I doubt I’ll change anyone’s mind — especially this close to the holidays — but I’m gonna say this anyway: It. Is. Not. Safe. To. Gather. For. The. Holidays.
No, not even if you test
I don’t care if you have a negative COVID test. It doesn’t matter. This article does a great job of laying out why. But the TLDR:
- You could get infected in between taking the test and leaving for the trip, or
- You could get infected at the testing site itself, or most notably
- YOU COULD GET A FALSE NEGATIVE
Did you know that in the first four days of infection, tests can come up falsely positive as much as 67% of the time?
In the early days, there may just not be enough of the virus in your nasal cavity to be detected. And that’s with PCR tests — which are far more accurate than antigen ones used for rapid results.
Then there’s the chance that:
- The swab isn’t administered correctly (which I imagine is even more likely if you do one of the drive-through tests where you swab yourself)
- The sample gets contaminated
- The sample isn’t stored at the correct temperature
- The chemicals used for the test simply don’t work properly that one time.
But even assuming the collection, storing and testing processes go perfectly, unless your entire household has completely quarantined for four days before the test, there’s a chance — a potentially very large one — that you’ll get a false negative.
Still not convinced?
The article cites a summer camp that required teens to quarantine for a week before leaving and to bring proof of a negative test result that was no more than a week old.
Having taken those precautions, they felt they didn’t need to use masks or social distance — the same conditions as family gatherings. (Actually, no, there’ll probably be way more hugging at family gatherings.)
The overnight camp resulted in 116 COVID cases.
Can you even get results in time?
Not to mention that people are assuming they can actually get their test results in time. The couple people’s plans I heard were discussing getting tested five to seven days before leaving.
That may not be enough based on some comments I’ve seen from people on PF Twitter.
One said that where they live in Long Island PCR tests are taking 10+ days, so most people are resorting to antigen tests (which, again, are less accurate). Someone in Pennsylvania reported not being able to get a test at all with a doctor’s referral. A woman in Westchester County New York went to a testing facility that was all but deserted, yet it still took her a full week to get her results.
And the number of people exposed are predicted to keep ramping up as pandemic fatigue heightens and people get more careless. So more and more tests are going to need to be run, extending wait times.
So I worry that some people will feel pressure not to upset “the whole family’s plans” if they don’t get their test results back in time. I think they’ll reason that they feel fine and most people’s symptoms develop within five days, anyway. Which ignores the fact that around 20% of cases are asymptomatic (but still contagious).
Even if you get the results in time
But maybe you test nice and early — 10 or so days before you leave — and you went straight home after the test to isolate, avoiding any more potential encounters with infected people.
Well, again, you could’ve been exposed at the facility. Because certainly some of those people are infected, and masks aren’t 100% effective at blocking droplets.
But no, you probably won’t get infected there.
And if you were mostly staying home even before the test, you probably weren’t in the early stages of an infection when you went to take the test. Which means you probably won’t get a false negative.
And if you’re careful you probably won’t get it at that pit stop on the road, traveling to the gathering. Though a quick note about that…
When I mentioned my concern about pit stops, a friend pointed out that scientists now believe it’s pretty uncommon to get infected from surfaces. The only really risky times are apparently if someone has recently sneezed or coughed on a surface and you touch the surface within one to two hours.
Yes, I said, but that’s not really my main issue. Most bathrooms you use on the road don’t generally have a ton of ventilation. And you don’t know if any other users in the last few hours were maskless or briefly took their masks off. That’s a problem because larger droplets can remain in the air 8 to 14 minutes and aerosol (microdroplets) can remain up to three hours.
But yes, the people before you probably wore and kept on their masks. And even if they didn’t, longer exposure to the virus is the more common cause of infection, so you probably won’t get COVID walking through a single cloud of droplets.
And once you get there, well everyone else coming to the gathering is probably being as careful as you all agreed to.
But as I told a friend, once you get up to four or five probablys for a proposed single activity, I feel like you should just nope right on outta that idea.
Generations of infection
Remember, please, that you’re not just risking yourselves.
It’s great that everyone in your family will wear masks everywhere they go after the gathering. But those aren’t 100% effective, so that’s no guarantee. Meanwhile, most of us see people in our social bubble without masks. Ideally, if it’s not someone we’re dating, it’s usually distanced bisits. But even that is still not a complete guarantee because aerosolized droplets can travel farther than six feet.
So if someone at your gathering is sick and infects many of you, the infection will spread to people in your social bubble, who will spread it to people at work or someone else in their social bubble. And that means that, statistically, someone down the road will die.
Maybe not someone at the gathering or even someone you/they know. It could be a few tp several generations of infection down the road. But at least one death will likely occur. Because you guys had to see each other in close quarters without masks.
