Canadians are heading into the holidays with COVID-19 weighing heavily on their minds.
Across the country, many families are looking at — and trying to calculate — the risk of a gathering, an evening out or even a trip together.
Omicron has made that math all the harder. Add to it questions around rapid tests and the push for booster shots.
What if the adults in your family are all vaccinated and the kids have each received their first dose? Is dinner a go?
What if you have one sibling who’s recently travelled abroad? What if some relatives are anti-vax?
The Star asked readers for their questions — and took them to the experts.
Be forewarned: Some of their answers come with more questions.
Dr. Samir Sinha, director of Geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto, says there is a list of factors one can take into consideration to determine how risky a particular holiday plan might be.
Scenario 1: “My wife and I bought Come from Away tickets for our adult children who should all be triple vaxxed shortly. I am not afraid to lose my tickets but, if safe, would rather not lose them. Are 600 people in a 1200-seat theatre at high risk and would be advised to not attend? Thank you.”
When it comes to large event gatherings, Sinha said, there are several things to consider, primarily regarding the theatre audience. Will they be vaccinated? Will they be wearing masks? And will there be physical distancing? If the answer to all of these is yes, it would be a low-risk scenario.
“If I change it to ‘I’m going to my super church right now, where basically there are no restrictions … we’re all going to be singing, standing up and holding hands, that that will be a much riskier proposition than simply going to a theatre, where everybody else has been vaccinated,” Sinha said.
Colin Furness, an epidemiologist and assistant professor at the University of Toronto, said in an emailed response a person can be “virtually certain” Omicron is circulating in a hall of 600 people. He said people should be OK if they are triple vaccinated, with the third shot at least two weeks prior to show time and if they’re wearing a properly fitted N95 mask.
But, he added, “By attending you are contributing materially to a situation where some other, less mindful audience members may become infected and later die. Are you OK with the moral implications of your participation?”
Scenario 2: “We’re meeting up with people we don’t live with for walks outdoors during the holidays. They are double or triple vaccinated. Are masks necessary?”
Furness said he would be fine with this scenario, provided people don’t walk too closely together and allow the breeze room to do its work.
If people are just walking outdoors, Sinha said, a mask is “probably not” necessary. But the way humans naturally interact can increase the risk of transmission.
“We like to say we’re just walking and we’re outdoors. But is there going to be a hug involved? If you tell me that there’s a possibility that you might be within six feet of each other, you’re on a crowded sidewalk, you bump up next to each other, whatever the case, a mask is massively helpful. … It’s just that other layer of protection,” he said.
Scenario 3: “My husband and I, no children, will be staying at home seven days prior to Christmas with no outside contacts. If we do this and a rapid test on the day of visiting, are we safe to be around one other household (my parents)?”
“You would be wasting a rapid test,” Furness said.
“If you have no conceivable exposure for seven days, the rapid test will come back negative even if you are infected. That’s because you won’t be particularly contagious. Assuming all parties are fully vaxxed, you are not much of a health threat to your parents,” he added.
Sinha said in this scenario, it’s equally important for the parents to do a rapid test, depending on what their activity has been like.
“Are there parents going out to clubs and hanging out? We don’t know. So it depends on what their parents are up to. … If everyone’s quarantined and everyone does rapid tests, it’s probably a pretty low-risk gathering,” he said.
Scenario 4: “If I am triple-vaxxed, wear an N95, practise safety protocols, and buy insurance with COVID-specific policies, how bad of an idea is travelling right now?”
While it can be done safely, it’s generally not a good idea, the experts said.
“The problem with travel is that you are only as safe as the riskiest person with whom you have forced contact. I wouldn’t do it,” Furness said, adding that his objection is related to both safety and morality, because travel can spread the virus even if you yourself are vaccinated.
Sinha’s answer was also blunt — he recently cancelled a planned Boxing Day trip to Panama.
“I’m tripled vaxxed, I wear N95 masks, I practise safety protocols and have COVID insurance. So how bad it is travel right now? Well, bad enough for me to say I’m going to cancel that trip,” he said.
He added that one should consider what could happen if they get sick while abroad.
“If you’re travelling to a low-resource country for a sudden vacation, if you end up in that local hospital, the question is how overwhelmed are they? Especially when that destination is probably not likely to have as high a rate of vaccination as we have right now,” Sinha said.
Scenario 5: “My friend wants to go to church and sing just before our two families, eight persons Christmas dinner. Is it safe? I am very concerned and my adult children too.”
Again, it depends on the restrictions at that church — are they allowing unvaccinated people? Are people wearing masks and distanced?
Furness said going to a church and singing is “one of the least safe things” he can imagine anyone doing and would advise against gathering indoors with people who participate in high-risk activities.
“If they are exposed immediately before the family dinner, they won’t infect the people at the dinner, because the virus needs 2-plus days to reproduce. But the mindset is such that I would expect them to have engaged in multiple risky behaviours apart from church singing,” he said.
Scenario 6: “How safe are gatherings of double-vaxxed adults (10 of us) and three single-vaxxed kids? One of the family units travelled internationally a week ago and another has anti-vax family they’re seeing two days before our gathering. I’m feeling uneasy about it, but is it safe?”
Sinha said the double vaccinated adults don’t necessarily have a good protection from the Omicron variant. The kids who have received only one vaccination are also at risk.
“Depending if the kids have been going to school or not, and we know that one in four schools right now in Ontario has been experiencing an outbreak, that’s a problem,” he said.
Gathering with people who also travelled internationally recently makes this a moderate-to-potentially-high-risk situation, Sinha said.
“They say ‘I’m feeling uneasy about it.’ Well, you should, because there’s a lot of red flags. It is it safe? Well, nothing is safe. But there are things they can do to potentially make it safer.”
The National Institute on Ageing, in partnership with the Public Health Agency of Canada, has developed an online tool that allows people to input factors and assess the risk of contracting COVID-19 in advance of an upcoming gathering. There is both a three-minute survey and a more comprehensive 10-minute survey.
“It’s as if you have your own private epidemiologist or infectious disease expert,” Sinha said.
The tool focuses on factors that people can easily determine, such as who’s been vaccinated, how large the gathering is and if people have comorbidities, so it doesn’t take into consideration other factors that are harder to verify, such is if the highly-transmissible Omicron variant is circulating at the planned gathering. But Sinha said they are adding the use of rapid tests as an option in the coming weeks.