Santa Could Cause a Massive Christmas Flu Epidemic.

I was chatting with a parent and her 7-year-old son about the seasonal flu.

In addition to getting the flu shot, I stressed the importance of hand-washing prior. The boy then asked an insightful question:

“Do you think Santa washes his hands before eating cookies?”

The more I thought about it, the more I realized how ridiculous his question was – there’s no way Santa has enough time to wash his hands at every house. Also, last time I checked, there are no places to get a flu shot in the North Pole. The boys question sparked a chain reaction in my head.

Elderly people are at particular risk of getting complications from the flu. Santa Claus is 1747 years old and odds are high he’s had the flu before. The fact that he’s still alive is already a Christmas miracle. And, once again he’s about to become a Petri dish from all these home visits. Santa could very well be patient zero in a massive yuletide flu epidemic.

So how exactly could Santa spread the flu?

First let’s consider American household exposure.

According to NORAD’s Santa Tracker, on Christmas Eve, Santa starts at the international date line and heads West. Once he gets to the United States, he has about 14 hours of darkness to get presents to every American child.

There about 61 million American children under the age of 14 year-old. (Folklore says Santa visits all children who believe in him, of any faith. There are 9 million Jews and Muslims and I’m not sure how many children, who believe in Santa, are in this bunch.) We’ll subtract a few million and say there are 58 million eligible children for a Santa visit. Naughty children are not visited and there are about 2 million children in juvenile detention each year, so let’s call it 56 million.

Nine out of ten Americans claim to celebrate Christmas and there are about 125 million American households so this leaves about 112 million households for Santa. The average household has 3.14 occupants but there’s a distribution between some with multiple kids and others with zero so for simplicity, we’ll just say Santa is visiting 58 million homes.

Given Santa’s 50,400 seconds of present-giving-time in the United States, this gives him about 0.001 seconds per home.

0.001 seconds to park a sleigh, break into a house, drop off presents, and get out. There is no time for adequate infection control.

(I am not taking into account Santa’s visits to hospitals, malls, and group homes on the days surrounding Christmas.)

Add in flu facts and Santa is headed for danger.

Based on the 58 million homes and the average occupancy, Santa is exposed to the environment of 182 million Americans, who may or may not have the flu.

5-20% of the US population will contract the flu in a given season and based on weekly flu surveillance by the CDC, there’s an upward trend heading into Christmas. Adults with the flu are contagious for 5-7 days after symptoms start, while children are contagious for 7 days or more. Last year, there were about 31 million outpatient visits related to influenza which is roughly 10% of the population. Taking both into account, we could theoretically have millions of infected households on Christmas Eve. 

The R0, or basic reproduction number, of a disease is the total number of individuals directly infected by a single individual. For influenza, it’s about 1.27. In other words, each person with the flu is going to infect an average of 1.27 people. The easiest way to catch the flu is direct contact but this isn’t a likely scenario with Santa unless mom is actually kissing him under the mistletoe.

What about sneezing on Santa?

Influenza can survive in an airborne environment for several hours. Airborne droplets can spread disease from about 6 feet. Nonetheless, this means a child or adult would have to sneeze in a 6 foot proximity of Santa, within a few hours of his quick visit. This is improbable.

Surfaces are the real threat for St. Nick. The Influenza virus can survive for up to 24 hours on surfaces. That includes areas in the living room, where the Christmas Tree is, and the kitchen, where the cookies are. Santa could reduce his risk with 20-seconds of hand-washing but his 0.001 second window doesn’t allow it.

In the end, Santa’s fate may follow one of two scary paths:

He will catch the flu himself and likely be hospitalized given his advanced age

OR

He will become patient zero given his contact with millions of families. What’s worse, he could actually spread influenza to other countries that celebrate Christmas later such as: Armenia and Lebanon, where he visits on January 6th or Georgia, Kazakhstan, Russia, Serbia, Ukraine, Egypt, Ethiopia, and Eritrea during the Orthodox and Coptic Christmas celebrations on January 7th.

How can we help Santa?