It’s hard to believe it’s only been a year since COVID ruined yet another Christmas. This time last year, seven-hour queues stretching for kilometres, just to get pre-flight PCR tests were all par for the course. Twelve months on, things are looking very different. While restrictions have eased, a new wave of COVID is upon us. “The onus is really on us to keep ourselves safe,” explains Dr Norman Swan. But what is the best advice for staying well now? If you’ve lost track, or can’t figure out what the latest recommendations mean, read on.
If I have symptoms, should I ge a PCR test?
One of the biggest changes from last festive season is around who is eligible for a PCR test. “Now, PCR tests are reserved for people who are at risk. That’s because the aim now is mainly to identify people who would qualify for antiviral medication.” explains Dr Swan. This includes all people over 70, and other groups such as those over 50 with two or more risk factors and First Nations people over 30 who also with at least one additional risk factor (listed in detail below). Previously we were doing PCR tests to control the pandemic and find out what types of virus were circulating.”
If I have symptoms but don’t qualify for a PCR test, what should I do?
“If you get sick, the government recommends that you should rely on a rapid antigen test (RAT),” says Dr Swan. “The only problem is that RATs are not as accurate as PCRs and can sometimes take a while to read positive.”
That’s why it’s just as important as ever to stay in if you’re feeling unwell.
“If you’ve got respiratory symptoms – remembering it could be anything – the flu, RSV infection or COVID – stay at home, don’t mix with other of people, and wear an N95 mask if you do have to go out,” says Dr Swan.
Should I avoid hugging at Christmas?
Before you reinstate the elbow bump, consider this: “The whole ‘1.5 metre rule’ is a bit iffy, there’s not a lot of evidence that it makes a huge difference,” says Dr Swan. “Assuming no one has respiratory symptoms such as a scratchy throat or runny nose, a quick peck on the cheek or hug when you arrive is almost certainly low risk.”
But does the same apply for at-risk members of the family?
“If you have a very frail elderly person coming to lunch, you might choose not to hug them or encourage them to wear an N95 mask, but you know, you can’t manage every risk. At the end of the day, it’s about what you and your family feel comfortable with. The really important thing is to be absolutely up to date with your COVID vaccinations.”
How do I avoid fights about vaccinations at Christmas?
Conversation over Christmas lunch should be a whole lot less heated now the vaccination debate has shifted. The reason? The vaccines are now mainly a measure to protect yourself – not other people.
“The government is now promoting personal responsibility. Earlier versions of the virus were very responsive to the vaccines and in addition to excellent protection against severe disease, they gave some protection from contracting the virus in the first place, and therefore helped slow the spread,” explains Dr Swan. “That’s far less true with Omicron. With these latest strains of the virus, the vaccines still protect you from becoming infected but less well and for shorter periods of time, but – and I must emphasise this, they still are very good at reducing your risk of ending up seriously ill.”
That’s good news if you were worried about your unvaccinated niece making Grandma ill. “People who have symptoms. Vaccinated or not, they should stay away,” says Dr Swan. As for the rest of us? “You can go back to complaining about your cousins behind your back just like you always did.”
Why should I bother getting the third or fourth dose?
If you’ve had two shots and think you’re covered, think again. “Almost certainly all these vaccines would’ve ended up being three dose vaccines had they had more time in research and development,” says Dr Swan. “This is the way hepatitis vaccines are, ecause sometimes you need three doses to get your immune system going.” The third dose is essential to getting your immune system where it needs to be. “After the second dose, the protection against severe disease goes down. It doesn’t go down to nothing, but it does start to drop. And the third dose brings it right back up again.”
Who is eligible for a fourth vaccine?
Anyone over the age of 30 is eligible to receive the fourth dose if they wish, and some especially high-risk groups are even eligible for a fifth. “The latest data from Israel shows if you’re over 50, you get a lot of benefit from the fourth dose – even some surprising protection against infection for a while,” explains Dr Swan. Severely immunocompromised people can also receive a fifth dose. Talk to your GP if you’re unsure whether you might qualify.
Are all the boosters offering the same protection?
Research shows the latest bivalent booster, which covers for some Omicron strains are worth having. “The bivalent vaccine offers you more protection against Omicron,” says Dr Swan. “But if all that’s available are the old versions of the vaccine, it’s not so much of a difference that you’d wait. The important thing is to have that third dose, and fourth if you’re eligible.”
What precautions can I take on Christmas Day to keep everyone safe?
The most important thing is to make sure anyone who does have symptoms takes a raincheck. If everyone is well and vaccinated with at least their third dose, you should feel confident you’re taking reasonable steps to protect everyone. Another simple tweak is thinking about where you set up the table. “Stuffy indoor environments which are poorly ventilated, where you’re stuck for a while, breathing other people’s air, are high risk for COVID and other respiratory infections,” says Dr Swan. “You can lower the risk by setting up your table outside and if inside, open windows and doors and maybve add a fan.”
Do I still need to wear a mask?
If you want to maximise your protection, especially if you’re going to be in a confined space with recycled air like a plane, a mask is a good idea. “If you want to protect yourself, wear an N 95 mask, not blue mask, not your own homemade cloth mask, but an N 95, probably the ones that go over the back of your head rather than round your ears, are best,” says Dr Swan. “This style tends to form a better seal. You can check if it’s a good seal if you breathe in quickly when you’ve got the mask on, it sucks in.”
Who is eligible for a PCR test and antiviral medication if they test positive?
If you receive a positive test, you may be eligible under the latest government guidelines if you fall within any of the following categories
- You are 70 or older
- You are 50 or older with at least two risk factors
- You are 30 or older and Aboriginal or Torres Strait Islander with at least one risk factor
What are the risk factors?
- You live in a residential aged care facility
- Neurological conditions such as dementia, stroke and demyelinating conditions such as MS and Guillan-Barre Syndrome
- You live with a disability and multiple conditions, and/or frailty
- You suffer from diabetes (both type I and II if medicated)
- You are obese
- You suffer from cirrhosis or kidney failure
- You live remotely with limited access to high-level healthcare
- You suffer from coronary artery disease, cardiomyopathies or heart failure
You are 18 or over and are at least moderately immunocompromised due to conditions such as:
- Being a transplant recipient
- Suffering from a form of blood cancer or some red blood cell disorders (thalassemia, sickle cell disease)
- You have primary or acquired (HIV) immunodeficiency
- You have had chemotherapy or whole-body radiotherapy in the past three months
- You have cerebral palsy or Down Syndrome
- You have had high dose corticosteroids or pulse corticosteroid therapy in the last 3 months
- You have undergone immunosuppressive treatments in the last three months
- You have undergone rituximab in the last 12 months
- You have congenital heart disease
- You are living with disability with multiple conditions and/or frailty.
For more information, visit HealthDirect or call the Australian Government’s National Coronavirus Helpline on 1800 020 080 — 24 hours a day, 7 days a week
