How to Safely Gather With Family and Friends This Holiday Season

As we enter a second pandemic holiday season, many are comforted by the added protection of vaccines and the widespread availability of reliable testing to combat COVID-19. But the unpredictability of the virus means that we should continue to be vigilant.

Krystina Woods, MD, Hospital Epidemiologist, Medical Director of Infection Prevention, and Deputy Chief Medical Officer at Mount Sinai West, explains why it is safer to gather with family and friends this year and offers advice for how to navigate get-togethers that have a mix of vaccinated and unvaccinated guests.

Is it safe to gather with family this holiday season?

This holiday season is a lot safer compared to last holiday season. We have vaccines, which didn’t become available for most of the public until January 2021, as well as a third dose available for those who are immunocompromised, as well as boosters for the elderly, and those with underlying health conditions or who are at high-risk of contracting COVID-19 due to their occupation. Also adolescents and children, even those as young as five years old, are now eligible for vaccination. The increased availability and eligibility of these vaccines adds an extra layer of protection that we didn’t have last year. You may still become infected, but the vaccines increase the likelihood that your symptoms will be mild and there is a lower chance of serious illness and hospitalization.

We also know more about the virus in general, how to treat it, and what we can do to mitigate its spread. Having learned all this definitely puts us in a better place.

There will be a mix of vaccinated and unvaccinated at my holiday gathering. What precautions should I take to keep myself and my family safe?

To the extent that you can, the best thing you can do for your unvaccinated family members and friends is to try to get them to understand how important the vaccine is and to be an advocate for vaccination. The best gift you can give your loved ones is to make sure that they are protected coming into the holidays.

However, that process takes three to five weeks, depending on which vaccine is used, and it is certainly not going to help you in the moment that someone is walking through the door into your Thanksgiving dinner. If you’re inviting somebody into your home, you have to decide the appropriate level risk to yourself and your family, and whether or not you’re willing to assume the increased risk that comes with having someone who is unvaccinated come into your home.

In a post on how to safely date during a pandemic, Mount Sinai pulmonologist Lina Miyakawa, MD, advised asking potential partners the following risk profile questions. They provide a great start in assessing anyone who enters your home for a holiday get-together.

The other tangible precaution you can make is to take the festivities outdoors. We have seen that gathering outdoors presents a significantly lower transmission risk than gathering indoors. Unfortunately, this is not always easy in the New York area especially as the weather gets colder, but it would be helpful. Other options include opening up windows to improve ventilation. There are also some filtration units that can be purchased for homes that help facilitate improved air quality indoors. And then, distancing and asking the unvaccinated individual to wear a mask will also help. What you’re looking to do is layer interventions to decrease the risk.

Should an unvaccinated family member get tested for COVID-19 prior to gathering with family and what about a vaccinated family member?

That’s a difficult question to answer. But, I think if I were in a situation where I was going to have a gathering inside my home and I had an unvaccinated adult coming, I would ask them to produce a negative test. I would not mandate that unvaccinated children be tested, but I would strongly encourage it. We know children can spread COVID to adults. For vaccinated family members, testing isn’t essential. But if you’re having someone older or immunocompromised at your holiday dinner, you may want to ask a vaccinated person to get tested, if they work in a high risk setting. For example, if they work in a hospital, grocery store, or some other essential work that interacts with multiple members of the public.

Often times, we can have a false sense of security around negative test results, so I would caution that I wouldn’t necessarily assume a person who tested negative can’t have coronavirus.

It is important to remember that there is an incubation period of two-14 days with this virus. If, for example, your guest receives a negative test on Tuesday, this result does not tell you what their status will be on Wednesday or Thursday. So, if they attend Thanksgiving dinner and start experiencing COVID-19 symptoms on Friday, everyone who they encountered will likely have been exposed to the virus.

Despite this, it would be good to know that at least when that person is entering your home, they are negative. And if they were to be positive, then they would not come. So there is some benefit in testing.

Is masking and distancing necessary while gathering with family?

I encourage anyone who has not been vaccinated to mask. We know that if an unvaccinated person were to be positive, the mask will help to contain some of their virus by physically containing some droplets.

Also, as far as distancing and masking goes, you have to consider the venue and the mix of vaccinated and unvaccinated individuals. If you’re outdoors, the necessity to mask is a lot less—even if you have some unvaccinated guests. If you are indoors, and everyone has been vaccinated and feels well, I don’t feel strongly that you must be masked in that situation.

In short, to make a decision about whether or not you need to distance and mask, think about where the gathering is taking place, the ventilation and air filtration within the space, the risk profile of your guests, and the mix of vaccinated and unvaccinated guests.

How can families maintain safety in the days following a get-together?

I think it’s important to monitor yourself. Not just in the 14-day period following the gathering, but on a daily basis. If you begin to feel unwell, it’s important to stay home and get tested. Because you want to make sure that if you are not feeling well, and if you do end up testing positive, that you haven’t gone on exposing more people than was necessary.

So, just as a general rule of thumb, I think it’s a good thing to check in with how you are feeling. You don’t need to quarantine yourself after gathering with family, but be mindful of how you’re feeling in the days following.

Also, in addition to COVID-19, flu and several other respiratory viruses are starting to circulate. That is only going to ramp up throughout the winter and the holiday season. Many of these illnesses have overlapping symptoms. You should not assume that your sniffles are just a cold, it could be something more. Don’t be overly anxious about it, but if you’re feeling out of the ordinary, consider if you are really well enough to go to work, school, or to socialize.

Is there anything else that people should consider as they gather with family this holiday season?

It is important to stress that vaccines are safe and available for a wide range of the general public, including children as young as five. Everyone who is eligible should be vaccinated. Getting vaccinated will give everyone a level of comfort when they’re visiting family.

There are also a lot of questions around boosters. For people who fall into the categories that the U.S. Centers for Disease Control and Prevention has outlined as who should get boosters, they really should consider getting one coming into the winter season. This is not just to protect themselves as they mix with their family members, but because other viruses are floating around which could adversely affect them. We want to make sure everyone is as healthy as possible.