For the past three years, the holidays have been clouded by pandemic concerns. Now, with COVID, influenza and RSV circulating, what should people be aware of at gatherings?
The Sacramento Bee Service’s journalism team asked the same questions of three California hospitals. The following doctors provided responses via email:
Dr. Matthew Eldridge, Chief of Infectious Diseases for Kaiser Permanente South Sacramento
Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis
- Dr. Namrita Gogia, Vice President of Internal Medicine and COVID-19 Czar at Dignity Health
Here’s what they had to say:
The following has been edited for clarity and brevity.
Is it safe to congregate indoors – or should we go outside?
Eldridge: Gathering outdoors is safer than indoors; if there’s a gathering inside, you want the space to be well ventilated — open doors and windows, run HVAC systems, and install high-quality air filters. Properly worn masks remain an effective option to reduce the risk of viral respiratory infections.
Blumberg: Outdoor events will be safer, but it may be uncomfortable or impossible due to weather.
Gogie: I think it really depends on the level of risk that each individual and each family is willing to tolerate. All in all, I think it’s reasonable to congregate indoors.
Is a potluck type gathering safe?
Eldridge: Potluck style can be done safely, but you may want to limit everyone to touching the same foods and of course people should wash their hands before eating.
Blumberg: No problem at all. COVID and influenza are transmitted primarily through the respiratory route, and RSV is transmitted through large droplets, which means touching contaminated serving utensils can lead to transmission. But food is not a risk of transmission of these viruses. To reduce the risk of RSV transmission, you can carry a small container of hand sanitizer and use it after serving yourself with shared utensils before eating.
Gogie: Most of the illnesses we see this season are respiratory illnesses, so whether the food is served potluck or plated, it should be fine.
If someone is sick with the flu – not COVID – should they congregate?
Eldridge: If someone is sick with the flu, they can easily infect others. People with the flu should isolate themselves at home until they have been fever-free for at least 24 hours.
Blumberg: No way. The flu is not a cure and can cause serious illness or death. People with the flu should stay home until they are clinically better and fever-free for at least 24 hours, usually 4-5 days after symptoms appear.
Gogie: People who are not feeling well or have upper respiratory symptoms such as a runny nose, cough, fever, chills, nausea, body aches or sore throat are recommended to stay at the House.
What advice do you have for those hosting a holiday gathering?
Eldridge: When it comes to how to congregate safely, the same approaches that were relevant to COVID in recent years still apply. As public health agencies have noted, there are clear ways to reduce the spread of disease or lessen the severity of illness.
- Get the annual flu shot and COVID boosters. These are ok to receive at the same time.
- Stay home if you are sick or unwell and be sure to get tested for COVID
- Wash your hands often
- Consider testing for COVID before gathering
- If you are meeting indoors, try to open windows and doors to ensure good air circulation in the room. Consider running the HVAC system with high quality air filters.
- Flu screening is not recommended for everyone, but it is important for certain high-risk groups. Talk to your provider if you are unsure if you should test for the flu. RSV testing is not required for most people.
Blumberg: Make sure everyone at home is fully immunized with the reminders listed for COVID and flu, and request that your guests be fully immunized as well. Anyone who has a fever or respiratory symptoms should withdraw from the gathering so that others are not at risk of infection. For those who wish to further reduce risk, have all attendees tested for COVID on the day of the event to ensure those with asymptomatic infection stay away to further reduce transmission.
Gogie: This holiday season, I encourage my patients to get together with family, friends and loved ones. That being said, no one wants to host a superspreader event! Hosts may consider asking attendees to refrain from coming if they have upper respiratory symptoms. If possible, hold the event in an outdoor space or open space with good ventilation. In some situations, for example, if an elderly or immunocompromised person will be attending, it may be ideal to ask those present at the event to test themselves beforehand.
What is your advice to those attending the holiday season and how should they prepare?
Eldridge: As above.
Blumberg: Be fully vaccinated and stay home if you are sick. For those who become symptomatic after a large gathering, quickly test for COVID – and if the COVID test is negative – then consider getting tested for the flu if you want to start antiviral treatment, as it is more effective if it is is started within 48 hours. of the onset of symptoms. (And for those who drink a lot, stay hydrated!)
Gogie: After the event, if they develop symptoms of an upper respiratory tract infection, they should stay home and test for COVID-19. They can do a rapid home test when symptoms appear and, if negative, retest within 48 hours to reduce the risk of missing an infection and spreading it to others.
Is there anything else you would like to add?
Eldridge: We encourage everyone, on an individual level, to do what they can to protect themselves and others. We urge people to get their flu shots and COVID-19 shots/booster shots, which continue to protect against serious illness and death. And we continue to recommend the wearing of masks and social distancing, especially during surges in indoor spaces between other people. These measures are helping to protect the most vulnerable people in our communities from COVID-19 disease.
Blumberg: I didn’t mention masking for these situations because it’s less practical when people are going to eat and drink. But masking has also been shown to reduce the risk of COVID, influenza and RSV and therefore can be considered if possible.
This story was originally published December 17, 2022 5:00 a.m.
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