Visiting Family Over the Holidays? Here's How to Lower Your Risk for COVID-19

One of the lowest-risk ways to gather is outside. Last spring, San Francisco placed circles on the grass at Dolores Park in the city's Mission neighborhood to encourage groups to be socially distanced.  (Josh Edelson/AFP via Getty Images)

It’s been months of quarantine and the urge to see friends and family is real, especially as the holidays approach. But as people are considering traveling to spend Christmas or Hanukkah with loved ones, COVID-19 cases are again surging across the U.S.

While doctors say there’s no way to completely eliminate the risk of catching or spreading the novel coronavirus when venturing out, there are things you can do to reduce the risk, and all nine Bay Area counties plus the city of Berkeley released recommendations Monday for doing just that.

Along with these recommendations, we consulted public health experts and guidelines from the Centers for Disease Control and Prevention for ways to minimize your travel risk. Think of it as a checklist to help you track your household’s distancing habits and test for leaks in your stay-at-home bubble. You’ll also want to consider the health of the people you’re visiting, how you’ll travel, and getting tested.

If it’s been a challenge to follow health recommendations, you’ll want to consider postponing that big trip until you’re more confident you’ve minimized the risks.

Consider Age and Health

Age is a major risk factor for the severity of COVID-19. CDC guidance says 8 out of 10 coronavirus deaths have occurred in people age 65 or older, and the greatest risk for serious illness is among those who are at least 85.

People of any age with serious medical conditions, including cancer, diabetes and respiratory disease, are also at higher risk for severe cases.

If you or the people you plan to visit are elderly or have underlying health problems, consider eating Thanksgiving turkey together on Zoom instead.

Have You Been Wearing Your Mask?

The CDC now says the coronavirus can be transmitted by large respiratory droplets at short distances and sometimes by smaller “aerosolized” particles over longer distances. This makes wearing a face covering over your mouth and nose whenever you’re out in public a key component of protecting yourself and others.

“What I’ve seen in the hospital is we’re just not seeing transmissions if people just wear surgical masks. I’m not talking about N95 or hazmat suits,” said Dr. Yvonne Maldonado, professor of pediatrics, epidemiology and population health at the Stanford School of Medicine.

Remember, even if you’re scrupulously wearing a mask, if the people you are in close contact with aren't, your coronavirus risk goes up.

Remember the 6-Foot Rule

Health experts say social distancing is here to stay, and it’s one of the best ways to combat the coronavirus. In addition to wearing your mask, you should keep 6 feet or more from others when at the store, park or other public spaces.

Follow the same rule when meeting a friend for a socially distanced picnic.

Wash Hands Often

Scientists say washing your hands for at least 20 seconds is another important way to protect against infection, because soap and water can destroy the virus. If you can’t wash your hands when you’re outdoors, use a sanitizer with at least 60% alcohol.

Limit Your Exposure

COVID-19 is thought to spread mainly through close contact between people. That’s why health experts say to limit how much exposure you have to people outside of your household.

In California, gatherings with people from more than three households are prohibited. State guidance is to limit these events to no more than two hours.

Some health officials say if you want to socialize, keep your group to a social bubble of 12 or fewer people, including household members, with everyone agreeing to the same rules.

Here are other ways to limit your potential for exposure:

  • If possible, work from home
  • Avoid mass gatherings
  • Limit the number of outside visitors into your home
  • When shopping for groceries, make a list to reduce time spent inside and buy extra to limit trips. Or consider a delivery service like Instacart or Good Eggs.

While the Risk Is Lower, Children Can Spread the Virus

Early research suggests kids are at a lower risk for getting sick and spreading COVID-19 — but this doesn’t mean they are immune. In some cases, children can transmit the disease.

“We’re recommending that older adults avoid contact with children,” said Dr. R. Sean Morrison, a geriatrician with Mount Sinai Health System. “We want to minimize the risk of that child passing on disease to their grandparents, who are at increased risk.”

If your kids are going in person to school, day care or other group activities, make sure your care provider is taking precautions and following state and local guidelines.

Consider Outdoor Visits Over Indoor

The CDC says indoor spaces are more risky than outdoor ones for spreading the virus.

If an outdoor meetup is impossible due to weather or other factors and you decide to meet indoors, the CDC recommends you “avoid crowded, poorly ventilated, and fully enclosed indoor spaces. Increase ventilation by opening windows and doors to the extent that is safe and feasible.”

Choose a Car Ride Over a Flight

Some health experts say driving is safer than flying, where you’ll be in tight quarters with strangers for hours. But long car trips may require stopping for gas or food, so you’ll still want to take precautions. The recommendations are that you don't share vehicles with people you don't live with and that everyone where a mask. You should also open windows to increase air circulation.

Before flying, doctors say it’s a good idea to check the airline’s coronavirus policies. Most require passengers to wear a mask, and some limit the number of passengers aboard a flight or block out middle seats. Remember that it's likely you will be sitting within 6 feet of other people for hours on end, depending on where you're traveling, plus time in airline terminals that may be more crowded over the holidays.

Get Tested or Plan to Quarantine

Health experts say getting tested, while not a fail-safe, can give you a measure of confidence. Dr. Bob Wachter, chair of the Department of Medicine at UCSF, says receiving a negative test result before your trip significantly reduces, though doesn’t eliminate, the chance you’ll transmit the coronavirus when traveling.

“If I was on the fence about visiting and I had a negative test in the last couple of days, it might get me to leave the fence and go,” Wachter said. “But it would not lead me to give them a hug and a kiss.”

A second test four to five days after your journey can help rule out infection during a flight or road trip. Getting a test immediately upon arrival, Wachter says, will likely be too soon for you to test positive. While you wait for the results, doctors recommend keeping your distance from others.

If testing isn’t an option and you have the luxury of time, experts say quarantining for 14 days before and after your travel is prudent.

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Monitor Spikes in Cases

Nonessential travel to or from a place with a high positivity rate is not advised, and many states and counties have their own rules in place — so you’ll want to check local guidelines before planning a trip.

Start the Conversation

Taking basic precautions can go a long way, but there will still be some risk of coronavirus spread when exposing yourself to more people and different environments. Before you travel, take stock of your own habits and have a conversation with your loved ones about the potential risks of getting together.

“We can think of transmission risk with a simple phrase: time, space, people, place,” explains Dr. William Miller, an epidemiologist at Ohio State University.

Here’s his rule of thumb: The more time you spend and the closer in space you are to any infected people, the higher your risk.

Interacting with more people raises your risk, and indoor places are riskier than outdoors.

Once you’re confident in your family’s stay-at-home vigilance over the course of 14 days, experts say, it becomes less risky to visit loved ones. You’ll want to be extra cautious during a surge and if your family members are elderly or have health problems.

Jon Brooks contributed to this post.

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