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Experts share how the recent COVID surge has changed their holiday plans

We asked infectious disease experts what precautions they’re taking this season, whether the rise of Omicron has changed their plans, and what advice they have for holiday gatherings.John Tlumacki/Globe Staff

This year’s holiday season is increasingly being overshadowed by the alarming rise of Omicron and a surge in COVID-19 cases in Massachusetts.

Scientists at the Broad Institute of MIT and Harvard said Monday the highly contagious variant has overtaken Delta as the dominant form of coronavirus in the state.

“It’s incredibly painful and incredibly unfortunate that this is all happening during the holiday season,” said Jacob Lemieux, an infectious disease specialist at Massachusetts General Hospital and coleader of the viral variants program at the Massachusetts Consortium on Pathogen Readiness.

“It’s been pretty clear that we’re probably at the worst point we’ve been at since last winter,” said Mass. General epidemiologist Dr. Mark Siedner.

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At the same time, the latest state data shows that vaccines are protecting the vast majority of people: nearly 97 percent of vaccinated Massachusetts residents who have contracted COVID-19 have avoided severe health outcomes, such as hospitalization or death, according to the state Department of Public Health.

So what do the dire headlines about Omicron, coupled with reassuring statistics for those who are vaccinated, actually mean for people hoping to spend their holiday with friends and family?

We asked infectious disease experts what precautions they’re taking this season, whether the rise of Omicron has changed their plans, and what advice they have for holiday gatherings.

“It really comes down to two things,” said Dr. Sandra Bliss Nelson, an infectious diseases physician at Mass. General and an assistant professor at Harvard Medical School: your likelihood of contracting the virus and your individual risk for developing severe disease, factoring in your overall health and vaccination status.

“The main change with Omicron is the part about the likelihood of being exposed,” Nelson said. “The more disease that circulates, the greater chance that all of these individual chance encounters or any of them could result in an exposure.”

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Most infectious disease experts are already quite cautious because they work in hospitals where the risk of infection is high and they interact frequently with medically vulnerable people.

But as cases increase, some specialists are becoming even more vigilant.

In the last week, Dr. Brian Hollenbeck, chief of infectious disease at New England Baptist Hospital, said he has seen a “a large uptick in cases . . . which is continuing and persisting.”

“What that’s meant for my family is that we basically have pulled back on a lot of our plans in this week leading up to Christmas, hoping that we’ll all still be healthy and be able to be together on Christmas Day,” he said.

That meant canceling a basketball game and avoiding large groups so neither he, his wife, nor his four children would inadvertently become infected and have to quarantine during the holiday.

“We just want to make sure that, as we are heading into the holidays, we’re at least all together,” he said.

For Dr. Sabrina A. Assoumou, an infectious disease physician at Boston Medical Center who Mayor Michelle Wu of Boston recently appointed to her COVID-19 advisory committee, the recent surge in cases made one tough decision a bit easier to make: She decided not to have her mother come visit for the holidays.

“I just don’t feel comfortable putting her on a plane at this time,” Assoumou said, even though her mother is vaccinated and has received a booster shot. “She’s in her 70s.”

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She said travel can be safe with good ventilation on the plane, a good-quality and well-fitting mask, and distancing from large groups at the airport. But with the rise of Omicron, it was a risk Assoumou said she just wasn’t willing to take.

“We thought that Delta was transmissible. This one is dwarfing it,” she said, adding that Omicron appears to have a doubling time — how long it takes twice as many people to become infected — of around two days, compared to four or five days for Delta. “The jury’s still out on whether or not it’s more severe or if it’s milder.”

Many experts are keeping celebrations to just their nuclear family

“We’re having a quiet holiday dinner at home with just me, my wife, and two grown kids. No extended groups of people,” said Dr. Robin Colgrove, an infectious disease specialist at Mount Auburn Hospital. “We’re all vaccinated and boosted, so we won’t be masking in house. But when we’re going to any other indoor space, we’re wearing masks. And we’re not going to any big shows or places where large numbers of people congregate.”

