SARS-CoV-2 (the virus that causes COVID-19) didn’t want to be left out of the gift-giving, so it gave us a present that none of us wanted: a new variant called omicron. I mean, come on! We weren’t even finished with delta yet.
So now what do we do? Do we call off the New Year’s parties and the family get-togethers? What about the winter break ski trips (assuming there’s snow somewhere)? Not necessarily. The answers to these questions depend on three factors: your risk tolerance, your local COVID-19 “weather,” and your personal COVID-19 status.
Your risk tolerance
The first thing to remember is that there’s no such thing as no risk in this situation. Unless we lock down and cut off face-to-face interaction with people outside our households, we cannot completely prevent the possibility of getting COVID-19.
Now that that’s off the table, you need to decide what your tolerance for risk is. In part, that should depend on who’s involved. Will your holiday gathering involve children under age 5, who can’t be vaccinated yet, or someone who’s immunocompromised, in whom the vaccines don’t work as well? Then your risk tolerance should be low. If everyone coming to your party is fully vaccinated, boosted, healthy, and under age 50, then your risk tolerance could be higher—as long as everyone who’s invited is okay with that. Even with outside factors taken out of the equation, some people just have very low tolerance for risk, and that needs to be respected.
Your local COVID-19 ‘weather’
You know how you judge what to wear each day based on what the weather is outside? Our anti-COVID-19 behavior should be based on the current pandemic “weather” in our area, too. You can use The New York Times’ county-by-county map of COVID-19 risk as your weather map. Handily, it also tells you what “clothes” to wear for the weather you’re facing: It provides user-friendly guidance from the Johns Hopkins Bloomberg School of Public Health and others about what activities are safer or less safe for both vaccinated and unvaccinated people.
An example: Here in Worcester County, the level of COVID-19 transmission is extremely high right now. Fortunately, my spouse and I are fully vaccinated (and boosted, which you should be, too, if you’re eligible), as are both of my children (minus the booster). The friendly folks at Johns Hopkins recommend that I “avoid large indoor events with more than 50 people” and “socialize inside the home with only one or two other vaccinated households.” If anyone in my household is at high risk or if anyone attending the gathering is unvaccinated, I should “consider wearing a mask.” If I weren’t fully vaccinated, the advice to me would be very different.
Your personal COVID-19 status
Ideally, the day you attend a holiday gathering—especially one that’s indoors and unmasked—you should get tested for COVID-19.
Remember, a COVID-19 test tells you only one thing: whether you are infected at that moment. That’s all. And if you’re using an antigen test, it doesn’t even necessarily tell you that. You can be infected with very low levels of virus—either at the very beginning or at the tail end of the infection—and an antigen test won’t pick it up. That’s why almost all antigen tests are sold in packs of two; you’re supposed to take one test now, and the second one 24 to 36 hours later. When you do that, the test is much more likely to correctly identify whether you have an infection.
Dr. Katelyn Jetelina, assistant professor of epidemiology at the University of Texas Health Science Center, published a terrific flowchart in her newsletter, “Your Local Epidemiologist,” back in November, to help folks understand how best to use antigen tests before Thanksgiving gatherings. I highly recommend checking it out if you’ve got a party on the calendar and your risk tolerance is low (see “For more information,” below). If your risk tolerance is high, a quick rapid antigen test the day of the party could be enough. (No guarantees.)
I recognize that antigen tests are thin on the ground right now. As of this writing, they were still available at ihealthlabs.com, projectn95.org, and cvs.com. I ordered a few tests from iHealth on Dec. 7 and they arrived five days later (on a Sunday, no less). My family plans to use them before our one holiday gathering with older relatives. Meanwhile, we’ll continue to wear our masks whenever we’re indoors in public, and the girls will continue to get tested once a week in school. Will we be perfectly safe? No. But we’re doing the best that we can.
For more information
- New York Times – A Guide for Covid-19 Risk in Your County; https://www.nytimes.com/interac tive/2021/us/covid-risk-map.html
- Using antigen tests for Thanksgiving week; https://yourlocalepidemiol ogist.substack.com/p/using-anti gen-tests-for-thanksgiving
- It’s Time to Level Up Our Mask Game; https://1truething.substack.com/p/its-time-to-level-up-our-mask-game
Liz Ruark is the founder of covidsafeschools.org and co-chair of COVID-Safe Schools, Harvard Public Schools’ community COVID-19 screening program. She holds a DVM degree from Tufts Cummings School of Veterinary Medicine.
