Doctors Say Not To Gather For Thanksgiving, But If You Must, Do These Things To Limit Risk

As the Thanksgiving holiday approaches and the state confronts the highest levels of COVID-19 transmission and hospitalizations it’s seen since the start of the pandemic, many health experts are worried that another major spike is on the horizon.

That would in turn lead to even more hospitalizations, the continuing stretching of hospital resources and ultimately deaths.

“Some people have said gather at Thanksgiving and regather for your funeral on New Year's Day,” said Dr. Andrew Pavia, chief of the Division of Pediatric Infectious Diseases at University of Utah Health. “And that's a bleak way to put it. But at this point, we really have to be honest.”

Given current levels of transmission, Pavia said there is a good chance asymptomatic people will turn up to Thanksgiving dinners and infect others.

So what should you do?

The short answer, according to Pavia and two other University of Utah infectious disease specialists, is to not spend the holiday with people who don’t sleep under the same roof. That includes immediate family members who live elsewhere, such as college students no longer at home.

But if people choose to meet anyway, here is how to limit the spread:

Basic Guidelines

The first thing people should do is plan ahead, said Dr. Emily Spivak, associate professor of the Division of Infectious Diseases at the University of Utah. Ideally, they would’ve already started to do that by quarantining and limiting their contact with others as much as possible.

Short of a strict two week isolation period, people should get tested several days before the holiday, Pavia said. If the results are positive, obviously that person should no longer go. If negative, they should quarantine for ideally seven days, having no contact with anyone without a mask and within six feet. And then be extremely careful on the trip home.

“We think that airplanes are a fairly modest risk, but all of the things involved in getting home are much riskier,” Pavia said. “Taking the bus or taxi to the airport, being in the airport, getting from the airport to your house, are all pretty high risk situations. And that's where you want to be really careful.”

Hosting

Hosts should ask people to wear masks inside, and let guests know ahead of time they’ll need one, Spivak said.

They should also have open and frank conversations with people about how safe they’ve been prior to coming, according to Carlos Gomez, also an associate professor with the U’s Division of Infectious Diseases. If people have not been able to adequately quarantine, have COVID-19 symptoms or may have been exposed to someone with the virus, Gomez said they should stay home.

Hosts should also consider if anyone in their household or guests might be at risk for serious complications of the disease. If so, that person should not come or the event should be canceled.

The state recently issued orders to limit casual gatherings to 10 people or fewer. Spivak said that should be the maximum number of people allowed, but less is ideal.

She also recommended eating outside and with as much distance between people as possible. Masks should be worn at all times other than while eating, and people should pay extra attention to physical distance while masks are off.

Spivak says people should avoid eating family style, instead either bringing food individually or having one person cook, while wearing a mask and bring the food to guests.

Indoor Risk

If people chose to eat indoors, particularly in small or poorly ventilated spaces, there will be a much greater chance of spreading the virus, Spivak said. The risk is likely greater when people are eating, crowded around a table and potentially talking loudly.

She said people should open doors and windows and turn on fans to circulate air.

What If You’ve Already Had COVID?

Spivak said doctors and scientists are still learning about the potential immunity someone has after contracting the virus. Evidence so far suggests that antibodies, which protect someone against infection, decrease over time but probably last longer than what was originally thought. Some studies suggest that immunity could last for years — and at least eight months for most people who have recovered — though there have also been reports of people getting infected twice after only a few months.

To be safe, Spivak said people who’ve had COVID should still take the same precautions as everyone else.

“People are probably immune,” she said. “But I would not use that as an excuse to sort of be an outlier and not look the same and act the same as we're all trying to engage all of the community to do the same things to protect each other.”

Other Options?

If people can resist venturing outside their homes for the holiday, there are still ways to connect with family and friends. Spivak suggested cooking or eating dinner with others on a Zoom call or FaceTime.

People could also eat Thanksgiving dinner with their household members, then put on a mask and meet friends for a walk outside or bring a pie to a neighbor.

For more recommendations, the Centers for Disease Control and Prevention has created guidelines for people to consider in addition state and local rules.

Hartford Healthcare, a hospital system in Connecticut, has also ranked the riskiness of routine activities for spreading COVID-19.

If the guidelines are followed and people can limit their interactions with others, Gomez said the benefits will pay off down the line. Lower transmissions following Thanksgiving would mean a better chance of gathering for later winter holidays and fewer restrictions into 2021.

“I think it’s keeping the long term perspective and the real damage that we can do if we don't respect these recommendations,” he said.