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Baylor College of Medicine

Take Control of your Holiday

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Oct. 28, 2020

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Dear Members of the Baylor College of Medicine Community,

My message last week – Build Your Own Holiday Bubble – clearly resonated.  After only a week it has generated three times the web traffic of my previously most-shared posting, which has been circulating for weeks.  If you have not read that message I would encourage you to do so.  Please share it as widely possible using the following link:  https://bit.ly/31tBKNs.  Links in English and Spanish to the actual Holiday Bubble Checklist can be found at the end of this message.  I think the checklist concept resonated because it is a timely message, and is an issue we are all contemplating.  How can we have a joyous holiday in the midst of the pandemic?  I think you would agree, we are certainly due for a little joy.

Today, I want to review some of the weekly COVID-19 developments, and continue on the holiday preparation theme.

The news on a global level is not good.   Communities around the world are experiencing viral resurgence that in many cases exceeds their experience from earlier in the year.  It was reported that last Sunday France had 52,000 confirmed cases, compared to the U.S. with 85,000 cases, a stunning number given France has only 20% of the population of the U.S.

But we do not have to go as far as France to see these sorts of disparities.  KHOU here in Houston has been tracking new growth numbers across the state.  Based on their analysis, if you aggregate all the new cases by region over the past two weeks, the overall growth rate in Texas is 23.6 new cases per 10,000 population.  Good news, Harris County is significantly below that rate at 15.6 cases.  Bad news, El Paso is our France: 123.6 new cases, five times the rate of growth in Harris.

The metrics out of the TMC are much like last week.  Slow increases in new case rates and hospitalizations.  Test positivity rates for TMC, the city and county are all increasing.  R(t) is again above 1.0 (virus is spreading). The city monitors viral load in the sewage system, which shows increased viral presence.  All our metrics are trending in the wrong direction.  I believe we are in the early phases of a new surge.  Some of the data trends out of the Baylor labs suggest we will see a peak sometime between late November and mid-December.  As we saw in earlier in the year, we need to take these peak predictions with a fairly large grain of salt, but I think most people who follow the data closely believe we are destined for another surge.

What do we learn from this?  Unfortunately, the same lesson.  The virus is still with us, it is not defeated, it remains infectious.  Let our guard down, it will resurge.  We are in a dangerous time: as cooler weather drives more people indoors, many are fed up with masking and distancing.  A real danger is in the emergence of a collective sense of helplessness.  We have been dealing with too much for too long.  We know vaccines are on the horizon, but when will they be administered to enough people to really to get us back to our pre-COVID normal?  Next summer? 2022? It is tempting to give up. 

We need to work to maintain hope.  There is much for which we are grateful.  Safe and effective vaccines are on the horizon.  Clinical management of COVID-19 has improved substantially.  Our health system is well prepared.  Overall, school reopenings have gone fairly well.  We have proven we can live in détente with the virus, if we follow appropriate precautions.  Let us continue to control what is in our power to control.

Which brings me back to holiday planning.  After last week’s message I heard from many of you.  My dad, who is 82, was planning on making two separate trips to San Antonio to visit my sister for Thanksgiving and Christmas.  After family discussion, he will stay home for Thanksgiving, cutting his risk in half. Sad, but the right decision for us.  A faculty member contacted me to say they had decided to celebrate with their usual household – no guests.  I was gratified that many wrote that they are committed to forming a Holiday Bubble.

Here is the most important part of the holiday preparation message:  we need – this week – to have conversations with our family and friends to prepare for the holidays.  Review last week’s message.  Assess your risk tolerance. Make a plan you can realistically follow.  Relatively safe options include:

  • Create a Family Holiday Bubble, as previously described.  This gives you the best shot at a safe holiday that feels almost normal – family and friends gathering and celebrating.  However, this requires significant work and commitment.  If you cannot do this well, and get everyone on board, do not select this option.
  • Re-engineer your holiday.  If you are going to have people over, and you cannot commit to a bubble, design a safe experience.  Continue scrupulous attention to masking and distancing.  If weather permits, eat and gather out-of-doors.  If you must be indoors, maintain distance.  Consider notching up the heat and opening windows to promote circulation.  Avoid trying to host a very large group, more than ten or so.
  • Celebrate with your usual household.  This is safest option.  Limit your holiday celebration to the people that live in your home.

It seems to me – as is unfortunately the case for many issues these days – we seem to be presented with two extremes.  Do not celebrate, or follow your usual holiday routine and pretend the virus does not exist.  The latter is dangerous; the former is unrealistic.  If we all commit to rational center – driven by science and common sense – we can have gatherings that are safe and joyful.

Stay hopeful.  We will get through this.

James T.  McDeavitt, M.D.
Senior Vice President and Dean of Clinical Affairs

As always, feel free to share this message using the following link: https://bit.ly/2Tv5qVY

Links to Holiday Bubble Checklist: