Celebrate The Holidays Safely This Pandemic : Short Wave Millions of Americans are planning to travel this week and gather inside for Thanksgiving — many in groups of 10 or more. At the same time, COVID-19 cases are rebounding. NPR correspondent Allison Aubrey's been talking to experts to find out how to gather in-person as safely as possible and minimize a new surge.

Read the CDC's tips on gathering for the holidays: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html

Celebrate The Holidays Safely This Pandemic

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EMILY KWONG, HOST:

You're listening to SHORT WAVE...

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KWONG: ...From NPR.

Hey, SHORT WAVErs. It's Emily Kwong here with correspondent Allison Aubrey. Hey, Allison. What's up?

ALLISON AUBREY, BYLINE: Hi, Emily. Great to be here.

KWONG: Yeah, so Thanksgiving's almost here. COVID-19 is still a danger. But things have changed. And you've been reporting on how we can gather safely for the holidays this year.

AUBREY: Yeah. People are going to get together in the next few weeks. I mean, a recent survey found about half of Americans say they plan to gather with a group of 10 or more. So the celebrations are happening.

KWONG: Yeah. The Kwongs are not one of these people. We were going to have a big Thanksgiving, and then my mom, pretty wisely, called it off. Obviously, I think it's because of what's happening with cases now, but also memories of last year when cases surged around the holidays. So...

AUBREY: Right.

KWONG: Should we be as worried about COVID-19 spreading like that again?

AUBREY: I completely understand how your mom is feeling. I think a lot of people share her concern. But remember, a year ago, vaccines had not been approved. We were told by the CDC not to gather at all, not to travel because things were bad and quickly becoming worse. I mean, deaths soared to a few thousand a day by early December of last year. This year, 80% of people 12 and up are now vaccinated with at least one shot. But cases are rebounding right now to nearly about 95,000 new cases a day, so we still need to keep all of the COVID risk reduction strategies in mind.

KWONG: Yeah. I think part of our thinking as a family is, you know, even if people are fully vaccinated, we got to take care of our most vulnerable family members.

AUBREY: That makes sense. I mean, the risk of serious illness does increase with age, no doubt.

KWONG: Yeah.

AUBREY: I mean, the data shows it's really people over 80 and immunocompromised people, people with serious medical conditions who are at highest risk of severe COVID. And I'd say two years into this pandemic, nearly, we've learned a lot about how to reduce the risks of catching and spreading the virus - I mean, the simple things, Emily, like masking and hand-washing. So we have to keep those things in mind to try to minimize a new surge.

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KWONG: Today on the show, things to keep in mind about how to keep your family safe as you gather for the holidays this year. I'm Emily Kwong, and you are listening to SHORT WAVE, the daily science podcast from NPR.

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KWONG: OK, Allison, when extended families get together for the holidays, it obviously includes our elders.

AUBREY: Yes.

KWONG: Older folks.

AUBREY: Absolutely.

KWONG: And we know that if someone is 80 and over, they are at a greater risk for COVID, even if they're vaccinated. So what can we do to keep them safe?

AUBREY: You know, the simplest way to protect them is to have everyone at your gathering vaccinated and boosted with a booster shot if they're eligible.

KWONG: Yeah.

AUBREY: If you're not infected, you can't pass it on to a vulnerable person, right?

KWONG: You tell no lies.

AUBREY: Yes, the vaccines offer such strong protection against hospitalization and death, but breakthrough infections do happen. Often, breakthrough cases are very mild, especially in younger people. But older people and people with compromised immune systems are at higher risk of getting a severe illness from a breakthrough case. I mean, CDC data from August showed that fully vaccinated people aged 80 and older were about 13 times more likely to die from COVID. So that's kind of a reality check...

KWONG: Yeah.

AUBREY: ...That, you know, elderly people - they are protected relative to someone who's not been vaccinated at all, but they're still at risk. That's why the CDC is recommending booster shots. I actually spoke to Dr. Anthony Fauci. He made the case for getting one.

