For many people, the holidays are all about getting together with friends and family. But is it safe to gather while COVID-19 is still an issue? Dr. Avish Nagpal, a Sanford Health infectious disease expert, says the answer is simple.

"Celebrate Thanksgiving and celebrate Christmas," says Nagpal. "Get vaccinated to celebrate them safely."

He says it only takes one person to infect a lot of people.

In the below question and answer session, Nagpal discusses COVID safety during the holidays.

Q&A with Dr. Avish Nagpal

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Williams: Is it safe to gather indoors for the holidays?

Nagpal: "When you have family gatherings indoors, especially in the winter months, your risk of transmitting a respiratory infection is higher. Why? The air circulation is limited in the indoor setting. You're talking, singing and sometimes family gatherings can be loud. All these things lead to aerosolization [of the virus]. The air that you exhale carries the virus. It can travel some distance and stay in the air for some time because of the limited circulation inside. You have a greater risk of passing it on to another person or catching it from another person when you are indoors. When at a family gathering, wearing a mask is impractical, because you're eating and talking. This is all part of normal life and, unfortunately, this also creates ideal conditions for transmission of a respiratory virus. The risk is higher indoors."

"You can cut down that risk be getting vaccinated."

Williams: Can you catch the virus that causes COVID-19 by touching food or other objects and then eating?

Nagpal: "That is difficult to determine. There ay be some risk, but it is not as substantial as your chances of getting the virus by inhaling air that has virus particle floating in it. Because we cannot guarantee that no transmission happens through direct contact, we still continue to do hand hygiene, which is a good practice in itself, as it protects you against other infections. By far the predominant mode of transmission is respiratory and not contact."

Williams: What about parties? Is it safe to throw or attend holiday parties that include people outside of your family and should you limit the number of people you invite?

Nagpal: "That's a difficult question to answer. It depends on how much transmission is going on locally and what the vaccine uptake rate is in your community. If transmission in your community is lower and vaccination uptake is higher, then you don't need any limit on gathering. But if you are living an area of high transmission and if your community's vaccination uptake rate is low, then it might be a better idea to limit that gathering to a few people or a few households."

Williams: If you attend an event or travel, should you get tested for COVID-19 afterwards?

Nagpal: "Testing is a good strategy, because one of the things we always worry about is asymptomatic spread of the infection, which means that abotu 48 hours before you start getting symptoms, you are able to exhale the virus and spread it to others without even knowing that you have it. If you are traveling or at gatherings with a lot of people, we recommend that 3 to 5 days after a suspected exposure or an event where the exposure risk is high, you can get a quick test through your local health department or through your local doctors office."

Williams: If you attend a large event or travel, do you need to then quarantine during the 3 to 5 days before you get a test?

Nagpal: "If you are vaccinated, then we don't recommend quarantine. But if you have not been vaccinated, we recommend quarantine until you get a negative test."

Williams: You mention going to your local health department or health care provider for a test. Why not use a rapid test you can purchase at the pharmacy?

Nagpal: "Rapid tests are not as sensitive as the other tests. But they are an option to consider."

Williams: This time of year, stores are filled with shoppers. Is shopping a risky situation for transmission?

Nagpal: "If you are not vaccinated, you should consider wearing a mask while shopping. Grocery stores may be relatively low risk if the store is large, because there's usually good air circulation. But the risk may go up if it is packed with holiday shoppers."

Williams: For some people, caroling is a holiday tradition. Does singing increase risk of transmission?

Nagpal: "Singing and even shouting are activities that lead to higher numbers of particles being exhaled and that leads to a higher density of virus particles in the air. If you're planning to participate in one of these activities, by all means, do so, but please, please consider getting vaccinated. Keep in mind that if you're vaccinated, your risk of getting the infection is significantly lower. And if you do have a breakthrough infection, your risk of needing medical attention is also significantly lower."

"I think its possible in your hands to have a normal holiday season. If you're vaccinated."

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