This week my partner (@drjenadjacent on Twitter) and I hosted a dinner party. It is something that he and his friends started in November 2019 with plans to make it an annual event. Those plans were quickly interrupted by COVID-19 in 2020.
But now that we have vaccines and rapid tests we wondered if we could safely have a party and feel comfortable that we were minimizing the exposure risk of our guests and ourselves to COVID-19? Here are the considerations and steps I recommended (and we followed).
Step One. Consider the local positivity rate for COVID-19
This means that based on all of the tests being performed locally, where most of our guests would be coming from, how many are positive? The CDC defines a low level of community transmission as a positive test rate of 4.99% or less, so I decided our local positivity rate had to be less than 4.99% to consider taking my mask off to eat and drink in a party setting. At the time were started planning the party, the rate in California was about 2.1%
But California is a big state. Locally in Santa Clara County the rate was even lower, 1.1%.
With the number of COVID-19 cases in our State and locally our community both low, I felt confident planning a party.
During the weeks leading up to the party, I watched the local and state COVID-19 trackers, with the understanding that we would cancel if there was a spike in positive tests. For me, this meant cases going over 5%.
Step Two: Everyone was required to show proof of vaccination.
This was non-negotiable. Everyone readily agreed. We accepted a photo of the vaccination card or a screenshot of the state online vaccine record emailed in advance. If you think someone is going to send you a fake card, then you probably shouldn’t invite them.
Step Three: Any symptoms, stay home.
We didn’t have to enforce this at all, but I was fully prepared to send anyone away if they had the sniffles.
Step Four: Everyone received a rapid antigen test for COVID-19.
Everyone was tested with a rapid antigen test outside, before they could come into the house. We purchased the tests, which was obviously an added expense as they were about $12 a piece. The party ended up being smaller than expected, and we only needed 11 tests. We had planned for 20 guests, so now we have extra tests on hand, which I think is great.
The cost of the raid antigen tests is ridiculously high considering they are a good strategy to further lower the risk of COVID-19 spread. In my opinion, they should be heavily subsidized by the government, as they are in other countries. Ideally they should be free.
My partner originally ordered the tests online a week before the party, but of course they were delayed. Fortunately, local drug stores were well stocked, and as it turned out, significantly cheaper! Getting tests in advance is another part of party planning. I suspect as the holiday season ramps up it may be harder to find tests.
There is the financial burden in buying all the tests as the host, and I recognize our good fortune to be able to afford this for our guests. In addition, we didn’t want to be in the position of people not being able to find a test locally because they left getting one to the last minute. If guests are coming from out of town, testing before getting in the car for a long drive or getting on the plane is also something to consider. If I had friends or family coming from a place with a high test positiver rate, Id’s ask for a pre trip/pre-flight test.
Other hosts may feel comfortable asking their guests to share the cost of the host-provided test, self-test the morning of the party, or bring their own test to the party. Clearly this is a personal decision. We decided to make testing a part of the party. We set up a testing station outside (being California, inclement weather was not an issue). People got swabbed, and as they were waiting the 10-15 minutes for their results, they socially distanced themselves in the backyard, but were handed a lovely cocktail called a Tangerine Spritz, made with clementines picked that day from the tree (another California advantage), to help pass the time.
The cocktail is from the book Drinking French, by David Lebovitz and as a side note, this book is a must have! Everyone raved about the drink and it is incredibly quick and easy to make. The book is filled with many other lovely libations, and if you are looking for a holiday gift idea (or gift ideas in general), look no further! You could also buy a nice martini shaker to go with it and/or a couple of bottles of liquor that are featured frequently in the book, such as Campari and Lillet. For more about the book and where to buy, click here.
Okay, back to COVID-19 (I know, I would rather write about lovely cocktails!). How do the rapid COVID-19 antigen tests help lower risk? This is what the CDC says about antigen testing:
“When testing an asymptomatic person for COVID-19, the healthcare provider generally can interpret a negative antigen result to indicate that a SARS-CoV-2 infection is not present. However, a negative antigen test result may need confirmatory testing if that asymptomatic person has a high likelihood of SARS-CoV-2 infection. For example, a high likelihood of SARS-CoV-2 infection would be a person who has had close contact or suspected exposure to COVID-19 within the last 14 days and the person is not fully vaccinated and has not had a SARS-CoV-2 infection in the last 3 months.”
Meaning these tests do a good job of telling you what you want to know for vaccinated people attending a party in an area with a low amount of COVID-19.
The rapid antigen tests have a high negative predictive agreement with PCR testing. So someone who tests negative with a rapid antigen test will very likely also be negative by PCR, which is the gold standard. There are two brands of rapid tests that give you quick, easy to read results, BinaxNow (Abbott) and QuickVue (Quidel). BinaxNow has a negative predictive agreement with PCR of 99.2% (based on this study) among people without symptoms and the Quidel test has a negative predictive agreement of 99.1% (based on their product insert).
So in the end for us, because we live in an area with a low local rate of infection, where everyone attending was vaccinated, and after all guests tested negative we had an evening of maskless fun.
But what if there is a vaccinated immunocompromised person or an unvaccinated child, either at the party or at home? In that event, I would certainly be more cautious. Adding an additional antigen test for everyone a few days before the party is definitely a reasonable strategy, meaning everyone attending would need to be tested twice.
I wouldn’t feel comfortable socializing in an area with high rates. For example, in Michigan right now the test positivity rate is 15.4%. However, many people who are vaccinated in these areas may still gather, and antigen testing is definitely something to consider to lower risk. I admit, it is worrying looking at places with high infection rates, like Michigan, New Mexico, and Minnesota, knowing that they are heading into Thanksgiving.
Any socializing involves some degree of risk and there is no way to give guests a guarantee of zero risk to COVID-19 exposure. What we did for our party may not work for you and yours. However, performing antigen testing is a very reasonable strategy to help reduce the risk associated with any gathering you have this holiday season and help give you and your guests added peace of mind. And also, if you had COVID-19, wouldn’t you be devastated if you unknowingly gave it to your family and friends?
P.S. I made a French Apple Frangipane Tart for the party, and it was possibly my best one yet (and @drjenadgacent just confirmed with a thumbs up from across the room). I will be putting up the recipe shortly as a treat for subscribers.