Take the now-infamous Maine wedding from this summer. One single presymptomatic person infected 27 of the 55 guests. It resulted in 177 cases and seven deaths within just three generations of infection:
- One prison guard was infected and kept going to work even with symptoms. The prison ended up with 50 infected inmates and 18 infected coworkers. The coworkers infected 16 more people, and presumably it went on from there.
- One wedding guest visited his mom, who works at a long-term care facility. That led to 13 infected coworkers and 24 sick residents, six of whom died. (Yes, they were over 70; yes they had underlying conditions. It’s still lives lost unnecessarily.)
- Six other wedding guests directly infected 14 people in their community, one of whom died.
Also, it’s worth noting that a complete guest list wasn’t actually made available to contact tracers, so the count could be higher. In fact, a later article linked an eighth death to the wedding and had an updated case count of 270.
So I really feel like we cannot overstate the issue of the potential for exponential growth of infections.
Your being healthy doesn’t matter
I saw one Twitter user who said high-risk family members were staying away, but otherwise plans were unchanged from previous years.
Since his family is so concerned about high-risk members, then presumably they interviewed everyone in their social bubble and at work for medical history — and asked for the medical history of the people those people had direct contact with. And maybe for good measure, that of the folks in contact with those people’ too.
Remember, people with medical conditions aren’t always broadcasting it. It’s more likely they would now, while they fret about risk of exposure. But it’s not certain. And even if they’re definitely not high-risk individuals, you don’t know everyone they see who might be high risk. And so forth.
Also, since this seems to be some sort of secret: YOU DON’T HAVE TO BE HIGH-RISK TO DIE OF COVID.
And I really wish people would stop focusing on death as the only long-term issue from getting COVID.
We may not find out for ages how many people “recover” from COVID but are later found to have long-term damage to their internal organs. So this isn’t just about who will survive COVID.
And this definitely isn’t just about you.
I get that I don’t get it
Having grown up far from extended family, I didn’t spend many holiday seasons with anyone more than my mom and dad. We flew out maybe three or four times to see family, but three tickets from Anchorage to the East Coast at peak holiday prices was probably staggeringly expensive.
So mainly we stayed home and had holidays with just us three. And since Dad was Jewish, Mom and I didn’t make a big fuss. I had a small tree in my room, we opened presents Christmas morning, and we had a nice meal that night, with my cousin sometimes coming over once she moved up there.
Starting around age 22, I stayed in Seattle for the holidays. So before I met Tim, I spent several Christmases alone. (Even when Mom lived in Seattle, she often went back East for Christmas. And thank god she took advantage of time with her dad while she could.) And even when Tim and I were together — even when his parents were in the guest house — we didn’t do a lot of Christmas celebrating. Mainly we just opened presents and then Nadine cooked a nice dinner.
So I know that I can’t understand what it’s like for some people to be away from family for important holidays. Especially after this stressful year we’ve all had. And especially because, yes, there is a chance that this will turn out to be the last year you could have seen that relative. (Though if someone at the gathering is unknowingly infected, that could be a self-fulfilling prophecy.)
Thus to some extent, I know that I can’t know exactly what I’m asking from some people out there when I say, “I know you really want to see family. But maybe you could just… not?”
Still, the precautions that people have convinced themselves make it okay, aren’t nearly as much of a guarantee as they think. And yes, it sucks. It may even be soul-wrenching for some.
But could you just… not?
Unfortunately, the fact remains: Travel isn’t safe; indoors, unmasked family gatherings aren’t safe. No matter what you do, and no matter what you tell yourself.
If you want to visit with family outdoors at six feet apart, or drop by to wave through windows, okay.
But indoors? Unmasked? Well, I’ll just leave you with this graphic from the aftermath of Canadian Thanksgiving.
Who else is staying home this year?
This year we are not hosting a family dinner. If the weather is warm enough our son will come and we will eat outside. If it rains or is too cold it will just be the hubs and me. Our son is very aware of our ages and my underlying conditions and is extremely careful, only visiting outside. I am constantly amazed at how many people are just doing their normal activities without considering others at all.
Change of plans: Son has been exposed to the virus and will be quarantined for 10 days. Hubs and I will deliver a box of food to his front steps, then drive home and eat our dinner. Praying our son will not get sick as he has lung damage from multiple bouts of pneumonia as a child.
Oh no! I hope the exposure turns out to be inconsequential, but I’m glad he’s quarantining to help keep everyone safe. I’m sure he’ll greatly appreciate the dinner.
I’m glad you’re playing it safe. And yes, the lack of consideration for others is quite shocking and dismaying.
We don’t have a large family locally, but we still are not getting together with everyone here because there are folks who work outside of their home with the public. My MIL and FIL will come over, but they are retired and in our bubble (they help with childcare). We got a call from our daycare director over the weekend that a teacher in another room has been exposed and was on site last week. We are keeping our son home for at least this week. I am recovering from a pulmonary embolism (in addition to having asthma) and am concerned that I am at higher risk. I wish folks would all hunker down so we can get this under control.
