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Navigating COVID-19 this holiday season

December 13, 2021 | UCI Health
A group of adults, some wearing masks, gathered in a foyer at the holidays..
The best way to minimize COVID-19 risk and keep your family and friends safer is to get vaccinated and a booster shot, if you’re eligible, says the CDC.

With the winter holidays almost upon us, the emergence of a highly contagious new variant of COVID-19 is calling into question what it means to celebrate safely this year.

The omicron variant was first identified by scientists in South Africa and Botswana on Nov. 24, 2021. By Dec. 8, cases of the virus strain were reported in at least 19 U.S. states, including California, and more than two dozen nations around the world.

“Omicron is moving fast and furious,” says infectious disease expert Dr. Susan Huang, medical director of epidemiology and infection prevention for UCI Health. “This could overtake the delta variant in a matter of weeks. The key question is whether it is will be milder in severity than delta in the United States, where we have a much higher proportion of elderly and immunocompromised people compared with South Africa.”

Although more data is needed, Huang says the omicron variant so far appears to cause less severe infection in both vaccinated and unvaccinated patients.

Manufacturers and scientists are scrambling to determine how effective the current COVID-19 vaccines are against omicron. The makers of the Pfizer-BioNTech vaccine have already determined that three doses of its vaccine are needed to neutralize the omicron variant.

Booster shots a must

For Huang, this finding means that getting a COVID-19 booster is no longer optional. “Booster shots are essential for protecting ourselves, children under age 5 who aren’t eligible for the vaccine, and people whose immune system can’t mount a full response to the vaccine.” she says.

Unlike other COVID-19 variants, omicron has been associated with an increase in hospitalizations of very young children in South Africa. Huang says that anyone who will be around infants and toddlers for the holidays should ensure they get a booster and are fully vaccinated to protect those children.

While gatherings for Christmas, New Year's and other festivities will require certain protections again this year, having COVID-19 vaccines for people ages 5 and older is still an important step to protect families from the delta variant and getting some immunity to omicron as it moves around the world.

“With some extra planning and precautions, we can still have a wonderful time with friends and family and stay safe this holiday season,” she says.

Even before the omicron variant, many Americans were planning to proceed very cautiously with holiday gatherings, according to a recent national survey. About half the 2,000 adults questioned said they would ask their guests to wear masks and nearly 75% planned to celebrate only with members of their immediate household.

Half of survey respondents also planned to ask guests about their vaccination status; 46% said they would require unvaccinated guests to provide a negative test for COVID-19 before attending a gathering.

Protect others

Because many generations tend to gather to celebrate holidays — including children under age 5, who cannot yet be vaccinated — the best way to minimize COVID-19 risk and keep your family and friends safer is to get inoculated if you’re eligible, according to recent holiday guidelines from the U.S. Centers for Disease Control and Prevention (CDC).

More than 70% of eligible Americans have had at least one dose of the three available COVID-19 vaccines, and 60.4% are fully vaccinated, the CDC reports.

Now that boosters are widely available for all vaccinated adolescents and adults, age 16 and older, Huang encourages everyone who is eligible to get theirs at least two weeks before visiting grandparents or other high-risk family members.

Booster shots enable the body’s immune system to fight breakthrough infections of COVID-19 and can help prevent severe cases and hospitalization.

“It’s terrific that the boosters provide protection,” she says. “Let’s use them to full advantage. We need to protect our little ones under age 5, who can’t yet receive the vaccine. We need to remember that while breakthrough COVID-19 infection is often mild or asymptomatic, it is still highly contagious to unvaccinated individuals who may experience more severe disease.”

When in doubt, get tested

If you are sick or have COVID-like symptoms, do not host or attend a gathering. The best way to ensure you don’t have COVID, is to get tested.

“Get checked, even if you have the mildest symptoms of cough or fever,” Huang says.

“Breakthroughs do happen and even a mild case makes you highly contagious. So this recommendation applies to all — no matter your vaccination status.”

Outdoors or indoors?

If you’re hosting or attending a holiday gathering, think it through. How many people will be there? Are they fully vaccinated and boosted if they are eligible? Are they likely to wear masks? Will it be outside or inside?

Celebrating outdoors is safer than indoors and we’re fortunate to have mostly good weather in Southern California during fall and winter.

If possible, avoid crowded, poorly ventilated spaces, because the virus spreads mainly as respiratory droplets from infected individuals. If you must be inside, limit the number of households you invite, open windows or promote air circulation to dilute the droplets and reduce the risk of exposure.

“If you are going to a party with several households, wear a mask indoors if anyone in attendance has a weakened immune system, is unvaccinated or is at increased risk for severe disease,” says Huang. "This winter season is not the time to let down your guard.”

However, children under two years old should not wear face masks.

Masking has been shown to reduce the risk of COVID-19 exposure for both the wearer and the people around them. Throughout the holidays and winter, the CDC recommends wearing a well-fitting mask over your nose and mouth in public indoor settings, especially if you are not fully vaccinated.

Even those who are fully vaccinated and have had a booster shot should wear a mask in communities that are experiencing substantial and high rates of COVID-19 transmission because it’s possible to spread infection without becoming ill yourself.

Huang is hopeful for 2022, when we will see more therapies and greater protections that will bring us all closer to normal.

In the meantime, she says, “Thanks to science, we have vaccines that make this holiday season much safer and more enjoyable than last year. Most of us are protected from severe disease. Now we must do all we can to protect those who are still waiting for their chance to be vaccinated or boosted.”

Dr. Susan Huang describes everything you need to know about the omicron variant (video) ›

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