Robert Roy Britt | elemental.medium.com

Kristen Carpenter, PhD, comes from a big family in Michigan, and she hasn’t yet decided how to approach the holidays, which traditionally involve road trips for large gatherings. Carpenter, the chief psychologist in the department of psychiatry and behavioral health at the Ohio State University Wexner Medical Center, is keeping one eye on the rate of Covid-19 infections in Michigan and the other on the wishes and concerns of her far-flung family.

Whatever they decide to do or not do, “We’ve got to get a lot of people on board,” she says, pointing out that each of her relatives has their own risk threshold. Communicating with everyone about their desires and concerns, and being understanding of the differing comfort zones, is key, she says. “And that’s hard. It’s probably not just one conversation, but many. And the bigger the family, the tougher that gets.”

With Covid-19 cases rising and expected to approach or exceed the April peak in the fall, infectious-disease experts advise strongly against large holiday get-togethers.

“I’m not going to tell people not to have a family gathering, because mental health is important, especially now more than ever,” says epidemiologist Saskia Popescu, PhD, an assistant professor at George Mason University. “But I can’t in good conscience say, ‘Yeah, it’s okay to have a big one.’”

“There is no 100% safe way for two households to get together for the holidays in any area where Covid is circulating, which currently includes the entire United States.”

Popescu worries not just about the gatherings themselves, but the risks of getting there.

Airplanes have good ventilation and air filtering, she says, but you can’t control who sits near you. If one of those passengers is shedding virus, your risk rises with every hour onboard. Also, having flown for work during the pandemic, Popescu sees people avoiding airport restaurants and getting food to go, then eating at the crowded gates where there’s no physical distancing, or on the plane — maskless, of course.

“The last thing we want to do is put people at risk during the holidays because we were so hell-bent on having a large gathering,” Popescu tells Elemental. So what’s her bottom-line advice? “It’s risky. So I would say, really, don’t do it.”

Reducing risk if you must go

Roger Shapiro, MD, has seen his octogenarian parents only once during the pandemic, outdoors with good physical distancing.

“It’s hard,” says Shapiro, an associate professor of immunology and infectious diseases at Harvard T.H. Chan School of Public Health. “I’d really love to go home for Thanksgiving. My family has been talking about it, but I don’t think it’s going to happen… There is no 100% safe way for two households to get together for the holidays in any area where Covid is circulating, which currently includes the entire United States.”

Still, Shapiro and Popsescu understand some people will travel and gather during what will be the high season for virus transmission, so they offer advice for those who must:

• Move gatherings outdoors, weather permitting.
• Wear masks except when eating.
• Maintain as much physical distance as possible, with six feet as a minimum (more is better).
• Limit time spent with others, especially indoors.

If you must be inside, open the windows if possible, to increase ventilation, or get an air purifier or upgrade your whole-house air filters to help reduce the concentration of any virus particles. If someone is shedding the coronavirus, it can build up in a poorly ventilated space, and the risk grows with each passing minute.

You and your family could also agree to quarantine for 14 days prior to a gathering, Shapiro suggests, and you might consider getting tested just before setting out. However, while testing can be useful at the population level, a negative result is not a guarantee that any given person is actually Covid-free, or that they wouldn’t test positive the next day. Shapiro points to the White House’s September 26 ceremony for Supreme Court nominee Amy Coney Barrett, where everyone was reportedly tested beforehand, yet an outbreak resulted.

“Think of that event as a large version of a Thanksgiving dinner, relying on rapid testing alone and no other protective measures,” Shapiro says. “It clearly didn’t work.”

The anxiety of indecision

We’re all a little on edge. Anxiety is running high, generating more nightmares, ranging from Covid death fears to vivid scenes of the apocalypse. Indecision feeds these anxieties, psychologists say. It’s better to face facts — we’re in the middle of a horrifically deadly pandemic — and deal with them. And, they say, start the holiday talks with family now.

“If you’re that person who’s ready to go, ready to walk through the door at Aunt Becky’s house, understand that your siblings, your cousins, your mother, whomever, may not be comfortable doing so.”

“We suffer a lot because we are waiting for things to change, as opposed to loving or accepting what is,” says Karen Dobkins, PhD, a professor of psychology at the University of California, San Diego. “Yes, the holidays will be different than last year, but no use crying about that loss. All of life is gain and loss, over and over.”

Americans in general are particularly bad at accepting things as they are, Dobkins says. It could be our collective tendency to equate “doingness” with worth, she says, or because our country is so young we haven’t experienced as much repeated destruction and reconstruction from wars, illnesses, and other misfortune as other cultures.

Once you’ve accepted the insanity that is 2020, you can take the next important step.

Make new traditions

“Being prepared in advance can really lessen anxiety,” says Jane Timmons-Mitchell, PhD, a clinical associate professor of psychology at Case Western Reserve University. “It’s always better to have a better plan.” Rather than spending energy fighting the inevitable change, put the energy into figuring out a new tradition. “Think about what you value most about the holidays,” she suggests, and decide on a way to recreate it or replace it. “You may not be able to travel to be with family but you could cook together and eat together over Zoom.”

Or, consider completely different and new traditions.

“Gratitude is a great concept to address holiday blahs,” Timmons-Mitchell says. “If you are able, contribute to charity for those less fortunate in gratitude. Since it’s the season of giving, take time to think carefully about what you would like to give and to whom.” Urge kids to think deeper about gift-giving too, she suggests.

Carpenter, the Ohio State psychologist, says whatever you and other family members or friends decide to do, make sure there’s open discussion and a lot of compassion and understanding of others’ risk thresholds. And make sure everyone agrees to the rules, lest one person’s advance quarantining be rendered moot by someone else’s cavalier attitude.

“Everyone has to be on the same page,” she says. “If you’re that person who’s ready to go, ready to walk through the door at Aunt Becky’s house, understand that your siblings, your cousins, your mother, whomever, may not be comfortable doing so.”

Source: www.elemental.medium.com