And now a second teacher has tested positive, so even though they were not in my kiddo’s room we are keeping him home through the holidays. We will not be doing thanksgiving with my in laws just in case our son is an unknown carrier
Oh no! Are you going to have him tested? I assume not, since the infected teachers weren’t directly exposed to him. Though they were likely exposed to his teacher. Ugh, trying to weigh the likelihood in these cases is exhausting. I hope your son remains healthy and that your in-laws can see him again soon without worry.
He is really little andwe are going to quarantine as a precaution to prevent any spread. I had a COVID test when I was in the ER last month and know he will not do well. If he develops symptoms we would get him tested. So over 2020. Hope you had a nice thanksgiving 🙂
It was quiet, but okay. I’m glad you’re staying safe.
Yeah, people in your bubble don’t really count. I mean, ideally even people (who aren’t their kids or partners) are trying to maintain a bit of a distance. But in this case, since they help with childcare, they’re already exposed to anything the kids are, and the kids are exposed to anything you are. So a dinner together really doesn’t do much to increase risk of exposure.
I hope your son stays symptom-free. Take care of yourself as you heal. And just in general in this ridiculousness.
Well, i just got my first COVID test on Friday. I exposed to someone who tested positive and right now it’s Monday it’s been about 3 days and no results yet. I’ve been masked at work which is protocol plus social distancing but we don’t stay home awaiting results. I checked. Since i work with first responders and I myself is a Frontline worker this point it’s kinda hard to put out the clusters until the test comes back. I have no symptoms and it’s been about 10 days now since I seen that friend that tested positive but i’m taking the test just to make sure i’m not an asymptotic super spreader. It’s super hard because I want to make sure i have enough time off of work to stay home for the 14 days if necessary. I also stayed home when my kids came back from their dad’s in July just to get them tested and stay home for the results.
Update got tested negative! Yay so i can stay in my bubble
Ugh, I hate that this country STILL hasn’t provided safeguards so people who have definitely been exposed can stay home and keep others safe. You know, without risking financial hardship.
Obviously, I really hope your test comes back negative. Please keep me updated here/on Twitter.
I turned down 2 invites (both gatherings of less than 10 people…..but still) – as I felt it was the one thing I COULD control about this pandemic – NOT going anywhere for the holiday as advised by Dr Fauci.
I have purchased a few items to make my favorite parts of the traditional Thanksgiving meal…(PUMPKIN PIE, stuffing, green bean casserole, and corn muffins)….and will stay home and watch movies’ all day, while being thankful I don’t have Covid , nor have I lost anyone to it.
So glad you turned them down. And that at least the gatherings, if potentially ill-advised (depending on who else was going) were small. I want to make pumpkin pie but I also don’t want to HAVE a whole pie. I might get Aaron to eat a piece, but I think that’d be about it. He’s super healthy. We had pizza the other day (but also a salad) and it was the first one he’d eaten in 2 years. So I’d definitely be on my own.
Anyway, I’m glad you’re staying safe and enjoy your food and movies. I hope your streak of not losing anyone to this dreadful illness continues!
We were going to eat outside at my parents house but I was exposed at work so its a no go. My mom was disappointed but she’s in the middle of chemo so I’m kind of relieved we aren’t going. She is very careful anyway but wanted to at least see us. Maybe when we get our test results we can do a quick meet across her driveway. I think Christmas will be the same and it makes me so sad. I worry that we won’t have next year with her.
Yeah, outside meals are probably safe. (Well, except for a person I read in an article where they’re having “30 masked guests” but they’re setting up TENTS. So… they’re enclosing the guests, negating the point of being outdoors? And if there are 30 people in a yard, I doubt they’re 6 feet apart when eating. Oy.) But given your situation, it definitely sounds safest to shoot for Christmas.
I hope the tests comes back negative. Keep me updated!
Just saw a news story that said 2 million people were screened at U.S. airports in the past weekend.
I say again: Two. Million.
Imagine how many more will travel on Tuesday or Wednesday.
Dammit.
Donna Freedman recently posted…Why I threw away my underwear.
Three million between Friday and Sunday. Bookings are down 40% from last year but… last year it was 26 million. So that means more than 10 million bookings this year. And that’s just flights. Sob.
I’m just gonna hunker down and hope Arizona’s holiday travel-induced spikes aren’t too terrifying.
I think there is a “stranger danger” element to COVID. I am not riding the bus because I don’t know who those folks are… But sharing a table with a dozen family members where no one wears a mask is OK. The virus doesn’t care whether you are related or “how nice” someone is.
