The past three years the holidays have been clouded with pandemic concerns. Now, with COVID, the flu and RSV circulating—what should folks look out for at gatherings?
The Sacramento Bee service journalism team posed the same questions to three California hospitals. The following doctors provided emailed responses:
Dr. Matthew Eldridge, chief of infectious diseases for Kaiser Permanente South Sacramento
Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis
Dr. Namrita Gogia, vice chair of internal medicine and COVID-19 czar at Dignity Health
Here is what they had to say,
The following has been edited for clarity and brevity.
Is it safe to gather indoors—or should we head outside?
Eldridge: Gathering outdoors is safer than indoors; if there is an indoor gathering you want the space to be well ventilated—open doors and windows, run HVAC systems, and install high-quality air filters. Properly worn masks remain an effective option to reduce the risk of respiratory viral infections.
Blumberg: Events outdoors will be safer, but this may be uncomfortable or not feasible due to the weather.
Gogia: I think it really depends on the amount of risk that each individual and family is willing to tolerate. Overall, I think it’s reasonable to gather indoors.
Is a potluck-style gathering safe?
Eldridge: Potluck style can be done safely, but you may want to limit everybody touching the same foods and of course people should wash their hands before eating.
Blumberg: No problem at all. COVID and influenza are primarily transmitted via the respiratory route, and RSV is transmitted via large droplets, which means touching contaminated serving utensils may result in transmission. But food is not a risk for transmission of these viruses. To reduce risk of RSV transmission, you can carry a small container of hand sanitizer and use it after serving yourself with shared utensils prior to eating.
Gogia: Many of the illnesses we are seeing this season are respiratory illnesses, so whether the food is served potluck style or plated, it should be fine.
If someone is sick with the flu—not COVID—should they gather?
Eldridge: If someone is sick with the flu then they can readily infect others. People with the flu should isolate at home until they have no fever for at least 24 hours.
Blumberg: No way. Influenza is no treat and may result in serious illness or death. Those ill with the flu should stay home until they are clinically improved and without a fever for at least 24 hours, generally 4-5 days after symptom onset.
Gogia: It is recommended that those who aren’t feeling well or have any upper respiratory symptoms such as a runny nose, cough, fevers, chills, nausea, body aches, or sore throat stay home.
What tips do you have those hosting a holiday gathering?
Eldridge: In terms of how to gather safely, the same approaches that were relevant to COVID these past few years still apply. As noted by public health agencies, there are clear ways to reduce the spread of disease or decrease the severity of illness.
Getting the yearly flu vaccine and COVID boosters. These are ok to receive at the same time.
Stay home if you’re sick, or if you feel under the weather, and be sure test for COVID
Wash your hands often
Consider testing for COVID before gathering
If gathering indoors, try to open windows and doors to ensure good air flow through the room. Consider running the HVAC system with high quality air filters.
Flu testing is not recommended for everyone but is important for certain high-risk groups. Talk to your provider if you’re unsure if you should test for flu. RSV testing is not required for most people.
Blumberg: Make sure that everyone at home is fully vaccinated with indicated boosters for COVID and influenza, and request that your guests also be fully vaccinated. Anyone who has a fever or respiratory symptoms should opt out of the gathering so that others are not at risk of infection. For those who want to reduce the risk further, request that all attendees test for COVID the day of the event to make sure that those with asymptomatic infection stay away to further reduce transmission.
Gogia: This holiday season, I encourage my patients to gather with their family, friends, and loved ones. That being said, nobody wants to be the host of a super spreader event! Hosts can consider asking those attending to refrain from coming if they have any upper respiratory symptoms. If possible, have the event in an outdoor area or an open area with good ventilation. In some situations, for example, if an elderly or immunocompromised person will be in attendance, it may be ideal to ask those attending the event to test beforehand.
What are your tips to those participating in holiday parties and how should they prepare?
Eldridge: Same as above.
Blumberg: Be fully vaccinated and stay home if you are sick. For those who become symptomatic after a large gathering, are quick to test for COVID—and if the COVID test is negative —then consider getting a test for influenza if you are interested in starting antiviral treatment since this is most effective if started within 48 hours of symptom onset. (And for those who may be drinking a lot, stay hydrated!)
Gogia: After the event, if they develop any symptoms of an upper respiratory infection, they should stay home and test for COVID-19. They can do a rapid test at home when symptoms begin and, if negative, test again in 48 hours to reduce the risk of missing an infection and spreading it to others.
Is there anything else you would like to add?
Eldridge: We encourage everyone at the individual level to do what they can to protect themselves and others. We urge people to receive their flu vaccines and their COVID-19 vaccinations/boosters, which continue to protect against severe illness and death. And we continue to recommend wearing masks and social distancing, especially during surges in indoor spaces amongst other people. These measures help protect the most vulnerable in our communities from COVID-19 disease.
Blumberg: I didn’t mention masking for these situations since it is less practicable when people will be eating and drinking. But masking is also proven to reduce risk of COVID, influenza and RSV so can be considered if feasible.
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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
