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By Meera Jagannathan, MarketWatch

'The safest way to celebrate Thanksgiving is to celebrate at home with the people you live with,' the agency said

'The safest way to celebrate Thanksgiving is to celebrate at home with the people you live with,' the agency said

The U.S. Centers for Disease Control and Prevention has urged Americans not to travel for Thanksgiving (http://www.marketwatch.com/story/were-alarmed-cdc-issues-blunt-statement-against-travel-this-thanksgiving-11605808198), the agency's strongest guidance yet on holiday gatherings during the pandemic. Risk comes not just from the mode of travel, the CDC said, but from transportation hubs that can make physical distancing more difficult.

"Amid this critical phase, the CDC is recommending against travel during the Thanksgiving period," Henry Walke, the CDC's COVID-19 incident manager, said in a news briefing this month.

See also:'We're alarmed': CDC issues blunt statement against travel this Thanksgiving (http://www.marketwatch.com/story/were-alarmed-cdc-issues-blunt-statement-against-travel-this-thanksgiving-11605808198)

The CDC also issued detailed guidance for a pandemic Thanksgiving (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/thanksgiving.html) as coronavirus cases surged across the country (http://www.marketwatch.com/story/coronavirus-tally-global-cases-of-covid-19-515-million-and-us-counts-more-than-a-million-in-november-to-date-2020-11-11) and hospitalizations rose, stressing that "the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with." Potential alternatives include a virtual Thanksgiving meal with friends or loved ones and contact-free delivery of safely prepared traditional dishes to family and neighbors, the CDC suggested.

In addition to the updated recommendation against traveling, the CDC also updated its definition of a household. "If people have not been actively living with you for the 14 days before you're celebrating they are not considered a member of your household and, therefore, you need to take those extra precautions, even wearing masks within your own home," said Dr. Erin Sauber-Schatz, CDC's community intervention and critical population task force lead.

Risk factors to consider before attending a gathering include community spread (https://www.webmd.com/lung/qa/what-is-community-spread) of COVID-19, both where the gathering is held and attendees are coming from; exposure during travel; the location and duration of the gathering; the number of attendees and capacity for physical distancing; and attendees' preventive behaviors before and during the gathering, according to broader CDC advice (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html) on how to navigate holiday celebrations and gatherings.

"Use of alcohol or drugs may alter judgment and make it more difficult to practice COVID-19 safety measures," it warned.

M. Kit Delgado, an assistant professor of emergency medicine and epidemiology at the University of Pennsylvania, told MarketWatch in September that traveling to family festivities this holiday season presented medium-level risk at best -- and "can very easily be high-risk." Sitting out this year's big family gathering can help keep everyone safe -- especially vulnerable family members -- and avoid overburdening hospitals during flu season, he said.

"Unfortunately, the merriment we crave -- eating, drinking and singing together in a cozy room -- are among the highest-risk scenarios for transmitting COVID-19," Delgado said. "I'm optimistic that things will be different next year, and we can give up this year as an act of charity to our friends, family and community."

But while it might be ideal to forgo holiday travel and gatherings, the decision is also a risk-benefit calculation that people have to make for themselves, said Sandra Albrecht, a Columbia University assistant professor of epidemiology and chief epidemiologist for the science-communication project Dear Pandemic (https://dearpandemic.org/).

Related: New Yorkers don't have much hope that the city will recover from COVID-19 anytime soon (http://www.marketwatch.com/story/bracing-for-a-cold-winter-new-yorkers-dont-hold-out-much-hope-that-the-city-will-recover-from-covid-19-anytime-soon-2020-10-15)

After all, seeing family members is important to many people, and mental-health problems have proliferated (http://www.marketwatch.com/story/we-can-get-through-this-how-to-manage-your-mental-health-during-the-coronavirus-pandemic-2020-03-30) during the coronavirus crisis, Albrecht pointed out. And if this feels like the last Thanksgiving you might have with an elderly relative, for example, that would likely factor into your plans. "The benefit of seeing that family member could outweigh the risk," she said, "but you'd have to assess the whole slew of risks involved."

