Maximizing safety during the holidays if you can’t achieve the NBA-style social bubble

Some families have chosen to create a COVID-19 social bubble to celebrate the holidays this year, after the National Basketball Association leveraged the technique during its most recent season.

But since creating a bubble requires two weeks of diligent quarantine, testing, and temperature checks for anyone planning to be included, if you’re planning to gather for Christmas, the time has passed to start preparing.

Infectious diseases experts at The University of Texas Health Science Center at Houston (UTHealth) say the best way to guarantee safety is to celebrate the holidays virtually with anyone who lives outside of your home. However, if you do plan to gather, Michael Chang, MD, infectious disease pediatrician with McGovern Medical School at UTHealth and UT Physicians offers advice on how to maximize safety.

Follow the new quarantine guidelines

There are many essential workers and others who may not be able to stay home for two weeks in quarantine before seeing their family.

In this case, Chang recommends a shorter quarantine. The U.S. Centers for Disease Control and Prevention (CDC) recently released new guidelines for a seven or 10-day quarantine, shorter than the original 14-day recommendation.

“The shortest quarantine recognized by the CDC currently is seven days, and that applies if you have a COVID-19 test performed between days 5 to 7 of the quarantine. You need to stay in quarantine while you wait for results, and if you get results back before day 7, it is still recommended you quarantine until then. You need to be asymptomatic for the entire seven days to end quarantine with the negative test,” Chang said.

Without testing, quarantine can end after day 10 only if no symptoms were reported during daily monitoring. In both cases, continued symptom monitoring and masking must continue through day 14.

“It’s important to note that the risk associated with following these new guidelines is not zero. To come up with the new quarantine guidance, the CDC modeled transmission risk based on available data. Based on these models, for the 10-day option, the risk of transmitting COVID-19 could still be up to 10% after quarantine,” Chang said. “Clinically, we do see that most people become symptomatic between five and seven days after exposure. There are some cases reported outside of that time frame, but it’s definitely the minority.”

Get tested

If you can’t quarantine for seven days, Chang said you must get tested around three days before gathering with anyone.

Testing should be done via polymerase chain reaction (PCR) testing which is molecular, meaning it detects genetic material that is specific to the coronavirus that causes COVID-19. In contrast, antigen tests detect protein fragments of SARS-CoV-2 – those are typically rapid tests.

“Try to test and then quarantine if possible so at least you can be reasonably sure you didn’t get exposed between the test and the gathering,” Chang said. “Keep in mind that a negative test does not exclude infection 100%. You should still take all the recommended precautions, including handwashing, physical distancing, and mask-wearing.”

Chang’s most important piece of advice is to stay home if at any time you start to show symptoms.

Important considerations while gathering

Once everyone is gathered, it’s still wise to maintain all safety measures advised by the CDC such as frequent handwashing, physical distancing, and wearing a mask.

Chang also recommends the following to maximize safety:

• Bring your own food, drinks, utensils, and cups.
• Gather outdoors whenever you can.
• Avoid large gatherings where you can’t physically distance.
• Keep your mask in a safe place while you eat that won’t contaminate other things or surfaces (e.g., don’t place it on the dinner table while you eat).
• Individuals at high risk for severe infection should consider virtual celebrations only.

For more information, visit the CDC’s guidance on holiday gatherings.

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