4. We've already had a bad outbreak in my town. Have we reached herd immunity?
As the pandemic has progressed, you may have heard about getting the U.S. population to a point where enough people have been exposed to the virus — either by infection or vaccine — that it's no longer a threat. This “herd immunity” is a real thing — the U.S. all but eradicated measles because an effective vaccine created herd immunity. Just don't expect this to happen soon with COVID-19.
"Herd immunity requires somewhere in the neighborhood of 60 to 70 percent of the population having immunity,” Ison says. “The epidemiology studies have gone on to tell us that even in the worst areas like New York, it's in the 20 percent range, and in most areas in the 3 to 10 percent range."
A COVID-19 vaccine could change that, but again, we're nowhere near that point. “As we've seen with other viruses, if people don't get the vaccine, we get outbreaks,” he says. “So herd immunity not only takes an effective vaccine, but a willingness to get that vaccine."
5. If I do host a holiday gathering, are there any rules I should put in place for my family?
Here's a good one: Nobody gets to come to dinner unless he or she has had a flu shot. The reasons go far beyond the usual in 2020. Flu and COVID-19 symptoms are similar, so if you become ill with the flu, it could necessitate a trip to the doctor or even the hospital, which puts you at additional risk. And yes, it's possible to get both, either one after the other, or simultaneously, Vermund says. Just imagine getting COVID after your lungs have already been dealing with the flu.
Vermund puts it bluntly: “It is essential for people to get the influenza vaccine. And I mean everybody: children, pregnant women, young adults, middle age, older adults, seniors, everyone."
6. My whole family is in excellent health. Does COVID-19 really pose a threat to us?
The fact is, researchers cannot predict how sick any one person will get if infected by the coronavirus. Recent research out of Stanford suggests that patients with more severe COVID-19 symptoms tend to have higher levels of certain inflammatory molecules in their blood. This could help experts predict severity in the years to come. But right now?
"None of us are clear [about] what's going to happen,” Fekete says. Which means even if you're a “healthy” person, getting COVID-19 is a risk to yourself and everyone else.
"In the best of all worlds, [precautions] would reduce the impact of coronavirus, but also other respiratory viruses. If that's the outcome, I think people will be relatively OK over the winter months,” Fekete argues. “Having said that, I'm expecting to see significant outbreaks in certain populations, such as nursing homes and adult living facilities, and also in immunosuppressed people."
"We've had some terrible ageism creeping into politics and medicine,” Vermund says. “There are people who have an attitude, like, ‘Why should I suffer just to protect the elderly?’ And that's a very unfortunate turn in American society."
What can you do? Watch out for you and yours, of course, but set a strong example for others you know who may not be as enthusiastic as you are to prevent virus spread.
7. Are our holiday traditions ruined?
After more than six months of distancing and isolation, the pressure to gather for Thanksgiving and other holidays will be massive. But this is just one year, and it would be tragic to get even one family member or friend (or yourself!) sick. Remember: An August wedding in Maine was linked to 178 COVID cases and eight deaths — and none of those who died even attended the event.
"Thanksgiving is one of my favorite holidays, but this year it can't be done safely in the usual sense,” Ison says. “We won't just have COVID-19. We'll have the flu and other respiratory viruses as well. So it has the potential to be a perfect storm, and we can't let our guard down. We'll have to get creative with the holidays, which will require more virtual visits."
The good news: It's temporary. “We're not condemning people to a lifetime of this,” Vermund says. “I do have a great deal of optimism for 2021 because we've got more than 400 clinical trials of new antiviral drugs, new biologic agents like monoclonal antibodies, and different steroid strategies. We've got 10 vaccines now in phase 3 clinical trials, which is absolutely remarkable. And we can avoid circulating the virus. So I'm just trying to remind people that 2020 is not 2021. We probably can be closer to normal by the end of next year.”
Holiday Gathering Safety Checklist
- Make the most of the situation: Order or make personalized masks for everyone!
- If weather permits, go outdoors. If not, ventilate the room as best you can.
- Keep people circulating to limit extended exposures between individuals.
- Embrace aggressive hygiene: Have soap at every sink, hand gel in every room.
- Lean on technology. A Zoom dinner may not be ideal, but it can be fun.
- Respect those who choose not to attend or ask you to stay distant and not touch.
- Avoid unnecessary mass transit. If flying, be ultra-cautious and keep distant from strangers the best you can.
- If you're sick, stay home. We'll see you next year!