There is much to celebrate this Christmas. COVID has been significantly, if not completely, “detoxified” thanks to vaccines and treatments. Christmas parties, Christmas shows and New Year’s Eve parties are back in the party calendar.

However, the return to “normal” brings with it the return of high percentages of all other winter insects, which had been largely contained over the previous two winters due to reduced socialization.

Along with COVID, countries in the Northern Hemisphere, including the US and the UK, are currently or have recently seen a sharp increase in influenza, RSV (respiratory syncytial virus) and the common cold.

Together, these infections lead to high hospital admissions and strain healthcare systems.

A social distancing debt

Some have spoken of a lockdown-induced “immunity debt”. This suggests that a lack of exposure to seasonal viruses during the pandemic suppressed our immune systems, leading to high rates of certain infectious diseases, especially among children. This hypothesis is controversial because there is not enough evidence to support it at present.

I would say we are definitely seeing a social distancing debt. After two years of restrictions, UK data shows people mingled a lot more before this Christmas compared to last year. It goes without saying that with the return of socialization, so will the beetles.

So what should you do if you get symptoms on Christmas Day?

Cold or COVID?

In the past, many countries had laws, guidelines, and guidelines that had to be followed about what to do when you were sick (although sometimes they were contradictory and confusing). This year it’s all about personal responsibility and “common sense”.

I’ve argued before that there is no such thing as common sense when it comes to COVID—no one has been through a pandemic before, and we learn as we go. Lockdowns and other strict social distancing laws are definitely a thing of the past and should be. But people still need guidance.

There are still COVID-related guidelines, for example from the World Health Organization. But the challenge is knowing if you even have COVID.

Part of the problem is how common COVID symptoms are with other respiratory illnesses. Symptoms of newer COVID variants are no longer as characteristic as those of the original strain (eg, a “persistent cough” or a loss of taste or smell).

The most common COVID symptoms now include a sore throat, runny or stuffy nose, and a cough without mucus. These are also symptoms of colds and flu.

In short, when in doubt, buy a COVID test. Admittedly, this is easier said than done during a cost-of-living crisis (I would argue that governments should try to make rapid tests free, at least in winter). Testing is the only way to know for sure if your cough or sneeze is due to COVID.

Although COVID has been particularly devastating in recent years, overall respiratory illness should be prevented whenever possible. Combined, COVID, influenza and pneumonia continue to account for a significant proportion of all deaths in many countries, including the UK.

A hierarchy of safeguards

To protect ourselves and others this Christmas, we can make use of what I call a “hierarchy of protection”. It is inspired by a model for workplace safety management, the “Hierarchy of Controls”.

The model outlines five levels of protection against workplace hazards. By substituting occupational hazards for respiratory viruses, we can use this model to guide our actions when we have symptoms – COVID or otherwise – at Christmas (or any other time).

1. Elimination Protection: The only safe way to avoid the spread of an airborne disease is to avoid close contact with someone who is contagious. But some people may not be able to isolate themselves. They may have loved ones to care for this holiday season, or they may not be able to face the prospect of another Christmas on their own.

2. Protection by Substitution: If we cannot eliminate our contacts when we are sick, we can at least make an effort to reduce them, especially those who are clinically vulnerable. If possible, it is also a good idea to meet outside. Viruses spread much less often during caroling or Christmas markets than indoors.

3. Technical protection measures: If we can’t meet outside (it is winter after all), then we can at least try to ventilate the indoor spaces well (eg by opening the windows and buying portable HEPA air filters).

4. Administrative protection: Where we must meet, short encounters and avoidance of physical contact, such as hugs and handshakes, can help with illness.

5. Protection by PPE: In many countries, mask wearing and even hand hygiene practices have declined significantly over the past year. But it’s especially important when you’re sick. We can think of face masks as umbrellas and use them when needed.

Of course, some of these actions can be used in combination and depend on the context.

Doing what we reasonably can to combat the spread of respiratory viruses may mean some personal sacrifice this Christmas if you’re one of the unlucky few who aren’t doing well. But it will benefit loved ones and wider public health.

Simon Nicholas Williams, lecturer in psychology, University of Swansea

This article has been republished by The Conversation under a Creative Commons license.