2020 has been a year full of unpredictable surprises. Over the past 10 months, we have deepened our understanding of COVID-19, how it is transmitted, how it affects our bodies and its short and long-term physical consequences. It has us adjusting our routines, changing plans and adapting to a new normal. Despite this, the holidays can still be a time of family, unity and traditions — even during a pandemic.
At the time of this article, the United States is experiencing its highest seven-day average of daily new cases, most of which are thought to have been caused by small gatherings. It is well known that the virus is primarily transmitted through droplets when an infected person coughs, sneezes, or talks to those in close proximity, usually within six feet and for a cumulative total of 15 minutes or more over a 24-hour period. Other, less common ways the virus can be transmitted include touching infected surfaces followed by touching your mouth, nose, or eyes, as well as airborne transmission, which occurs when small droplets remain suspended in the air over long distances over a longer period of time. There is no current evidence to suggest that COVID-19 becomes more infectious in colder temperatures, but the colder temperatures do drive people indoors where infection can be more likely. This is likely due to higher concentration of viral particles in the air and longer exposure, especially in poorly ventilated areas.
The best ways to prevent infection and spread continue to be wearing a mask in public, maintaining six feet or more of distance, washing your hands with soap and water for at least 20 seconds (or using a 60% alcohol based hand sanitizer when hand washing is not possible), avoiding touching your eyes, nose, and mouth, disinfecting high-touch surfaces and staying home when you feel sick.
When planning your holiday activities, consider the risks involved and how to mitigate them. Activities with the lowest levels of risk are those that allow for the strictest adherence to CDC guidelines. Examples of these activities include engaging in fun family activities at home such as decorating your Christmas tree or making DIY holiday ornaments. Then, if you want to connect with folks outside your home, consider a modern spin on an old classic, like a virtual gift exchange. Take your white elephant and secret Santa traditions online with www.whiteelephantonline.com and www.elfster.com.
Of course, if you are eager to leave the house, take a walk with the family around the neighborhoods in and around Austin to enjoy the holiday lights — just make sure to wear a mask and keep six feet from others. You could also pile your household into the car and enjoy drivable holiday light displays like Santa’s Ranch and the iconic Austin Trail of Lights at Zilker Park, which will be drive-thru only this year.
To get together or not? Before making this decision, assess the risks of exposing yourself, your family members and others who you will be meeting with. Do you or your loved ones have high-risk medical conditions? Are the members of your “quaranteam” social distancing, wearing masks and avoiding others? What is your plan if you or a member of your family are exposed? Asking yourself these questions and having a plan is vital prior to organizing a social gathering.
While no indoor or outdoor event is completely risk-free, recent evidence suggests a lower risk of transmission with outdoor events, likely due to better air circulation and natural social distancing that occurs when outside. Quarantining for 14 days prior to the event and asking your guests to do the same, wearing masks, limiting the number of guests and minimizing movement throughout the event space can help to further reduce your risk.
If you do plan to gather with friends or family, consider taking advantage of the mild Texas winters and host your masked gatherings outdoors. Plan for an outdoor ugly sweater party with tables spaced six feet apart to minimize movement of guests. Instead of gathering for a cookie exchange, consider quick cookie drop-offs on the porch to reduce the amount of time exposed to others. For an Austin holiday classic, decorate a tree along 360 or choose a tree to cut down, bring home and decorate from the Elgin Christmas Tree Farm.
Travel is among the most popular activities during the holiday season but poses a high risk for contracting COVID-19. Given the recent rise in cases nationwide and the limited ability to social distance in airport security lines, terminals and on crowded airplanes, air travel should be avoided unless traveling for medical care. If you must travel by air, consider trip insurance to account for last-minute cancellations and plan enough time to quarantine for 14 days at your final destination before meeting with your loved ones. If you think you had a significant exposure, it’s best to wait 5 to 7 days before getting tested, as testing too soon can lead to false negative results.
Traveling by car can reduce your risk of exposure to others with the greatest risk occurring during stops for gas, food and bathroom breaks. Consider packing your own food to minimize food stops, try to avoid entering into convenience stores while stopping for gas, and always wash your hands or use a 60% alcohol-based hand sanitizer after touching frequently touched surfaces like gas pump handles, buttons and door knob handles. For lodging, consider a short-term rental such as a house, condo or cabin rather than staying in a busy hotel.
Remember that no indoor or outdoor event with others outside your household is completely risk-free, even with masks. Assess your risks, establish your risk tolerance, come up with mitigation strategies and develop a plan in case you or your loved ones become exposed. 2020 may have been a year of surprises, but with proper planning, you can still make the holidays a time for family and unity while creating new memories and traditions, too.
Dr. de Lota is a Family Medicine physician working at Austin Regional Clinic. He enjoys treating people of all ages and has a passion for preventative care evidence-based medicine, and patient education.