Don't let omicron crash your holiday gathering. Here's how to keep your family safe

Updated Dec.18, 2021 at 3:05 a.m.

Maria Godoy, Michaeleen Doucleff, Carmel Wroth - NPR

Here we go again.

Just in time for the holidays, federal officials announced that omicron is spreading quickly in the U.S.

It could be the dominant variant in many regions by early January, according to the Centers for Disease Control and Prevention. And it may already be a big presence in many places. For instance, it's already causing more than 13% of cases in the New York and New Jersey area, the CDC estimated on Wednesday. And Houston Methodist Hospital in Texas, which does its own genomic sequencing, said Friday that 45% of its cases are now caused by omicron.

Scientists are still trying to learn more about omicron's severity, but they already are certain of two things: it's extremely transmissible and it's causing many more breakthrough infections than the delta variant.

The vaccines' ability to stop infections after two doses has dropped to about 30% against omicron, scientists in South Africa have found. And in the U.K., health officials say the risk of a household member spreading the virus to another member is three times higher than it was with the delta variant.

Health officials are urging Americans to step up COVID safety measures now.

The good news is, you don't have to hibernate like it's 2020. We're in a much different place than we were last winter. Even if they can't stop all infections, scientists have found that vaccines still offer good protection against severe disease. And if you get a booster, it will likely help restore some protection against infection.

That said, if this pandemic has taught us anything, it's that when you don't know what you're dealing with, "we should invoke the precautionary principle," says Dr. Abraar Karan, an infectious disease physician at Stanford University.

In other words, don't panic, but do take steps to reduce your risk.

We spoke to several infectious disease experts for advice. Remember: things are changing quickly, so stay alert for new public health guidance. But here's what to do right now.

Get a booster asap

Don't delay in getting your booster, especially if you have never been infected with the coronavirus or have increased risk for severe disease. Omicron has a huge ability to evade antibodies generated by the vaccines, many studies have found. Two shots will not offer much protection from infection with omicron, especially if you received the shots more than three months ago.

A booster will reduce your risk of catching omicron and offer enhanced protection against severe disease. Researchers in South Africa found that two doses of the Pfizer vaccine still offer about 70% protection against severe disease, but this protection likely drops for older people.

Boosters don't just increase your antibodies. A recent preprint study showed that getting a third dose of the mRNA vaccines could "generate a much broader immune response," says Dr. Kavita Patel, a nonresident fellow at the Brookings Institution and a primary care physician. This will give better coverage against omicron, she says.

But the booster takes several days to start to protect you, so go right away if you're hoping to get enhanced protection in time for Christmas.

Mask up indoors in public places – and upgrade your mask

It's time to start masking up indoors again, even if you're vaccinated. At Friday's press briefing, CDC director Rochelle Walensky urged Americans: "There is action you can take to protect yourself and your family: wear a mask in public indoor settings."

This is especially crucial if you are at higher risk of severe disease because of your age or underlying health conditions — or if you are going to be spending time with people who are vulnerable over the holidays. Scientists know that vaccines aren't always as protective among older people and the immunocompromised.

That advice would hold true even without the omicron variant, notes Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, "because we still have [delta] cases circulating in this country."

While you don't generally need to wear masks outdoors, it makes sense to if you're in a crowd and you don't know the vaccination status of the people around you, said Dr. Julie Vaishampayan, chair of the public health committee of the Infectious Disease Society of America, during a media briefing in early December.

Many experts say it's also time to start to use an N95 or KN95 respirator in crowded indoor public spaces. Three-ply cloth masks or surgical masks do a good job at preventing you from spreading infectious particles and offer the wearer some protection as well — if they fit snugly — but well-fitted respirators offer more complete protection.

If you can't find a N95, double masking with a surgical mask topped by a cloth mask will also boost your protection, notes Gandhi. You just really need to get a snug fit, whatever you wear.

Downsize or cancel the holiday party

If you're planning to host or attend a large indoor holiday party, consider canceling. "Avoid some really risky things like large indoor gatherings where people are eating and drinking," Ashish Jha, dean of the Brown University School of Public Health, told NPR's All Things Considered Friday. In fact, Jha said, his school cancelled their planned 200-person holiday party.

