When the story of 18 members of an extended family with COVID-19 hit the news, it documented what experts had already known was likely. Multiple family members attended a party where one person was sick. Over the course of a couple of weeks, 18 family members became infected. While it’s possible some of those 18 were infected elsewhere, all were primary or secondary contacts to the index case.

I’ve stated that for respiratory diseases, it’s difficult to identify the source. And we typically don’t search for the source, except when we see a cluster of cases. Identifying the source in this case doesn’t tell us anything about the location where the party took place. Instead, it helps us to understand the transmission dynamics — close contact indoors in settings where people let their guard down.

Most businesses are adhering very strictly to the guidelines. It’s when people leave the bar, the bingo hall, the shop, that we let our guard down.

I’m sharing this NOT to shame the family. I appreciate their willingness to share their story. We’re a friendly community. A loving society. We gather with family and friends.

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NOT during COVID. A party at my house in November. We haven’t had one of these in awhile and won’t for a long time.

How many families have a weekly Lotería night or dinner with the extended family? These are crucial events in our lives. Without them, our mental and emotional health suffers. I love parties. I’ve had 90+ people in my house before. I can’t do that now.

In the Time of COVID, we need to re-think if/how we host such gatherings. How do we socialize safely? No method of risk reduction will bring it down to zero, but we can bring the risk down nonetheless.

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I loved gatherings like this, but we’re not having them. This is from 2013.

At a typical family gathering, even if it’s outside, people are hugging, kissing, arms on each other, sharing food, sharing drinks. That’s what I love about our culture. And that’s what’s spreading SARS-CoV-2, the virus that causes COVID-19. We have to change the way we show our affection and celebrate milestones.

  • Limit the number of people. Less than 10, ideally 5, but those aren’t magic numbers and all carry risk. Can you fit 10 people in your house in a way that allows for distancing? The more people, the more likely you are to crowd together, just by nature. So limiting the number isn’t just based on physical space. Keep it small.
  • Is anyone high risk? If so, find others way to interact with them one on one, with proper masks. Don’t bring grandma into a house full of 20-somethings. We zoomed my mom’s 86th birthday and while it wasn’t the same, it had the added advantage of allowing family from across the continental US and Guam to participate.
  • Each person has their own bowl of chips, don’t put your hands in the same big bowl. Avoid the buffet with 20 hands touching it all. Avoid communal food.
  • BYOB is great here — bring your own and keep it to yourself. That may feel selfish, but it’s actually very giving.
  • Stay outside when possible, still adhering to limited numbers. Heat doesn’t kill the virus (you need 130F+ directly on it), but the virus is more “diluted” for lack of a better term. It’s less likely to hang in close contact for very long. But you still need 6ft+ between you.
  • Wear a mask, properly, consistently. Masks aren’t perfect, they’re just one tool to limit spread. Of course you’re going to eat and drink and take the mask off. Take it off properly, not grabbing the front of it, not pulled down on your chin. Keep a distance from others when eating/drinking. Put the mask back on when you’re done. Don’t take it off to talk.
  • If the music is so loud people need to shout, turn it down. Shouting increases the volume of air, and therefore spray, that comes out of your mouth.

I can tell you don’t mix with anyone outside your household, ever. And yes, that limits risk even more.

But we need people. It doesn’t need to be all or nothing. Safe, controlled, minimal gatherings can keep us mentally and emotionally healthy AND physically healthy.

Proceed with caution.

Dr. Rohr-Allegrini is an epidemiologist and tropical disease scientist currently working to prevent diseases through immunizations.

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