ANTHONY FAUCI: You boost now, within days, you start to increase the protection. You don't get the peak of protection for two or more weeks. So my recommendation would be, as we go into the winter and the holiday season, where there's a lot of gathering indoors, I would recommend if you are eligible for a boost, go get boosted right now.

KWONG: So Fauci says getting a booster can shore up protection over the long term, and that is really going to make a difference this holiday season, for the next three months.

AUBREY: Yeah. I spoke to Judy Guzman-Cottrill. She's a pediatric infectious disease expert at Oregon Health & Science University. She said booster shots gave her more confidence that it's OK for her parents to travel and come see her.

JUDY GUZMAN-COTTRILL: My elderly parents are planning to visit my family, which includes a flight from Illinois to Oregon. And they're both in their 80s, and my mom also has underlying health conditions. So they received their booster vaccines a couple weeks ago. I think that's a really important point when making travel plans for the holidays.

KWONG: Yeah, I completely get that - the confidence and the peace of mind so you don't have to worry about how your party's going to affect your parents, you know?

AUBREY: That's right.

KWONG: And, like, at the other end of the table, the kids are still vulnerable, too. Kids under 5 - they don't have a vaccine yet. The vaccine is available to my cousins ages 5 to 11, but those just got approved, meaning none of them are fully vaccinated. So what kinds of precautions need to be taken for the kids in our families?

AUBREY: Yeah. Well, first of all, for all these newly vaccinated kids who may have one dose, I mean, immunity builds gradually after they get their first shot, but it's not known exactly how much protection one dose of the COVID vaccine provides. That means that, you know, a lot of families find themselves in this kind of annoying state of limbo because their kids aren't fully vaccinated yet. It is not a reason to cancel multigenerational gatherings, but it's a reminder to take precautions. And every family's kind of different, so you really have to think about the risks of the people you're gathering with.

I spoke to Dr. Emily Landon. She's an infectious disease physician at the University of Chicago. She says consider the health and the age of the people you're gathering with.

EMILY LANDON: I think that depends a little bit on the situation of Grandma. If Grandma is a spry, young, 70-year-old woman who has no medical problems and has, you know, two doses of a vaccine plus the booster, you know, I don't think these kids are going to pose a ton of risk.

KWONG: All right, so we got these two populations, grandkids and grandparents. What should you do if your family has both unvaccinated children and an elder who is at greater risk or someone who's immunocompromised?

AUBREY: Sure. Well, I mean, children have less of a chance of getting seriously sick from COVID, even if they're not fully vaccinated.

KWONG: True.

AUBREY: So what you really need to think about is the possibility of them passing the virus on to someone who is at risk. So you want to limit exposure as much as possible in the days before the gathering by, for instance, staying masked in crowded indoor places and during travel. All of that's a good idea.

Dr. Emily Landon says she would not recommend keeping kids out of school to avoid exposure unless there are some extra risks associated with your kids' schools - an outbreak of cases or a lack of masking. But there are a lot of things you can do to kind of layer on protection as needed.

LANDON: Additional layers might mean they should maybe wear a mask around Grandma. Maybe you should have as much of the gathering outside as possible. Maybe you choose to not sleep over at Grandma's house, but just come to Grandma's house during the day for the big event.

AUBREY: And then consider driving home or staying in a hotel or staying with a friend just to kind of limit the exposure.

KWONG: OK. So if people are traveling, what else should they think about beyond where to stay?

AUBREY: Well, remember, the TSA's face mask requirement remains in effect through January 18 of next year, so masking is mandatory in airports, aboard commercial airline flights and on commuter bus and rail systems.

KWONG: Yes, I have taken a few flights. I have been rocking the mask and the mascne that results. But honestly, it's completely worth it to be able to see my family. What about, like, testing as you travel? That was a big thing last year.

AUBREY: Yeah. I mean, not a bad idea at all to ask your guests to take a COVID test before a large gathering. It just kind of gives peace of mind.

