Fall is finally in the air, Halloween is almost here and the winter holidays are just around the corner. Are you ready?

This time last year, most people didn’t quite know what to expect or how to prepare for Halloween, Thanksgiving and beyond. Now, with more people vaccinated against COVID-19, many of us are in a more optimistic frame of mind than we were last year.

Should we be?

It’s complicated.

Although the Delta variant seems to be leveling off somewhat, there’s always the chance of other yet-to-emerge variants. And, while many people are vaccinated, many still aren’t.

As if that weren’t enough to keep us on guard, there’s also the approaching cold and flu season. In 2020, the measures taken to slow the spread of COVID-19 — masking, physical distancing and hand washing, for example — also contributed to an almost non-existent cold and flu season.

But, with COVID-19 precautions relaxed, children back in school and many people returning to pre-COVID-19 activities, will colds, flu and other viruses be back with a vengeance this fall and winter — while we’re still battling the pandemic? If so, will we be able to celebrate the holidays together?

“It’s really too soon to know how the coming cold and flu season is going to affect COVID-19,” says Clay Dunagan, MD, BJC senior vice president and chief clinical officer. “Things are moving in the right direction right now, and we are about halfway down from the peak levels of early August, but there are still 4 to 5 times as many cases as we saw in June.

“We could continue on this path until rates are very low — or we could see them turn back up as winter weather causes people to retreat indoors. We really just don’t know what will happen.

“The one thing that we know will help, the one that thing we need to focus on, is getting as many people vaccinated as possible,” Dr. Dunagan says. “This will further reduce transmission of the virus and help keep it at bay during the winter months and beyond.”

What About Those Who Can’t Get Vaccinated Against COVID-19?

If you’ve been fully vaccinated against COVID-19, you’ve taken the first step toward protecting yourself and your family and returning to many of the activities you loved before the pandemic.

And although children ages 5-11 might be eligible for the vaccine in coming weeks — until then, parents will have to weigh the risks of various activities for their children and continue taking precautions, such as masking, physical distancing and hand washing, says Ericka Hayes, MD, Washington University infectious diseases specialist at St. Louis Children’s Hospital.

She encourages parents to model mask-wearing for their unvaccinated children.

“Wearing a mask is highly protective against COVID-19 infection,” she says. “You can feel confident if you and your kids are consistently wearing a mask and social distancing.”

Dr. Hayes also urges parents to speak up, noting that they shouldn’t be afraid to ask people in close contact with their children whether they’ve been vaccinated.

“Ideally, people you are friends with or who are related to you are invested in everyone’s safety,” she says. “So, hopefully, you can ask those questions and have those conversations.”

The CDC notes that all unvaccinated family members, including children 2 years and older, should wear a mask in all indoor public settings. Do not put a mask on children younger than 2 years old.

How to Handle Halloween with Younger Kids

With proper masking, physical distancing and hand washing, your kids can have a happy Halloween this year. Planning to go trick-or-treating? Many experts say trick-or-treating is one of the safest Halloween activities since it takes place outdoors, whereas indoor parties and events remain higher risk.

To help celebrate the holiday, St. Louis Children’s Hospital’s “Mom Docs” offer some additional tips and tricks to help your family have a fun and safe Halloween:

Street Smarts — As ghouls and goblins fill the night, trick-or-treaters fill the streets. If you decide to travel from house to house on Halloween night, it’s important to keep your family’s safety in mind. Mom Doc Jamie Kondis, MD, who specializes in pediatric emergency medicine, offers Halloween safety tips for your family.

Can I eat this? — It’s hard enough for kids with food allergies to navigate meals and snacks from day to day. But imagine a Halloween bag filled with dozens of different kinds of candy! See how Mom Doc and pediatric neuropsychologist Suzanne Pierson, PhD, ABPP, and her family handle her son’s tree nut allergy at Halloween.

Speaking of Halloween Candy — Even if your kids are able to eat all of their candy, you don’t want them to eat it all at once, right? Mom Doc Kerry Prout, PhD, explains how you can create a plan to help your kids enjoy their Halloween candy in moderation.

Tips for Healthy Teeth — Did you know that some candy is better for your child’s teeth than other types of candy? It’s true! Mom Doc Emily Hahn, DDS, a pediatric dentist with St. Louis Children’s Hospital, discusses the best and worst types of candy when it comes to your kid’s teeth.

Will We Have a COVID-19 and Flu ‘Twindemic’ This Year?

