A collection of scientists, clinicians, virologists, and infectious disease experts offer their insight into a safe approach to the upcoming holidays.
Holiday celebrations should be safe and fun -- that has always been, and still is, true. Just as our knowledge on how to create those safe celebrations has increased over the past 40 years, so too has our knowledge on COVID-19 and SARS CoV-2 (the virus that causes COVID-19).
This season, we can plan safe, fun, and spirited celebrations while still maintaining the spirit of our holidays. We encourage you to think of new and creative ways to celebrate Halloween and the Dia de Los Muertos weekend. Our latest scientific understanding of COVID-19 and the virus that causes it, SARS CoV-2, can guide our celebration planning and choices.
Things to Consider Include:
An updated understanding of spacing between people.
Outdoor events for better ventilation.
Choice of mask to use.
An increased understanding of the amount of asymptomatic transmission of this virus.
Reminders of hand hygiene practices.
Current knowledge of the various symptoms with which infection could present.
Trick-or-treating is discouraged this year. We hope that people will embrace new celebrations while still maintaining the spirit of our upcoming holiday season.
Studies are finding infective viruses can remain infective on various surfaces for greater than 24 hours, longer in cooler temperatures, and longer in the absence of UV light. This fact, taken with our knowledge of asymptomatic transmission, leads us to determine that passing out candy at the door, and having children moving household-to-household is not a good experience to pursue.
One idea: Remember "It’s the Great Pumpkin, Charlie Brown,” by Charles Schultz? In the spirit of new traditions and staying vigilant in controlling the spread of SARS CoV-2, have "The Great Pumpkin” visit and leave small gifts for children in a pumpkin patch in your yard. Making “Welcome Great Pumpkin!” signs could establish a fun new tradition. The sign-making, wearing costumes, staying within household members/small groups, and the anticipation of wrapped small gifts that “magically” appear during the evening is a good example of a new, healthier, and safe Halloween celebration choice.
The greater the space between people, the better. Based on our increasing knowledge of the biology associated with air currents, a distance of six feet or more is recommended, at a minimum. Six feet should be considered the bare minimum, not the goal.
Based on our increasing knowledge of respiratory droplet size and spread on air currents, once the droplet has left the source, smaller moisture particles -- either those produced at the source as we breathe, talk, laugh, and sing or those that become droplet nuclei and are now aerosols from initial larger droplets -- can potentially transmit the infective virus.
Outdoor events where physical distancing is properly practiced are better than indoor events, as an outdoor environment improves airflow and natural ventilation.
Nighttime activities in the cooling fall months offer increased transmission opportunities for the virus. Studies show that the SARS CoV-2 microbe stays infective longer at cooler temperatures and in the absence of UV (ultraviolet) light. As air temperatures decline, and as the sun sets earlier, the virus's ability to remain infectious increases.
Asymptomatic people may produce as many infectious viruses as those that show symptoms. These people can easily transmit the virus to others because they don’t know they have it and may be less cautious around others. The CDC has regularly updated our knowledge on asymptomatic transmission rates, with current estimates from the CDC being in the 40-45% range. Studies from around the world, including Iceland and most recently Korea, indicate an asymptomatic transmission rate in the 80-88% range.
Currently, the CDC recommends staying home if an individual has experienced any of the following symptoms in the previous 48 hours:
- Fever or chills (fever of 100.4 F (38 C) or above)
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
Masks (Costume and Face Masks)
The choice of mask use for Halloween and celebrations is important as we combine our growing knowledge from different aspects of this microbe and its transmission.
Unless a person is under the age of 2 or has a medically identified breathing problem, cloth mask use (preferably 3-layer) aimed at providing absorptive ability from the inside is recommend, required in many settings, and should be sought.
Many Halloween and Dia de Los Muertos masks are made of a polymer (plastic) of some sort and most with have a smooth surface. Current CDC guidelines do not recommend use of plastic face shields in place of a mask. Such smooth, inanimate surfaces can assist the virus in maintaining its infectivity.
Use a 3-ply cloth mask under your costume to benefit from the absorptive function of such masks. Make sure the mask completely covers the nose, since this has been shown to be a significant site of viral replication.
We are entering into respiratory infectious disease season in the northern hemisphere and, as such, should maintain vigilance.
To safely approach the holidays this year, seek to follow the currently established public health guidelines, including those at the CDC, Yakima Health District, and Washington State Department of Health.
While our vigilance has helped to remove Yakima County from a list of “hot spots” of new infections in the country, we must continue working together to avoid losing the progress of the good work we have done. The virus has an innate reproductive number of 2-3 (i.e., each infected person can transmit it to 2-3 additional people).
Yakima County had 632 new COVID-19 infections and 15 deaths over the past month at the time of this writing (October 13, 2020). This produces over the past month an average of 21 new infections per day (7 times the State Department of Health acceptable rate) and a death every other day in our County. While rates of new infections in Yakima County have decreased significantly, we must continue to be vigilant and united in our efforts.
Written by William Elliott, M.D., Ph.D. Kimberly Taylor, Ph.D., Albert Brady, M.D., and Julie Randolph-Habecker, Ph.D.