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Published on December 22, 2020

Should you gather with family this holiday season?

Virtual Holiday

In hindsight, the pandemic summer was a stroll in the park – literally. We could safely socialize if we were outdoors, maintained a distance of six feet from others and wore a mask. But in the Northeast, winter is driving people indoors and safely socializing has become a lot more difficult.

COVID-19 spreads through aerosol respiratory droplets in the air and, outdoors, the droplets dissipate fairly quickly. But indoors, they can remain trapped and build up, making it far more dangerous for disease transmission. The very thing that helps us conserve energy and save money on heating bills, is what makes homes a dangerous place to socialize.

Americans learned the hard way over Thanksgiving when many people traveled and gathered to enjoy a holiday with family and friends. Cape Cod Healthcare infectious disease expert Ana Paula Oppenheimer, MD, MPH, believes that the spike in cases we are now experiencing is a direct result of that activity.

“The numbers are going up so fast,” she said. “If you look at the tally of all the cases since this started, this is the third wave for the United States. It’s much steeper than the prior two. We had the first one in March/April and the second one July/August. It was summertime so people were relaxing a little bit more. And then we just started seeing it going up in November and it continues to go up. You look at the curve and it almost looks like we are climbing Mount Everest. It’s extremely scary.”

Unfortunately, this means that as much as we want to see family for Christmas or New Year’s this year, it just isn’t safe, according to Dr. Oppenheimer.

“I think that people should really stay home with their inner circle, with their nuclear family and everything else should be on the telephone, or texting and exchanging pictures,” she said. “People need to show their love in a different way. That is my recommendation. I don’t think that this is being too conservative. I don’t know how much longer we can take 3,000 deaths a day. It’s a pretty impossible number.”

Most Know the Guidelines

Dr. Oppenheimer said the spikes in cases are because people aren’t following the guidelines recommended by the scientists and doctors, and she doesn’t believe it’s because people are not educated about what they should be doing. Most Americans, even children, know that the guidelines are to wear a mask, maintain a distance of at least six feet from others and wash your hands thoroughly or use hand sanitizer after every trip out of the house.

The problem is that mask-wearing became political, she said, and people are getting information from politicians, social media, television personalities or Hollywood actors, rather than an authentic source, like the CDC and the state health departments.

“The United States is a country with so much wealth, so much information, and high-tech medical knowledge and care but we are the worst in the world in controlling the virus,” Dr. Oppenheimer said. “It’s not a failure of the medical field. It’s not the public health officers’ failure. No. It’s a situation where we as citizens have to turn around the way we think about this.” 

Around Thanksgiving, a lot of people thought that they could safely gather if they were tested and the results were negative. That was faulty thinking, Dr. Oppenheimer said. For one thing there are many different types of tests and not all of them are accurate. The only test being done by Cape Cod Healthcare is the PCR test, which is the gold standard for testing, she said.

Antigen tests are less reliable. Even though a positive result on an antigen test is considered indicative of disease, false negative results are common. That means that someone could believe they are safe when they really aren’t. Timing also matters. If the test is administered too early, it will not detect the virus. The same is true if the test is not properly administered.

“It’s not just the test,” Dr. Oppenheimer said. “There is history behind each person taking the test and that history needs to be analyzed to really come to the conclusion that this negative test, correctly done, on a person who has not been exposed is really a true negative and then this person can go and gather with somebody else.”

For example, getting tested in Florida and then getting on a plane, means that the test was all but meaningless. You could have been exposed at the airport, on the airplane or anywhere else along the way.

Now that a vaccine is on the horizon, a lot of people think it will be the magic bullet that allows life to go back to normal. But even after you are vaccinated, you still need to take precautions, because we haven’t even reached the summit. Cases need to come down dramatically before we can relax our guard.

“They still need to follow all of the other guidelines: face masks, hand washing, social distancing,” Dr. Oppenheimer said. “No individual measure alone is sufficient. The combination is what works.” The 3 Cs to avoid: Crowds, Confined spaces and Close contact!