Holiday Season 2020: Traveling, Gatherings and COVID

By |2020-11-25T14:15:05-05:00Updated: November 25th, 2020|Diabetes Management, General Information, Health & Wellness|0 Comments

Instead of our annual November ADW newsletter reviewing “How to stay on track with your healthy eating”, we will take a different focus. We need to get through this holiday season as healthy and as safely as we can and avoid getting coronavirus. Do not let the holidays signal a vacation from healthy routines and good habits. This holiday season will be all about modification but still experiencing joy.

Over 34 million Americans are presently living with diabetes. One in ten Americans suffer with diabetes and one in three are pre-diabetic. Almost everyone knows someone with diabetes. World Diabetes Day is celebrated internationally on November 14th. Diabetes is an “equal opportunity disease.” It can develop at any age, to any gender, or race, in people all shapes and sizes. With our aging population, we need to focus on diabetes awareness even more. All communities nationwide should bring attention to diabetes in both adults and the youth.

We need to take control in order to avoid future negative consequences of diabetes complications in those we love. Since diabetes remains a major risk factor for worse outcomes of COVID, we need to act fast. According to a poll conducted by the American Psychological Association, “48% of Americans say they are anxious about developing COVID, while 62% of Americans are anxious that their family members and loved ones will develop the virus during the winter months.”

Traveling and Gathering for the Holidays

Distance traveling

Since traveling during the holidays is usually “the busiest time of the year”, staying home is still the best way to protect yourself and family from developing COVID. If you do decide to travel, take every precaution. Things that should factor into your trip:

  • Type of transportation (total time spent on the plane, bus, car, train)
  • Total length of trip
  • Number of stops before your actual destination
  • Ventilation system on your transportation
  • Handwashing availability
  • Mask wearing
  • Cleaning of the transportation system between uses
  • Adding a face shield, eyeglasses or disposable gloves
  • Social distancing
  • No hugging, kissing or hand shaking
  • Avoid being near someone who is sick or is displaying symptoms

Some of these things are in your personal control and others are not. Remember, it is not just the plane ride, but the airport terminals, lines in the airport (including the bathroom and food lines), and waiting to board the plane. A mask should always be worn unless you are eating or drinking. It could be a train station, seaport, ferry terminal, subway station, bus station, and/or rest stops along the way which may become troublesome. After 9 months, and with obvious “coronavirus fatigue”, we have become slack. This is a troublesome factor for everyone.

Things that you can’t see such as virus droplets and aerosols in the air may really harm you. Always avoid touching your eyes, nose, mouth, or any part of your face. Keep your hands washed and clean. Stay away from anyone who seems sick. Maintain social distancing at all times. The best form of travel at this point remains driving yourself and making the fewest stops. Pack hand sanitizer, tissues, a selection of food, snacks, disposable utensils and sugar-free drinks.

Social Gatherings

If you do decide to open your home for the holidays, keep it small. New York State is now requiring “10 or less in a private home” due to a recent increase in positive cases. There is no general CDC guideline for “group gathering sizes” at the present time. Start with only your immediate family if you can. The people you are exposed to daily pose the lowest risk. Every person outside of that circle raises the risk of infection for everyone.

Consider the present health of your family members including the elderly, and those with chronic illnesses, like heart disease, lung disease and diabetes. College students returning from school and out of town guests pose an added problem outside your immediate circle. Plan a cocktail hour prior to dinner or a dessert party after dinner on Zoom, Skype, FaceTime or Google Hangout with your extended family and friends as this limits your exposure.

Keep the actual dinner hour limited in numbers attending. Make a detailed list of all ingredients needed and have groceries delivered this year. Even beer, wine and spirits can be delivered. Watch your guest’s alcohol intake for many reasons including the fact that it can raise risky behavior. This increases virus possibilities. Always wear a mask except when eating or drinking. Stock bathrooms with extra soap and individual paper hand towels. Keep hand sanitizer close by. Offer disposable masks to anyone who may have forgotten.

Larger Gatherings

If you just can’t avoid the extended family gathering, make sure they test and quarantine prior to your event. Watch out for multi-generational families. If you do decide to get together, the length of time together matters. The shorter, the better. Eat dinner with your immediate family and then have a dessert and coffee gathering. Set expectations with your guests before and do not allow surprises. Let them know dinner will be from “6-7:30pm” so they know what to expect and no one lingers for hours. No singing or shouting which increases respiratory droplets.

The CDC has warned that “with people traveling from multiple, different places, the risks increase. If you can, stick to people living in your local area.” Use ceiling fans and added air filtration systems, when possible. Crack windows for fresh air. Leave heat or air systems on continuous circulation. Avoid large functions entirely if you have family members who are at high risk such as the elderly and with pre-existing conditions, including diabetes.

Gathering Outdoors

If you live in a warm climate, think about keeping the entire dinner outside. This remains the safest way to gather. Include social distancing and masks when not eating or drinking for extra safety. If your climate is turning colder, rent a space heater and have the cocktail hour or dessert hour outdoors. Provide wraps or blankets to reduce the chill. Serving warm appetizers and beverages may lessen the cold air affects.

Holiday Serving Style

Buffets and potlucks use to be the “go to” way of serving the holiday meal. It’s easy and everyone gets to pick what they want and how much they want. During COVID, it is not the recommended way to serve your food. It is best to put the meal together in the kitchen and simply offer seconds as everyone finishes their meal. The person preparing and serving the food should always wear a mask. Do not allow extra people into the kitchen and limit excessive kitchen activity. No sharing of utensils in the salad or side dishes. Single serving packets of condiments and salad dressings should be used if possible.

