Philadelphia Health Commissioner Cheryl Bettigole turned heads Wednesday when she advised people, just 10 days before Christmas, not to gather with other households for the holiday or host indoor parties.

Let’s break down what Bettigole said, and what it means.

What did Bettigole say?

Bettigole initially asked people to avoid gathering with other households and to not attend indoor holiday parties.

“I know just how important it is for all of us to see our friends and family for the holidays,” she said during a news conference. “We all miss those gatherings and connections. After nearly two years of doing everything we were supposed to do, we want the chance to see everyone’s smiling faces. It’s hard and it feels impossible, and it feels unfair, but I know and our contact tracing tells us that these gatherings when we get together with friends and family are when we infect each other with COVID.”

She said she’s worried that Thanksgiving gatherings contributed to the rise in COVID-19 cases the city is seeing now.

» READ MORE: How many Philadelphians need boosters? Vaccine-tracking challenges make it ‘impossible to say.’

“As a human being, as a mom, as a friend, as a community member, I don’t want to say this,” Bettigole said. “But as health commissioner and someone who cares deeply about all of the people who will get sick, will miss out on work, on school, will get sicker, will end up in our hospitals, and those who will die, I have to say it: Please do not get together with other households for Christmas. Or if you do, keep those gatherings small, have everyone do a rapid test before they come, and ask everyone to stay home if they feel even a little bit unwell.

“Please do not hold or attend holiday parties indoors,” she added. “It’s just too dangerous. And instead, profess your brotherly love and sisterly affection by wearing your mask, by avoiding crowded indoor spaces, by staying home if you’re sick, and by getting every dose of the COVID vaccine that you’re eligible for.”

But what if I’m fully vaccinated and also got a booster shot?

Asked whether she has the same recommendation for families where everyone is fully vaccinated, Bettigole answered:

“If everybody has been vaccinated and boosted, they’re clearly safer than families that have somebody who isn’t vaccinated for whatever reason. That said, we do still have some risk of breakthrough, and there’s clearly some risk of breakthrough with omicron. So, you know, we’re asking that people be kind of cognizant of the risks that they’re taking.”

“You could reasonably get together with more people if everybody’s vaccinated and boosted,” she went on. “I’d still think about doing a rapid test, if somebody either who’s coming to the event or someone you’re going to be around after the event is at high risk. You know, if you have a grandmother or somebody who’s on cancer treatment, or a newborn baby or a pregnant woman who will either be coming or you know, you’re going to go visit them afterwards, you know, think about doing those rapids beforehand just to decrease your risk even further.”

What is and is not allowed in Philly right now?

The COVID-19 rules in Philly have not changed, but Bettigole urged people to follow her recommendation. In most of the country, health leaders have not imposed new restrictions for the holiday season, but many are recommending that people get vaccinated and avoid large gatherings.

In other words:

  • There is no citywide stay-at-home order, and James Garrow, a spokesperson for the city’s health department, said there are no plans to issue one.

  • An indoor mask mandate remains in effect.

  • A vaccine mandate for indoor restaurants and bars, sports venues, movie theaters, and more is still set to go into effect in January.

» READ MORE: What you need to know about Philly’s vaccine mandate for indoor dining

Why are gatherings discouraged if indoor dining is still allowed?

“We think that they are completely different situations,” Garrow said.

Most homes aren’t as well-ventilated as restaurants, Garrow said. Plus, restaurants keep tables set apart, and everyone is required to wear a mask until they are eating or drinking.

At gatherings inside a home, people are often sitting closely together without masks on for extended periods of time, and you have closer contact with people, Garrow said.

“How many people do you hug in a restaurant?” he asked.

What do health officials recommend?

Bettigole urged everyone to get their COVID-19 vaccines and booster shots ahead of the holiday.

And if you’re gathering for the holidays, she said, do it outdoors.

Garrow said even if everyone you’re gathering with is vaccinated, “residents should still keep their gatherings to one to two other vaccinated households at most,” because of the risk of breakthrough infections and the highly transmissible omicron variant.

How can I best protect myself during the holidays?

Follow Bettigole’s recommendation not to host or attend holiday gatherings.

All in all, Garrow said, “the things that worked earlier in the year will still work now.”

Wear a mask (and consider double-masking), get vaccinated, limit your time in crowded places, and increase ventilation in spaces where you’re gathering with others.

Watch the full news conference here

Staff writer Justine McDaniel contributed to this article.