We know the more people come together during COVID-19, especially indoors without proper social distancing and safety protocols, the greater the risk for COVID-19 transmission. But during a call with governors on Oct. 13, CDC Director Robert Redfield, MD, voiced concern about small gatherings as well, given that cases and hospitalizations are still on the rise nationwide. To put things into perspective, The New York Times reports that there has been a 23 percent increase in average cases per day in the past week.
"What we're seeing as the increasing threat right now is actually acquisition of infection through small household gatherings," Dr. Redfield said, according to CNN. "Particularly with Thanksgiving coming up, we think it's really important to stress the vigilance of these continued mitigation steps in the household setting." Two public health experts gave their own opinions on the risk of small gatherings - here's what they had to say. Spoiler alert: they agreed with Dr. Redfield.
Are Small Gatherings Safe During the COVID-19 Pandemic?
Anna Bershteyn, PhD, assistant professor of Population Health at NYU Langone, told POPSUGAR, "Household gatherings can create a big temptation to bend the rules in order to feel more normal and friendly, but they are also where the stakes are highest for us because we wouldn't want to risk putting our loved ones in harm's way." She explained that though it's reasonable to guess that household gatherings will become a growing source of transmission as the holidays approach, the truth is "for most COVID-19 cases, we never find out exactly where the transmission happened." She reiterated that transmission can happen anywhere people gather and especially without masks, good ventilation, and social distancing.
"You have very little control over the risk in an indoor environment unless you require everyone to wear masks all the time, which is not possible when eating or drinking," Dean Winslow, MD, an infectious-disease doctor at Stanford Health Care, told POPSUGAR. "Understand that you're assuming a fair degree of risk unless you can gather outdoors and maintain reasonable social distance."
Should I Go to Small Gatherings During COVID-19?
Dr. Bershteyn suggests that you only have small gatherings like holiday dinners with your household members and said you can invite your pod (aka people who follow strict safety guidelines while in public and who then socialize together in person), as long as nobody is sick or has had close contact with people outside the pod. "If you're inviting anyone else, you'll need to be outdoors or have lots of open windows, maintain social distancing - think separate tables for each pod at least six feet apart - and keep masks on when you're not sitting down to eat," she said.
Dr. Bershteyn added that virtual dinners might be your best bet for seeing loved ones, but outdoor gatherings with masks, hand hygiene, and at least six feet between different households is an option if safety measures are followed. She also noted that it's great to request that people get tested before coming together, but "the safety that you get from having people test before visiting has a very short shelf life. To really bring down your risk, you would need people to test that same day or the day before, but often you can't even get a test result back in such a short time."
What Is Considered Close Contact For COVID-19?
On Oct. 21, the CDC expanded its definition of what "close contact" is during the pandemic. Previously, the agency defined close contact as someone who spent at least 15 consecutive minutes within six feet of a person with a confirmed case of the virus. Now, the CDC is saying a COVID-19 close contact equates to shorter but repeated contacts adding up to 15 minutes or more over a 24-hour period "starting from two days before illness onset (or, for asymptomatic patients, two days prior to test specimen collection) until the time the patient is isolated."
This change came after a report found that a correctional officer in Vermont had "multiple brief encounters" within six feet of six inmates who ultimately tested positive for the virus. The report showed the interactions totaled at least 17 minutes during an eight-hour shift, and while the officer wore a microfiber cloth mask, gown, and goggles, there were some encounters where the inmates did not wear masks. The CDC did note, however, that lack of data makes it difficult to precisely define "close contact," adding that now, "15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition for contact investigation."
Caitlin Rivers, PhD, MPH, a senior scholar at the Johns Hopkins Bloomberg School of Public Health, told NPR that this change in definition will "mostly impact workplaces, schools, and other places where people spend all day together off and on." Dr. Bershteyn told POPSUGAR that, ultimately, "Six feet and 15 minutes aren't magic numbers. They are just a general guideline of where, together with masks and good ventilation, the risk [of transmission] gets pretty low."
Dr. Bershteyn noted, "It makes sense that risk can add up over many short exposures. It doesn't matter if it's 15 minutes in a single stretch or a series of shorter contacts that add up to 15 minutes. Either way, it's the same number of breaths when someone could inhale infectious virus." Bottom line? Keeping further distance is better, and so is minimizing your time with others.
The CDC advises anyone who has been in close contact with a COVID-19-positive person to stay home for 14 days from the last time you had contact with that person and to monitor your own symptoms. Plus, aside from the aforementioned definition, the CDC says close contact can be providing care for someone who has COVID-19, kissing or hugging someone with COVID-19, sharing utensils with them, or having been coughed or sneezed on with respiratory droplets.
A Small-Gathering Checklist If People Are Coming Over to Your House During COVID-19
Dr. Bershteyn laid out some suggestions for what to do when people are coming to your house in order to minimize your risk of getting COVID-19. Though we know that every situation is different, keep these in mind:
Have a clear idea of who will be at the event ahead of time. The number of people you can safely host depends on the space you have.
In order to understand exposure risks, ask where people have been working, where their children have been going to school or day care, and who they have seen.
If you're inviting your pod, make sure they've been as careful as possible beforehand and ask if they've gotten tested recently (keeping in mind the aforementioned note).
If other people are coming over besides your pod, encourage six feet in between people from differing households, masks, and hand hygiene. If there isn't plenty of airflow indoors, consider an outdoor gathering (outdoor gatherings are recommended over indoor gatherings).
Avoid crowding at entrances, and take extra precautions for bathrooms. Turn on the bathroom fan, and offer extra handwashing options such as the kitchen sink to minimize bathroom traffic.
Try to keep your gathering on the shorter side. If you can't see yourself calling an early end to a gathering that you deem unsafe, have an excuse ready (not that you need one).
Know that things can come up unexpectedly during your gathering. Have a plan for what to do if you're uncomfortable, and talk about this with your partner or household members beforehand.