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Ahh, Halloween. Gaggles of Hermione Grangers and Casper-the-Friendly-Ghosts running through the streets, breathing heavily behind plastic masks, packed tightly in yelling, giggly groups. Knocking on doors, yelling “trick or treat,” raiding candy bowls.  

If this seems like a vignette from a more innocent time, well, it is. With Oct. 31 fast approaching – and with Thanksgiving and Christmas not far behind – three Duke doctors spoke to media Wednesday about ways to navigate the trickiest of holiday seasons with COVID-19 lurking around the darkened corner. Watch the briefing on .

Here are excerpts: 

ON CELEBRATING THIS HALLOWEEN 

Dr. Emmanuel Walter Jr., chief medical officer, Duke Human Vaccine Institute 

“Trick or treat will not be as normal this year. Understanding everybody is kind of fatigued from COVID, I just have real concerns about trick or treat as usual going door to door … with large crowds of kids. I just think that’s a perfect way to potentially spread the virus.” 

“People could do pumpkin carving at home. They could potentially even do it in some smaller groups, socially distanced. You could do a home scavenger hunt with candy, just keeping it small. You might consider doing a home movie night instead.” 

“For those so compelled that they really want to do a trick or treat … what I would advise is that you not do it in large groups. Keep it really small. If you’re a person that’s handing out candy, you might consider putting the candy out at the driveway on a table in little bags. That’s one thing you might consider to keep it safe.” 

“Parents should make sure their children are wearing masks – and not Halloween masks – they have to wear a cloth or surgical mask. Maybe just incorporate that into their costume. And they ought to carry hand sanitizer with them.”  

 

ON YOUNG ADULTS ENJOYING HALLOWEEN THIS YEAR 

Dr. Emmanuel Walter Jr. 

“If you have COVID you really should follow recommendations and not be participating in any Halloween or trick or treat activities. The biggest risk is social gatherings with older teens and young adults for Halloween festivities. Those are very, very common. If you potentially mix alcohol in with those kinds of events, you really risk a high-transmission, super-spreader type of event. I really would caution people against larger gatherings.”  

Dr. Cameron Wolfe, infectious disease specialist, Duke Health 

“When we’ve looked on our college campus at the amount of virus that’s shed by different students, I am consistently shocked that some of the most prolific shedders of COVID are completely asymptomatic. If there’s a message there, it’s please don’t fool yourself into believing you’re safe just because your symptoms aren’t there. If you know you’ve had an exposure … please take that seriously even if you’re feeling well. There’s a reasonable chance you can be infected and just not know.”  

 

ON THANKSGIVING TRAVEL THIS YEAR 

Dr. Cameron Wolfe  

“Travel is a congregant activity by its very nature.” 

“When it’s important to consider if I can travel by car … that would be a better choice from a safety point of view.” 

“If you have to travel and you have to travel in a way that involves public transport, be mindful of the groups around you. Wear your mask. Hand washing is still important. We’ve hammered the masking message … but we still need to be respectful that this virus survives on surfaces much longer than many typical viruses like flu. So hand-washing remains important.” 

“When you sit in the waiting wing of the airport, that is a busy place with lots of people around. People would do themselves well to be very sensitive to the groups of the people around them. Perhaps not stop for that extra meal.” 

“I encourage folks to take a second mask when they’re going. How often do we find that an ear loop snaps or something and you’ve got five hours sitting beside someone on a plane.” 

 

ON HOSTING HOLIDAYS THIS FALL 

Dr. Viviana Martinez-Bianchi, associate professor, family medicine and community health 

“It is a different and difficult year. We have to plan properly. If you or anyone in your household has symptoms of COVID-19 or the flu …. do not host or participate in any in-person gatherings. If you are a person on quarantine or in isolation, you should celebrate only with those who you may quarantine with. Avoid larger gatherings.” 

“There are safe ways to gather for the holidays. A low-risk activity would be to have a small dinner with only the people who live in your household. Think about preparing traditional family recipes for family and neighbors.”  

“You could have a virtual dinner and share recipes with friends and family.” 

“On shopping day, shop online rather than in person so you aren’t exposing yourself to crowds.”  

 

ON PREVALENCE OF HOUSEHOLD TRANSMISSION 

Dr. Emmanuel Walter Jr. 

“If you have an infected parent and you have a fairly dense living situation with a lot of people in one house, the attack rate is much higher. If you have three or four children coming in from that house, often if it’s four, three will test positive.” 

Dr. Viviana Martinez-Bianchi 

“In primary care, we often are seeing … that whole family units are sick. If it’s someone who is coughing a lot … it is more likely that family members are also going to be infected as well.”  

