Harvard experts advise on vaccination, ventilation, and extra care for those who need it most.
As we gather for the holidays this year, it’s wise to note that spotlight-hogging COVID-19 is not the only virus circulating: the flu, RSV, and other culprits are well able to cause serious illness, or worse, among young and old alike. Basics count: wash hands often, stay home when sick, try to sidestep people who are coughing or sniffling. We also asked Harvard experts to share their tips on ways to keep everyone healthy, and have edited their responses lightly for clarity.
Kristin Moffitt, MD
Pediatric infectious disease specialist, Boston Children’s Hospital
Assistant professor of pediatrics, Harvard Medical School
Start with the children: It’s so important that infants and children are up to date on routine immunizations. Vaccine-preventable infections such as measles and polio have been able to re-emerge in recent years because vaccination rates have fallen below the threshold needed to keep these infections from being able to circulate. Everyone older than 6 months is eligible for flu and COVID vaccines, which partially reduce the chance of becoming infected, and significantly reduce the likelihood of getting severely ill from these infections.
Across the US, children’s hospitals, including emergency departments and inpatient units, are under significant strain right now given the high volume of respiratory infections circulating in our communities. Reducing severe illness via vaccination would help preserve these resources for diseases that cannot be prevented by vaccines.
Involve the adults: Respiratory viruses — the flu, COVID, and RSV — can spread very efficiently within households. The more household members who are up to date on available flu and COVID vaccines, the lower the chances of introducing those viruses into a household.
The same applies to gatherings of families and friends. People with a compromised immune system, medical conditions like diabetes or obesity that put them at increased risk for severe infection, or infants too young to be immunized are particularly susceptible to these infections. Vaccination of the people they come into close contact with helps protect them as well as the person who gets vaccinated.
Joseph Allen, DSc, MPH, DIH
Associate professor, Department of Environmental Health, Harvard T.H. Chan School of Public Health
Director, Harvard Healthy Buildings Program
Improve ventilation for indoor gatherings: It all starts with recognizing COVID-19 and other airborne diseases like flu spread indoors in places with poor ventilation. If we start there, it’s easier to see simple steps we can take. Think ventilation, dilution, and filtration. For example, we can help dilute the virus through ventilation simply by opening up a window, and we can help filter out respiratory particles of virus by using a portable air purifier with a HEPA filter.
Most people won’t get sick on airplanes: Really. When airplane systems are running, they offer excellent ventilation and filtration. Think about this: in a surgical suite [where experts work to reduce the likelihood of infection], there are about 12 air changes per hour; in an airplane [with ventilation systems running], there are 20 air changes an hour.
During boarding and after landing, this system is not always running. So, if you’re concerned about getting sick during air travel, wear a high-grade mask during boarding and when disembarking. All masks help, but all masks are not created equal: if you’re concerned about getting sick or are immunocompromised, wear a high-grade mask like an N95, KN95, or KF94 that fits well over the bridge of your nose and is snug along the cheeks and chin. I personally feel very comfortable taking off my mask during the flight.
Extra care for those who need it
Suzanne E. Salamon, MD
Associate Chief, Geriatric Medicine, Beth Israel Deaconess Medical Center
Assistant professor of medicine, Harvard Medical School
COVID isn’t done yet: There are many opinions out there, but I think it’s a mistake to think we’re done. There are still 300 COVID deaths every day in this country. As a geriatrician who treats older patients, I’ve gotten more calls in recent months from people who turn up positive for COVID than I ever remember getting.
So many people tell me that they’re sick of all this, they just want to get back to living life. I get it. But when I hear about getting together with 20 people coming from all over the country, family and friends with different vaccination statuses and different mask rules, I think there’s a high chance somebody is going to get COVID.
Take precautions, particularly around vulnerable people: I have in my family my 100-year-old mother, who lives with us, and a 4-month-old granddaughter I see often. So I am extremely cautious and take a more conservative approach than many. Get vaccinated — and understand that it takes a few weeks for vaccines to reach their full potential. Take a COVID test before you arrive at a gathering. Even repeated tests are not 100% reliable, of course, so if you have any symptoms of a cough or cold, it's safest to skip it. If you decide to go anyway, wear a high-grade mask to help protect others. Sit far away from more vulnerable people and take off your mask only when eating.
Quick hugs are okay, it seems, as long as you have no symptoms. While we can enjoy being together, small gatherings are best.