Family health

Here's what experts say about quarantining before Christmas so you can see your family

It’s not recommended, but Canadians desperate for connection in the middle of a pandemic might do it anyway. Is there any way to make a holiday gathering safe?

As the winter holidays grow nearer, many families are mourning the loss of traditional gatherings. We have been asked to stay home to avoid increased spread of COVID-19—no travel, no visitors and no in-person contact outside your household. That said, there’s increasing talk of parents pulling kids out of school early to isolate as a family before seeing grandparents or other relatives over the holidays. This strategy is clearly not recommended (and might result in a hefty fine, depending on where you live), but since parents are saying they’re going to do it anyway, we asked the experts if it could—theoretically—be safe.

Honestly, I understand the temptation. When my kids went back to school in September, we knew our bubble had to pop. After spending the summer visiting in person and unmasked with my mom, my inlaws, and my sister’s family—a group of ten people that met recommendations from the Ontario government at that time—we mutually decided to un-bubble and stop seeing each other as my kids returned to school and my baby nephew started daycare. Despite all of the faith and trust I have in teachers—who are doing an amazing job with the hand they’ve been dealt—and the fact that my kids are wearing masks in the classroom all day, none of us were comfortable with the increased risk of transmission. Suddenly, it felt like we were bubbled with all 23 families in my son’s class and all 22 families in my daughter’s class, plus anyone else those kids and parents came into contact with.

But nine months into a pandemic, and with Christmas a few weeks away, my family and I are missing each other more than ever. Like many Canadians, we’re grasping at straws and trying to somehow figure out a way to gather safely. 

If we all isolated at home for a full two weeks, I wondered, could my sister’s household and mine safely spend Christmas Day together? It would mean no playgrounds, no grocery stores, no last-minute Christmas shopping and pulling our kids from school and daycare a week early. But since we’re all lucky enough to work from home, it seemed like a viable option. 

Except, of course, for the obvious dilemma: would we be completely irresponsible to do this?

In the past few weeks, Prime Minister Trudeau told Canadians that “a normal Christmas, quite frankly, is out of the question.” Then Premier Doug Ford told Ontarians to stick to their own homes for the holiday. And in some parts of the country, communities are on a full 28-day lockdown again, with smaller retailers and restaurants shuttered and a total ban on private indoor gatherings. (Those who live alone are allowed to visit one other household.) In these zones, Canadians have been asked to leave home only to get essentials, to exercise outdoors, or to go to school or work. Combining households—even if it’s an outdoors-only visit—is not recommended.

It’s confusing—we’ve been asked not to gather at all, but technically, it’s still legal in most of Ontario and several other provinces (as long as you don’t live in the Toronto and Peel lockdown zones). Where we live in Ontario (now a red zone), the indoor limit recently changed from 10 people to five people, max. Indoor private gatherings that exceed the limit can result in fines, with guests fined $750 each and the hosts fined up to $10,000. But who knows how these rules will change as time goes on and Christmas approaches. 

Is this strategy safe?

According to the experts, it’s definitely not an airtight plan—but it does mitigate risk to some extent. “Two weeks is often discussed as the ‘magic number,’ but it isn’t foolproof,” says Jennifer Kwan, a family physician in Burlington who has been posting daily COVID updates on Twitter. She explains that while the incubation period for COVID-19 is up to 14 days, a person with a positive case may be infectious for 10-20 days depending on the severity of the case (as per the latest guidance from the Centers for Disease Control and Prevention in the US). Essentially, someone could be exposed to COVID-19 in early December, develop very mild symptoms 4-5 days later, and still be infectious 10-20 days after that—meaning, they could still infect someone over Christmas, even if they’ve just isolated at home for two weeks. 

Ahmed Al-Jaishi, an epidemiologist in London, Ont. who posts his own daily updates, adds that human error plays a role. “In theory, if everyone involved were isolated for the 10-to-14-day period before gathering, this would be a safe strategy. However, I find it unlikely that everyone will follow a strict isolation period,” he says. If one person breaks quarantine during the two week period, everyone involved is at risk.

What would a two-week isolation period or quarantine look like? Can I go to the grocery store?

While isolation typically means not leaving your house at all, Kwan acknowledges that this isn’t realistic for most families. Someone will need to visit a grocery store or wants to take a walk outdoors, for example. “This is again about a balance of risk and what is feasible and essential,” says Kwan. “Of course, if you never left the house, then the risk is low, or if you go outside but are a kilometre away from anyone else, then the risk is low. But each additional interaction increases risk.” She notes that if you chose to go to the grocery store, for example, the exact level of risk would depend on your location, proper mask usage, the ventilation of the space and how well you were able to distance from others. Opting for a grocery delivery or curbside pickup while taking precautions (wearing a mask and physically distancing) would pose less risk than shopping in a store.

