely get together for the holidays. A few of the highlights:
Can you get tested, self-isolate and get your flu shot before traveling?
Getting a COVID-19 test, especially if you’ve been in a variety of environments at higher risk for transmission to have occurred, can provide some extra reassurance. You might consider testing before leaving, after arriving and again on arrival home, to increase your ability to detect infection. And while a positive test means, of course, that you will need to skip your holiday plans and self-isolate, a negative test isn’t a license to abandon other precautions. Testing too early can lead to a false negative and give a false sense of security, and not all asymptomatic infections will be detected. It is important to continue to wear a mask, wash your hands and practice social distancing. Self-isolating as much as possible for at least two weeks prior to the trip can decrease risk to others considerably.
Is it warm enough to gather outdoors? If not, can you improve ventilation?
At the gathering, maximizing distance between people and minimizing density and duration of time is helpful. If people can’t eat outdoors, spreading out throughout the house to eat can be helpful. Try to improve indoor air flow by opening windows or using air purifiers.
Will everyone be wearing a mask? What will you do at meal time?
Wearing a mask, particularly if density makes 6-foot social distancing difficult and/or if the gathering will not be outdoors, is important. Making the most social part of the gathering the non-eating (mask-wearing) time and having a more silent eating time, spread apart from others not in your “bubble,” can also decrease risk. You can try staggering eating times so that people from the same household eat together at the same table.
We wish everyone a safe and joyful holiday celebration.
Jennifer Abrams, MD, December 22, 2021