Dr. Cameron Wolfe 

“One of the things we’re also trying to figure out is to better understand household and close-contact transmissions.” 

“It’s not just the household. It’s the household plus who travels with you to work. What’s the work transport like? What comes back into the house?” 

 

ON THE IMPORTANCE OF FLU SHOTS AND OTHER REGULAR MEDICAL CARE 

Dr. Viviana Martinez-Bianchi 

“Getting a flu shot right now is extremely important. We don’t want to end up crowding hospitals with people with influenza. Go and get your vaccine for the flu. If you have chronic medical conditions you want to keep them in check. You want to treat your hypertension. You want to treat your diabetes. Check with your primary care doctor.” 

“We’re already going through a pandemic. We don’t want a second pandemic of the problems that went untreated or unchecked.” 

 

ON COLLEGE STUDENTS HEADING HOME FOR THE HOLIDAYS 

Dr. Cameron Wolfe 

“We recognize travel is an added risk. It moves your little bubble. It blends risk and potentially you bring it back to your college campus.” 

“Not everyone goes home. If you’re a grad student, if you’re an international student, going home may not be possible.” 

“If you have to travel at all, let’s consider a car travel rather than airline travel if you can. If you have to travel, consider it to be one-way where you don’t have to come back in December. If you know you’re going to have to travel and then come back, really try to think about the two weeks leading up to Thanksgiving, for example, as your pre-quarantine. Where you can minimize the risk of inadvertently bringing COVID to loved ones.” 

 

ON SAFELY CELEBRATING LATINO HOLIDAY DAY OF THE DEAD (DIA DE LOS MUERTOS) 

Dr. Viviana Martinez-Bianchi 

“To make it safe, you want to avoid the larger gatherings. You want to prepare traditional family recipes. Play music in your home that your deceased loved ones enjoyed.” 

“You can work with your kids to make and decorate masks or make an altar. You can set out pillows and blankets in your home intended for your deceased to rest. You can join a virtual get together.” 

“If you’re going to go to the cemetery, do it, but keep that distance.” 

“The most important thing is to avoid high-risk activities during Day of the Dead. You don’t want to attend large, indoor celebrations with singing or chanting. Avoid having a large dinner party.” 

 

ON GETTING TESTED BEFORE HOLIDAYS 

Dr. Emmanuel Walter Jr. 

“It might be somewhat helpful … but we can’t be fooled totally by testing. Somebody may have been exposed and may not have totally developed symptoms. If you test them too early you may miss the test positivity. It can be reassuring but potentially, falsely reassuring. I wouldn’t put all my stock in testing.” 

Dr. Cameron Wolfe 

“You can’t do testing by itself and expect it will get you out of a problem.” 

Dr. Viviana Martinez-Bianchi 

“You have to do the prevention and mitigation. We know that wearing masks, doing good hand-washing and keeping distance really helps. Testing alone will not do this. The most important element we have right now is to wear a mask. If it wasn’t for masks, everybody at our health system would be sick.” 

“Just do it.” 

(EDITOR’S NOTE:  demonstrates effectiveness of mask use in health care settings.) 

 

AND FINALLY, A SHRED OF OPTIMISM 

Dr. Emmanuel Walter Jr. 

“We are hopeful. There are many candidate vaccines that are in the pipeline. It’s a really complicated situation. There are many vaccines out there. Not all of them will come to be available at the same time. There will be limited amounts to start off with.” 

“I think we will see a gradual rollout of vaccines next year. I’m hopeful by mid-next year we’ll have a broader dissemination of vaccine in the population. Once we get through this second surge of infection and we have a vaccine by mid-next year … things may normalize a little bit more. Does that mean we’ll be back to normal? I don’t know that I can guarantee that at this point.” 

 

The experts:

Dr. Viviana Martinez-Bianchi 

 is an associate professor in Family Medicine and Community Health, where she is a primary care physician and director of health equity. She specializes in health disparities and access to health care. Martinez-Bianchi will make her opening comments in Spanish and English, and can answer questions from reporters in both languages. 
 

�ٰ�. Emmanuel Walter Jr. 

 Jr. is chief medical officer of the Duke Human Vaccine Institute, where he directs the Duke Vaccine and Trials Unit. Walter is also a professor of pediatrics at ��ţӰ�� School of Medicine.  
 

Dr. Cameron Wolfe 

�ٰ�.  is an infectious disease specialist at Duke Health and an associate professor at the ��ţӰ�� School of Medicine. His areas of study include infectious diseases and biological and emergency preparedness for hospital systems.