Pies should be pre-cut and placed on a single dessert plate. Even better, order desserts that are individually portioned such as cupcakes or fancy cookies instead of sheet cakes. Rolls or bread should be pre-placed on bread plates with a pat of butter. Even drinks should be individually served. Do not pass the punch bowl, wine bottle or water pitcher. Everyone should be given and take the opportunity to wash their hands with soap for at least 20 seconds immediately before eating. Hand sanitizer with at least 60% alcohol can also be used. The less sharing, the better. Clean table linen and place mats as soon as possible. Use disposable paper napkins instead of linen napkins. Wash dishes in the dishwasher at the hottest setting.

Home Gardens

The COVID pandemic has led us to grow more home gardens, box gardens, and windowsill gardens. Share your fresh produce and herbs with your guests. Herbs may offer medicinal qualities. Some people have lemon or orange trees in their yard. Citrus fruits have vitamin C which can strengthen your immune system. Many people have time to make healthy home cooked meals more than ever before. Use this opportunity, but do it safely.

Holiday Shopping

Avoid shopping in person when possible. Black Friday no longer exists like it once did. It was fun to leave the Thanksgiving meal or shop late into Thanksgiving evening. Many enjoyed getting up early to arrive at stores on Friday morning before they opened. Putting yourself on a crowded line to get into a packed indoor mall or big box store is no longer the best choice. Many stores have started Black Friday online starting in November and going through December. Take advantage.

All your added home downtime should give you plenty of an opportunity to shop online. If you do decide to take a chance on in-person shopping, make a list of what you really need and do not just wander through the stores checking all the merchandise. Longer exposure means more risk. Don’t forget about making homemade gifts with your extra time or purchasing a houseplant which helps clean the air of toxins. Quick breads and holiday cookies are always welcome and appreciated.

Holiday Events

The annual Macy’s Day parade is an example of what to avoid this year. It would be best to stay at home and watch it on TV. Avoid bringing your children or grandchildren to see Santa Claus in the mall or store this season, due to crowds and closed in spaces. Dress up as Santa yourself and take pictures at home. Watch football games on the big screen instead of going to the game. There will be award ceremonies, concerts, variety shows, and wonderful old movies offered on television during the holidays so take advantage of these entertainment options. Play holiday music to get in the spirit.

What else should I know?

COVID Testing:

Testing availability has had steady progress. Your area has many testing sites which you can easily find online. Look at state and local health departments for the latest testing sites. Unfortunately, with fall/winter cases rising, lines for testing have become longer. Contact your own health care provider prior to your testing and then again with test results. A tracker will contact you, if results are positive, and ask who you have recently been around.

To make testing terms less confusing:

  • Diagnostic tests. These look for active virus in mucus or saliva. PCR/RNA tests are more sensitive. With this test you can remain positive even after you are no longer sick and no longer shedding virus. These are more highly accurate and may be required when you need to return to work or school. Mucus is collected from your nose or throat by a health care provider. Newer tests seem to be more forgiving and less invasive. It takes minutes to days to obtain the results depending on if an outside or onsite lab is being used. The most highly regarded test is still the nasopharyngeal swab that goes deep into your nose and throat. It may be uncomfortable for some people.
  • At home tests. You collect your own spit or mucus and send it to a lab for overnight results. They are easy to use and considered accurate.
  • Antigen tests. These are also known as a “rapid test”. They are quick and cheap but considered less accurate. Antigen tests are more likely to report negative results and can miss cases of active infections and virus. These tests have a shorter turnaround time and are used to check large numbers of people. The collection is like the PCR/RNA test, but you can get results in less than an hour. They can lead to false negative results even when you display symptoms.
  • Blood tests. Blood tests look for antibodies to let you know if you have already been infected with COVID. Your immune system produces antibodies to fight off invaders such as a virus. Antibodies are detected several days after the beginning of the infection. There are no home versions of an antibody test. Your health care provider will prick your finger or draw blood from a vein. It had originally taken days for a turnaround time, but the FDA recently approved an antibody test that gives an answer in 15 minutes. This test is usually done 14 days after the start of symptoms. At this time, we are not sure how long the antibodies remain active and how long they can protect you from the virus in the future. It is said, “the more and stronger the symptoms the more antibodies are formed.” The problem is the information keeps changing as fast as it is reported. The good news is currently cases of reinfection with COVID are rare.
  • Negative tests. A negative test only means you did not have COVID at the time of testing. This does not mean you can’t get sick later. Do not let it give you a false sense of security.
  • Positive tests. If you do test positive, then self-quarantine and call your health care provider for further instructions. If you have trouble breathing, an oxygen saturation level below 90%, an uncontrollable cough, chest pain, high fever or blue lips, call 911. Stay at home if you can be safely treated at home. Hydrate well with fluids, rest, isolate from others and control your fever with Ibuprofen.

What is the positivity rate?

The positivity rate is “the percentage of people who test positive for the virus of those overall who have been tested.” An example would be if 100 people were tested and 25 were positive then the positivity rate would be 25%. The higher the positivity rate, the more concerning it is. State and local officials look at this number to track community spread. The World Health Organization looks for a rate of below 5%. Numbers are reported from commercial and public health laboratories. It is more complicated than it seems since many people get tested several times. The bottom line is a lower positivity rate is what we want and what we need.

In Summary:

Protect yourself and your family this holiday season as best you can. A healthy lifestyle includes:

  • Plenty of sleep
  • Exercise
  • Fresh air
  • Eat fresh fruits and vegetables
  • Increase fiber intake
  • Stress management and reduction
  • Keep a positive attitude
  • Taking all medications correctly
  • No smoking / limit alcohol
  • Testing and controlling blood sugars

Reach out to someone else who has diabetes this holiday season. Lend support, share your knowledge and offer goodwill. Give positive suggestions and show them how good it feels to take care of yourself. They will be appreciative!

About the Author:

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia. She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past. She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.

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