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You are reading The Checkup With Dr. Wen, a newsletter on navigating covid-19 and other public health challenges. Click here to receive it in your inbox.
Next week is Thanksgiving, and while most Americans don’t perceive covid-19 as dangerous as it was in 2020 or 2021, many readers have asked how to reduce their chances of getting and spreading the coronavirus. during Christmas gatherings.
Here are five tips for assessing and managing the risk of covid-19:
(1) Determine your risk tolerance level. Many people no longer prioritize avoiding covid-19. They’ve returned to all pre-pandemic activities, and Thanksgiving for them is no different than any other gathering they’ve attended.
Still, many others do not wish to contract the coronavirus. They may be medically vulnerable and susceptible to serious illness. Maybe they are worried about the long covid. These people will probably want to continue to take precautions during the holidays.
(2) If you are hosting a Thanksgiving dinner, know the preferences of your guests. If everyone is back to their pre-COVID-19 lives and you’re still the same, you may not need mitigation measures. Attendees should be aware that they could catch the coronavirus from this gathering, as well as dining out, going to the gym, and attending concerts.
If there are guests who want to be cautious, discuss with them how careful they want to be and how many layers of protection you need to institute.
Outdoor gatherings remain the safest option. Weather permitting, you can host the entire dinner outdoors. Inside there will be a much higher risk. You could reduce that risk by asking everyone to take a rapid test on the day of the event. Some hosts offer rapid tests at the door to reduce hassle and ensure all guests are tested.
(3) Consider a voluntary quarantine. I have received numerous questions from readers about what to do if they have guests staying with them for several days. If guests, hosts, or both really want to avoid covid, consider asking everyone to self-quarantine for at least three days, ideally five days, before meeting up.
During this quarantine period, everyone should minimize their in-person interactions without a mask. Wear an N95 or equivalent mask at work and school and while traveling. Do not gather indoors with people outside of your immediate household.
Upon arrival, take a quick test. If you are the host and want to be cautious, ask your guests not to gather inside with anyone outside your home while they are staying with you.
(4) Prepare what you can. Those vulnerable to severe illness from Covid-19 should get the bivalent booster now if they haven’t already, and everyone 6 months and older should get a flu shot. It takes about two weeks to reach optimal protection. Getting your shots today, a week before Thanksgiving, won’t give you full protection by then, but it will give you some extra immunity.
Now is the time to stock up on rapid home coronavirus tests. Make sure you have enough for all the events you’ll be attending that require it. You may consider purchasing tests in bulk if you are hosting an event.
(5) Plan for different scenarios. I have long been an advocate for everyone to have a covid plan. Are you eligible for Paxlovid? How will you access during holidays and after hours? If you are traveling and you test positive, do you have a place where you can isolate?
Also, think about what you will do if meetings take unexpected turns. If you find out that the people you’re hosting haven’t quarantined as promised, are you willing to take the extra risk? Or will you ask them to make alternative arrangements?
If you are someone else’s guest, you could end up in more risky situations than you expected. What if a lot more guests show up than they told you would, and you have no idea if they were cautious or tested? Decide, in advance, how strongly you feel about avoiding covid, communicate that to the people you’re celebrating the holiday with, and know your limits on when you might want to leave a gathering.
I’ll be out with my family next week. The Checkup will be back in your inbox on Thursday, December 1st. Until then, happy Thanksgiving!
Newsletter subscribers are invited to submit questions to Dr. Wen. Not a subscriber yet? Click here to register.
“I see in your columns that you are not recommending reinforcement for all groups. Wouldn’t it be beneficial for everyone if everyone got the boost so that fewer new variants of concern would emerge? Also fewer opportunities for vulnerable people to get infected?” —Valerie from California
Your argument would be correct if it were true that vaccines, and updated boosters, provide substantial protection against infection. This is what we thought when coronavirus vaccines were first introduced. If that were true today, then yes, boosting everyone would reduce transmission of the virus overall, thus reducing the chance of new variants developing.
Unfortunately, we know that this is probably not the case with existing vaccines. Vaccine effectiveness against infection with the omicron subvariants is not as high. One study, published in JAMA, found that during the time of omicron prevalence, the effectiveness of the vaccine against symptomatic infection after two months was only 29% in children 5 to 11 years of age and 17% in adolescents. Another large study, published in the New England Journal of Medicine, followed more than 11,000 healthcare workers. After its second booster, the vaccine’s effectiveness against symptomatic infection dropped from 52 percent during the first five weeks to virtually zero between weeks 15 and 26.
I think it’s important that we continue to emphasize the main reason for vaccination: to reduce the chance of serious illness or death. That’s a compelling reason to get the booster. It reduces the chance of getting seriously ill and, on a societal level, helps prevent hospitals from being overwhelmed.
So it’s easy to argue that people most vulnerable to serious illness, like nursing home residents and the elderly, should keep up with their boosters. But it’s not so clear that such a public health rationale applies to people already unlikely to get seriously ill. Some people will want the booster because they want to reduce the chance of getting the virus. But others might want to wait. Both are reasonable decisions.
“I give blood regularly, usually platelets. Does it matter how long I wait to donate after a flu shot or covid booster?” —Virginia J.P.
The American Red Cross specifies that there may be a short waiting period if you received a live attenuated virus, which is not the case with coronavirus or flu vaccines in the United States. If you have received any of the flu or coronavirus vaccines authorized by the Food and Drug Administration, you do not need to wait before donating blood, as long as the side effects of the vaccination, such as fatigue and headache, have subsided. .
“Because tests are often negative when one has already contracted the coronavirus, and only turn positive a couple of days or more later, what is the point of testing immediately before attending an event or visiting the someone’s house?” —Minnesota Hope
The reason to test before attending a gathering is to find out if you might be infectious to others. If you are infected, but with such a low amount of virus that a rapid test cannot detect it, it is highly likely that you are not yet actively contagious to the people around you.
That’s why rapid tests are best when taken as close to the event as possible. If you take a test the day before an event and it comes back negative, but you were already infected, you could develop a high enough viral load to infect others the next day. But if you test negative just before attending a meeting, the amount of virus is likely still low.
Of course, rapid tests do not provide a 100 percent guarantee against infection. But if everyone gets tested right before a gathering, the likelihood of asymptomatic spread will decrease.
The Post has also collected questions and answers from my previous newsletters. You may read them here.
While many people experience significant side effects from coronavirus vaccines, such as fatigue, fever, and arm pain, others do not experience any symptoms. I’ve heard from concerned readers that a lack of symptoms indicates the vaccine didn’t work. A new study in JAMA Network Open puts an end to this concern. A strong antibody response is seen in almost all people, including those who did not report symptoms after vaccination.
Binge drinking and alcohol-related deaths increased during the first year of the pandemic, according to a new report from the National Center for Health Statistics. These deaths have risen steadily over the past two decades, but 2020 saw a sudden 26 percent increase in deaths compared to the previous year, from approximately 39,000 deaths to 49,000. For women, the largest increase in death rates was among those ages 35-44, with a 42% increase between 2019 and 2020. For men, those ages 25-34 experienced a 46% increase , and those from 35 to 44 years old, 45%. increase.
i appreciated this Atlantic Op-ed by economist Emily Oster, who has been a strong advocate of opening schools during the pandemic and has received both praise and harsh criticism for her views. She argues that both those for and against the pandemic restrictions have become defensive and more withdrawn. “Treating pandemic elections like a scorecard where some people score more points than others prevents us from moving forward,” she writes. “We have to put these fights aside and declare a pandemic amnesty.”
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