With Omicron Variant Infections Rising, Should You Change Your Holiday Plans? Here's What Experts Say
'Tis the season to be jolly—but the COVID-19 Omicron variant is doing its best to dampen our festive spirits and making us rethink how to safely celebrate the holidays.
The US government classified Omicron (B.1.1.529) as a Variant of Concern (VOC) on November 30, two weeks after it was first detected in Botswana and South Africa. The first confirmed US case of Omicron was identified on December 1, and as of December 14 it has been reported in 77 countries.
It's also spreading faster than any previous COVID-19 variant, according to the World Health Organization (WHO). This feature of Omicron is causing particular concern right now, when most people want to gather with their loved ones for the holiday season.
"From what we know so far, Omicron appears extremely transmissible, including in individuals who have had COVID-19 or those who have been vaccinated," Scott Weisenberg, MD, infectious disease specialist at NYU Langone Health in New York City, tells Health. "To avoid spreading the virus to vulnerable individuals, people should consider trying to lower the risk of activities as they plan holiday gatherings."
In the absence of official guidance from the Centers for Disease Control and Prevention (CDC) on cancelling or modifying holiday plans due to Omicron, here's what experts advise about enjoying holiday get-togethers as the virus continues to spread.
Should you get tested before a holiday gathering?
It's definitely a wise move. "Testing provides an additional layer of protection beyond vaccination to ensure that asymptomatic spread of COVID-19 does not result in outbreaks," Supriya Narasimhan, MD, chief of infectious diseases at Santa Clara Valley Medical Center in San Jose, California, tells Health.
Testing is particularly important if you're going to be meeting people outside of your usual bubble, Dr. Narasimhan explains, especially those who might have traveled from another location, either domestically or internationally. "We recommend that people evaluate the risk of getting COVID-19 based on the behavior of all the persons coming together at the gathering," she says.
And if you don't know for sure how seriously the people you plan to see have taken COVID protocols (like wearing face coverings and practicing physical distancing), err on the side of caution and encourage everybody to get tested before you meet.
Charles Bailey, MD, medical director for infection prevention at Providence Mission and Providence St. Joseph Hospitals in Orange County, California, agrees that testing may offer peace of mind. But he stresses the importance of understanding that a negative test result doesn't guarantee absence of infective COVID-19.
"The result could change from negative to positive a day after the test was performed," Dr. Bailey tells Health. Also, a positive result in an asymptomatic person might be a false positive.
That doesn't mean it's a waste of time to test—far from it. Yet testing should be done alongside other protective measures (more on those later).
Is an at-home test sufficient?
The most accurate type of COVID-19 test is a polymerase chain reaction (PCR) test, which isn't available for home use.
However, rapid antigen tests, such as the at-home COVID-19 tests authorized by the Food and Drug Administration (FDA), are recommended by the CDC for people who are otherwise at low risk for infection.
Dr. Narasimhan says the best strategy includes multiple tests. "We recommend testing prior to getting together; this could be a PCR test carried out within 72 hours before gathering or an antigen test on the day of the gathering," she says.
Testing is also recommended after a gathering. "The California Department of Public Health recommends testing as soon as you get home from travel or from visiting friends and then again three to five days after the event," Dr. Narasimhan says.
If you plan to get one test after gathering with friends and family, then testing three to five days after the event is the highest yield, she adds. And should you develop symptoms consistent with COVID-19 in the two weeks following travel or get-togethers, get tested without delay.
What about vaccination?
The experts agree that vaccination is the first line of defense against Omicron (and as Dr. Narasimhan points out, the bigger issue in the United States remains the high transmission of the Delta variant of COVID-19, which is currently causing high numbers of cases in the Midwest).
"First and foremost, I would recommend that everyone getting together over the holidays be vaccinated, and also be boosted if eligible," she says. "We now have good scientific evidence that immunity to the initial vaccination series wanes in about six to nine months and boosters restore that immunity against both the Delta and Omicron variants."
If you know there will be unvaccinated people at the gathering (and you can't persuade them to get their shots), it's up to you to decide if you should still attend or give it a miss. Remember, every unvaccinated person is a risk to everybody else. "Somebody who hasn't been able to receive the COVID-19 vaccine, with or without a booster (or has chosen not to get it), might be better off not attending," says Dr. Bailey. "If they attend, they should wear a mask and physically distance themselves from any unmasked attendees."
How to have the safest gathering
If you're attending a large gathering with more than one family unit, Dr. Bailey recommends physical distancing between different family units (but not within your own family unit) and to wear masks whenever interacting with members of another unit.
"Families should assess the risk of the individual members in planning Christmas and other holiday gatherings," says Dr. Weisenberg. Strategies to minimize transmission risk—which are particularly important if there are older or other vulnerable family members who could get infected—include masking, social distancing, spending time outdoors or at least in optimally ventilated indoor settings, and regular hand-washing.
Don't forget that the coronavirus isn't the only virus doing the rounds right now. "Apart from COVID-19, we are seeing increased transmission of respiratory viruses including influenza, RSV, and rhinovirus, which is different from the past holiday season," says Dr. Narasimhan. "These respiratory viruses also pose a high demand on testing and hospitalization." By masking, physical distancing and following hand hygiene guidelines, you're helping to protect against other respiratory viruses as well as COVID-19.