One of the key features of the holiday season is the coming together of families. Often, family members live long distances apart for the rest of the year. We know that, in general, viruses that cause respiratory disease are already common in the winter. This year, we have added concerns around COVID. In the United States, we have the double anxiety of the Omicron variant as well as the established Delta variant that are circulating widely. To reduce the risk from these variants, we should follow simple guidance. The evidence suggests that the most effective approach to reduce the risk of serious harm from COVID is to follow 5 simple rules:

  1. For indoor gatherings, everyone should be fully vaccinated and have had their booster shot.
  2. Anyone who has had COVID should also have received at least one dose of a vaccine as well.
  3. Ideally, prior to gathering, everyone should have a rapid antigen COVID test(s). These tests are useful because they screen for whether a person is infectious.
  4. Although it would be best if gatherings are outdoors, this may not be realistic. For indoors, opening windows or using air filters make sense.
  5. For masks, both K95 or N95 masks are preferred when masking is possible.

Current evidence suggests that the Omicron variant is more transmissible. In terms of severe illness, the experience so far is that it has caused less severe illness than other known variants. This includes a lower chance of needing hospitalization. However, because it appears to be more easily spread, this does increase the risk for vulnerable people. Moreover, thus far we do not know that the risk of the serious “long COVID” disease is less with this variant.

The availability of new oral medicines, which if taken early can reduce the severity of COVID, is also welcome. Until these medicines become widely available, common sense is the best approach.


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