Covid-19, RSV, and flu prevention tips to stay healthy this holiday season

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Winter 2020 was the season of Zoom holidays. By 2021, the omicron surge spoiled end-of-year plans. So far, the 2022 holiday season is off to a bumpy start with an early, sharp surge of flu and respiratory syncytial virus cases with an expected wave of Covid-19 cases on the horizon.

With a lack of national and local precautionary guidance, individuals are now on their own to gauge risk and protection. However, Americans have more tools in their arsenal when it comes to protecting themselves against Covid this holiday season: vaccines, boosters, tests, masks, knowledge of how the virus spreads. Keep these best practices in mind, experts say, and you can celebrate like it’s 2019. “This is going to be the first year we’re actually going to go visit our family for Christmas because we haven’t done it the previous two years because I’ve been too nervous,” says Sarah Ruff, a family medicine physician at UNC Family Medicine. “There’s really no reason to not do it this year because we do have all these tools.”

Keep your most vulnerable guests top of mind

The amount of risk the group is willing to take should depend on the guest list. Think about the people who will attend each gathering this season. Elderly people, those who are immunocompromised or who have other medical conditions, or newborns (vaccines are available to babies 6 months or older) are most susceptible to severe cases of Covid-19. Take precautions in order to best protect them. “It does make sense to think of the most vulnerable person when you’re trying to make decisions about what precautions to take,” Ruff says.

Make a plan with attendees on precautions. Maybe you’ll all take a rapid test before coming inside, maybe you’ll wear masks when you’re near Grandma, maybe your host will keep the windows open, or maybe you’ll all choose to gather outside. Getting vaccinated, boosted, and wearing masks in public places prior to the gathering should be sufficient protection for most families, even those with older relatives, Ruff says.

Make sure you’re up to date with your Covid booster (and flu shot)

The most effective way to avoid Covid-19 this holiday season is to stay up-to-date on your vaccines, says Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System. Most people are eligible for a bivalent booster at least two months after completing their first two shots, according to the Centers for Disease Control and Prevention.

In an October press briefing, White House Covid-19 response coordinator Ashish Jha recommended Americans receive their boosters before Thanksgiving in order to gain the most protection this holiday season. If you recently recovered from Covid, wait three months before getting boosted, Camins says. Schedule your annual flu shot, too, which you can get the same day as your Covid booster.

Be strategic with your masking

While nationwide mask mandates have expired, it’s still a good idea to keep N95 or KN95 masks on hand for travel purposes. Wear a mask at the airport and during takeoff and landing or if the flight is short, keep it on for the entire flight, Camins says. “It’s relatively safe if you’re up in the air because the air is HEPA-filtered,” he says. “When you’re taxiing, when you’re deplaning, when they turn off the engines, you want to make sure your mask is on.”

For train or bus travel, where the air isn’t as well-ventilated as on planes, Camins suggests masking for the entire trip.

Ensure all guests test for Covid-19 before the event

According to CDC guidelines, if you have symptoms of Covid-19, test immediately. If you’ve been exposed, wait five days and then test. However, if you’ve been around other people lately in any capacity, “you can no longer tell who among your vicinity was positive for Covid,” Camins says. “You just assume you were exposed prior to your event.” He suggests serial testing in the days leading up to your party. For example, if you’re gathering for Thanksgiving, do a rapid test on the Sunday and Tuesday before the holiday, and then once more on Thanksgiving, he says.

If you’re showing symptoms such as fever, body ache, sore throat, cough, and chills, but are still testing negative for Covid-19, you should consider staying home. Because RSV and flu are circulating, it’s possible you could risk infecting a loved one with another respiratory virus. “You shouldn’t be going anywhere if you have a fever,” Ruff says. “You want to make sure you’re at least 24 hours [without] having a fever.”

For people with common colds, Camins says as long as they wear a mask, they can attend. Ruff says to be transparent with your family in such a case and ask them if they’re comfortable with you coming.

Stay aware of certain Covid trends

Since reported case data isn’t released as regularly as in the past, and is likely an undercount due to rapid tests taken at home, Ruff says to keep an eye on the CDC Community Level, which measures hospitalizations and cases and offers prevention strategies for each tier of community spread. You can enter the state and county where you’ll be having Thanksgiving to check community levels and determine what amount of precaution you’ll take. “If we’re going to a higher-risk area, it may be worth putting your mask on when you’re going out in public around people you don’t know, and maybe you choose not to wear your mask around your family who’s all vaccinated,” Ruff says, “but when we all go out as a big group, maybe you do.”

For all intents and purposes, Camins says this holiday season is a return to form. Just take a little extra care in the days leading up to your gathering and you can celebrate like years past. “Can people sit around the table again instead of having the grandma and grandpa eating by themselves in another room?” Camins says. “I think we can.”

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