Ian M MacKay, CC BY 4.0, via Wikimedia Commons

The holidays are upon us! This time of year is when I like to take stock of my personal and professional life. I’m not ready to make new commitments (save it for January) but looking back helps me see the big picture.

One of the things I have been looking back on is this series of columns on COVID. When I began, it seemed like a lot of the information coming into our community was very authoritative, and also absolutely relentless. I wanted to speak to people where they were at, without judgment, and also infrequently. Too much information isn’t much better than none at all.

This is what makes infection messaging so challenging. As we have learned, there is no silver bullet for diseases like COVID: You don’t get to do one thing right and then you’re good. There are always ways to make yourself and those around you safer, or more at risk.

So when I give you a huge list of steps you can take, don’t look at it as an impossible test you’ll never pass. Think of it as a buffet. You can have everything, but you don’t have to. Start with me at the salad bar, or skip right to the ice cream. Any steps you take for your health is to be celebrated.

Let’s recap what we’ve talked about over the last several months:

In August we covered things like COVID-fatigue, masking (KF 94s and KN95s), COVID testing, vaccination and – very important! — ventilation. Remember the Corsi-Rosenthal box? All of these mitigations are still valid.

In September, topics were lightened protective guidelines, checking the county levels on the CDC website, Corsi-Rosenthal boxes for ventilation (yes, again), staying home if you are sick, getting tested, mask-wearing if you are sick and long COVID.

October brought the news that the pandemic was “over,” and reminders about exercise — how are you doing with that? I walked for a minute, but now I’m back to simply encouraging others. But I refuse to get too down on myself for it, as I have been good about masking, ventilation and several other methods. I am hereby granting myself and you a pass for letting this slip.

Graphic: Johns Hopkins Bloomberg School of Public Health.

November’s article brought up the (surprisingly to me) controversial topic of hand hygiene. Apparently, some are still debating on whether or not it is a worthy step to take when trying to avoid illness.

Maybe I confused people by listing it in a COVID article. General infection prevention strategies usually begin with handwashing. That means that — generally — the best way to not get sick is to wash your hands. I know this is the Internet, and the head of a pin can be many different sizes, but for the love of your mother, wash your hands.

Now that we’re all washed, I would like to whip up a few more food metaphors. Our buffet of choices to prevent sickness has a name - the Swiss Cheese Model.

As we dive into the holidays, we need to bring the Swiss cheese back!

Slice of cheese side dish
Stay home if you’re sick communicate that you don’t feel well—your friends and family will understand
Don’t go around people who are sick respectfully decline any offers to hang out with people who have had the bug but are just now getting over it
Proper masking mask if you are feeling unwell and when indoors with others from outside your home
Hand hygiene, cough etiquette it’s the right thing to do—any way you slice your cheese—-cover your cough, wash your hands
Cleaning/disinfecting Disinfect high-touch surfaces to minimize germs (any kind of germ!)
Avoid touching your face try it—I dare ya!
Social distancing when out at those sweet holiday parties and craft fairs, try to maximize the space between you and others
Quarantine and isolation if you are sick—stay away from others for the recommended days (see next section)
Testing use antigen tests (or PCR if you need) to determine return to work and gathering with others
Ventilation, outdoors, air filtration super important! Open a window –let some fresh air in and move the air around
Vaccines there are a couple of different options if you aren’t up to date with your COVID and flu vaccines
Boosters Same as above—get caught up with the recommended vaccines
Exercise/eating right/staying up with your health maintenance stay moving! Eat well! Stay hydrated! Have fun!!!

That’s a lot of cheese!

As many of you already know, along with COVID, RSV and Flu are making the rounds this year in our communities. So if you’re not feeling great during the holidays, here’s how long you may be contagious:

Flu: 1 day before the start of symptoms and 5-7 days after the start of symptoms

RSV: 1-2 days before symptoms and 3-8 days after the start of symptoms (or longer for some people with immunosuppression)

COVID-19: 1-2 days before symptoms begin, and 2-3 days after symptoms are gone

Testing with antigen tests after COVID-19 will help with decisions about returning to your usual activities and being around others after a COVID-19 infection. It is recommended that you test twice 24-48 hours apart to make sure you have a negative result. Have plenty of antigen tests available for repeat testing.

Sickness will inevitably spread, but you can protect yourself and others by a layered swiss cheese strategy. Enjoy your holidays and I will see you next year!


Michelle Lewis-Lusso (she/her) is an Infection Prevention and Control nurse at United Indian Health Services, serving the 11,000+ clients and staff at their seven area clinics. Michelle wants you to use the buffet of choices for infection prevention, but take it easy on the actual buffet.