With a recent jump in new coronavirus infections and the emergence of the highly contagious omicron variant, Americans are weighing whether it’s safe to gather for the holidays — again.
Though vaccinations have helped curb the spread of the virus and encouraged the return of holiday traditions this year, an uneasy sense of déjà vu is hanging over the office party punch bowl.
Thousands of people in Missouri are testing positive for the coronavirus each day, a surge likely driven by the delta variant. The newly identified omicron variant appears to be even more contagious and more likely to cause infections in vaccinated people, raising concerns about the possibility of a post-holiday COVID surge.
St. Louis Public Radio’s Shahla Farzan spoke with Dr. Steven Lawrence, an infectious disease physician at Barnes-Jewish Hospital who also works at Washington University, about ways to reduce the risks this holiday season.
Shahla Farzan: If families and friends are planning to gather for the holidays, what steps can they take to cut down their chances of catching the coronavirus?
Steven Lawrence: There are a number of tried-and-true measures that are very effective at reducing risk for people coming together. First and foremost is the vaccine. If everybody's vaccinated, the risk of anybody getting seriously ill is extremely low, especially if everybody who's eligible has been boosted recently.
The other measure that we know works very well is masking. So having events where people are in close proximity to each other and indoors, [if] they're masked, that also really dramatically reduces the risk of transmission. The next most important thing is if somebody is having symptoms, don't get together. Most of the transmission of COVID and other respiratory viruses occurs when people are symptomatic. Asymptomatic transmission can occur, but more often than not, when people get sick from somebody else, that's when the person who was infected was showing symptoms.
Farzan: You mentioned getting vaccinated, but obviously, there are still a lot of people who haven’t been vaccinated, including some who aren’t eligible yet, like kids under 5. How do we navigate that?
Lawrence: In a group that is completely fully vaccinated, there’s certainly a little more reassurance that the likelihood of anybody becoming sick is going to be much lower than a group that's mixed with some who are vaccinated and some who aren't.
Vaccination status is one thing to consider, however, even [for] those who are vaccinated, we do need to at least consider taking additional measures to reduce the risk. Some of those measures then that take into account are the space that you're going to be gathering in: Is there good ventilation that is achievable in that space and the number of people who are in that space? It’s just a mathematical equation; the more people who are closer together, the increased risk that if one of them happens to have COVID, that it would pose a risk to the others of potentially getting COVID as well.
At this point in time, the CDC and many others — myself included — have had a shift in the importance of boosters. It has to do partly with omicron, but more immediately, the rapid rise in cases that we’ve seen that’s due to the delta variant. For those two reasons, we’ve identified that boosters do provide significant protection against infection and illness. It’s very, very likely that having the additional protection offered by a booster will significantly reduce the risk of the omicron variant, both to individuals and the public at large.
Farzan: What are your thoughts on rapid, at-home COVID test kits? Is it worth trying to take a test at home before you get together?
Lawrence: The role where at-home testing might be most valuable is in a setting where you are about ready to go visit relatives and it's the morning of or the night before. And one, if you have any symptoms whatsoever, doing an at-home test will have a not perfect, not great, but a reasonable chance of catching COVID if it is indeed COVID that’s causing it. The best test would be the PCR tests that are done in a health care setting; those are going to have the highest accuracy. But oftentimes, there’s a delay in getting the results of those. So the rapid antigen tests where you get immediate results, I would say that would be the minimum that I would do before visiting or hosting other people.
Farzan: Thinking a little about where we’re headed, the omicron variant looks to be more contagious and more likely to cause infection in vaccinated people. Are you worried that we could see another big surge in cases come January?
Lawrence: Historically, we would expect to see even higher bumps after holiday get-togethers and travel, such that we're all bracing for the impact of what's going to happen in January with the cases, especially if you look at the trajectory that we're on right now. We as a region hit our peak of worst-case scenario about a year ago in November and December, where the numbers were so high that we were on the brink in several hospitals in the region of what could be handled before there was no longer an ability to provide effective care to all patients.
With the steep rise that we're seeing and the holidays yet to come and the overall sense of backing off of public health measures that we know work — the timing is terrible for that. I do have some concern that if this trajectory continues, we really could be in a bad place in January. We never know for sure, but the way the trajectory is looking now, it doesn’t look great.
Follow Shahla on Twitter: @shahlafarzan
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