Gathering for the Holidays? — You Probably Should Not

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You may be thinking about getting together on Thanksgiving, Hanukkah, Christmas or New Year’s with a group of your close friends or family, now often dubbed as your “bubble.” This is probably not a good idea. Let’s remember that the virus is disbursed especially in settings of crowding, prolonged contact, poor ventilation, or where there is loud talking, singing, or heavy breathing. Does all that sound like a holiday gathering?

We all have “caution fatigue.” It’s a very real phenomenon, resulting from all the stresses that you are under — the necessity of wearing a mask, social distancing, and keeping your hands clean. All of which creates more stress. And the holidays are often stressful times for many people anyway so adding all this together makes it all the worse. Yet, holidays bring a great desire for family and friends to get together. You don’t want the pandemic to interrupt your long-standing traditions. But the pandemic is still going strong.

USA Covid19 Cases as of Nov 11, 2020

Coronavirus infection case counts, as we all know, are going up and going up dramatically across the country. A recent fascinating article in the journal Nature from investigators at Stanford and Northwestern universities and Microsoft on how the virus is most readily spread indicates that most transmission occurs in group settings such as restaurants and bars, coffee shops, and gyms. The other major place for spread is among family and friends right at home. “Our model predicts that a small minority of “superspreaders” account for a large majority of infections.”

Dr. Anthony Fauci, Director of National Institute of Allergy and Infectious Diseases and something of a household name commented that Thanksgiving gatherings could cause coronavirus cases to rise even faster than they already are. That makes common sense. The more people get together, the more the virus is transmitted. Today on Meet the Press, Fauci suggested “When you think of the holiday season and the congregating indoors at what are innocent, lovely functions, like meals with family and friends, you have got to at least think in terms of evaluating, do you have people in your family that are elderly… that weaken their immune system?

This is why the Center for Disease Control strongly recommends staying home and having your holiday gathering only with those people who live in your home and nobody else. “As cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with. Gatherings with family and friends who do not live with you can increase the chances of getting or spreading Covid19.”

If you must meet with others, the CDC recommends not traveling, avoiding large group settings, meeting outdoors rather than indoors, being sure there is good air circulation, and wearing masks and social distancing except while eating. These recommendations will be difficult at best to adhere to fully which is why the CDC recommends you just stay home.

That is a difficult recommendation to accept for many reasons. We are tired of being cooped up. We are tired of being careful. We are tired of being scared. We’re all just tired. We wish it would just go away. So, we can easily become less cautious. I call it “caution fatigue,” others call it Covid fatigue.

As a result of this very real caution fatigue, it’s easy to relax your guard; it’s easy to assume your close family and friends are not infected. After all, Uncle George doesn’t frequent bars or coffee shops and if he goes to a restaurant he only eats outdoors or takes carryout. Yes, that sounds logical but unfortunately it really is not.

You think you are in your own “bubble,” a small group of maybe six family and friends who are all careful, all the time. But let’s think about a bubble for a moment. You may think of your bubble as having six people that are all very careful about masking, distancing and hand hygiene. So, when you’re together with the other members of that bubble you feel comfortable taking off your mask and having a meal together. But this is probably not a good idea. Here’s why.

Someone in your bubble, let’s call in Bubble A, is likely part of another bubble, let’s call that Bubble B. That bubble of say, eight people, are also careful in what they do and so they are comfortable removing their masks to have a meal or sit in a coffee shop together. It is likely that someone in Bubble B is also a member of Bubble C. Those in Bubble C are likewise generally careful but this is where caution fatigue comes in. One person goes to their local gym and forgetting about the opportunity for spread, takes their mask off while exercising hard on a bike thinking that their risk of infection is still very low. But the coronavirus was there in an asymptomatic person who was also breathing heavily. The coronavirus is easily transmitted through the air on aerosols and it’s now inside of Bubble C in a few days yet in an asymptomatic individual. Bubble C people all get together as they frequently do and the virus now transmits from this asymptomatic person to someone else who is part of Bubble B. And so it goes until it soon reaches Bubble A — your bubble! So, although your Bubble A may seem quite safe, it is not.

What can you do? Recognize caution fatigue and talk about it with other people in your bubble. Remember that most virus spread is from asymptomatic people who have no idea that they are infected. And you do not know that they are infected either.

You could go through a risk-benefit analysis before deciding what to do over Thanksgiving or the other holidays. Whatever your decision, limit the number of people attending. But why not be creative and consider other options. Meet without food so one need not take off masks. Or do something entirely different like go to the park and take a hike together.

If you do decide to increase your circle for Thanksgiving, the CDC recommends that only one person serve food, avoid potluck style, and wash your hands frequently. There should be no hugging or handshakes and there should be no loud singing or loud talking since that’s a great way to increase the spread of the virus if an asymptomatic person is present.

Remember that caution fatigue is real. My recommendation is to not let the short-term pleasure of getting together with friends and family risk having the long-term implications of getting infected. It’s been nine months now and you’ve been through a lot as have we all. This is not the time to take a chance, especially with vaccines just around the corner. Don’t mess it up now. As president-elect, Biden recommended — let’s be careful this Thanksgiving so we can all meet again next year. That is good advice.

(The essence of this article is also available as a video.)

Quasi-retired physician, academic medical center CEO, professor & researcher. Author of 6 health & wellness books.

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