Reflections on COVID Christmases

On New Year’s Eve 2019 as we ushered in the start of a new decade, the words ‘I have a feeling it’s going to be a great year’ were spoken. No one batted an eyelid and the celebrations continued into the early hours. Three months later, the country was in lockdown and the world was coming to terms with a global pandemic on a scale not seen since the Spanish flu. As we approach the end of another year, it’s worth reflecting on Christmases affected by COVID-19 and what we might learn from them as clinicians and as people.

Christmas 2020 took place amid the chaos of the tier system with a newly identified strain of the virus spreading rapidly in South East England.¹ Having claimed it would be ‘inhuman’ to cancel Christmas and taunted the opposition for suggesting it may be prudent to do so, Boris Johnson created a ‘tier 4’ area covering London and the South East.² No one in these areas was allowed to mix with anyone from other households other than a single person outdoors. Elsewhere in the country, up to three households were allowed to form a ‘Christmas bubble’ for 25 December only. Having spent every previous Christmas with family (being very lucky with rotas and supernumerary jobs over the years), spending the day with friends offered the chance to experience new ways of doing things and to realise how varied everyone’s experience of something as seemingly ubiquitous as Christmas can be. The opportunity to reflect on why we do what we do, in the context of a day of secular or religious social traditions, was thought provoking. Similarly in medicine, continuing to develop as a clinician by exposing yourself to other perspectives and ways of practising keeps the job interesting and can lead to transformative change.

VULNERABILITY

In 2021, the legal landscape around COVID-19 was markedly different, with no curbs on socialising.³ As we had done for a number of pre-COVID years, my partner and I travelled to stay with her parents. We had both crawled through difficult jobs and rotas towards Christmas, and arrived with an air of desperation, hoping to switch off from the outside world. When my partner awoke with a sore throat on Christmas morning, the tree wasn’t the only thing lit up as a positive lateral flow test revealed our fate.^*

Soon afterwards we were queuing in a car park for a PCR test before heading home to spend the festive period isolating, dejected and despondent. At a time when the world around you seems to be celebrating and full of joy, feelings of loneliness can be heightened. For those people who have never felt safe to fully return to a world in which exposure to COVID-19 remains eminently possible, who we still regularly encounter in clinical practice, this may be a particularly difficult time of year. As clinicians, we should be cognisant of the physical and psychological sequelae of loneliness,⁴ and keep our most vulnerable patients in mind. As members of the community, we can reach out to those we know are struggling and support organisations acting to combat this hidden pandemic.⁵

And so to today. Staff are no longer required to wear masks in clinical settings and most healthcare workers are no longer required to test even when symptomatic;⁶ however, daily deaths with COVID-19 have steadily increased over recent months⁷ and long COVID continues to impact thousands of lives.⁸ As we celebrate with friends and family, questions of risk and reward may arise: Should I test? Should I stay away? What precautions, if any, should we take? Finding the ‘right’ answer, when society and work appear to have returned to normal, may be complicated.