James T McDeavitt, M.D., Senior Vice President and Dean of Clinical Affairs has created the HOLIDAY BUBBLE CHECKLIST click HERE for the printable version. Below is a further explanation of what the breakdown of the checklist will look like

Today

  • Get your flu shot. This will decrease the likelihood of developing a flu-related illness around holiday time, which could disrupt your plans.
  • Have a serious family conversation. Do we want to commit? Are we willing to create and maintain a safe environment? DO NOT SKIP THIS STEP. Obtaining real commitment to form your bubble is the single most important part of this process:
    • Who is at high medical risk in our family? What is our risk tolerance for exposing them in a family get-together? If your risk tolerance is low, even a bubble may be too risky for you.
    • Are we committed to doing the substantial work necessary to create a “holiday family bubble?”
    • There is variability in how seriously people are taking precautions. Beginning two weeks before you come together, is everyone willing to rigorously adopt good viral control practices? (mask, physically distance, avoid crowds). Your bubble will only maintain its integrity if everyone is fully committed. If you have a family member that cannot commit, they cannot be safely invited to your holiday bubble.
    • Have everyone print the Holiday Bubble Checklist.
    • Assign a Family Bubble Commissioner, a single individual who will take responsibility for reminding bubble participants of key milestones and encouraging compliance.
    • Sign a family pledge. I know this may seem a bit overboard to some, but obtaining commitment is critical.
  • Agree on a location. One of the best options is a private home where everyone will come and stay. It would be ideal if the location included some outdoor space, weather permitting. Keep in mind, this will be your bubble. Once everyone arrives, you are there to stay. No excursions, no visitors. Once in the bubble, you stay in the bubble.
  • If flying, order face shields or goggles to protect your eyes, which are a potential portal of entry for the virus. Consider trying to obtain N95 facemasks. Cloth masks used in combination with eye protection afford an acceptable level of safety, equivalent to the protective equipment used by health care workers during routine hospital care. An N95 combined with a face shield or goggles would provide maximal protection, and is equivalent to the equipment used by health care workers when dealing directly with known or suspected COVID-19 patients. Regarding eye protection, either a plastic face shield or eye goggles are effective. Goggles must fit snugly. Air purification in many planes is excellent, but varies based on the airline and model of aircraft.
  • If flying, take a direct flight if possible.
  • Check any travel restrictions for the state that you will be visiting. Note many states have restrictions and quarantine requirements. Some international destinations have testing requirements. Remember to check the regulations for the state to which you are returning after the holiday as well.

Two weeks (14 days) prior to holiday:

  • Everyone planning to enter the holiday bubble must make extra effort to limit contact with other individuals to reduce risk of exposure.
    • If your job duties permit, work from home. Self-quarantine. Important: Quarantine is more than being cautious. It means staying home and avoiding all contact with anyone outside your regular household, even if masked.
    • If self-quarantine is not possible, maintain scrupulous attention to distancing and cloth masking along with hand washing/sanitizing.
    • Add a plastic face-shield or goggles to your cloth mask when you are indoors and in contact with others. Note, the face shield is in addition to, not in the place of a cloth mask.
  • Daily symptom and temperature monitoring. If you become symptomatic or have any fever (even low-grade), seek evaluation by a physician and tested with a PCR test (for this purpose, avoid rapid tests). If your test is positive, cancel your participation in the bubble, along with all others who live in your household.
  • Decide who will be cooking during the holiday. Stock up on non-perishable food items in advance.

5-7 days prior to holiday:

  • Get a diagnostic test (PCR, not a rapid test). If positive, cancel your participation in the bubble, along with all others who live in your household.
  • Stock up on hand sanitizer and disinfectant wipes for travel.
  • Complete your food shopping. If you plan to drive, buy travel food in advance. Purchase perishable items for your holiday meal(s). Remember, you are quarantined. Use a grocery service with touchless delivery to maintain your quarantine status.
  • Recheck travel restrictions.

Traveling to the bubble:

  • Drive if possible.
    • Make the trip in a single day if you can do so safely.
    • Bring your own travel snacks
    • Limit time in — or avoid altogether — crowded roadside fast food restaurants, truck stops, etc. Mask and distance when out of the car. Consider adding a plastic face shield in addition to a cloth mask.
  • If you must fly:
    • Wear a cloth mask (or N95 for maximal protection) and a face shield or goggles. Remember, eye protection is in addition to your mask.
    • While on the plane, leave your mask and face shield/goggles on as much as possible. Ideally, they should stay in place for the entire flight.
    • Skip the snacks and drinks.
    • Use the restroom prior to boarding.
    • Limit fluid intake for 30 minutes prior to departure, and during relatively short flights (two hours and less).
    • Avoid use of the airplane lavatory. If you must use the lavatory, keep your mask on, and wash your hands thoroughly.

During the holiday

  • If you are confident everyone has followed the above guidance, you are relatively safe in your bubble. Continue to use common sense. Play games, eat, sing songs, throw the football. Enjoy fellowship with (bubble compliant) friends and family. After all your hard work, planning and preparation, you can relax and enjoy the holiday.
  • For high-risk family members (elderly, immunosuppressed) it is probably prudent to continue to follow good masking, hand hygiene and distancing practices.

This is not easy, but what in this pandemic has been easy? Decide who is in your holiday bubble, and start the conversation today. If people are committed, begin the process as outlined above. Do not skip steps.

Let us try and spread this message. If most of us create a bubble, we can minimize the risk that the holidays will become a super-spreader event, and we can keep our loved ones safe.

Take the pledge. If you are on Twitter, post when you have committed to creating your bubble using #HolidayBubbleBCM. Encourage others to do the same. Finally, please share this widely using the following link: https://bit.ly/31tBKNs.