Oh, excellent point! “People *I* know must be fine. It’s just all those other people who are risky.” is definitely a mindset here. Sigh. The fact that so many people feel confident just testing before they leave is very worrisome. No they PROBABLY won’t be infected in between if they quarantine but… (And also, are you SURE everyone in your extended family is being completely upfront about their activities?)
I will be staying home alone as my family thinks everyone who is family is okay and doesn’t need to wear a mask. Not the right answer and not worth the risk.
Of course, I haven’t been inside a grocery store since March and they think I’m crazy. My sister and her husband have both had covid. Guess who has not had it?
Oh dear, I’m sorry your family is being kind of cavalier. Good for you for not even going to a grocery store! I definitely have some level of exposure, like grocery store trips and haircuts/very quick beauty services (though I’m nixing both of those now that cases are upticking again). I tried to switch to store pick-up for my last grocery trip, but even skipping around to three different stores online, I wasn’t able to find items that I *know* are in stock in the store. So I just did my best. I know masks mainly protect others, but since my new mask (“It Goes Over Your Nose”) is a bit thin, I wore a second one underneath just in case. So that is a little extra protection hopefully.
In the meantime, I’ll try to mainly just stay home and watch TV or chill with Aaron. It’s a helluva lot easier to hunker down when you have at least intermittent company (who has a reassuringly low level of exposure and high level of worry about COVID). The single people out there who have been single this whole pandemic and stayed so safe… I’m completely serious when I say I’m in awe. I’m glad you’re staying so safe!
I appreciate your efforts to convince people.
Pedantic points about testing:
“The chemicals used for the test simply don’t work properly that one time.”
The way most tests are set up, this is not possible. Just as home pregnancy tests have that positive control line that tells you the sample reached the test chemicals, Covid tests have controls (both positive and negatives) built in.
“And that’s with PCR tests — which are far more accurate than antigen ones used for rapid results.”
Two quibbles:
1) “rapid” tests come in both antigen and nucleic acid versions, both of which have some pretty reliable versions (personally I trust the Sofia rapid antigen and the ID NOW rapid isothermal nucleic acid tests; I haven’t looked into the performance stats of all the tests though. NB: Do not use any test that is not at least on the EUA list from the FDA https://www.fda.gov/medical-devices/coronavirus-d…
2) full RT qPCR tests, that take longer to run, are more sensitive, but not necessarily better for “healthy population screening” because of the long turn around (also, supply chain issues).
“The sample gets contaminated”
Unlikely to lead to false negatives (and also not a documented problem- this is important because of the number of people who think false positives exist on a meaningful level- spoiler: they don’t)
“The sample isn’t stored at the correct temperature”
Most tests are robust to realistic storage temperatures for samples… if you were having to ship a test in Arizona in August I’d worry a little, but generally this is a known issue that is compensated for.
“The swab isn’t administered correctly (which I imagine is even more likely if you do one of the drive-through tests where you swab yourself)”
Many people imagined that. But the peer-reviewed papers showing equivalence disagree. Swabbing is error prone, regardless of whether it’s done by a trained healthcare provider or the patient. But you shouldn’t avoid a test that uses saliva instead of that unpleasant NP swab, for example.
Bottom line: primarily due to swabbing issues, no test is reliable enough you should use it to feel “safe” traveling to visit a relative over the age of 50, with asthma/obesity/high blood pressure or other risk factors, if you have any level of exposure. But “is my risk 0%?” is a very different question from “if we test everyone and anyone with a positive isolates, can we cut the transmission down massively?” Tests are imperfect as *diagnostic instruments for individuals*. Tests are helpful as *surveillance instruments for groups*.
Thanks for the additional info. I figured most of the potential issues were generally going to be rare. Especially at this point, lab techs are probably pros. But I imagine it could be possible to get a bad batch of chemicals once in a while. But good to know that the potential issues mentioned are unlikely.
I don’t think false positives are super common. It’s just more that the “I tested negative twice and then finally tested positive” stories stick in our head; though I do think the high potential in the early days is concerning. No, you PROBABLY won’t get a false negative. Most of the scenarios are unlikely, including encountering someone sick at a rest stop or the airport (rather than the plane). From what I’ve read, most infections happen with at least several minutes of exposure to a sick person, not walking through a cloud of droplets once. But as I said in the article, too many “probably” or “it’s unlikely but…” situations make me itchy.
And yes, I dread the idea of a nasal swab. Some people say it’s not so bad. Others say it is. One friend has had mixed experiences: once was fine, one was bad and once she actually gagged. But I would happily submit to widespread, regular testing to help make sure I wasn’t getting anyone else sick. Aaron and I each live alone and wear masks anytime we’re out, so it’s pretty likely that if either of us did get sick, transmission would end at the other person. But I would still prefer to know if I were infected so a) I could tell him to stay away if he tests negative and b) not go anywhere, even with a mask.