After spending most of the year confined at home, Bay Area residents now face a holiday season where they may not get to see family and friends as coronavirus cases continue to spike around the country.
With more than 217,000 confirmed deaths and 8 million cases in the U.S., public health officials are urging people to rethink their plans for Thanksgiving and other traditions. Dr. Anthony Fauci, the country’s top infectious disease expert, said social gatherings pose a high risk for COVID-19 spread, and his children would not be coming home this year.
But there are ways to come together safely.
“Coming onto nine months into the pandemic, the mental health toll of isolation needs to start prefiguring into our guidelines,” said Monica Gandhi, a doctor and researcher with UCSF. “I think we need to acknowledge that we need to see each other, especially in California, where we have been doing so well.”
Gov. Gavin Newsom gave the go-ahead for small gatherings with a set of guidelines that allow people from three households to get together for up to two hours, as long as they do it outside, wear masks, and practice physical distancing.
The state does not endorse private gatherings, he said, but is asking that people take precautions before engaging in hig-risk activities such as attending parties, sharing meals, or traveling.
“We just want to be able to provide important ways to reduce your risk, so we make sure you protect yourself, your families and your communities, as we go into what is going to be a hard time with COVID,” said Mark Ghaly, the secretary of California’s Health and Human Services Agency.
Experts say the science remains the same: there is going to be some risk in everything we do. There are ways to mitigate it.
Here are some tips for planning your holiday gatherings.
Gathering safely
Whenever mixing with people who are not members of your immediate household, make sure to follow the pillars of pandemic control.
“Masking, distancing, and ventilation,” said Gandhi.
The risk of infectious transmission is lower outside than inside because virus particles tend to scatter and dilute quickly in the air, said Mark Cullen, founding director of the Stanford Center for Population Health Sciences.
You should also wear face coverings and practice social distancing.
“You don’t get any points for being outdoors when you’re standing within a foot of people,” said George Rutherford, an infectious disease expert at UCSF.
As fall temperatures lure people back into their homes, the risk of transmission could become higher. Within indoor enclosed spaces, the coronavirus can spread through the air on microscopic particles that are released when people cough, sneeze, talk, laugh or sing; and travel further than the established 6-foot physically distancing guidelines set for indoor spaces.
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“As we move inside for the holidays, the chances of aerosol transmission are going to go up,” said Rutherford.
Mitigating risk indoors
California state guidelines specify that small gatherings may only happen outside or in spaces where at least three sides are open to the outdoors, such as canopies, awnings, and other shade structures.
That may work for people who live in single-family homes in the suburbs, but what about the people who live in the Bay Area’s urban centers?
“Open windows establish the same goal,” Gandhi said.
The experts caution that most transmission events take place indoors in poorly ventilated spaces. If you find yourself inside with others, it is critical to have a constant air exchange, whether it means running HEPA filters or leaving doors ajar.
“A good standard is what we’re doing with indoor dining,” she said.
Like restaurants, you should cap the number of guests at private gatherings, especially if people are going to set foot in the home.
More people means more potential exposure. Crowded spaces also make it difficult to practice social distancing, which is crucial in any environment where people are going to remove their masks to eat and drink.
Arrange the seating so that people within a household or pod are spaced at least 6 feet apart from others. Guests should stay put and use the restroom in turns.
In many states, a large number of outbreaks have been traced back to family parties.
“There’s a formula in which the combination of being indoors, at a close distance with other people, and laughing and eating that leads to a really concerning environment,” said Eric Feigl-Ding, a senior fellow with the Federation of American Scientists and epidemiologist at Harvard University.
Testing concerns
Taking a coronavirus test before seeing family and friends could give you peace of mind, but it could also give you a false sense of security.
With COVID-19, there can be a lag time between a person becoming infected and showing a positive test result, said Chaz Langelier, a professor of medicine and infectious disease at UCSF.
Tests only work in coordination with the other standard safety measures.
“All the other precautions remain in place,” said Ben Pinsky, medical director of the clinical virology lab at Stanford School of Medicine. “Even if you test negative, you might develop enough virus to be infectious.”
Gandhi does recommend testing for people who are at higher risk for infection, such as essential workers or people who frequently socialize with others, especially if they plan on visiting any guests who are high-risk, such as those with underlying health conditions or over 60.
While antigen rapid-tests are more convenient, they are less accurate than laboratory tests and often give a false-negative result with a sensitivity of anywhere between 50% and 90%, according to a study published in the journal Science.
PCR tests, which can detect the virus with 98% sensitivity within 24-48 hours, are better. But remember, you may become infected between testing and attending an event with others.
Sharing food
As researchers learn more about SARS-CoV-2, the virus that causes COVID-19, there is less concern about the risk of surface transmission, as the main routes of transmission are inhaling respiratory droplets and aerosols.
You should still take precautions. Avoid sharing utensils, cups and plates. Do not put food and drinks in one place where guests have to congregate. If that is not possible, let each group serve itself one at a time. The risk of exposure increases when people from different households are stationary next to each other for extended periods.
Make sure each pod has disinfectant wipes and hand sanitizer available within reach.
Keep in mind that some people may lower their guard as they grow more comfortable around friends and family members. Alcohol can also make people more lax about sticking with safety protocols.
“We do get used to each other and we do forget there is a pandemic,” Gandhi said. “That is why we have to keep the chairs far apart and have a reminder for people to wear masks when they are not eating.”
Encouraging safety
Communicate expectations — as well as local, state and federal guidelines — ahead of any gatherings. People who are sick, showing symptoms of COVID-19, or may have been exposed to someone who is infected in the previous 14 days should not participate in any in-person festivities with others, according to the Centers for Disease Control and Prevention.
Make sure other guests are taking the same safety precautions as you do before getting together with them, according to Dr. Peter Chin-Hong, an infectious disease specialist at UCSF.
“You have to be able to trust the other family,” he said.
People should avoid traveling to or from places where the prevalence of the virus is high. Interacting with people from outside your local area increases the chance of getting and spreading COVID-19.
Abstain from things that promote close contact, such as hugging, shaking hands, or dancing. A small outbreak with one gathering could affect many people.
In a call to state governors, CDC Director Robert Redfield expressed his concern that holiday gatherings may lead to a surge of new cases.
“What we’re seeing as the increasing threat right now is actually acquisition of infection through small household gatherings,” he said. “Particularly with Thanksgiving coming up, we think it’s really important to stress the vigilance of these continued mitigation steps in the household setting.”
Gandhi said it is important we take precautions seriously so we can get back to normal life.
“The exhaustion and mental health effects of not being around people we love are really difficult,” she said. “We have to understand we are in a position where we may not have conquered it, but we certainly learned a lot. We can start seeing each other and keep ourselves safe.”
Aidin Vaziri is a San Francisco Chronicle staff writer. Email: avaziri@sfchronicle.com
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October 18, 2020 at 06:00PM
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How to plan a safe, small Bay Area holiday gathering during pandemic - San Francisco Chronicle
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