The past three years the holidays have been clouded with pandemic concerns. Now, with COVID, the flu and RSV circulating — what should folks look out for at gatherings?
The Sacramento Bee service journalism team posed the same questions to three California hospitals. The following doctors provided emailed responses:
-- Dr. Matthew Eldridge, chief of infectious diseases for Kaiser Permanente South Sacramento
-- Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis
-- Dr. Namrita Gogia, vice chair of internal medicine and COVID-19 czar at Dignity Health
Here is what they had to say:
The following has been edited for clarity and brevity.
Is it safe to gather indoors — or should we head outside?
Eldridge: Gathering outdoors is safer than indoors; if there is an indoor gathering you want the space to be well ventilated - open doors and windows, run HVAC systems, and install high-quality air filters. Properly worn masks remain an effective option to reduce the risk of respiratory viral infections.
Blumberg: Events outdoors will be safer, but this may be uncomfortable or not feasible due to the weather.
Gogia: I think it really depends on the amount of risk that each individual and family is willing to tolerate. Overall, I think it’s reasonable to gather indoors.
Is a potluck-style gathering safe?
Eldridge: Potluck style can be done safely, but you may want to limit everybody touching the same foods and of course people should wash their hands before eating.
Blumberg: No problem at all. COVID and influenza are primarily transmitted via the respiratory route, and RSV is transmitted via large droplets, which means touching contaminated serving utensils may result in transmission. But food is not a risk for transmission of these viruses. To reduce risk of RSV transmission, you can carry a small container of hand sanitizer and use it after serving yourself with shared utensils prior to eating.
Gogia: Many of the illnesses we are seeing this season are respiratory illnesses, so whether the food is served potluck style or plated, it should be fine.
If someone is sick with the flu — not COVID — should they gather?
Eldridge: If someone is sick with the flu then they can readily infect others. People with the flu should isolate at home until they have no fever for at least 24 hours.
Blumberg: No way. Influenza is no treat and may result in serious illness or death. Those ill with the flu should stay home until they are clinically improved and without a fever for at least 24 hours, generally 4-5 days after symptom onset.
Gogia: It is recommended that those who aren’t feeling well or have any upper respiratory symptoms such as a runny nose, cough, fevers, chills, nausea, body aches, or sore throat stay home.
What tips do you have those hosting a holiday gathering?
Eldridge: In terms of how to gather safely, the same approaches that were relevant to COVID these past few years still apply. As noted by public health agencies, there are clear ways to reduce the spread of disease or decrease the severity of illness.
-- Getting the yearly flu vaccine and COVID boosters. These are ok to receive at the same time.
-- Stay home if you’re sick, or if you feel under the weather, and be sure test for COVID
-- Wash your hands often
-- Consider testing for COVID before gathering
-- If gathering indoors, try to open windows and doors to ensure good air flow through the room. Consider running the HVAC system with high quality air filters.
-- Flu testing is not recommended for everyone but is important for certain high-risk groups. Talk to your provider if you’re unsure if you should test for flu. RSV testing is not required for most people.
Blumberg: Make sure that everyone at home is fully vaccinated with indicated boosters for COVID and influenza, and request that your guests also be fully vaccinated. Anyone who has a fever or respiratory symptoms should opt out of the gathering so that others are not at risk of infection. For those who want to reduce the risk further, request that all attendees test for COVID the day of the event to make sure that those with asymptomatic infection stay away to further reduce transmission.
Gogia: This holiday season, I encourage my patients to gather with their family, friends, and loved ones. That being said, nobody wants to be the host of a super spreader event! Hosts can consider asking those attending to refrain from coming if they have any upper respiratory symptoms. If possible, have the event in an outdoor area or an open area with good ventilation. In some situations, for example, if an elderly or immunocompromised person will be in attendance, it may be ideal to ask those attending the event to test beforehand.
What are your tips to those participating in holiday parties and how should they prepare?
Eldridge: Same as above.
Blumberg: Be fully vaccinated and stay home if you are sick. For those who become symptomatic after a large gathering, are quick to test for COVID — and if the COVID test is negative —then consider getting a test for influenza if you are interested in starting antiviral treatment since this is most effective if started within 48 hours of symptom onset. (And for those who may be drinking a lot, stay hydrated!)
Gogia: After the event, if they develop any symptoms of an upper respiratory infection, they should stay home and test for COVID-19. They can do a rapid test at home when symptoms begin and, if negative, test again in 48 hours to reduce the risk of missing an infection and spreading it to others.
Is there anything else you would like to add?
Eldridge: We encourage everyone at the individual level to do what they can to protect themselves and others. We urge people to receive their flu vaccines and their COVID-19 vaccinations/boosters, which continue to protect against severe illness and death. And we continue to recommend wearing masks and social distancing, especially during surges in indoor spaces amongst other people. These measures help protect the most vulnerable in our communities from COVID-19 disease.
Blumberg: I didn’t mention masking for these situations since it is less practicable when people will be eating and drinking. But masking is also proven to reduce risk of COVID, influenza and RSV so can be considered if feasible.
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