It is possible to gather safely in small groups — with some ground rules

Even doctors who were planning to gather with people outside of their immediate households had some ground rules: keep the group small, ensure everyone is vaccinated and boosted if eligible, conduct rapid tests beforehand to make sure no one is infected, and be prepared to cancel plans if circumstances change.

Siedner said his family is planning to gather with a small group of relatives under these guidelines. Still, “everything from a positive test to a head cold really could change our plans and bring things back to remote family gatherings,” Siedner said.

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Nelson said her family is traveling to Vermont by car the day after Christmas to share a rental with some friends, all of whom are vaccinated and boosted with the exception of her youngest daughter, who is not yet eligible for a booster.

The group will take rapid tests upon arrival and perhaps again shortly afterward, and don’t plan to go to restaurants.

“It’s a bit of a hybrid. It’s not a zero risk,” Nelson said.

Assoumou, who is celebrating only with her immediate family, which includes an unvaccinated 2-year-old, said “we can gather safely this holiday. We’re not back in 2020.”

Vaccines and boosters, rapid tests, masking, and improved ventilation are all critical tools.

“It’s been a long two years. And we can do this safely, but just still need to be vigilant,” Assoumou said.

Rapid tests can be a significant tool for safe gatherings

All the experts the Globe spoke to strongly encouraged rapid testing before any gatherings, especially to protect people in high-risk groups (older individuals or those with certain health conditions).

But Nelson said the tests are not easy to find. Many people she knows spent last weekend going from store to store in search of them.

Some cities, like Boston, are distributing free rapid tests to high-risk communities. Siedner suggested looking online to find where tests are being distributed or available in stores.

“Frankly, what I do is nothing more than than scour the Web,” he said, lamenting that tests are so scarce compared to some European countries where they are widely available for free or at a reduced cost.

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“Testing is always just a small part of the response, but at this point I think we should expect more and hopefully we will start to do better,” he said.

It’s also much safer to be around others with additional protections, such as masks, social distancing, limiting time spent in crowded places, and improving ventilation by meeting outdoors or even just opening windows, Colgrove said.

Large gatherings are just not a good idea right now

“I think great big gatherings are probably ill-advised at this point,” Colgrove said. He said there’s no magic number, but a limit of 10 people is probably a good start.

Vaccines are our best defense against COVID-19

Especially with booster doses, vaccines are highly protective against severe disease.

“We should really encourage people to get it because that’s how we get to the other side together and can celebrate Christmas next year,” Assoumou said.

Boosters provide a quicker immune response than the initial vaccines, taking effect within days rather than weeks, specialists said.

“If you were to get boosted today, you would already be getting some increased protection by Christmas and a big increase by New Year, so it’s not too late to go out there and get your booster,” Colgrove said.

While immunity wanes over time, even people who are not boosted are at a lower risk for complications from COVID-19 if they are otherwise healthy, Nelson said.

“They may not be protected against developing infection, but they’re still likely to have some good protection against severe disease.”

But older and immunocompromised people remain at risk

Even though the vast majority of people with breakthrough infections experience mild symptoms, complications are more common among people who are older or have underlying immune vulnerabilities, Nelson said.

“That’s the population that I would say should err on the side of being very careful, minimizing unnecessary exposures, wearing masks, avoiding large gatherings,” she said.

Colgrove said it’s also important for younger, healthier individuals to be conscious of vulnerable family members.

“We’d like to protect ourselves, but we also want to protect all the people from us,” he said. “This is something where we all have to help and protect one another.”

Ultimately, taking precautions is about more than just your own health and safety

Limiting the spread of COVID-19 is also essential for protecting the health care system.

“There’s a little bit of a split between what’s important for the individual and what’s important for society and public health,” Nelson said. “Even if the proportion of individuals that are hospitalized is very small, if it’s so prevalent the hospitals in the health care system could become overwhelmed. The testing capacity could become overwhelmed.”

That means fewer resources are available to treat even non-COVID patients, like those having a heart attack or a fractured leg.

“This is something where we’re really all in this together,” Colgrove said.


Sahar Fatima can be reached at sahar.fatima@globe.com Follow her on Twitter @sahar_fatima.