KWONG: Yeah.

AUBREY: I mean, a year ago, it was really hard to get real-time information from COVID tests due to delays in test results, a lack of rapid test options. Now there are plenty of over-the-counter rapid antigen tests, such as the Abbott BinaxNOW test or the OraSure InteliSwab test. They're available online and in pharmacies. And Judy Guzman-Cottrill says, you know, these rapid antigen tests, they are an added layer of protection, but they're not perfect.

GUZMAN-COTTRILL: People must remember that the antigen tests are a quick snapshot. So a person could be negative on Monday but then positive a few days later. So I usually recommend, if people are going to be using a home antigen test, to use it as close to the event that you're gathering with others as possible.

AUBREY: So you might want to consider taking the test the morning of the gathering. Or if you're traveling, she said some families take a test on the day they travel and then again a day or so later when they arrive, depending on the risks of the people they're joining with.

KWONG: OK, good to know. Good to know. Going back to booster shots, when should someone time their booster shot?

AUBREY: You know, the FDA has authorized boosters for people 18 and up, and federal health agencies recommend boosters very strongly for everyone 50 and up. The timing is six months after their last shot. The agency's decision was really based on emerging evidence that immunity can diminish over time, and evidence shows that a booster dose can boost protection. White House medical adviser Dr. Anthony Fauci pointed to a new analysis from the U.K. It shows a significant increase in protection against symptomatic infections from COVID from a booster shot. He says in people over 50, protection had fallen down to about 63% but boosted back up to about 94% after the booster.

KWONG: All of this is making me want to sign up for my booster now. So thank you, Allison Aubrey. There's a lot to calculate with COVID safety during the holidays - beyond that, hotel rooms and masking and testing and travel. But what about family members who are unvaccinated? What do you do with those folks?

AUBREY: I think you have to really give some thought about how to or whether to include unvaccinated family members who are eligible for a vaccine but have decided not to get it. I mean, how your family gathers...

KWONG: Yeah.

AUBREY: ...Is a matter of personal discretion. But experts say at this point in the pandemic, it is pretty clear that a fully vaccinated group is the safest scenario.

KWONG: Yeah. This is the hardest part of this whole thing for me because we want everyone to be there. But if you have someone who is immunocompromised or elderly, it's undoubtedly a risk. And asking everyone to be vaccinated at your gathering could lead to, like, hurt feelings or conflict, and we don't want any more of that around the holidays, you know?

AUBREY: True. That's right. You don't want to add that...

KWONG: No.

AUBREY: ...To politics, right? You know, I think an alternative option really is to ask the unvaccinated guests to get tested.

KWONG: Sure.

AUBREY: I mean, as we just said, the rapid antigen tests are a good option. They're not 100%, but they can give some peace of mind. Ask the guest to do it the day of. Offer to buy the BinaxNOW test. Have it there and have the person do it when they arrive. In addition, Emily Landon recommends asking unvaccinated guests to take extra precautions in the week leading up to the event, including wearing masks in public places and limiting their exposure to risks. I mean, I think overall, we got to remember we have a lot of tools in the toolkit now, right? We have tests. We have vaccines. We have boosters. We have masks.

KWONG: Right.

AUBREY: So think about how you can use all of these tools to keep you and your family safe if you are getting together for the holidays.

KWONG: Allison, thank you so much for bringing this to us. You know, it's not, like, fun to talk about COVID public health measures. And yet I know that what we do right now, this week, next week, heading into the holidays is going to decide the size of any surge this winter. And that is going to make a big difference on the outlook of the pandemic overall in this country.

AUBREY: That's a great point. Great to be here, Emily.

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KWONG: This episode was produced by Rebecca Ramirez, edited by Sara Sarasohn and fact-checked by Margaret Cirino. I'm Emily Kwong.

AUBREY: I'm Allison Aubrey.

KWONG: Thanks for listening to SHORT WAVE, the daily science podcast from NPR.

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