Unvaxxed loved ones? How to handle tense family gatherings over the holidays

How to prevent a holiday surge in COVID-19 cases Infectious disease specialist Dr. Dale Kalina says people who are unvaccinated should avoid public gatherings.

TORONTO — The holiday season is just a month away, and unlike last year when gatherings meant video calls and quiet celebrations with household members, this year promises to be a little less muted.

But with family transmissions a key source of infections and vaccinations a source of tension among some relatives, how do we navigate family gatherings during the holidays?

Over the past year, conflicts over masking and vaccination have created an enormous divide -- friendships have been broken and family members estranged. But if cutting off loved ones is not something you want to do especially during the holiday season, what are some best practices to keep the peace -- and everyone safe at the same time?

“It's a personal decision as far as an evaluation of risk … but I think this year, trying to make the gathering small or mainly with vaccinated people would be the best idea,” says Dr. Anna Banerji, an associate professor with the University of Toronto’s Dalla Lana School of Public Health.

You may have to make the hard choice this year to require vaccinations, she says.

“There are going to be some family members who are not happy with the decision you make. But you have to make a decision that works for you and your family.”

CAN I REQUIRE THAT EVERYONE BE VACCINATED?

Canadian etiquette expert and author Julie Blais Comeau says when it comes to hosting, it is absolutely OK to ask that your guests be vaccinated.

“Your house, your home, you are king, you are queen. It's completely up to you, and you have a responsibility as a host, as a hostess, to the safety and the security of your guests,” says Blais Comeau, adding that this has always been the case, even before the pandemic.

As a host, she strongly recommends picking up the phone to extend the invitation, since nuances and tone can get lost in a text message, email or E-vite. If it’s a neighbour or family member, then invite them in person.

Let them know that you are looking forward to seeing them and hope they can make it, but tell them your decision is because you want to make sure everyone is safe, secure, and that there are no consequences as a result of the gathering. This may be especially important if grandparents or someone immunocompromised will be present. You can ask if they are OK with the requirement.

“There’s going to be that little pause. You can also offer a virtual option so you can say to your guest, ‘We will also be inviting people that are more comfortable on Zoom...and we hope that you can make it,’” Blais Comeau says.

If they tell you it’s not going to work for them, that they have no intention of getting vaccinated, this is not the time to get into a debate on the issue.

“You're not going to judge, you're not going to shame, and it's not the time to have a conversation,” says Blais Comeau. Instead, you can propose an alternative time to meet up individually that both sides are comfortable with. Let them know how important they are to you and be benevolent and empathetic, because we never know what other people are going through.

“Simply say, ‘I respect that. I understand. Maybe we can look forward to going for a walk during the holiday season outside.’ .... but it's important that you stay firm because all of your other guests are going to expect that everyone will be vaccinated.”

Depending on the relationship, you could gently ask why to show that you genuinely care and want to understand their reasons, but tone of voice is important.

Ask if your attitude could be perceived as friendly or confrontational, Blais Comeau says. Tell them how important the relationship is to you and explain, without judgement, why vaccination is important to you. But generally, these conversations are best left for another time, not during an invitation for a get-together.

The same guidelines apply if you are a guest and for any gathering requirements around wearing a mask, she adds.

It is perfectly OK to decline an invitation, she says. Start by thanking the host for the invitation. You can tell them you are not ready to step outside of your bubble and propose an alternative that works for both sides.

WHAT IF I DON’T WANT TO ASK THEIR VACCINE STATUS?

If you decide you don’t want to ask about someone’s vaccine status, then there are other steps and considerations to keep in mind, experts say.

“If you decide to have people there, independent of their vaccine status, then make sure that most people are vaccinated and that there are no vulnerable people there, or people who are immunocompromised,” Banerji advises, acknowledging that the situation is never easy.

