They started about two weeks ago, the calls that is, asking about the holidays. At times, I suspected I was being led to an answer, “So is 14 people OK – we know them well?” “What if we get this test beforehand?” “Can we just quarantine for a week?”.
My answer is always the same: The holidays will be tough this year. Many people will skip them and many more will hold large, indoor unmasked gatherings. The safest approach is to stay home. While there is no way to guarantee a safe holiday event, there are some middle ground options for a safer holiday event:
Respect surge
As an epidemiologist, I think staying home for the holidays this year is the smart way to go. As a pragmatist, I favor advice that is feasible and acceptable. That said, as of this writing (early November) the rising case counts are foreboding. Hospitals could run out of capacity and become unable to deliver the level of needed care for COVID-19 or other conditions. If you are considering gathering in a city where hospital capacity is being featured in the news, supplemented by personnel deployed from other areas, or where tents and civic centers are being erected to keep up with the demand for hospital beds, please reconsider.
Outside
Although the weather might not cooperate, being outdoors (and that means truly outdoors - no helpers in the kitchen from outside the household!) is the safest opportunity for a gathering that includes anyone outside your household. It’s not without some risk. Smaller events and more spacing are still recommended but the risk is substantially less than that from an indoor meal.
Split the difference
Take on a Thanksgiving dinner food exchange and group dessert. Every family brings their signature dish packed ready to share and swap beforehand. Every household eats a Thanksgiving dinner of exchanged dishes separately. Then, gather as a group for dessert only.
An indoor gathering is not without risk so aim for a group of ten or less, a short duration (ideally 30 minutes or less), masks on unless you are eating, and space at least 6 feet between households. Work to increase fresh air circulation by cracking or, if not bitterly cold, opening windows, and employing air filters/purifiers. When considering a portable air filter, make sure it can achieve at least five air changes per hour in the space where it is employed and has a HEPA filter. For helpful guidance on portable air filters, see this guide.
Eat apart, be together
Just like it sounds. Enjoy company indoors with good ventilation, good spacing, and masks but no meals. Maintain a six-foot distance and try to keep these interactions to small groups of 5 or less and just one or two visits a day for an hour or less. What a great excuse to take a break from family!
Hotel rooms, not guest rooms
If you are traveling or welcoming out-of-town visitors, this is the year for the hotel instead of Aunt Mila’s guest room. It’s just too hard to maintain masks and distance for long days and overnights. Plus this seems like the year to negotiate some great hotel rates.
Hotels are working hard to get your business. Look for lodging that has a COVID-19 safety plan, universal masking and distancing outside of rooms, and advertises attention to ventilation, HVAC systems, and disinfection. Unless you are staying for an extended period of time, reduce your exposure by letting the housekeeping staff take their own holiday, having them enter your room to clean only after you check out.
Virtual Tradition
My extended family is holding our own Turkey Trot. Complete with tee-shirts. So far it will span three time zones and five cities. We will all run or walk 5k at the same time, snap some photos in our snazzy tee-shirts and share them with each other. It’s not as tasty as Grandma’s Apple Pie but it's fun, festive, and a way of connecting.
Beware of gimmicks!
A family member sent me this some weeks ago. It’s an advertisement for a Biohit test that came in the mail with one of her regular bills. A gimmicky diet might be expensive and ineffective. A gimmicky COVID-19 test? That’s downright dangerous.
According to the CDC, “An antibody test may not show if you have a current COVID-19 infection because it can take 1–3 weeks after infection for your body to make antibodies.” The Biohit test is an antibody test approved under an FDA Emergency Use Agreement but it is the wrong test when planning for the holidays. Why? Because test timing is important and this test screens for an adaptive immune response that few people have mounted early in a COVID-19 infection. I am asking my family not to rely on this test!
How about Thanksgiving in April?
Did you know that the “First Thanksgiving” was in October? Or that for many years it was celebrated on the final Thursday in November? FDR made Thanksgiving the third Thursday in November. You too are free to move it around and celebrate when it is safe for your family to be together.
None of us has a special force field against COVID-19 and this virus’s only mission is to “find a way” to its next victim. The holiday table offers so much opportunity: your family will have planes to catch, kids in school, essential work to perform, or just that one visit to the gym last week. And the transitive property applies here: you are exposed to the people close to you at any given time and they were exposed to the people close to them. And all these people may feel perfectly well while unknowingly transmitting the virus. So do your best to thwart the virus. If you choose to celebrate with anyone outside your household, take a careful approach to reducing risk with the outdoors, distancing, masking, short duration events, and ventilation.