This is probably wise given research on omicron from Norway, where the variant looks to be explosive in large, indoor gatherings. At a large Christmas party in Olso, one person infected with omicron passed the virus onto more than 80 other people, making the attack rate at the party about 74%. Nearly 90% of the people who attended had received two doses of the mRNA vaccine, the study found.

Given how close Christmas is, it might be best to skip parties to avoid picking up omicron right before seeing your family.

"If we want to spend the holidays with our families, it's a good idea to limit our contacts in the next couple of weeks," tweeted biologist Lucky Tran, who helps direct the science advocacy group March for Science. "It's frustrating that there's almost zero messaging about this from the top, but attending crowded indoor holiday parties is a really bad idea right now," Tran added.

If you don't want to cancel, consider moving the party outdoors, or keeping it really small. Remember, risk increases the more people gather together. And make sure everyone present has gotten a COVID-19 vaccine and booster shot if they're eligible, says Karan.

As a guest, if you're at higher risk because of your health and age (or live with someone who is), it may be best to skip the party, says Karan. "If you have a high-risk person at home, this is probably not the time to have a large gathering because vaccines here don't completely stop transmission, they just reduce the chance it can happen," he says.

If you're determined to go, wear your best mask and keep it on the whole time.

Use testing to shore up safety at family gatherings

Safety is important, but so is gathering with loved ones at this time of year, and there are steps you can take to lower the risks for everyone. "What we need to do is add more layers of protection," said Vaishampayan.

If you have access to rapid antigen tests, have your family members take one, especially if they're traveling from other parts of the country. "That's a great way to prevent somebody who is infected from coming in and infecting somebody else," Dr. Carlos Del Rio, an infectious disease specialist at Emory University, told reporters last week.

As Karan notes, "testing is really a snapshot in time," so make sure guests test the day of the actual gathering if at all possible. That's because if a person was just exposed and the virus is still incubating, a person can test negative one day and positive the next.

Ideally you'd want to test daily after flying for the first five days or so, he says, but he recognizes it's not always practical, so wearing a really good mask during travel is key. "Any travel could result in exposure— which is why wearing a high filtration mask in public is so critical," says Karan.

Since testing isn't a perfect strategy, Karan says, it's probably best for elderly, immunocompromised or people with serious medical conditions that put them at higher risk of COVID to wear masks when gathering.

Rapid antigen tests aren't cheap. Even the most inexpensive one will cost you around $12 per test — if you can find one. The Biden administration last week announced plans to address that: People with private health insurance will now be able to get reimbursed for the cost of at-home tests, and health clinics will offer free tests to the uninsured.

In the meantime, if you have to ration, Gandhi suggests prioritizing testing anyone who isn't vaccinated or is vaccinated but showing symptoms.

Take extra precautions when you travel

You don't necessarily need to cancel your holiday plans, but be very thoughtful about them, says Dr. Henry Wu, director of Emory TravelWell Center and an associate professor of infectious diseases at Emory University School of Medicine. "Anyone who's thinking of traveling should pause and consider both your own risk, as well as certain other practical issues about your destination," he says.

Though it's not required, it's a good idea for domestic travelers to test before flying and after arrival — especially if you are visiting someone in a high-risk group.

If you're unvaccinated, over the age of 65 or have medical conditions that put you at higher risk of severe disease with COVID-19, you should seriously reconsider if now is a good time to travel, Wu says.

And of course, if you do fly or take public transport to your destination, wear a high-quality, snug-fitting mask like an N95 or KN95.

For international travel, the U.S. is now requiring all travelers entering the U.S., including Americans returning home, to be tested for the coronavirus no more than one day before departure. If you're in another country, you'll have to make sure you know where to get a test that qualifies within that time frame, which could be a logistical headache.

And remember, the situation on the ground is changing, so keep a watch on the CDC's travel notices. "You certainly want to avoid traveling to countries that are in the midst of a surge and potentially have overwhelmed health systems. You certainly don't want to risk needing to go to an overcrowded hospital if you have your own health problems, COVID or not," Wu says.

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