Being cautious is the best thing you can do this Christmas | Devi Sridhar

Few times of the year are as challenging or stressful for families and relationships as Christmas. This year we face the additional pressures of the pandemic and the government’s ambiguous Covid-19 Christmas guidance, which seems to encourage families and friends to meet in their homes and travel over a five-day period, while at the same time pushing the responsibility for those decisions on to individuals themselves. It’s both confusing to know what to do and clear that although the government has permitted us to do certain things, this doesn’t necessarily mean we ought to.

As a public health expert, I’ve repeatedly been asked what families should do over the holidays. I’m torn between giving people the emotionally reassuring and comforting answer they want to hear or sticking bluntly to the best scientific evidence we have about transmission and suppression. While independent scientists are one of the few groups who can be unpopular and forthright, politicians are stuck in an unenviable dilemma: tell people what they need to hear based on the facts, or tell them what they want to hear based on emotion.

The truth is the virus that causes Covid-19 does not care that it is Christmas or New Year’s Eve. It rapidly spreads indoors and in poorly ventilated settings, particularly in households, when people gather together informally in comfortable and close conditions. Disinfecting surfaces and sitting two metres apart just isn’t going to stop transmission. It’s best to imagine the virus like cigarette smoke: if one person in the room is smoking, you’re likely to smell the smoke. It’s the same with this coronavirus: if one person is infected, you could also become infected from the aerosols emitted when they breathe and talk.

There are ways to exercise caution. If you want to safely see your family, you can check the local prevalence of Covid cases in the area – the number of cases per 100,000 people. If there are fewer cases and positive tests results, the risk of catching or passing on Covid-19 is lower. But of course there is never no risk. Socialising outdoors, going on walks and spending time in nature with friends and family are ways to see people in a less risky environment. So is connecting with family and friends virtually, on the phone or on Zoom.

If you are keen to spend time closely with family members indoors, especially vulnerable or elderly individuals, the only truly safe way to do so is to isolate for two weeks before seeing them, to ensure you’re not carrying the virus or incubating it. Private providers are now offering rapid Covid tests, but they’re not 100% safe because the virus has an incubation period of up to 14 days. You could test negative today, for example, and be infectious and test positive tomorrow. Two negative test results taken five to eight days apart is one way to help mitigate this risk, albeit an expensive one.

As the UK heads into a tiered system of restrictions, the government’s decision to lift travel restrictions over the festive period is particularly concerning. Movement from higher- to lower-prevalence areas means all tiers are more likely to be upgraded after Christmas, with the possibility of the entire country being in tier 3 by early 2021. The virus moves when people move; as data from the past 10 months has shown, restricting travel is an important way to protect areas from Covid.

With each passing day, we get nearer to effective and safe vaccines, treatments for Covid-19 patients, and effective mass testing. Indeed, next week, the first 800,000 doses of the Pfizer/BioNTech vaccine are due to be rolled out in the UK. Many people may decide that, with mass vaccinations on the horizon, the risk of being infected or infecting others over Christmas isn’t worth it. As someone in one of the lower risk groups, I’m less concerned about getting Covid-19 myself than I am worried about unintentionally infecting someone else, contributing to a chain of infections that could result in someone being hospitalised.

While we all clapped for months for the NHS staff, we should keep them in the forefront of our minds this winter. NHS doctors, nurses, support staff and cleaners have to show up each day to work in hospitals and GP practices and deal with whatever is thrown at them. Relying exclusively on the health service to fight this pandemic is like leaving a goalie alone on a football pitch. We all need to play our part in keeping the burden off health services. This might mean postponing group gatherings until the spring or summer next year, and doing our best now to avoid getting the virus and passing it on to others.

The Guardian

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