I was invited to a New Year's Eve Day gathering of some friends who have met annually for a couple decades or more, but who had not met during the pandemic. Our group number 25-30, all in our 70s now. The invitation said masks were 'welcome' but said nothing more about precautions. I was thrilled and excited, but also puzzled at the lack of mention of testing.

I responded to the invitation that I really wanted to attend, but that my household's approach to indoor social events like this is that we rarely attend unless everyone agrees to do a rapid antigen test before attending. I asked if they had considered this. They hadn't, but immediately replied that it was a good idea and shared my request with the invited group, all of who willingly agreed to test.

In the first 30 minutes of the gathering, a number of those present commented that knowing we had all tested negative helped them relax, feel safe, and enjoy themselves without masks. Then one of the invitees called to say that she was asymptomatic but had had a likely exposure in the previous week and had just tested positive so she and her husband were not coming. In addition, they now knew to check with their PCP about Paxlovid, take precautions to prevent spread outside their household and minimize the exposure risk within their household - which they would not have done without the positive test.

As this information spread at our gathering, it was accompanied by the realization that testing had very probably prevented a 'spreader event' among a group of 70+ year-olds, some of whom have chronic medical conditions, and despite full vaccination status, would be at measurable risk for bad outcomes. (Of note, the protection against getting infected after a booster wanes fairly soon and is probably negligible after 2-4 months, but the protection against serious illness, hospitalizations, and death is quite durable for the fully vaccinated and boosted. This distinction was something most in the group had not understood until we discussed it.)

My take homes are:

  • Asymptomatic and minimally symptomatic individuals can (and often are) the cause of spread and spreader events. You don't have to have symptoms to be infectious.
  • Testing (with a rapid antigen test or RAT) before attending an indoor event is easy, safe, and effective at identifying people who are infectious and would therefore put others at risk.
  • It is possible to have safe indoor social events with people who are willing to test before attending.
  • It doesn't hurt to ask. If I hadn't asked, this event would undoubtedly have resulted in cases among our group, and possibly in some serious illness or bad outcomes.
  • Most people are willing to protect their friends. Not only did no one object to the testing request, even BEFORE we discovered that testing had prevented a group exposure event, there was consensus that it was a good idea and made everyone feel safer and more relaxed.
  • This is obviously less scalable to large events involving strangers who may not feel an obligation to consider the welfare of others in the abstract. My suggested solution to this is that as many of us as possible do this in our small groups. It will help keep our circles safe, and if enough small circles do this and spread the word of the benefits, it will become a cultural norm.

 

The event was fantastic!


 

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