The following guidance, provided by Washington University medical experts, may be helpful to members of our community while celebrating or traveling this holiday season.

Background

  1. COVID-19 activity is still high and rising in the region and much of the country.
  2. Vaccination reduces the risk of catching COVID and dramatically reduces the risk of becoming seriously ill from COVID. Vaccinated individuals with compromised immune systems and some who are over age 65 or have serious underlying medical conditions are still at some risk for significant illness from COVID.
  3. Vaccines are now available for children age 5-11.  It takes five weeks to achieve full immunity so there is an opportunity to start the vaccine series now to fully protect children and their contacts for the December holidays. Those who are recently vaccinated will not yet be fully immunized by Thanksgiving.
  4. Masking while indoors with people who don’t live with you will further reduce risk and is recommended when COVID transmission in the community is elevated.
  5. Viral tests performed prior to gathering with others may provide some additional value in reducing the risk of COVID transmission.  Anyone with symptoms should either not participate or test prior to any group activity and wear a mask.

Recommendations

To protect against COVID, we use layers of protection. The more layers of protection, the safer the event. How many layers of protection are necessary depends on how much virus is circulating in the community, the risk of severe illness for any individual involved in the event, and the risk associated with the activity itself. As a reminder, COVID is a respiratory illness that primarily spreads when people cough, sneeze, talk, sing, etc., and particles are released from the nose and mouth.  When circulating levels of COVID in the community are at substantial or high levels (more than 50 weekly cases per 100,000), more layers of protection are needed to create a safe environment. As cases drop, you can reduce the layers and still have a safe environment. Note that currently the St. Louis region has over 100 weekly cases per 100,000 of COVID and cases are rising. Below we note the layers of protection we have available and have prioritized  them based on the existing evidence:

  1. Vaccination is the cornerstone and protects you from severe illness, death and disease.
  2. Masking when indoors protects you from getting sick and spreading disease to others. Indoor masking is very important particularly when transmission is high.
  3. Staying home if sick with any symptoms consistent with COVID and getting tested if you have symptoms before engaging in group or work activities protects others.
  4. Having events outdoors when possible, or in a space with good ventilation helps reduce the amount of virus available to infect you or someone else.
  5. Creating safer eating situations where you spread people apart, keep people in smaller groups and in groups who live together, and improve ventilation (see #4) all reduce the likelihood of spreading virus.
  6. Avoid crowding (i.e., at a buffet line or bar) to limit contact between people who may be infected.
  7. Test prior to gathering to reduce the risk of having an asymptomatic or presymptomatic person at the event.
  8. Use more layers of protection in higher risk situations either for individuals or in the community such as the following:
    • Unvaccinated guests
    • Vaccinated but higher-risk guests (immunocompromised, age >65) 
    • High transmission in the community
  9. Travel tips
    1.  Check the COVID transmission rate in the areas you are traveling – if in the “substantial” or “high” category, be sure to always mask while indoors in public settings.
    2. Use additional layers of protection if going to areas with very high levels of transmission or coming in contact with visitors coming in from such areas.  
    3. Ensure all travelers who are eligible are vaccinated.
    4. If using public transportation, mask at all times (per CDC/TSA rules).  
    5. Avoid crowded areas in transportation facilities when possible.
    6. Do not travel if you are sick with symptoms that could be due to COVID or flu. 
  1. Masking tips
    1. Follow local jurisdictional rules and guidance.
    2. Mask indoors when not eating unless in a region with low to moderate (<50 weekly cases per 100,000) viral circulation.
    3. Masking is even more important when unvaccinated or other individuals at high risk for severe COVID are present (e.g., over 65, immunocompromised, chronically ill).

CDC information: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html