Do COVID and Holidays Mix? We Asked a Doctor What to Do to Stay Safe

With Christmas, Kwanzaa and New Year’s ahead, there’s sure to be the potential for  gatherings and get togethers. But with the current surge in Omicron likely to get worse, the activities of the coming weeks might require more care and forethought to stay safe.

Can you enjoy holiday dinner with extended family or friends without a mask? What about that New Year’s Eve party you’re planning on attending — if you get tested, can you still go? And since you’re vaccinated isn’t going to the movies on Christmas Day no big deal?

To get some expert advice, GOOD Morning Wilton spoke with Dr. Cornelius Ferreira, the System Chief for Primary Care at Nuvance Health and the lead physician on the COVID-19 task force for all Nuvance hospitals, doctors’ offices and urgent care.

GOOD Morning Wilton:  It’s holiday time, a lot of gatherings take place — parties, extended family gatherings, religious celebrations. Should people rethink whether or not to attend those kinds of get togethers?

Dr. Cornelius Ferreira:  I would say so, absolutely. They should absolutely be very conscientious of where they go, who they mingle with and then make sure that they do it in a safe fashion.

We know that there’s the Omicron variant, which currently accounts for 73% of the cases in the United States, it appears to be quite contagious. We do need some more research and investigation on how that occurs.

Dr. Cornelius Ferreira, Nuvance Health

The challenge is this — we have population that’s vaccinated, and we have a population that’s unvaccinated. What we are seeing with this variant is that even in some of our vaccinated individuals, especially those who are immunocompromised, they can still get COVID. In addition to that, there’s a subset of the population who have the Omicron variant and are asymptomatic — they don’t have symptoms, but they’re infected and they can thus spread the disease.

If people are vaccinated and they’re gathering with a community of folks that they know, that are also vaccinated, that will lower the risk for those populations. If you are vaccinated and you’re mingling with unvaccinated folks, that definitely will increase your risk because you do not know if those unvaccinated individuals may have the disease.

And then there’s about an incubation period of about 24 to 40 hours from the time that you get sick till you actually start exhibiting symptoms. For people who are planning to get together for the holidays, ideally, if they can get a COVID test two days prior to the gathering, that should be helpful because that will at least have them have some sense of safety and security that they’re not infected with the virus. And then it’s easier to get together.

At those get togethers, ideally they should mask, try to social distance, and follow good hand hygiene. I know that gets very difficult when you have family and friends that you’re close with, because nobody wants to wear a mask when that’s the case. But it would still be very beneficial to folks if they could do those things, to help protect them.

GMW: You recommend testing two days before a gathering. Does that also mean that once you test, you shouldn’t do anything that puts you at risk, in order to be able to safely go out and socialize after that?

Dr. Ferreira:  Correct. [After that test], you should then self-isolate to make sure that you don’t get exposed in those two days leading up your holiday party.

GMW: People are stocking up on at-home testing kits. Could people test right before they go? Say they take a test the morning of an event, and then feel comfortable going out?

Dr. Ferreira: You can get some benefit from that, because you know that you don’t have it. But again it takes 48 hours to develop symptoms. So if I was exposed yesterday, I test this morning, I may not develop symptoms until tomorrow, and my test may not be positive until tomorrow.

GMW:  Lots of people see movies on Christmas day, or go to a sporting event. A lot of people go to church. Would you personally do those things?

Dr. Ferreira: At this point I would not, because we are seeing a big uptick in the number of cases of Omicron in our emergency departments, but also on our inpatient side. We need to have common sense prevail. We have a new variant that’s now predominant in the United States. It is contagious. People who are unvaccinated can get very sick and potentially die from this disease. If you’re vaccinated, most people will see milder illness and not become as sick. But to protect those folks around us, that either cannot get vaccinated for a specific health reason, or family members that are debilitated or immunocompromised, keeping yourself safe is step one. So I would minimize social interactions as much as possible.

GMW:  Let’s talk about masks. When should people wear them and does it matter what kind they wear?

Dr. Ferreira: Our recommendation at this point is for folks to wear a surgical mask, as much as possible. We know that the cloth masks have some protection but they’re not nearly effective as surgical masks.

Then there are the N95 [and KN95] masks that healthcare workers wear. Those do help to decrease the risk, but they are fitted specifically to match your face and make sure that there’s air-tight seals. I see a lot of people in public who use N95 masks, but they’re not necessarily wearing them appropriately.

Those need to be fit tested to really make sure that they provide an appropriate seal and that you do not expose yourself. For people who are not fit tested for those, [the N95 and KN95 masks] do confer some protection, but they may not be as effective as people think they are because you don’t get good air seals around them. They don’t have a seal, then they’re at risk for infection.

Surgical masks for the general population is probably still the best way to go.

GMW: I’ve heard that some masks are not as protective against the Omicron variant as they are against the Delta or other variants?

Dr. Ferreira:  So, the precise mechanism for how the Omicron variant spreads, whether it’s droplets, whether it’s aerosolization, we’re not a hundred percent sure yet. But what we do know is for respiratory infections, preventing droplets and airborne particles from getting into your nose and mouth is the way to help protect you against those. So I would say that masks absolutely will help to protect you.

GOOD Morning Wilton: In a town like Wilton where the vaccination rates are so high, do we need to be so worried about rising case numbers? Some people believe it’s about how sick people become, and if they’re not getting as sick, maybe we can relax the protocols. With Omicron, a lot of people have it, but they don’t get as sick. When can we start just treating this like the cold or the flu? Someone with a cold or the flu could go to a supermarket for chicken soup, they don’t have to quarantine.

Dr. Ferriera:  Even if they had the flu, they’re really not supposed to do that because you can still spread the infection. At this point, it’s too early to know for sure because we know that this Omicron variant is the newest, but we know as long as this virus spreads through the population it can undergo mutations.

What we think is happening with the Omicron variant, and the reason that people who are vaccinated are getting less ill, is probably because we’re starting to see the first glimmers of — you know, I wouldn’t use the word hope — but we’re starting to see that we’re having less severe infections in those that are vaccinated.

And this may represent the turning point, as things move forward, that this becomes more like an influenza where some people have mild illness, there’s still gonna be those groups that get severe illness, but much like with the flu vaccine. If you get the flu vaccine, we reduce the severity of your illness, plus your risk of dying from it, plus we lower the duration of your illness. So you’re not as sick for as long as if you didn’t get the vaccine.

Time will tell, but I think things are moving in the right direction.

GMW: So are case numbers still an important metric to keep track of?

Dr. Ferreira: Yes, absolutely. Because our challenge is, even though we’ve done very well with vaccinations, there’s still a good percentage of the population that are unvaccinated.

GMW: If you’re vaccinated but get COVID, does the vaccine make you less contagious to other people, especially if you are not feeling any symptoms?

Dr. Ferreira: With the initial design of the vaccines for the initial COVID virus that was circulating, these vaccines were highly effective, right? A 95% efficacy rate. Over a six to 12 month period, that efficacy — the immune response to the vaccine — starts to dissipate and people become more susceptible to getting infected.

That’s where the booster comes in. That then bolsters your immune system to say, yep, this foreign thing that’s inside my body needs to be tackled. And that’s where the boosters are helpful.

They’re similar to the flu vaccine. You get all these different strains every year that come out, we make best guesstimates on which strain is going to circulate, and then we prepare the vaccines associated with that [strain] to help protect people. That’s how the booster component works.

If you get infected, you will still spread this virus to others. That’s why the recommendation is even if you’re infected and asymptomatic, you should still self-quarantine for 10 to 14 days to minimize the risk of spread to others.