The holiday season is upon us, and so is omicron. Manage your risk this summer with these handy tips.

You don’t need me to remind you that this year’s holiday season is different. This time last year we had Covid-19 eliminated and the whole country was at alert level one. We had an outbreak in Auckland in August 2020, but alert level three restrictions and our strategy of test-trace-isolate got that under control by October. Around that time, news broke of a new, potentially more infectious, version of the virus circulating in the UK. Remember alpha? Well, on December 18, 2020, the WHO designated alpha the world’s first Covid-19 variant of concern. 

Fast forward a year and alpha is a distant memory, replaced by the more infectious delta variant. This variant changed everything for us and means we’re entering this holiday season having to think more carefully about how to keep ourselves and each other safe from Covid-19. Our daily case numbers are currently very low, which is great. But they are not zero, so there is a risk that you, or someone you encounter, may have the virus. 

Of course, in recent weeks a new and even more infectious variant of concern has emerged. Omicron is already overtaking delta in many countries. It feels like many places are sleepwalking into another disastrous wave. Cases are now arriving in New Zealand, and we can only expect the number to grow. Currently the thousands of people managing our border, as well as those returning, are having to do all the heavy lifting to keep omicron out of our community. But that doesn’t mean we shouldn’t do our bit.

In fact, now is the time for us to up our game and adopt the habits that will reduce transmission of the virus, regardless of which variant it is. If omicron sneaks in, all these habits will help us. I’ll get to those habits soon, but first Toby Morris and I have pulled together a list of the factors to consider so you can minimise your chances of both catching and spreading Covid-19. 

Vaccination status

The first factor to consider is are you and the people around you vaccinated? If so, with how many doses, and when was the last dose? 

When it comes to delta, we know the vaccines do a pretty good job of stopping people becoming infected in the first place and an excellent job protecting people from serious disease. The real-world data shows that two doses of the Pfizer vaccine offer good protection initially but that protection wanes over time, hence the need for a third (AKA booster) dose. For omicron, it’s looking like two doses isn’t enough to stop people becoming infected and three doses are needed.

What all this means is that when it comes to delta, people who are unvaccinated are most at risk of catching and spreading Covid-19. At the moment that’s a dwindling number of over 12s but all of our under 12s. Despite what you might have heard, children can get Covid-19. In our current delta outbreak, one in four of our cases have been under 12. That’s nearly 2,500 children. 

When it comes to omicron, unless you’re boosted, definitely consider yourself at high risk of catching and spreading Covid-19.

Health status

Unfortunately, the vaccines don’t work as well for everyone. People with some types of cancer, those who’ve had an organ transplant, those who have kidney disease, or those who are immunocompromised are less likely to have a fully protective immune response. That means they are more at risk of having a severe Covid-19 infection if they catch the virus. 

If you or someone in your life falls into this category, I would urge you to be extra cautious. 

Indoors or outdoors? 

The most crucial thing to remember about Covid-19 is this: the virus spreads through the air. If someone is infectious – and people can be infectious before they even realise – they will shed virus particles into the surrounding air when they breath, talk, shout, sing, sneeze and cough. Those virus particles will hang around in the air to be breathed in by others. 

This means open-air spaces are safer than enclosed spaces, especially if the space is small or badly ventilated. Lower your risk by keeping meet-ups outdoors and visiting hospitality venues with outdoor spaces to eat and drink. If you are indoors, make sure windows and doors are open to provide better ventilation. Saying that, airflows are tricky, and in some spaces, opening a door or a window can create spaces where the air doesn’t flow well and where virus particles can accumulate if someone present is infectious.

Personally, if I’m going to be in a small, badly ventilated space then I make sure I’m wearing a well-fitted three-layer fabric mask or surgical mask. I love going to the cinema, so I’ve been avoiding small-sized theatres and forgoing the popcorn and keeping my mask on.

Someone asked me on social media about using pools and hydroslides. Again, outdoors is best. I’d be cautious about hydroslides that have long enclosed sections, though people whizzing through them probably means the air flow is pretty good. 

Proximity and time

Proximity to other people and time spent with them is also important, which is why we see so much transmission of the virus in households and workplaces. It’s safer when there are fewer people around, and you can keep your distance. Saying that, if you are keeping your distance but in an enclosed and badly ventilated space, after a while it won’t make much difference. The virus particles will accumulate and basically cancel out the distancing. 

All these factors work in combination

When assessing your Covid-19 risk, or the risk to those around you, you’ll need to weigh up all these factors. The more of them there are on the danger side, the more risk there will be of you catching or spreading the virus.  

Lowering the risk even further – masks, scanning and testing

I think it’s worth reiterating here that Covid-19 is a serious disease, especially for those who are pregnant. But it can and does hospitalise even young, fit and healthy people. A recent report from the UK looked at the characteristics of people with Covid-19 admitted to critical care between May and November this year. The majority were unvaccinated and ranged in age from 30 to 60 years old. Their average age was 49. For these unvaccinated people, just 3.6% had a severe underlying health condition and just 2.2% were immunocompromised.  

Even those who experience a mild infection can end up with debilitating symptoms that last for months – so-called long Covid. Some people with long Covid are now meeting the diagnostic criteria for chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME). If at least some forms of long Covid are CFS/ME, then it’s likely many of those people will never fully recover. Read Emma Vitz’s piece on what this might mean for New Zealand.

I know lots of people will be scared, angry or frustrated by the emergence of the omicron variant. The virus will keep evolving while the world doesn’t use all the tools in the toolkit to stop transmission. So let’s do our part. Here’s what else we need to do minimise the risk of catching and spreading Covid-19:

1. Get vaccinated. Get your third dose as soon as you are eligible. Get your children vaccinated as soon as that becomes possible (which we now know is January 17 for 5 to 11-year-olds).
2. Wear a mask. With omicron being that much more infectious, I think we need to be upping our game on the mask front. The more of us who wear them, and the better the mask we wear, the more protected everyone will be. And by mask I don’t mean those ridiculous little plastic things that just sit in front of your mouth and nose and which people are presumably choosing because they are more comfortable to wear. They are worse than not wearing a mask at all. They just trap air in front of your nose and mouth and increase your risk of getting infected if the virus is floating around.Masks need to fit well and be worn over your mouth and nose. Honestly, wearing it under your nose defeats the entire purpose. Single-layered fabric masks are better than nothing, but double or triple layers are better, especially if worn over a surgical mask. I have a triple-layered fabric mask with a changeable filter and have just bought some KN95 masks for higher-risk environments.

   

   3. Keep track of your movements. This will help you find out if you’ve been exposed, or, if you are infectious, will help contact tracers identify who you have exposed to the virus. 

   4. Get tested if you have any symptoms that could be Covid-19. Don’t brush them off or wait a few days. If you do have Covid-19, it’s vital that anyone who has been exposed is notified so they can isolate and break the chain of transmission. Remember, we also have new antiviral medicines now that look like they do a good job of preventing hospitalisations and deaths, but they need to be given within a few days of symptoms starting. The sooner you get tested, the sooner you can be treated.

   5. If you have symptoms and are awaiting a test result, isolate. 

I know we are all exhausted. This pandemic sucks. But ignoring it won’t make it go away. What will help is stopping the virus from transmitting. And we can all help do that. New Zealand has one of the lowest Covid-19 death rates in the world. Let’s keep it that way.