Christmas Trifle

The first vaccines really do feel like the beginning of the end, even if the end is far off. It’s a little bit of light in the dark. A promise that at some point when my kid starts vomiting it will just be vomit, not vomit plus the fear of COVID. But we are not there yet. And winter break — Christmas for some, New Years, general holiday festivities — is looming. So, today, I wanted to revisit (again) the question of seeing family or friends, in the context of these holidays. I’ll pull on earlier posts here, since many of the issues are the same, but add a couple of points to your consideration set. Oh: and just to let you know I hear you on wanting to hear more about vaccine and pregnancy. I’ll write on that Monday. First, Sidebar: A School Resource Most schools are headed towards a winter break, but discussions about January reopen — if, when, how — continue. One of the (many, many) challenges school leaders have cited is how to communicate protocols to their student populations. When do you stay home and for how long? What if a family member is exposed? When does my kid need a test? My hope is that as part of their school reopen push, the Biden administration will help provide consistent messaging on this, including better ways to communicate. But until then, the void will continue to be filled by volunteer efforts. And, today, I feature one by Emily Marsh of Colorbox Industries, who is offering this tool as a visual decision tree for schools to distribute. Basically, this is a flow chart schools could provide to families for what to do if a child is sick or if a family member is. An example of the image produced is below, but the tool is in a Google Slide, which you can download and edit, so schools with varying rules can generate their own. I found this very helpful, and thought maybe some of you would, too. Christmas Safety Back in October, I wrote about Thanksgiving, in this post on Safety Turducken. I’m not going to revisit all those points here. The basic message is that you can increase safety of a family gathering with layers of safety protocols — there are ways to decrease the chance the virus arrives at your gathering, ways to decrease the chance it spreads, and ways to decrease the chance it gets out to the broader community. If you do plan to see family, perhaps this will be helpful to revisit. As we all think this through, both what we are going to do and how we talk to others about it, I wanted to add two additional points. The first is on messaging, and the second is a more direct answer to whether anything has changed since Thanksgiving. Messaging In the lead-up to Thanksgiving the “Do not see others” messaging took on an increasingly loud tone. The message that came out ended up sounding, in some cases, like there was no safe way to do this in any situation and that anyone who did choose to see family or get together in a group should be publicly shamed. (I know this wasn’t the intention of all the messaging, but this is how it often came across). I think such extreme messaging can be counter-productive in that it may make people listen less. I made a version of this point in the New York Times in the lead-up to Thanksgiving, noting that we may want to provide people with intermediate options for safety. There, I emphasized the value of testing. Stepping back, a similar point could be made about any intermediate option. When we tell people there is no safe way to see family, and do not engage with intermediate options, we risk that people take the least safe route. I see some overlap with early parenting rules, with a similar message to one I wrote about in The Atlantic last year. When we tell new parents every rule is equally important, and it’s impossible for them to follow all of them, we risk them making less safe choices. The fact is that there are relatively safe ways to see family over the holiday. I know I will be pilloried by some for saying this, but it is possible to dramatically reduce risks. If everyone can quarantine for 7 days and get a test on both ends and there is no possible exposure on the way to see each other and no exposure on the way home, then that is really quite safe. Can you guarantee safety? No. But you can’t ever guarantee safety, COVID or not. Quarantining for 7 days on either end is a luxury, and one that many people will not be able to afford, and there is an inherent inequality in this, as with most things in COVID-19. But even a shorter quarantine will help. Three days is better than zero days, and a test is better than no test. Wearing masks when inside if possible is safer than not. Seeing people outside is better than seeing them inside. There is no question that from a COVID standpoint, the safest thing is to stay home with your immediate household. But it will not be everyone’s choice, so let’s focus on practical risk reduction steps over shaming. Is this any different than Thanksgiving? Many people didn’t see family for Thanksgiving and are now left contemplating: is this winter break any different? Is there any reason it would be safer to see people? Or less safe? Answering this requires, again, going back to recognizing that there isn’t a pure safe versus unsafe dichotomy but, rather, a continuum. When I wrote about the Safety Turducken, I emphasized thinking about rates in your area as part of the risk. If the rates are higher, the chance that someone comes to your celebration with COVID are higher. COVID rates are different now than a month ago, in some cases higher and in others, lower. In mid-November, for example, North Dakota had the highest case rates in the country and hospitalizations were climbing quickly. Rates are much lower now and hospitalizations are falling. Obviously, this doesn’t mean anything goes, and gatherings over the holidays could increase these rates again. But when you think about risk, the numbers matter. On the flip side, Tennessee (for example) has much higher rates now than in November. A randomly chosen set of guests will be more likely to bring COVID to a gathering. More caution is warranted. The other difference here is that the winter holidays are, for some people, longer. This provides a little more flexibility. Kids are out of school for longer, and a number of districts have delayed return to in-person learning (if they are doing it at all) for a week in January. This all delivers more opportunities to isolate for some period, test, see people and re-isolate. Again, this is a luxury not everyone will be able to afford, but if you can, and if you do choose to see people, it makes the decision a little different from Thanksgiving. Why Can’t Everyone Just Stay Home? I hear what you are saying, people of the Internet. Why can’t everyone just stay in their houses? Why do you need to see people at all? Can’t you wait? Why are you so selfish? It’s absolutely right that our choices have consequences for other people in the pandemic era, and the generalized American attitude of personal freedom is up against overflowing ICUs. There are more ways than usual to act irresponsibly, and more significant consequences. However: we need to be less quick to judge. As salient as it is, COVID-19 is not the only thing going on in people’s lives. There are reasons why people will see their families, reasons you may not be able to see. Helping people understand how they can do this as safely as possible if they choose to is fundamentally not the same as denying the reality of COVID. Recognizing that may lead us to more compassionate, and ultimately more effective, messaging.

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