Al-Jaishi agrees, saying that if you choose to isolate before the holidays, you should limit contact to your household and not visit any public spaces—stores, schools, parks and playgrounds included. “The mayor of Toronto, John Tory, eloquently said —and I am paraphrasing— ‘assume the virus is everywhere, because it can be anywhere.’ Anytime we contact people outside the household, there is the risk of exposure to COVID-19.”

What if everyone gets a COVID-19 test before gathering?

If you’re considering having each family member take a COVID-19 test before gathering over the holidays, Kwan and Al-Jaishi agree that this is not a safe prevention strategy. It’s just a point in time; you could be exposed on a Saturday (day one), test negative on a Wednesday or Thursday (day five or six), hang with relatives without taking precautions on the following Saturday and unknowingly expose them, and then develop symptoms on Sunday or Monday, having already infected your whole family. Additionally, testing for people without symptoms may not be available where you live.

In my opinion, getting a COVID test would not be an effective strategy because a negative result is only applicable at the time of the test,” Al-Jaishi explains. “A negative result provides a false sense of security because a person can be exposed directly before getting tested and after getting tested.

Quebec is moving school online temporarily (before and after Christmas), and considered allowing private gatherings for a few days. There were rumours of an extra long winter break in other provinces. Is this a good idea?

On this subject, the experts are divided. Al-Jaishi thinks a longer break might help avoid an explosion of growth resulting from those who gather in spite of recommendations, while Kwan is wary about what people may do with that extra time off. “Would they be attending even more gatherings or travelling between regions, which may actually increase risk? Clear recommendations would need to accompany the longer break.” 

Initially, Quebec Premier Francois Legault announced that their provincial ban on private indoor gatherings would be lifted between December 24 and 27, allowing groups of up to 10 individuals to gather in private settings. (Notably, these dates only cover Christmas, and not Hanukkah, or most of Kwanzaa.) Legault was asking Quebeckers to enter a “moral contract” in which they promised to visit only during this four-day period, isolating with their household before and after. But by December 3, Legault had backtracked on this plan and asked Quebeckers to cancel all Christmas gatherings in the province’s “red zones,” due to a rise in cases, hospitalizations and deaths. 

Should you isolate and gather this holiday season?

Neither of our experts endorsed this plan, but both agree that isolating beforehand is better than having a family gathering without taking steps to mitigate risk. “Isolating for two weeks may help to reduce risk, but it is not a guarantee of safety,” says Kwan. She strongly recommends following up-to-date public health guidelines and says if families do decide to isolate then gather, they should review this BMJ risk mitigation chart. Al-Jaishi also stresses that gathering outside your household is not recommended and hopes that those who get together anyway will wear masks (even indoors), maintain a constant physical distance of six feet or more (even if masks are used) and consider short visits instead of shared meals. They should also ensure adequate ventilation, such as opening several windows to create fresh air flow.

The number of people gathering and their individual risk factors should also play a role in your decision-making. “Risk comes in a gradient,” Kwan notes. “The more households [coming together] the riskier, the more people the riskier.” Are you planning a 25-person Christmas dinner combining multiple branches of the family? Not only would it be nearly impossible to physically distance in this scenario, it may be illegal in your region. Or, are you combining two smaller families of three or four people each? Other risk factors include the number of contacts each person has, the risk associated with their occupation, and their age group.

Additionally, Kwan notes that you have to have clear expectations and trust in your circle, as some people will promise to isolate and then pop out to a meeting, a store or even the gym. “It all adds up to risk for exposure.”

Challenging times—and tough decisions

I haven’t snuggled my baby nephew since Labour Day, but many Canadians haven’t seen their closest loved ones since March—particularly in the case of long-distance families separated by a closed border, or by a long plane flight with mandatory quarantines on either end of the trip. It’s easy to understand why so many families are considering a strategic period of isolation during the school break, but it’s still hard to make a decision when the risk can’t be eliminated entirely. 

Furthermore, the privilege of this choice only extends to those who can isolate for two full weeks, and isn’t feasible for most hourly wage workers, healthcare workers, teachers, anyone without paid vacation time, or those who can’t, realistically, work from home while also taking care of young children who’ve been pulled from daycare or school. It also isn’t likely to work for those who share custody and who cannot control interactions or enforce the bubble at the other parent’s house.

At the end of the day, families will need to make informed choices that consider not just their own risk tolerance, but the impact their decision will have on others. How we behave over the holidays will have a ripple effect across every community. If we’re going to flatten the curve, we need to think about the greater good, and not just our own growing loneliness, or our yearning for familiar traditions during this tough time.