If Christmas goes ahead, how safe is it to see elderly relatives?

After a year of little or no contact, is a Christmas bubble the right time to hug grandma?

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The government has promised people across the UK a five-day period over Christmas (23-27 December) in which three households may come together to “bubble” in spite of the three-tiered lockdown system. 

This exceptional period had been established as a uniformed approach across the four nations (although in Scotland alone the total number of people in a bubble is capped at eight), in a bid to stop people breaking the rules and taking greater risks with their families. 

But after London and parts of Essex and Hertfordshire were moved into Tier 3 on Wednesday 16 December, there were questions about whether relaxing the restrictions next week is the right thing to do. Scientists and medical experts warned against continuing with Christmas, and Sadiq Khan and Kier Starmer added their voices to the call to change plans.

Although Downing Street has not issued a public statement as of Wednesday morning, it is believed Mr Johnson is keen to stick to his original promises.

But even if the plans are allowed to go ahead as originally promised, how safe are bubbles to be in? And after almost a year of no physical contact with other households, is it really wise to ditch the two metre safety net?

What does the government say?

The government's official guidance focuses on washing hands frequently and wiping down surfaces like door handles but does not forbid hugging or being in close contact. It does say that if you’re only visiting for a short time to try and keep distance “as much as possible” but acknowledges that the rules allow for overnight stays and a 5-day stint.

It also draws particular attention to those considered vulnerable - the NHS considers anyone aged 70 and over as "clinically vulnerable" and at moderate risk from Covid-19.

But on 26 November, England’s chief medical officer, Professor Chris Witty did urge people to avoid hugging grandparents and elderly relatives. He told a press conference: "It's not against the law - and that's the whole point - you can do it within the rules that are there, but it does not make sense because you could be carrying the virus. 

“Would I encourage someone to hug and kiss their elderly relatives? No I would not.” He continued by saying it was best not to do so “if you want them to survive to be hugged again”.

"Take it really seriously during Christmas. Don't do stupid things. Don't do unnecessary things just because the rules say you can. Think sensibly,” he urged.

Patrick Vallance, the government’s chief scientific advisor, agreed: "I think hugging elderly relatives is not something to go out and do. It will increase the spread to a vulnerable population."

Scotland's First Minister Nicola Sturgeon also said that just because people are allowed to meet up, it doesn’t mean they should ignore all safety measures. "Just because we are allowing people to meet up in a limited way does not of course mean people have to do so, and people should not feel under pressure to do so," she said.

What do the experts say?

Dr Jenna Macciochi, an immunologist at the University of Sussex, tells The Independent that despite the change in government policy, the virus still poses a very real threat over the holiday. Although she acknowledges the strong desire to get close to family. 

“Our data on transmission is still incomplete but from a viral transmission perspective, close contact with another person provides the virus an opportunity to spread,” she says. “Sadly our need to hug has deep biological roots, soothing our fight or flight mode and easing stress and anxiety. By this point in pandemic restrictions we are all desperate to give our loved ones a good squeeze.” 

By this point in pandemic restrictions we are all desperate to give our loved ones a good squeeze

Ultimately she thinks people should make calculated decisions themselves. “I think everyone needs to make their own risk assessment and take care to be mindful of spreading the virus to elderly or vulnerable friends and family.” 

And Dr Simon Clarke, associate professor in cellular microbiology, at Reading University, agrees that there is an element of risk involved but people should make that call individually.  

“While it’s undoubtedly true that hugging relatives, who are not normally in your support bubble, is an enhanced risk to them and to you, it must be recognised that as a society we do not do absolutely everything to eliminate infection risk, otherwise there would be no bubbles, more shops would be shut and schools would closed.  

“It will be for people to decide whether they wish to take advantage of the relaxed regulations, they must judge for themselves how important a hug with a relative really is and whether it could mean that a parent or grandparent is around to be hugged next Christmas.”

What does the science say?

The World Health Organisation says “current evidence suggests that the main way the virus spreads is by respiratory droplets among people who are in close contact with each other.”

The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe heavily.

WHO says aerosol transmission can occur in specific settings: “Particularly in indoor, crowded and inadequately ventilated spaces, where infected person(s) spend long periods of time with others.”

The NHS advice on avoiding the spread of coronavirus says people should:  

• Try to stay at least 2 metres (3 steps) away from anyone you do not live with (or anyone not in your support bubble)
• Wash your hands with soap and water often – do this for at least 20 seconds
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
• Put used tissues in the bin immediately and wash your hands afterwards