On Friday, the United States hit a new record number of daily COVID-19 cases. Hospitalizations are up. Experts believe that the third wave of the virus is here and that it will be worse than what came before.
At the same time, many Americans are experiencing “pandemic fatigue” and now, of course, the holidays are here. Families are eager to get together and squeeze some typical connection and cheer out of this otherwise stressful and isolated year — but how?
HuffPost Parents spoke to several experts about some best practices for safety and having difficult planning discussions when it comes to grandparents, the holidays, and COVID-19.
First, the obvious: Staying home is the safety gold standard.
“While it is really sad, and feels like a loss — in addition to everything we have lost over the past months — it is really safest to not travel and not gather with family and friends in person,” said Dr. Sadiya Khan, assistant professor of preventive medicine in epidemiology at Northwestern University Feinberg School of Medicine.
“Staying home is really the best way to protect not only yourself, but others,” she said.
If you have decided to see one another anyway — and Khan said she knows plenty of people will make that choice — do your research, she urged. Public health groups like the Centers for Disease Control and Prevention, which has a hub on COVID-19 and the holidays, are providing some of the best, most up-to-date guidelines and considerations for families grappling with how to celebrate this year.
Khan said that certainly if anyone in the family has any symptoms, they should not get together — full stop. “Absolutely don’t travel, don’t go out, don’t see others.” Talk to your doctor about testing and next steps.
Also, look very closely at community levels of COVID-19, both where family members are traveling from as well as where they’ll be gathering, and consider whether anyone is at higher risk of getting really sick with COVID-19 should they catch it. The latter point is obviously a big one for grandparents. Eight out of 10 COVID-19 deaths in the U.S. have been in adults age 65 and up.
Testing is NOT enough.
“One of the biggest challenges with COVID is that the period of time before someone has symptoms can be quite long. It rages from five to 14 days and sometimes longer — and a lot of people are asymptomatic,” Khan said.
A person can get a false negative on a COVID-19 test if they have a low viral load, as is often the case in the first few days after they’ve been infected or at the tail end of their infection. As President Trump’s recent COVID-19 diagnosis showed, testing alone is not enough to stop individuals from getting (and spreading) the virus.
That doesn’t mean it’s a bad idea for everyone to be tested before family members gather for the holidays, if possible, Khan said. But know you could all test negative, and for one individual (or more) the results might be wrong.
“The test is not perfect. It misses a lot of people that have it, and it misses if you don’t yet have enough of the virus built up,” she said. “Using that as a way to guide unprotected interaction is not a good idea.”
Have a clear plan for the weeks before the holiday.
Before you get together with grandparents (or anyone) run through some basic questions so you are all going into the holidays with a clear sense of your collective risk. Dr. Anthony Barile, infectious disease medical director of Health First, recommends asking something along the lines of: “Has everyone been following CDC guidelines — socially distancing, wearing a mask in public, etc.?”
It’s also important to ask if everyone has gotten a flu shot, he urged.
Even if you have all been following guidelines, you might want to ramp up safety measures before you gather with grandparents or other family members. It might be a good idea to “ask guests to avoid contact with people outside their households for 14 days prior to your gathering.”
Of course, if you’ve got kids who are going to school in-person, that’s not really possible. Which is why it is important to have really clear conversations about everyone’s exposures and preventive behaviors ahead of time.
If you get together, layer on protection. Which — yes — means wearing masks.
If you decide to see grandparents this year, keep the gathering as small as possible. Hold it outdoors if possible. If you’re indoors, open the windows if you can, Khan said. Stay at least six feet apart. Wash your hands frequently. And wear masks.
When asked if there was one of those measures she believes is more important than any of the others, Khan was unequivocal:
“Masks, absolutely the mask. It’s annoying, it’s the first thing you want to take off when you’re indoors, especially if you’re gathering with family,” she said. “But it’s still not your immediate household. So that’s going to be the most important.”
She believes the best data we have on how risky it might be to gather indoors sans masks over the holidays comes from the emerging data on indoor dining, which is comparable in some ways because it’s people inside, eating, drinking and talking. And while it definitely has limitations, a CDC survey from September found that people who had COVID-19 were twice as likely to have recently eaten at a restaurant than those who did not have the virus.
In planning conversations, remind yourselves: You’re doing this out of love.
The holidays can be fraught and emotional enough without the added complications of COVID-19, so Dr. Aderonke Pederson, a psychiatrist with Northwestern Medicine, urged families to be really deliberate how they frame plans, whenever those conversations begin. Understand that people around the country—within your family and not—are making very different decisions even when presented with the exact same data.
“Each person, each family unit, has to make their own decisions, and no one should feel forced into a decision,” she said. “Have these conversations early — now. Don’t wait.”
Reassure each other that you still care for each other, even if this year your children don’t gather with their grandparents. The reason why families are having difficult discussions about forgoing holiday celebrations this year is because they love each other, and because everyone wants to stay healthy and safe.
“I think for everyone, one core value would be: ‘I don’t want to give COVID-19 to my family member, especially to my elderly family member,’” Pederson said. “The reason why these conversations are difficult is because we care about each other, and we’re really trying to look out for each other.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.