Like so many things during 2020, celebrating Thanksgiving in the age of COVID should look much different than previous years in order to protect the ones you love.
Cases of COVID-19 are surging around the country and in Michigan, and hospitalizations have increased. Medical experts and public health officials are stressing vigilance when it comes to following safety precautions, like gathering in small groups, physical distancing, mask wearing and handwashing.
Unfortunately, given this recent surge, the most responsible action right now having dinner with the people who already live in your home. We should not be taking any additional risks, whenever possible, in order to minimize the spread. After a long year, that’s obviously a hard reality to face.
The best advice Rana Awdish, M.D., a pulmonologist and critical care physician with Henry Ford Health, has is to take the long view on COVID, to not focus on 2020’s Thanksgiving but focus on your family’s wellness in the long-term.
“The important thing to remember is every family’s individual risk is different,” she says. “We know indoor gatherings of small groups of 6 to 10 people are very high risk for COVID, and that’s what Thanksgiving is. And I think we have to face that reality. Thanksgiving is about family and valuing each other. So, I’d hate to see it become something that hurts people.”
Understanding the Risks
The overall risk of COVID infection is high right now but it is layered according to different factors, Dr. Awdish points out. Families that include members of higher risk groups living in the same household – elderly relatives, those with pre-existing conditions or risk factors like diabetes, heart disease, obesity or compromised immune systems – have to be extra cautious.
“They may have to make different decisions to protect those people,” she said. “For some, that might mean not getting together at all. For some, it might mean making a special dinner, delivering it to their relatives’ house, then Zooming in together. Others may meet for cocktails outside, with precautions in place. I think we have to be creative to give it a sense of meaning.”
A great option to evaluate risk of gatherings is the MyCOVIDrisk app by the Center for Digital Health at Brown University, Dr. Awdish recommended. You check boxes according to the activity, and the app determines your risk and how to lower it.
“There’s nothing that’s zero-risk right now,” she says. “It gives people control and a sense of ‘How can I do the thing I want to do reasonably safely?’”
Have A College Student Returning Home?
One main concern over the holidays is college students coming back home after spending a semester on campus. Many young people are asymptomatic carriers, Dr. Awdish cautions. And even if the student has a COVID test just before coming home, there’s still a risk.
“In some ways, it’s a false sense of comfort; they still may be in a window when they are infected but haven’t demonstrated signs of infection or show positive in a test,” Dr. Awdish explains. “It’s useful in the sense that if they come back positive, you have that information. It’s less useful if it’s negative.”
A COVID-19 test is only a snapshot in time and not necessarily a reliable way to predict if it would be safe for people to gather together. It takes several days after exposure for a person to test positive for COVID-19. If someone had the test done before the virus was detectable (or was exposed to it since getting a negative test result), they could still potentially spread it to those around them. Also, different types of COVID tests vary in their sensitivity to detect the virus.
If a college student is coming home regardless, there are some precautions that can help. Wearing masks in your own home may seem strange, but it can help prevent spread if the returning student is positive. Not sharing eating utensils and maintaining social distancing can also help.
“It’s cumulative exposure that really generates risk,” Dr. Awdish says. “So if you’re literally hugging and snuggling on the couch for days, that’s different than giving them a hug when they get home and then maintaining space.”
A huge risk factor is returning college students visiting old high school friends when they are all home, she added, using the example of local surges after recent homecoming activities.
“It’s kind of that perfect storm as you don’t have full control but they’re in your home,” she said. “There’s going to have to be some hard boundary setting. Adults have to adult hard right now. They’re still our children and we have to guide them, even though they look like adults.”
What About Quarantining Before Thanksgiving?
Quarantining for 14 days prior to seeing loved ones can also help mitigate the risk of spreading COVID. That entails 100% masking up and not getting within 6 feet of anyone who lives outside your home.
“I think we have to really be honest on what that means – it means no quick trips to the store and not meeting the Amazon guy at the door, for example,” Dr. Awdish said. “It’s surprisingly hard to do.”
But it’s important to take any steps you can to help protect the ones you love – the ones you’re thankful for this holiday season.
“I have every hope that Thanksgiving next year will be a different conversation,” Dr. Awdish said. “And I think that families need to think about traditions this year that can continue in future years. Let’s embrace the mindset of the holiday, that it’s more than sitting together and eating turkey around the table.”
Dr. Rana Awdish is a critical care specialist and the director of pulmonary hypertension at Henry Ford Hospital, as well as the medical director of care experience for Henry Ford Health.