A Family's Holiday Fortress Is Tested by Cunning Omicron

Neha Pathak, MD


January 11, 2022

By the time the winter holidays arrived, I knew that the fortress we had built around our family very likely had cracks large enough to allow Omicron to sneak in.

Our family of six had maintained vigilance against COVID for close to 2 years ― even after dutifully presenting our arms for COVID vaccines and boosters ― to protect my elderly dad, who has heart disease and lives with us, and a toddler too young to be vaccinated.

Even with cases surging, we thought it would be OK to plan a small holiday gathering, during which we would take our first full family photo in years.

With a dwindling number of at-home rapid tests available in our community, we settled on what we believed was the most sensible testing strategy for our situation for the six tests we had been able to get. Years of clinical training had drilled into me NOT to perform a test unless it changed management. We had time and space on our side: school was on break, I could work remotely, and my husband was going to take his first full week off from clinical care in months. If any of us showed symptoms, we would assume COVID, start the clock, and isolate.

It's amazing how rapidly we shifted from feeling somewhat comfortable with this approach to desperately trying to figure out what scenario ― which group of symptoms, which member of the family, at what point in time ― would warrant a "test-worthy" scenario.

By the time our holiday gathering had ended, we were down to three at-home rapid antigen tests and hearing tales of hours-long lines at every testing site in a 20-mile radius from our home.

Just 1 day after our family gathering, our 8-year-old was the first to show symptoms ― a runny nose and intermittent bursts of sneezing. Was this test-worthy? Soon, the 10-year-old followed suit ― for the entire day, the two serially sneezing in the room we had designated for them.

We decided to consider them COVID positive and to greedily hoard our few remaining tests.

The next morning, both girls woke up with zero symptoms, no fatigue, no headaches, and no runny nose ― not a single sneeze to be heard. Though we had started the COVID clock on them, we congratulated ourselves on not wasting a test.

That evening, I watched with dread as the unvaccinated toddler started coughing, dripping from her nose, sneezing, and then developed a low-grade fever. OK, this felt like a test-worthy scenario.

We brought out the testing kit, set up our sterile surface, and then proceeded to chase the toddler around the house, finally pinning her down and obtaining a sample from a completely uncooperative patient. We waited 15 minutes, then 15 more ― still negative. Was it a different virus? Or a really dubious sample? Or was this a false negative, with Omicron making the test less reliable? The idea of sitting in an hours-long line with a highly combustible toddler waiting for a PCR test was a nonstarter for us.

Despite our confusion, we ended up instituting our COVID protocol for her as well, closely guarding our now two remaining tests. Even without a positive test, we informed friends and family that we likely had COVID.

The next morning, our toddler woke up with no further symptoms. Completely confounded, I allowed myself a moment to marvel at the strength of antibodies in my breastmilk ― one of the few tools I have to protect her.

Now 3 days into COVID isolation for our older children, my husband began to complain of a sore throat and headache.The urgency of knowing his status loomed. As a healthcare worker whose vacation was coming to an end, his ability to continue to isolate without a firm diagnosis was severely limited.

By the time I brought one of our two remaining test kits, he was complaining of body aches, fatigue, and hadn't gotten out of bed for hours. I carefully rotated the swab in both nostrils, following every direction meticulously, and inserted the swab into the test card. Glancing down, well before 15 minutes, two red lines appeared. Positive. Symptomatic. Out of commission. One test kit remaining.

When our school district announced that all children would be virtual for the week after the break, it was a major stressor, but it also allowed me to breathe a sigh of relief. More time for observation and time to get tested before reentering the world.

Just a few days after my husband's positive test, our oldest is again sick. She's fatigued, complaining of a headache, and sneezing again. Another test-worthy situation and another positive test, 1 week after her day of sneezing. Whatever the earlier sneezes had been, this was now confirmed COVID, and her isolation must begin again. With different reentry criteria for work for my husband, school for the kids, not to mention guidelines for returning to other activities, we are more overwhelmed than with the illness itself.

Clearly, this is a confusing, frustrating, and scary time for every family. It's made more confusing by a multitude of factors, including the broad range of vague, overlapping symptoms from many potential viral culprits, the limited availability of testing, and questions about when and how to safely reenter the world.

For our family, common sense lessons from how we tackled infections before COVID upended our lives have helped us to combat the confusion. My dad missed the COVID exposure because we sent him to stay with my brother right after Christmas, so he was out of the house during all the covid madness. Thankfully nobody else at the gathering got it except us, so it was probably an exposure we had from somewhere else.

Our brush with COVID doesn't mean we can throw caution to the wind. Just like other respiratory infections we're more familiar with, getting vaccinated and infected doesn't equal perfect immunity in the future. So we will stay up to date with all vaccines (COVID, flu, whooping cough) and stay home when we feel sick.

When we can or must reenter, we're going to move forward using new lessons from COVID, wearing masks and testing regularly. We'll never be in a place of 100% certainty, but we know that this strategy is the most sensible way forward.


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