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The 5 expert-approved steps to follow before, during and after your gatherings. Visit our blog for the full story.

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Welcome to the Michigan Medicine News Break, your daily destination for news and stories about the future of healthcare. Today, how to safely celebrate the holidays without getting sick. The five expert approved steps to follow before, during, and after your gatherings. It's the holiday season and while people are looking forward to stuffing their faces with food, or seeing loved ones after a long absence, most are also hoping to avoid getting sick. That's especially true this year as the rates of RSV, influenza and other respiratory illnesses have gone up dramatically as fewer people are wearing masks and more people are getting together. You can still gather, say University of Michigan experts, you just need a plan. Number one: Stay home if you're sick. One of the easiest ways to protect others can also be hard to do. Simply do not gather if you have symptoms of a respiratory virus.

"This is especially true if some people attending the gathering are more vulnerable, including the very young, the elderly, and those with medical comorbidities or those who are immunocompromised," says Laraine Washer M.D., a clinical professor of infectious diseases at the University of Michigan Medical School, and the hospital epidemiologist at U-M Health. And while for the past couple of years, COVID has been the number one threat, there are other potentially dangerous viruses, including RSV, influenza and adenovirus that have returned with a vengeance. If you're symptomatic, "Even if your COVID test is negative, you could have other viruses that may transmit to others," explained Washer. Number two: Get up to date with your vaccines. One of the most powerful tools for avoiding infection and illness are the COVID-19 and flu vaccines. "Before gathering, just make sure you've given yourself enough time to get the full effect of your flu vaccine or the bivalent COVID-19 booster dose. Especially if you're planning to go to a larger gathering or even a smaller gathering," Washer said. That means two weeks for most vaccines, including the vaccines for influenza and COVID.

Why? According to the CDC, the COVID-19 vaccines protect everyone age six months and older from getting infected and severely ill. And significantly reduce the likelihood of hospitalization and death. Unvaccinated people have higher case rates and higher death rates than those who are vaccinated against COVID-19. Getting the new bivalent booster dose offers even more protection from infection or reinfection. Number three: Wear a mask. While many have stopped wearing masks in public places, masks are still an effective tool to decrease risk of transmission of respiratory viruses of all types. The chances of you getting most respiratory illnesses depends on the number of particles you breathe in. The more particles the higher your chances. Masks reduce the number of particles breathed out and breathed in, protecting both the mask wearer and the people around them.

Washer says that in general, a well-fitting, multi-layered mask is sufficient to protect those who are potentially at higher risk around you. "If you are traveling by air, I highly recommend you wear a medical mask or N-95 mask in the airport, and on the airplane," added Washer. Additionally, as recommended by the CDC, it's important to wear a mask in public indoor spaces. Such as when out shopping for groceries or last minute gifts, in areas with substantial or high COVID transmission. Washer notes that people who are immunocompromised, even if vaccinated, should take extra precautions and wear a mask when around people who are outside of their household, even if those other people are vaccinated. Number four: Improve ventilation. Respiratory illnesses such as colds, the flu and COVID-19 spread through the air. "What you want to do is avoid being in closed spaces with many people for long durations with poor ventilation. That’s the perfect storm,” said Jesse Capecelatro, Ph.D., Assistant Professor in mechanical engineering, and Aerospace Engineering, at the University of Michigan.

When people talk or even breathe, they exhale droplets, which evaporate and then hang in the air unless a window is open or there is good ventilation. He notes that a cough can emit 10 to 20 thousand particles. "When it comes to mitigation, you want to avoid inhaling as many infectious particles as possible," said Capecelatro. "The longer you are around someone, the more of their exhaled particles you inhale. The more people at a gathering, the higher the risk that one of them may be infected." Aside from opening windows, or investing in HEPA air purifiers, which when placed with the air flow, or in a room where people are gathering, can reduce the number of particles in the air, controlling a ventilation can be difficult.

Finally, number five: Wash your hands. The tried and true advice to wash your hands frequently, especially before eating or touching your face, still holds. Adenovirus, which is currently widespread in some areas, and other nasty illnesses, can spread via contact with contaminated surfaces. With these steps in place, you can significantly reduce your risk of respiratory illness and have an enjoyable and healthy holiday. For more on this story and others like it, please visit UofMHealth.org/healthblogs. You can subscribe to the Michigan Medicine News Break wherever you listen to podcasts.