“If you're the host of the party, are other people comfortable going to a gathering where there may be unvaccinated people? Let people make that decision and say, ‘Everyone here is vaccinated, so you can come,’ or, ‘I'm not asking the vaccination status and so you're coming knowing that some people may or may not be vaccinated.’”

With vaccine rollout for children under 12 just starting, it is likely many children will remain unvaccinated or not fully vaccinated over the holidays. For more vulnerable individuals especially, even a family gathering where everyone eligible is vaccinated, there are some risks if there are unvaccinated children in attendance, especially with COVID-19 circulating more widely among children.

While Banerji did not specify a number for what constituted a “small gathering” she said there are a number of things hosts can consider: What is happening in the community? What is the positivity rate? What is the prevalence of COVID-19 infections in your region? Are cases going up or down?

“You don’t want to end up regretting having a big family gathering and then having many people sick,” Banerji says.

The National Institute on Ageing has a COVID-19 Visit Risk calculator online that can help people assess how safe a visit or gathering will be.

HOW TO MAKE YOUR HOME SAFER

Studies out of the U.S. and U.K. have illustrated how quickly transmissions can spread in households; there are steps you can take to try to make your home safer during your holiday gathering, especially if there will be a mix of vaccinated and unvaccinated guests.

Require that everyone wear a face mask when they are not eating or drinking, and ask that they maintain physical distance when they are. Experts widely agree that SARS-CoV-2 virus is airborne, and can remain suspended in the air as a fine aerosol -- so having a well-fitted mask is more important for keeping everyone safe than worrying about whether the delicious dessert Auntie Gertrude brought over is safe for sharing.

“I don't think that's the main focus of transmission. COVID is not transmitted, generally, orally. It's really in the air -- airborne droplets. And anyone who's sick, anyone with symptoms should stay at home,” Banerji says.

Ventilation in a home is also different from office and condo buildings -- to make it more energy efficient, there is often less air flow inside a house. This is where open windows, turning on bathroom and kitchen exhaust fans, and putting in HEPA air filters in the spaces where people are gathering, can help keep the air flowing.

ONCE YOU ARE AT THE GATHERING

For many families, holiday gatherings are especially fraught, with tensions rising when sensitive topics -- like vaccinations, vaccine mandates, mask requirements -- are raised.

With many people rusty from socializing, small talk can be a lot more challenging too, Blais Comeau notes, offering a few suggestions to break the tension. One possibility is starting a money jar where every time a pandemic-related word is mentioned, the offender must put in a set amount. The collected funds go to a charity. Proposing a toast can also break the tension too. Another possibility is having a basket of conversation starters that guests can draw from. As a host, you can redirect the conversation if it starts to become polarized, Blais Comeau says.

“The magic words are, ‘You and I can both be passionate about our health and what's best for each other. Let’s just agree to disagree and focus on the joy of gathering again,’ and then be ready to change the topic with something positive,” she says.

“The pandemic has shown us different profiles of people being in solitude, people suffering. We’re a lot more aware of mental health, and each and every one’s struggle. So it's not about judging. The holiday season is always challenging within families.”

And what if family members and guests start to get a bit lax with the mask or the distancing during your event?

Blais Comeau stresses the importance of enforcing the rules, but to do so privately, reminding them that you promised a safe environment for all your guests. If they are not co-operative, then ask them to leave, making sure they can get home safely. If you are gathering in a public venue, you can ask staff to do the enforcing. But in your own home, you are responsible, she says. You can also make general reminders to everyone that comes across more casual.

As a guest, however, Blais Comeau says it is not up to you to be the protocol or mask police. If you are close to your host, you can talk to them and ask if they need some support with reminding guests. If not, then you have the choice to simply thank the host and leave the party.

“Things will get better. We’ve made a lot of sacrifices, but things are normalizing. We're now able to do things that we couldn't do before,” Banerji says.

“I just hope that during the holiday season, that people have some discretion...that people are patient, that this will be over ... just try to do the smart thing so that you don’t end up having regrets about people getting sick at gatherings and having another wave.”