Publisher Health

Is Omicron really going to ruin Christmas?

Ever since Covid-19 cases began rising sharply, long-awaited plans to see friends and relatives have suddenly been called into question. We want to see one another — but should we?

So far it appears as though Omicron won’t make a dent in holiday travel. AAA estimates that more than 109 million Americans will travel during the Christmas and New Year’s holiday season, a 34 percent increase from 2020.

But Omicron appears to be the most contagious variant yet. Should we worry about visiting older relatives? Is flying considered safe? What about Christmas dinner?

We asked three epidemiologists and a psychologist to help untangle these and other complicated questions, and offer tips on staying safe. Here is their guidance.

Is plane travel OK?

On Friday, Dr. Anthony Fauci, the nation’s top infectious disease expert, said on CNBC that despite Omicron, those who are vaccinated “and hopefully also boosted” should feel “reasonably comfortable” enjoying the holidays at a family member’s home, and that he “would not hesitate” to get on a plane if he had to.

But “the risk is never zero, that’s for sure,” he added.

In the end, the answer depends on your personal tolerance for risk and how important the trip is to you.

Experts say it is crucial to rely on a layered approach to lowering risk, namely: getting vaccinated, getting a booster shot if eligible, wearing a mask, having proper ventilation and using rapid home testing.

Katelyn K. Jetelina, an assistant professor of epidemiology at the University of Texas Health Science Center at Houston, is traveling to California on Sunday with her two young girls, 2 and 14 months. She is prepared to cancel their flight at a moment’s notice if she and her husband start to feel uneasy. So far, however, she isn’t overly concerned about air travel.

“I would consider it a low risk because of filtration systems and ventilation, as well as masks are required — not only that, they’re enforced,” she said.

If people on the plane are taking off their masks for extended periods of time for snacks or meals, that increases the risk of infection for everyone on that plane, she added. So she advised leaving your mask on. “Masks protect the wearer, too,” she said. “Not just the people around them.”

Dr. Jetelina recommends upgrading to an N95 mask, if you haven’t already. For children, she suggests KN95s because N95s don’t come in their sizes.

Many public health experts recommend the KF94 mask, which is made in South Korea, because of its quality, high filtration rate and snug fit.

When asked about masks on Friday, Dr. Fauci said that while the N95 was the best mask at blocking aerosol and droplet particles, they can be relatively uncomfortable to wear. “A regular surgical mask as well as a cloth mask is fine,” he added.

Getting to and from the flight creates additional risk because the trip adds more opportunities for exposure. So instead of taking a car service, Dr. Jetelina has asked her vaccinated relatives to come to the airport and pick her and her family up.

Her family is also aiming to minimize exposure to indoor crowds, especially in places that may have poor ventilation. Either she or her husband will take the children outside while the others wait at baggage claim, for example.

Dr. Michael Mina, a former Harvard epidemiologist who is now the chief science officer for eMed, a company that verifies at-home test results, said he plans to fly to Colorado this month with his wife and 2-month-old daughter.

“This isn’t going to be the last variant, and I think that we have the ability to gather safely if we do it right,” he said.

How can rapid tests help us?

Rapid antigen tests, which can indicate within minutes whether someone is contagious with Covid-19, are one of the best ways to help ensure everyone’s safety this holiday season, the experts said.

The tests remain expensive — a typical two-pack costs $14 to $24 — and sometimes they can be hard to track down in stores. But if you’re fortunate enough to have some on hand, Dr. Mina suggests that everyone test 15 minutes before gathering. It’s important to do the test in a room-temperature setting like a car, he added, because the tests lose some of their efficacy if they are conducted in temperatures below 55 degrees.

Dr. Jetelina and her family will be using the tests right before heading to the airport, once they land and then every other day before their family members gather for Christmas.

If your test is negative, you can feel reassured that you are not infectious at that moment. Because the tests function as a snapshot in time, taking one on the day before a gathering isn’t useful.

If you get a positive rapid test, you should not spend time with other people, said Eleanor Murray, an epidemiologist at the Boston University School of Public Health. But get confirmation with a P.C.R. test because false positives can happen.

What else can we do to stay safe?

Eat outdoors if you can. And if you are attending an indoor gathering, open the windows and consider buying a HEPA air purifier to reduce the amount of airborne virus, Dr. Mina said.

The Centers for Disease Control and Prevention recommends that all eligible people get vaccinated and boosted and avoid crowded indoor spaces before travel, particularly if they will be gathering with people from multiple households.

Those with weakened immune systems may not be fully protected even if they are fully vaccinated and have received an additional dose, the agency said, so they should continue to take all precautions recommended for unvaccinated people.

“The challenge is that everyone has their own risk tolerance level,” Dr. Jetelina said. “Someone that doesn’t want to get infected at all? Then no, they shouldn’t hop on a plane.” But by taking the right precautions, she added, you can reduce your risk.

Dr. Murray is taking a more conservative approach this holiday season.

“Omicron really drives home for me the importance of deciding not to travel this winter,” she said. “So I am staying home.”

For her, the risks of either contracting or spreading Covid right now are too high. Although the vaccines are very effective at preventing severe illness, they are not perfect, she said, and the family members she would be visiting this Christmas have young children who are not yet eligible for vaccination.

She recommended taking stock of your specific situation. For example, do you live in an area with a high proportion of Covid cases? Are you traveling to an area that has a high proportion of cases? Will you be gathering with a large group or a small group? Are you eating inside or outside? It’s also important to take into consideration whether the people you’ll be seeing are vaccinated and boosted; if you’re planning to visit more than one home; and the availability of rapid tests for yourself and your loved ones.

How do you weigh loneliness?

Families should think about the mental health ramifications of staying apart, an important consideration that often gets lost when examining the risks of contracting the virus.

“I think you have to make up a pro and con list, not only about physical safety, but also emotional needs,” said Barbara Greenberg, a clinical psychologist in Fairfield County, Conn. “Will it be harder for you to see your family? Or will the anxiety of not seeing them weigh more heavily?”

In her practice, she added, “person after person are talking about how sad they are about spending the holiday without family again,” she said. “Loneliness and isolation are setting in.”