Ultimately, there's no straightforward answer as to whether you should travel for the holidays, she said, because there are a number of factors to consider in evaluating risk. But Albrecht, Delgado and other experts, along with the CDC, provide a framework for reducing risk if you do decide to head to your folks' place or another gathering. (There are also charts that can help guide you (https://www.bmj.com/content/bmj/370/bmj.m3223/F3.large.jpg).)

Here are some questions to ask yourself:

Are you at higher risk for COVID-19 complications? What about the people you're visiting?

If you or a family member falls into one of the groups most severely impacted by the virus -- people who are older than 65, have underlying health conditions and/or have weakened immune systems -- you should be even more vigilant.

"Until a vaccine's available, I would say most people who will fall into those categories should shy away from those visits for the holidays," said Karl Minges, an assistant professor of health administration and policy at the University of New Haven.

The CDC goes a step further: "If you are an older adult or person with certain medical conditions who is at increased risk of severe illness from COVID-19, or live or work with someone at increased risk of severe illness, you should avoid in-person gatherings with people who do not live in your household," it says (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html).

Where are you coming from? And where are you going?

Be aware of the coronavirus infection rate in your own area, as well as in the area you're traveling to (https://covid.cdc.gov/covid-data-tracker/#cases_totalcases), said Usama Bilal, an assistant professor of epidemiology and biostatistics at Drexel University. Check state quarantine requirements for visitors (https://www.nytimes.com/2020/07/10/travel/state-travel-restrictions.html), he added; some states also require virus testing.

Consider too whether your destination is home to a lot of people at heightened risk for severe COVID-19 infection, such as elderly people, Bilal said. "It isn't only you and your family -- it's the community," he said. "If you are infected and you go visit family, there's a risk that could lead to an outbreak for people beyond your family."

Can you get tested, self-isolate and/or get your flu shot before traveling?

Don't host or attend gatherings if you or a member of your household has been diagnosed with the coronavirus and hasn't yet met the criteria (https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/end-home-isolation.html) for being around other people; has COVID-19 symptoms; is awaiting COVID-19 test results; or might have been exposed to someone with the virus over the last two weeks, the CDC says.

If you've been in a variety of environments in which virus transmission might have occurred, getting a COVID-19 test can provide some extra reassurance, Minges said.

Albrecht, acknowledging the barriers to testing access (https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-racial-disparities-testing-infection-hospitalization-death-analysis-epic-patient-data/) and long turnaround times (https://www.nytimes.com/2020/08/04/us/virus-testing-delays.html) for some people, also advocated for getting tested at multiple points on your journey if possible -- perhaps before traveling, after reaching your destination but before seeing family members, and again upon your return.

A positive test result, of course, means you should scrap your plans to see family. But a negative result isn't a license to abandon precautions, Albrecht said, because testing too early can lead to false negatives that give a false sense of security. Continue wearing a mask, practicing social distancing and washing your hands.

Delgado also recommended self-isolating as much as possible for at least two weeks prior to the trip. Get your flu shot before you go (http://www.marketwatch.com/story/get-your-flu-shot-in-september-before-cases-start-to-climb-11597851877).

Who else is going? How many people will be there?

Holidays typically attract large gatherings, which tend to be associated with higher COVID-19 transmission levels, Albrecht said. So you'd ideally want fewer people gathering than usual, and it's even better if they're people already in your "bubble."

The risk level also depends on attendees' social contacts and exposures over the preceding couple of weeks, Delgado said. Gathering two groups of people that had completely self-isolated in their homes for two weeks presents far lower risk, he said, than hosting family members from all over the country who have kids in school and travel by train or plane to their destination.

At the gathering, maximize distance between people, minimize density, and limit the duration of time spent together as much as possible, Delgado added. "People don't always have the privilege of living in housing conditions that are not crowded, but certainly having more space indoors and allowing for less crowding is helpful," Albrecht said.

Is everyone feeling OK?

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November 26, 2020 04:57 ET (09:57 GMT)

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