How to safely make it through the holiday season in the Covid-19 pandemic

CNN Medical Analyst Dr. Leana Wen is the cook in the family, and her husband is the baker, so they’re already trying out recipes for rib-eye roast, green bean casserole and gingerbread cupcakes for their holiday celebrations.

Their 3-year-old is painting ornaments and will help his parents to decorate the family Christmas tree. He’s also designing a Christmas stocking for himself and for his 8-month-old baby sister.

They’re already doing virtual game nights with her sister who lives in Seattle (the current favorite is Catan). On Christmas Eve, they’ll continue the family tradition of Christmas carols, with Wen playing the piano and the two families singing together via Zoom, followed by remote religious services on Christmas Day.

What the family of four won’t do is gather together with relatives outside of their household this year — not indoors, not yet. In light of all the good news about vaccine development, CNN asked Dr. Wen, an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health, to explain why she’s still being so safe.

CNN: We have a vaccine — isn’t that good news, just in time for Christmas?

Dr. Leana Wen: That is good news, but the vast majority of Americans don’t have access to the vaccine yet. Coronavirus infections are surging out of control, all over the country. The last million new infections were added in just five days. Already, hospitals are overwhelmed, and deaths are on the rise also. We are going to see the impact of Thanksgiving travel, and the number of infections and hospitalizations will continue to climb. Dr. Robert Redfield, the director of the US Centers for Disease Control and Prevention, is warning that the next three months will be the most difficult in public health history.

Hospitals, which are the last line of defense, are on the brink of collapse. If that happens, it won’t just compromise care for coronavirus patients. It will also hurt people who need help for heart attacks, strokes, cancer, asthma and other illnesses.

There is just too much virus, and we all have to hunker down to help “flatten the curve” again. That means a collective sacrifice, with each person doing their part. I know it’s really hard with Christmas and other important holidays coming up, but this is the time for us to commit to giving up seeing one another, in person and indoors. This individual sacrifice helps to protect our health care system — and protects ourselves and those we love — to get us through this winter.

CNN: Does that mean we can’t get together for Christmas?

Wen: I would strongly advise against getting together indoors with anyone outside your household. Mixing households is very high risk, especially given how much virus is in our communities. In many parts of the country, there is so much infection that if you have a gathering of 10 people, there is a nearly one in four chance that someone will have coronavirus. Up to 60% of the spread is by people who do not have symptoms.

I am certain that none of us would want to be part of a holiday gathering that ends up inadvertently sickening our family members or friends.

CNN: Why are indoor family gatherings considered high risk?

Wen: It’s fine to gather with the people you live with. But when you expand to other households, you increase the risk substantially, because if even one person engages in higher-risk activities, that risk is passed to you.

It’s also a matter of what people tend to do at indoor holiday gatherings. Usually, you are gathered closely together with extended family and close friends. You may hug or kiss, and sit closely together. When there’s food and drink served, people are not wearing masks. It may be cold, and windows and doors are closed, so there’s poor ventilation. People are gathered for long periods of time over dinner, which further increases risk. Altogether, these are some of the highest-risk settings for transmitting coronavirus.

CNN: What if we really want to do see each other over the holidays?

Wen: You can safely see one another outdoors, with households spaced at least 6 feet apart. This is challenging with cold weather, but there are some possible workarounds with warm blankets, firepits and short gatherings that can easily be rescheduled if it rains or snows.

For those who really want to see one another indoors, there is a safe way to do it: Everyone can quarantine for 14 days. (Ten days is also possible, though there is higher risk than 14 days, and it’s also possible to quarantine for seven days followed by a test.) This is hard for many people, but it’s one way to safely see one another.

CNN: What precautions do we need to take for seeing one another outdoors?

Wen: The most important precaution is to make sure that people from different households stay at least 6 feet apart at all times. That includes children. Make sure they are supervised, and if they are playing together, to wear masks and try their best to stay physically distanced. If you’re serving food, don’t do it buffet-style, but instead plate individually and have guests pick up their food one at a time. Same for drinks. Make sure people are not gathered together in one place, but take their drinks back to their seats that are spaced apart.

CNN: Can we make dining inside safe at all?

Wen: For people from different households, who did not quarantine, dining inside is not safe. There are methods that reduce risk — for example, keeping doors and windows open, with families seated spaced apart. But when people are not wearing masks, and with indoor rather than outdoor air circulation, there is risk. Also, there is the temptation to then engage in other higher-risk activities, like watching a movie together indoors. For all these reasons, I would not recommend dining inside with those not in your household this winter.

CNN: When can we expect to return to normal?

Wen: It’s truly a marvel of science that we have not one but two vaccines that look to be safe and extremely effective. There may be even more vaccines coming that show great promise, too. It will take time for everyone to receive a coronavirus vaccine, but we may be able to get most Americans vaccinated by late spring or early summer. We may well be able to see one another in person by the summer. We can plan for this, and also to have a really wonderful celebrations next December.

CNN: What about family members who don’t want to wait?

Wen: Approach them with compassion and try to understand their reasons. How you address someone who doesn’t believe that coronavirus is real will be very different from if their reason is that they just miss you too much. Come up with alternate ways to celebrate Christmas. Have virtual game nights, Zoom Christmas tree decorating and video cooking contests. Make plans to see one another this summer.

If a family member or close friend still cannot be convinced and will be hosting a gathering despite your best efforts, you should still say no for you and your family. This is about your health and the health of those in your household.

It is really hard to give up seeing one another this winter, but doing so allows us to celebrate the next Christmas — and many more ahead. The next few months will be very challenging, but we can get through it, together.