It's time to start masking up indoors again, even if you're vaccinated. At Friday's news briefing, the director of the Centers for Disease Control and Prevention, Dr. 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 over the holidays with people who are vulnerable. Scientists know that vaccines aren't always as protective among older people and people who are immunocompromised.
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 Diseases 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 an N95, double-masking with a surgical mask topped by a cloth mask will also boost your protection, notes Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco. You just really need to get a snug fit, whatever you wear.
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," Dr. Ashish Jha, dean of the Brown University School of Public Health, told NPR's All Things Considered on Friday.
In fact, Jha said, his school canceled its 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 Oslo, one person infected with omicron passed the virus on to more than 80 people, making the attack rate at the party about 74%. Nearly 90% of the people who attended had received two doses of an 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 all present have 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 or 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 this month.
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 that'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 older adults, people who are immunocompromised and people with serious medical conditions that put them at higher risk of COVID-19 to wear masks when gathering.
Rapid antigen tests aren't cheap. Even the most inexpensive ones will cost you around $10 to $12 per test — if you can find one. The Biden administration this month 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 people who are 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 the Emory TravelWell Center and an associate professor of infectious diseases at Emory University's 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 age 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 country, 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.
