(CNN) – With the arrival of the 4th of July weekend, many people attend small backyard barbecues, pool parties, and larger celebrations like reunions or fireworks shows.
What safety precautions should be taken into account, especially in the face of the increase in the delta variant, which is more contagious? What risks are vaccinated people and those who are not yet vaccinated? And what if you are fully vaccinated, but you feel anxious and are not prepared to see so many people?
CNN Medical Analyst Dr. Leana Wen shares her thoughts. Wen is an emergency room physician and visiting professor of health policy and management at the Milken Institute School of Public Health at George Washington University. She is also the author of the forthcoming book “Lifelines: A Doctor’s Journey in the Fight for Public Health.” These are their tips.
CNN: What kinds of meetings are safe from a COVID-19 perspective, now that the delta variant is in the United States?
Dr. Leana Wen: This depends on the answer to a key question: Are you vaccinated? For unvaccinated people, the risk of contagion of Covid-19 remains high. This is especially true with the more contagious delta variant that is spread across the United States. Unvaccinated people should only be with other unvaccinated people in outdoor settings. If there is only one unvaccinated person and everyone else is vaccinated, for example, if there is an unvaccinated child but all adults are vaccinated, the risk is low. The risk is higher if there are unvaccinated people from multiple households who gather in closed spaces, which I do not recommend.
People who are fully vaccinated, unless severely immunosuppressed, are well protected against COVID-19, including the delta variant. What you choose to do depends on your tolerance for risk. The safest thing is to meet outdoors; If you are indoors, it is also safe to be around other people you trust to be fully vaccinated.
What if the others are not vaccinated, but you are? The risk to you around unvaccinated people is low, but it is not zero. Some people will say that they are comfortable going to restaurants or indoor parties, where there are other people around them of unknown vaccination status. Others will continue to avoid these environments for now.
CNN: Does the size of the meeting matter?
Wen: Yes and no. If you are outdoors and there is a lot of space, it does not matter if there are hundreds or thousands of people around. But if it is a small and crowded space, especially if it is a closed place with little ventilation, the risk definitely increases if there are many people.
I think the size of the meeting is important if you are concerned about the vaccination status of the attendees. Let’s say you’re invited to dinner indoors, and you’d only want to go if everyone present is vaccinated. The larger the group, the more difficult it is to trust that everyone is vaccinated. That said, there are concerts and shows with tens of thousands of fans demanding proof of vaccination. The bottom line is that it is not so much the size of the meeting that I would be concerned about, but the vaccination status of the attendees. Unless it’s outdoors, in which case it should be safe even for unvaccinated people to attend with other unvaccinated people.
CNN: There are many vaccinated people who are not comfortable with this social activity. They are concerned about getting COVID-19, no matter how small the risk. What is your advice to them?
Wen: First of all, let them know that this is normal. People are responding in very different ways to vaccination and the end of covid-19 restrictions. Some are excited to resume all aspects of pre-pandemic life. Others need more time.
Second, think about the social activities that are most valuable to you, compared to the relative risk of that activity. It may not be very important to you to go to a restaurant and sit inside, but the thought of it makes you anxious. For now, you can put off that activity – there’s nothing wrong with dining outside, ordering takeout, or preparing your own meals. On the other hand, perhaps the most important thing is to resume bridge nights and see members of your extended family. If all attendees are vaccinated, you can be sure that the risk of contracting COVID-19 is extremely low.
Third, once you are participating in the activity, focus on the here and now. Enjoy the event and think about how wonderful it is to do something you love again, with people whose company you have missed. At first it can be strange to be around others and see people without masks. Focusing on the aspects of the activity that you really enjoy will help you make the transition easier.
Fourth, take it easy. If you haven’t seen anyone before, consider starting with a cookout in a patio or park with one or two other people, for an hour or two. Then you can invite the same people, or another small group, to your home for dinner for three hours. If you’re invited to a large party but you’re not sure you’re ready, go to a small gathering. Start little by little to have bigger and longer interactions and don’t complicate yourself if you don’t feel ready yet.
Lastly, don’t worry about saying no. Being invited to an event doesn’t mean you have to go. And just because others agree to take a higher level of risk doesn’t mean you have to, too. Each person has a different medical history and a different interpretation of risk to themselves and their family. We also have different values about the activities that we most want to recover. It is important that we try to move forward and regain what we enjoyed most before the pandemic, while acknowledging how difficult it can be.
CNN: What if you are at an event, but you are not ready to do something, for example, if someone tries to hug or kiss you, but you still do not feel comfortable?
Wen: I think it’s okay to step back and explain that you are not ready to hug or kiss yet. Not everyone was comfortable hugging or kissing, especially people they didn’t know well, before the pandemic. Leaving Covid-19 behind is an opportunity to readjust expectations in social interactions.
For those who were very fond of hugs before the pandemic, it may be a good idea to ask others if it’s okay to give them a hug before going for one. Just because we are comfortable with certain activities does not mean that others are too. Asking is always good etiquette, as is being tolerant of others’ different space needs.
CNN: There may be people who continue to feel very anxious about social interactions. At what point might someone need professional help for their mental health?
Wen: Mental health was a neglected health need even before the pandemic. Covid-19 has aggravated the mental health crisis in this country.
This is another opportunity for a readjustment. Mental health should be considered with the same urgency as physical health. People with pre-existing mental health problems, such as depression and anxiety, may have seen their problems worsen over the course of the pandemic. They need to seek help for these conditions; just as if they had diabetes that was not treated, they need resume routine medical care. Others may have new mental health problems that have emerged, which could also manifest as social anxiety.
Mental health problems are very common and it is essential to treat them. Ask your GP for a recommendation of a mental health specialist.
CNN: Are there other things people should keep in mind during the July 4th weekend when it comes to health and safety?
Wen: We’ve talked a lot about staying safe from covid-19, but coronavirus isn’t the only thing to watch out for on July 4. In addition to preventing other viruses and foodborne illnesses, such as protecting yourself from mosquitoes and ticks, and washing your hands frequently, be sure to consider the water safety with the kids. And please handle the fireworks in a way responsible, legal and safe also.
With all of this in mind, it’s possible to have a great and safe 4th of July weekend as Americans approach pre-pandemic levels of normalcy.