Giant feasts, candlelight, decorations, gift exchanges. With so much to look forward to during the winter holiday season, respiratory viruses might be the last thing anyone wants to focus on—but are important to be aware of and to take action on.
As the country enters its fourth holiday season of the pandemic, viruses are the last thing you want to give or receive. It is especially important to take precautions in colder months: Spikes in hospitalizations and deaths from viruses like influenza, Respiratory Syncytial Virus (RSV), and COVID-19 are highest from October through April.
“Respiratory illnesses are more likely to spread during the winter season because we’re in close quarters,” said Ayman El-Mohandes, a pediatrician, professor of epidemiology and biostatistics, and dean of the CUNY Graduate School of Public Health.
COVID-19 spread is down but not entirely out: Nationwide, the Centers for Disease Control and Prevention (CDC) is still reporting about 2,200 daily hospital admissions. On average, 488 New Yorkers are testing positive for COVID every day, according to the city’s health department, with the most transmission currently on Staten Island.
Black, Indigenous, and elderly Americans are still among those at highest risk of hospitalization and death.
El-Mohandes said that while the most recent variants circulating had milder clinical symptoms than previous ones, that doesn’t mean we shouldn’t be worried about the spread of the disease.
“COVID is still around; it’s not gone yet,” El-Mohandes said. “We should not assume that every single variant is going to be milder.”
In the weeks, days, and hours leading up to your next holiday gathering, here is a virus-fighting plan from New York public health experts for how to usher in a healthier holiday season.
Weeks before: Get your shots
Getting updated boosters even after getting multiple COVID-19 shots is important because the viruses are still mutating and immunity does wane over time. Call 212-COVID19 or visit vaccinefinder.nyc.gov to find a location near you and schedule a COVID-19 booster or your RSV or flu shot.
“Though we’re not hearing about the variants every day in the news like we were before, the viruses are still mutating, and they’re still variations that they’re accounting for in [new] vaccines,” said Lesley Green-Rennis, a public health professor and health educator at BMCC.
Céline Gounder, an infectious disease specialist and editor-at-large for public health at KFF, said that COVID-19, like RSV and flu, will continue to be a problem for [the] most vulnerable groups, including seniors and very young children.
Gounder said she got her COVID-19 and flu shots together and her RSV vaccine in a second appointment, weeks before Thanksgiving. For New York City residents, COVID-19 shots are free at NYC Health + Hospitals clinics.
“You can get all three together,” she said. “I would advise getting RSV separate from the other two just because we have seen a little bit more in the way of side effects. Nothing serious, but it’s just more uncomfortable.”
Getting severely ill just isn’t worth it, Gounder said, and a two- to three-week lead time before an event can help avoid a trip to the hospital. NYC Open Data from the city’s health department showed that about 1,595 New Yorkers died of COVID-19 between last December and this February. In the 2022–2023 season, 176 New York City kids died of the flu.
“The very young may not die from flu or RSV, or COVID, but they are at high risk for ending up in the ER in the hospital or the ICU,” she said. “And just because they didn’t die does not mean that’s not a tremendously traumatic experience for the parents or the child.”
El-Mohandes said RSV vaccines are available for everyone, including babies as young as eight months old. Infants and children, along with people with bronchial asthma or chronic obstructive pulmonary disease (COPD), are especially vulnerable.
He advised treating a trip to your local pharmacy for your shots like all of the chores that are gladly done during the holidays: cooking, going to the grocery store, and picking up the turkey.
“Check it off as one of the things you do in your expression of caring and love for people that you consider family and people [who] are close to you as friends,” he said.
Gounder said that for Thanksgiving, air filtration is a valuable way to reduce the spread of viruses in the air. You can spend about $80 at the hardware store to build a high-quality DIY air purifier. She also counts on having lots of tests available for the holiday season.
Although free supplies are limited, you can still order free at-home COVID-19 tests from the federal government at covid.gov/tests. Text “COVID TEST” to 855-48 to find a location near you or go to your local library to pick up free tests.
Before the holiday, Gounder suggested calling guests about the event and agreeing to a plan and contingency plans weeks before the event, in case someone gets sick.
“Don’t wait until that happens, because then it can be a lot more stressful and there might be more tension that could be avoidable,” she said.
Whether you’re staying in town or traveling for the holidays, Gounder said to map out where your most accessible urgent care or minute clinic might be. Aim for one with a pharmacy that can test you and fill a prescription treatment, if needed. She said antibiotics that people often request are completely ineffective toward fighting viruses.
“That’s the kind of thing you want to do ahead of time,” she said.
For those gathering for a meal or celebration, El-Mohandes advised thinking of the most spacious and well-ventilated place available to host large get-togethers. His tip: Pick the home of a family member or friend with the largest space and have everyone contribute to preparing the meal so that person doesn’t feel burdened.
Weeks before…
- ✅ Schedule vaccinations. Take COVID-19 and flu together, RSV separately. The ideal is to go to the pharmacy and get two or all three together, so make a date to get shots for yourself and a loved one.
- ✅ Get tests. Order free at-home COVID-19 tests from the federal government at covid.gov/tests.
