Category: Infectious Disease

COVID-19 during the Holiday Season


With daylight hours shortening, colorful leaves covering the ground, and a crisp breeze chilling the morning air, our New England fall soon will transition into winter.  Many look forward to this time of year with great anticipation, knowing the holiday season will soon arrive.  This usually represents a special time to spend with close friends and family inside our homes where we enjoy food, drink, and laughter.  However, with the COVID-19 pandemic rapidly expanding here in Massachusetts, throughout the United States and elsewhere, our holidays need to be approached differently.

We’ve received many inquiries about how to safely celebrate and would like to address some of these questions.

Can I spend the holidays indoors with friends and family?

While this can be a wonderful and joyous time of year, we must be mindful of the health of our family members, friends, and loved ones.  We each have a responsibility not only to ourselves, but to our greater community at-large.  Seemingly trivial decisions about small gatherings can have much larger ramifications.  In August, a small wedding celebration in Maine led to over 175 COVID-19 cases.

What if I obtain a COVID-19 test before the holiday?

A negative COVID-19 test shortly before attending an indoor gathering is not particularly helpful.  A single nasopharyngeal PCR test often will generate a false negative test result, especially if obtained too early in the virus’ incubation period.  The rapid antigen test is even less reliable, particularly in those who are asymptomatic.

While symptoms typically develop 5-7 days following an exposure, occasionally it may take 14 days for an infected individual to become symptomatic.  Thus, if one of your guests were to be exposed to COVID-19 on the Saturday before Thanksgiving, they may have a negative test on Tuesday, celebrate Thanksgiving with you on Thursday, but then develop symptoms on Friday.  Remember that those infected with COVID-19 are contagious 1-2 days prior to symptom onset.

How can we safely get together?

We do not advise you to spend time indoors with other households.  However, if you must do so, there are precautionary measures you should implement. Since COVID-19’s incubation period can extend 14 days, the only way to safely congregate indoors is for all participants to fully quarantine for 14 days prior to the gathering.

When getting together with others, consider the following suggestions:

  • Wear a mask as much as possible.  Remove the mask briefly only for food and drink
  • Try to maintain a distance of at least 6 feet from non-household contacts
  • Do not share food, drink, cups, or utensils
  • Spend time outdoors (weather permitting)
  • Open doors and windows
  • Keep group sizes small and visits short
  • Per current Massachusetts guidelines, indoor groups must be limited to 10 people, while outdoor gatherings should be limited to 25 participants
  • Avoid shaking hands, hugging, kissing, singing, and shouting
  • Increase the spacing between guests at the dinner table.  Consider placing multiple tables in multiple rooms
  • Give each household their own table
  • Be mindful of those who may be at increased risk should they be exposed to COVID-19
  • Do not allow guests who have COVID-19 symptoms or who may have been exposed within the past 14 days

We know these are challenging times, and this is not how we wish to spend the holidays.  Hopefully, a small sacrifice this year may enable us to celebrate the holidays together next year.

Wishing you good health during the holiday season,
Brad Weiner, MD


This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.

Summer Tick Safety

Summertime is one of my favorite seasons.  Warm weather, endless outdoor activities, and extra hours of daylight bring the color back to our cheeks after a long winter.

Last weekend, I attended a barbeque in one of Boston’s picturesque suburbs.  Guests mingled on a patio adjacent to a well-manicured backyard.  Deep blue skies, great company, and lemonade combined to make this a perfect summer day, until one guest spotted a tick crawling along her arm.  Not long afterward, another guest discovered a tick traipsing across his neck.  These little critters quickly reminded us that the arrival of summer also heralds the arrival of peak tick activity in New England.

Starting in the spring and continuing throughout the fall, I field numerous phone calls from patients reporting tick bites. Many express concern about their risk of developing Lyme disease.

Lyme disease is the most common tick-borne illness in the United States and is caused by the bacterium Borrelia burgdorferi.  In the northeastern United States, Borrelia burgdorferi is transmitted to humans by the deer tick, Ixodes scapularis.

Deer ticks often reside on tall grasses and shrubbery.   They may attach to any part of the human body, but are commonly found in difficult-to-see areas such as the scalp, behind the ears, underneath the armpits, inside the belly button, around the waistline, between the legs, and behind the knees.

Tick Photo

Measures to prevent tick bites include:

  • Avoid walking in tall grasses, brush, or other areas where ticks are abundant.
  • Wear protective clothing including long pants and long sleeves when entering wooded areas.
  • Apply a repellant containing DEET to skin and clothing.
  • Perform routine, full-body tick checks with a mirror after outdoor activities.
  • Bathe or shower within 2 hours following exposure to tick environments.

Generally speaking, a tick must be attached for 36 hours or longer to transmit Lyme disease.  If you find a tick attached to your skin, do not panic.  You have time to ensure proper removal.   I recommend the following steps for removal:

  • Locate a pair of fine-tipped tweezers or small forceps.
  • Grasp the tick as close to the skin as possible.
  • Pull straight upwards with firm but steady pressure.
  • Do not twist or jerk sideways. This may cause part of the tick to break off and remain in the skin.  If this happens, do not worry.  Leave it alone and your body will eventually expel the remaining tick part.
  • Cleanse the area afterward with soap and water.

Please call your physician if you discover a tick that may have been attached for 36 hours or longer.  They may prescribe a prophylactic dose of antibiotics to reduce your chance of developing Lyme disease.

Note that it is common for some people to develop a small, raised, red rash at the location of the tick bite that is about the size of a penny.  This is not Lyme disease and usually resolves on its own within a few days.

After removing the tick, I recommend observation for the following symptoms and signs:

Erythema migrans

  • Erythema migrans (EM) is an enlarging red rash at the site of the tick bite.  An EM rash may become quite large and may develop central clearing, creating a bulls-eye appearance.
  • Fever, chills, fatigue, muscle aches, and pains, headache, or enlarged lymph nodes.
  • EM rashes located elsewhere on the body, joint swelling (such as the knee), Bell’s palsy, or palpitations.

Please call your physician if any of these symptoms develop.

Wishing you a happy and healthy summer,

Brad Weiner, MD


This blog is for informational purposes only. It does not replace medical care from a licensed physician.  Please contact your doctor if you have any questions or concerns.