What you can do to make Christmas celebrations safer — advice from Dr. Wen

In this long and difficult year, pandemic fatigue has caught up with so many people who just want to be with their loved ones during the holiday season.

The reality, however, is that even as the vaccine rollout is underway the United States surpassed 18 million reported Covid-19 cases Monday. At least 319,000 people nationwide have lost their lives to the novel coronavirus, according to data compiled by Johns Hopkins University, and this loss of grandparents, mothers, fathers, cousins, children, sisters and brothers will keep escalating as the deadly virus continues to spread from person to person.

CNN Wellness spoke with CNN Medical Analyst Dr. Leana Wen for her guidance about getting together safely with loved ones between now and New Year’s Day, a time families traditionally gather with relatives for multigenerational celebrations. Wen, an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health, also addresses pressing questions about how the vaccine affects our behaviors, and what to make of this new coronavirus variant in the United Kingdom.

CNN Wellness: It’s tradition for so many families to get together over the holidays. Is there a way to do so safely this year?

Dr. Leana Wen: I know it’s been a very hard year. Right now, there is so much coronavirus all around the United States. Our hospitals are at the brink. We keep exceeding daily new infections and deaths. As much as we want to get together this Christmas, it’s really important that we prioritize safety.

There are ways to get together that are safer. Being outdoors substantially reduces risk, for example. You can see loved ones outdoors, with households separated at least 6 feet apart. Bundle up to keep warm, and reschedule if it’s raining or snowing.

If you want to get together indoors, the safest thing to do is for everyone who is gathering to quarantine for 14 days. It’s probably safe to shorten the quarantine to 10 days or to quarantine. The CDC also says that a quarantine for seven days and then a negative test can replace a 10-days quarantine, though a full 14-day quarantine is still the safest method.

It’s too late for this strategy if you were thinking of gathering for Christmas Eve or day, but you could still meet for, say, a New Year’s Eve celebration or New Year’s brunch if you and your loved ones start quarantining Tuesday and are able to get a rapid test the following Tuesday. Many people can’t get rapid tests in time, so outdoors or virtual gathering has to be the way to go.

If the test comes back negative for everyone, you can be with each other. But remember that one negative test is not enough, because you could have gotten infected just before the test and the test might not pick up on the virus yet — that’s why the quarantine period is so important.

CNN: What if people are planning on having visitors stay with them?

Wen: This is not the time to have visitors who are staying in your home. The virus that causes Covid-19 is highly contagious and easily transmissible indoors.

To be safe, any visitor needs to quarantine according to what I described above and then come to see you. I’m less concerned about the travel itself. If someone is driving, there’s minimal risk. If they’re flying, there is slightly higher risk — everyone should make sure to keep masking and be vigilant not just on the plane but at check-in, on trams, while boarding and so forth. Overall I’m more concerned about the activities people were engaging in before the travel. If the potential visitor has seen other people indoors or been to higher risk settings like bars and indoor restaurants, they should not stay with you for the holidays.

CNN: Does it change things for visitors who were just in the United Kingdom?

Wen: The UK variant of the coronavirus appears to be no more deadly, but it does appear to be more transmissible. It doesn’t change my holiday recommendations, because this is still a virus that spreads from person to person. If you don’t gather indoors, and if you keep masking and physical distancing, you will not acquire or transmit the virus.

Studies are ongoing now to make sure that the vaccines already developed will be effective against this new variant. As of now, there is no reason to believe that this variant is so different that the vaccines wouldn’t work just as well. Another reminder that we need to all get the vaccine when it’s our turn.

CNN: What if a host has already received the vaccine? Or if a guest has already gotten the vaccine — can they see each other?

Wen: Right now, the same guidelines apply even if you and/or your visitor already has had the vaccine. That’s because all you’ve had is one dose of the vaccine (unless you were in a clinical trial, in which case you don’t know if you’ve received the vaccine or the placebo). Both the Pfizer and Moderna vaccines require two doses for maximal effectiveness. Also, the vaccine protects you against infectious illness, but we don’t know whether you could still be an asymptomatic carrier and spread the virus to others.

And the vaccines just got rolled out, so someone who got the vaccine will only have had one dose, and also not have had enough time to develop sufficient immunity. So even if two people just received the vaccine, they shouldn’t see one another except outdoors.

CNN: Some people, especially parents, don’t have a choice about visitors. Children are returning home from school and they need a place to stay. What happens if you can’t say no?

Wen: In that case, they should quarantine once they arrive, meaning that they shouldn’t see you indoors and they should minimize their time in shared indoor spaces like restrooms or kitchens. Ideally, they avoid the nonessential spaces like living rooms. If they have to use a shared bathroom, keep the window open and don’t use it immediately after them. They should socialize with you only outdoors until the quarantine period is up. (Again, 14 days is ideal, but they can also do 10 days or seven days and then a test.)

Remember that when people travel, the virus travels. Many colleges have had outbreaks. Adult children who are working and socializing with others, with grandchildren who have been in school or day care, could unknowingly carry coronavirus and transmit it to you when they stay with you.

CNN: Say my relatives are hosting a dinner. It’s really important to them that we go. They say it’ll mainly be outdoors, but I’m worried that they won’t follow safety precautions. What should I do?

Wen: You should clarify with them exactly what their plans are. See what safety measures they have in place, then you can make a decision about whether you should go. For example, it may be safe to go if it’s a large outdoor space and you can easily keep your distance. You could consider going just to say hello but not to have dinner if the plan is for people to dine indoors. If food is going to be served outdoors, make sure that it’s separately plated and there isn’t a buffet where people are gathered around the food and sharing utensils.

CNN: For some, that’s not going to work. What would you say to those with relatives who don’t follow precautions and think the virus concerns are overblown?

Wen: It’s possible that your relatives might still value your helping them to make their gathering safer. If they don’t, consider not seeing them this holiday. If they aren’t willing to reduce risk for this gathering, chances are they are also engaging in high-risk activities in other aspects of their lives, as are some other guests they might have at the gathering.

Some people might feel it’s rude to question the host. These are unique times we’re in. We need to prioritize our own health and that of our loved ones. Even if some relatives may not agree, you still must do what’s best for you. You can respect their wishes and they can respect yours, too.

CNN: Is there truly no way to host safely indoors, with people who haven’t been quarantining?

Wen: This virus spreads inside so easily. There are measures that can reduce the spread, for example, opening all the windows and doors and having different families sit at different tables. But know that there is still going to be substantial risk. People can’t eat with their masks on.

With so much virus around the country, I hope we can get through this winter. Please avoid indoor gatherings with people not in your immediate households. The vaccine is on the way, but we must get through this holiday and keep safe.