The best way to help prevent a COVID-19 and influenza “twindemic” this year is to be vaccinated against both COVID-19 and the flu. Also, continuing the same COVID-19 precautions that helped defeat the flu last year would make a difference this year as well, says Steven Lawrence, MD, a Washington University infectious diseases physician at Barnes-Jewish Hospital.

“Last year was the mildest flu season we’ve had in the past 100 years,” says Dr. Lawrence. “And it was due to the masking and social distancing we were doing to stay safe from COVID-19. But, with the current relaxation on both masking and social distancing, this fall the flu could make a comeback — and I would almost guarantee, with 100% certainty, this flu season will be worse than last year’s flu season.”

Dr. Lawrence adds that many people typically are exposed to the flu each year. “But, when you go a year and a half without seeing any flu, some of that immunity might wane,” he said. “After all this time with very little flu exposure, the immunity our population has right now is likely lower than most years.

“When you combine those two things, we have a fair amount of concern that this could be a pretty bad flu season.”

His advice? Get your flu shot. And, if you haven’t already gotten your COVID-19 vaccine, he recommends doing that as well.

Learn more about the COVID-19 and flu vaccines in a recorded Facebook Live with Dr. Lawrence and Dr. Hayes. The doctors answer viewers’ questions, debunk myths and misinformation about the vaccines, and provide the information you need to keep your family safe during this year’s overlapping flu and COVID-19 seasons.

Taking Off for the Friendly Skies?

If you’re planning to travel this holiday season, here’s what the CDC says you need to know.

If you are fully vaccinated, take the following steps to protect others when you travel:

• During travel
  • Wearing a mask over your nose and mouth is required on planes, buses, trains and other forms of public transportation traveling into, within or out of the United States and while indoors at U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas such as open deck areas of a ferry or the uncovered top deck of a bus.
  • Follow all state and local recommendations and requirements, including mask wearing and social distancing.
  • In areas with high numbers of COVID-19 cases, consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
• After travel
  • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
  • Follow all state and local recommendations or requirements.

• Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
• Follow all state and local recommendations or requirements.

You do not need to get tested or self-quarantine if you are fully vaccinated or have recovered from COVID-19 in the past three months. You should still follow all other travel recommendations.

If you are not fully vaccinated and must travel, take the following steps to protect yourself and others from COVID-19:

• Before you travel:
  • Get tested with a viral test one to three days before your trip.
• While you are traveling:
  • Wearing a mask over your nose and mouth is required on planes, buses, trains and other forms of public transportation traveling into, within or out of the United States and while indoors at U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on open deck areas of a ferry or the uncovered top deck of a bus). CDC recommends that travelers who are not fully vaccinated continue to wear a mask and maintain physical distance when traveling.
  • Avoid crowds and stay at least 6 feet (about two arm lengths) from anyone who is not traveling with you.
  • Wash your hands often or use hand sanitizer with at least 60% alcohol.
• After you travel:
  • Get tested with a viral test three to five days after travel AND stay home and self-quarantine for a full seven days after travel.
    • Even if you test negative, stay home and self-quarantine for the full seven days.
    • If your test is positive, isolate yourself to protect others from getting infected.
  • If you don’t get tested, stay home and self-quarantine for 10 days after travel.
  • Avoid being around people who are at increased risk for severe illness for 14 days, whether you get tested or not.
  • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
  • Follow all state and local recommendations or requirements.
• Visit your state, territorial, tribal or local health department’s website to look for the latest information on where to get tested.

How Do I Get a COVID-19 Test or Vaccination for Activities or to Travel?

If you’re fully vaccinated, you don’t need COVID-19 testing for domestic travel; however, for those who aren’t fully vaccinated, the CDC recommends COVID-19 testing before and after your trip, even for domestic travel.

Many concert venues, restaurants and other activities also now require guests to show proof of vaccination or a negative COVID-19 test.

If you need to be tested for COVID-19, there are many options throughout the region, such as BJC Convenient Care and other non-emergency medical centers. Or check with your local public health department, which often offers free testing options. You can also contact your primary care physician. The ER is not the best place to receive a COVID-19 test.

Learn more about testing options:

BJC COVID-19 Testing Resources
Missouri Department of Health and Senior Services
Illinois Department of Public Health
St. Louis County
St. Charles County

Additional options include many retail pharmacies such as CVS and Walgreens.

If you need to be vaccinated against COVID-19, go to bjc.org or click here.