- ✅ Build a Corsi-Rosenthal box, a science-approved DIY air purifier ,for hundreds less by going to the hardware store. Tutorial here.
- ✅ Make a plan with family and friends, such as hosting dinner at the largest home to create more opportunity to socialize at a distance.
- ✅ Get vaccinated. Take COVID-19 and flu together, RSV separately.
Days before: Travel safely
Green-Rennis said that people often neglect taking care of one important factor for good immunity: stress.
“People are anxious about the holidays, and they stress themselves out. All of that impacts your immune system, which makes you more at risk,” she said.
Gounder, who is traveling for the holidays, said that in addition to being current with respiratory vaccines, she continues to wear masks in crowded public settings like the subway, airport, and planes, and especially encourages it in the days leading up to a holiday trip.
“Those are the three places I consistently continue to wear a mask,” she said. “Remember that COVID-19 vaccination is really more about preventing severe disease, hospitalization, and death, not necessarily infection and transmission, so masking is an effective option to prevent getting and spreading the virus.”
Another good motivation to mask: It’s not worth the risk of missing out. “You don’t want to lose the opportunity of celebrating with your loved ones and with your family,” El-Mohandes said.
He also advised being “extra cautious” in the days leading up to travel and wearing a mask on buses and trains as well. Strangers may be willing to take more risks than you would, “so just be cautious that way,” he said.
If you’re heading somewhere for the holidays, check out the incidence and prevalence of COVID-19 or other diseases wherever you’re traveling, Green-Rennis suggested.
If guests get sick in the days leading up to a gathering, Green-Rennis encouraged hosts to be firm about telling guests to stay home if they are not well. No one wants to do that around the holidays, but “if they have any symptoms at all, they should stay home and keep themselves isolated,” she said.
“Most people get together in multiple units of large numbers of people,” she said, such as at work, with family, with partner’s family, and in school settings. “All of those are opportunities for bacteria and viruses to be transmitted in all kinds of ways.”
For sick guests, El-Mohandes suggested finding alternative ways to connect when illness interrupts plans.
“Maybe have a Zoom call with them as they’re assembled around the table or around the tree…maybe your expression of love is to maintain safety,” he said.
Days before…
- ✅ Check in with family and friends about the plan; send reminders.
- ✅ Wear masks more often to reduce risk of getting sick, including on planes, trains, and automobiles.
- ✅ Make a backup-plan to get food to family members who get sick…and encourage them to stay home!
Day of your gathering: Test!
Before you leave, take a COVID-19 test. If you’re hosting, encourage your guests to test before they leave home and have spare tests on hand just in case.
Green-Rennis said public health actions, like washing hands frequently and avoiding touching others and then touching one’s eyes or mouth, help reduce the risk right before and during a gathering.
El-Mohandes said that close proximity at the dinner table creates higher risk, so if temperatures permit, sit outdoors where more ventilation is possible.
Hours before…
- ✅ Test everyone before you leave the house. Gounder said holiday plans with friends this year will include group testing.
- ✅ Wash hands, avoid wiping face and touching eyes.
- ✅ Mask indoors when possible.
- ✅ Turn on air purifier.
- ✅ Practice social distancing. Eat outside, if possible.
If you get sick…
What if someone gets a bug? Maybe it’s you. If so, take care of yourself and isolate. New York City residents who test positive for COVID-19 can schedule an appointment online to get tested at a clinic. For medication, set up a virtual appointment with a clinician.
Residents can also set up a free same-day telemedicine appointment with NYC Health + Hospitals by calling 212-COVID-19 (212-268-4319) to get assessed and treated by a medical provider. If you’re feeling severe COVID-19 symptoms, asking for Paxlovid, an antiviral COVID-19 treatment, in that appointment can mean same-day delivery. The drug is very effective at reducing how severe your symptoms are and how long they last. Tamiflu and Xofluza are good antiviral treatments for the flu.
“It’s worthwhile to get a test, because then you can actually get an antiviral that will do something for you and help you,” Gounder said.
With COVID-19 cases, the CDC advice is to isolate until you test negative at least two days in a row. Even a faint positive line means a positive test.
Sick or not, a key to safety over the holidays is being clear with yourself about the due diligence that is important to protecting your loved ones and yourself in the hours, days, and weeks leading to gatherings, said Green-Rennis. Know what you are comfortable with and need to do help advocate for it.
“Everything kind of goes back to like your own personal knowledge and conviction,” she said. “You may be asked about it. Being comfortable enough to…say it in a very polite way to use it as an opportunity to educate others and [make] sure that you’re doing everything that’s in your power to stay safe.”
If you get sick…:
- ✅ Test with an at-home COVID-19 test or make an appointment at a NYC Express Testing clinic. RSV and flu tests are available at local pharmacies.
- ✅ Seek an antiviral treatment if you get a virus.
- ✅ Mask indoors and avoid contact with others — a considerate move, even if you’re sick with something other than COVID-19.
For additional resources about COVID-19, visit www1.nyc.gov/site/coronavirus/index.page. COVID-19 testing, masks, and vaccination resources can also be accessed on the AmNews COVID-19 page: www.amsterdamnews.com/covid.