The US is battling rising cases of flu, COVID-19, and respiratory syncytial virus (RSV) this winter, and the holiday season could make it worse. Experts predicted the 2022 flu outbreak, which has already caused the highest rate of hospitalizations in the last decade, but there are growing concerns that abandonment of precautions such as mask wearing and social distancing is leading us into a “tripledemic.”
According to the Centers for Disease Control and Prevention (CDC), as of November 18, there have been 38,000 hospitalizations and 2,100 deaths nationwide due to the flu. Meanwhile, cases of RSV, which were almost nonexistent during the 2020 season, are on the rise among children and older adults in several states. Meanwhile, despite weekly COVID counts trending downward in the last few weeks, the pandemic has by no means gone away. According to the CDC’s COVID tracker, there have been 2,222 deaths reported in the last week.
As all three respiratory viruses spread via droplets from the mouths and noses of infected individuals, epidemiologists who study disease outbreaks are now urging people to take extra precautions to avoid catching a potentially life-threatening illness ahead of the holidays.
How can you protect yourself against infection?
“First and foremost, vaccination is the best defense in the prevention of influenza and COVID-19,” Jose Romero, the director of CDC National Center for Immunization and Respiratory Diseases, told media at a telebriefing earlier this month. Though there is no RSV shot for the public, the CDC has confirmed there are immunizations and other prevention products under development.
“People should also practice everyday preventive measures,” said Romero. This means doing all the things we did in the height of the pandemic: washing hands regularly, using alcohol gels, staying away from people who are ill, and practicing good cough etiquette; covering your coughs and sneezes. “[And you] may also choose to wear a well fitting mask as an added precaution.”
[Related: Is it flu or RSV? It can be tough to tell.]
In advance of holiday travel and family gatherings, “it’s important to take steps now to prevent respiratory disease, especially in people who are at higher risk of developing severe complications,” CDC spokeswoman Kate Grusich told PopSci in an email.
Should you wear a mask at your holiday dinner or party?
Mask wearing has been the subject of several studies since the COVID-19 outbreak. Initially, researchers found that the use of masks could lower the risk of COVID infection by up to 70 percent. More recent studies, though, have suggested their effectiveness is more likely around 19 percent, after controlling for other factors–in the beginning, the people who wore masks may also have been more vigilant when it came to social distancing and handwashing, for example, making their risk lower anyway. While new strains have emerged that have not been the focus of mask-wearing studies, Virginia Tech’s Linsey Marr says findings should still apply as the transmission method hasn’t changed from the original SARS-CoV-2 virus.
Marr, an influenza and aerosol-spread researcher, points out that other experts have found a 10- to 20-percent reduction in flu transmission when people wear masks. “However, it’s very likely that an individual can achieve much greater protection if they are vigilant about wearing a well-fitting, high-quality mask–these being the KN95, N95, and KF94 type masks,” she says.
[Related: Masks can work—even if you’re the only one wearing them]
Prior to the pandemic, the use of face masks and other PPE in hospitals with RSV patients was shown to greatly reduce transmission of the virus. The low levels of flu and RSV in the winter of 2020, Marr says, also points to the impact of safety measures on their spread, as pediatric doctors noted at the time.
According to Marr, you should wear a mask if you’re in crowded indoor environments, where lots of people are sharing the air. “If you take it off to eat in a crowded restaurant, though, it won’t really help protect you.”
By Marr’s definition, a crowded indoor space can include a dining or living room, even if you have just 10 people gathered together. “If someone is sick with the flu or COVID, the poor ventilation in our homes makes it more likely that the virus can build up in the air and infect others,” she says. But there are other options when it comes to clearing the air of viruses. Cracking a window and turning on the exhaust fan in your kitchen or bathroom will help pull cleaner, virus-free outdoor air into your home. If you’re really concerned, a portable air cleaner with a HEPA filter can remove virus particles, too.
Do you need to cancel your holiday plans?
Marr intends to see loved ones this holiday season, but she explains that she and her family aren’t classified as vulnerable. For those who are, or for anyone sharing the holidays with people who might have a more severe reaction to infection with COVID, RSV or flu, putting protective measures in place is much more important.
Knowing who you’re interacting with may change your holiday plans. “Older and more vulnerable people are less likely to have already caught COVID,” says Paul Hunter, a professor at the Norwich School of Medicine of the UK’s University of East Anglia. “So personal precautions are still important if you’re spending time with such people, unless you know they have had a recent infection.”
[Related: Getting COVID more than once might be even worse than we thought]
Anyone who has had COVID could still be infectious up to 10 days from the first day of symptoms; RSV is likely to be transmissible for up to eight days; and the flu becomes contagious a day or so before symptoms appear and can hang around for five to seven days after that.
When finalizing your plans, talk to the people you’ll be spending the holidays with and make sure you are all on the same page. Pick up some COVID-19 tests before you travel—though remember not to put all your faith in their results—and pack a well-fitting mask if you’ll be in crowded environments.
“Ahead of our family gathering, I’m asking everyone to try to avoid crowded indoor spaces in the week leading up to it, and to wear a mask at the airport or on their journey,” says Marr. “This will reduce the chances that someone picks up COVID-19 or flu along the way and then spreads it to the rest of us.”
Correction (November 23, 2022): Linsey Marr said her family would be gathering for Christmas and New Year’s, not Thanksgiving. Her quotes have been corrected.
