Thanksgiving In The Time Of COVID-19: To Grandmother's House Or No?

It's time to gather the family together for the talk. Not that talk — the talk about what to do for Thanksgiving this year as the pandemic rolls on.

It has been months since many of us have seen extended family — we're longing to check in on aging parents, to see old friends from back home, etc. But even though Thanksgiving often conjures up pictures of big happy reunions, how safe is it to make them a reality?

"Right now, in many areas of the country, COVID-19 rates are starting to surge again," says Dr. Tina Tan, pediatric infectious disease specialist at the Ann and Robert H. Lurie Children's Hospital of Chicago and professor of pediatrics at Northwestern University's Feinberg School of Medicine. Tan fears that the lure of holiday parties as well as more indoor activity because of the colder weather may result in more illnesses.

But if your heart is set on having a get-together, there are some things you can do to protect yourself, Tan says.

First, make sure you know who is attending and if you are traveling, how you'll get there. You need to know what coronavirus transmission rates are in the area you live and where you're going, Tan says. You can use NPR's coronavirus tracker to check this.

"Unfortunately, you're not really going to know that until fairly close to when you want to travel because these [transmission rates] are changing really rapidly," she says.

Family trip road trip

The safest way to travel is to drive, Tan says. The main risks in a road trip are the stops along the way, such as at restaurants, gas stations, or public restrooms.

"I would recommend you do anything you can to limit your exposure," says Dr. Ravina Kullar, an epidemiologist and spokesperson for the Infectious Diseases Society of America. "If you have to fill up the gas tank, put gloves on and use hand sanitizer" and wear a mask, she says.

That's what Clay Alling is planning to do — take a family road trip to the coast. Alling is a chef and general manager for a group of British pubs called Baker St. Pub & Grill, all located in Texas.

He often makes Thanksgiving dinners and delivers them to customers in the Houston area, where he lives.

"Not this past Thanksgiving, the one before that, I did 55 turkeys, I did 300 pounds of mashed potatoes, 100 pounds of green beans ... 42 dozen eggs, 12 dozen yeast rolls ... 12 cherry pies, 15 pecan pies, 28 pumpkin pies. It was crazy."

But he's not doing that this year. The pandemic has hit his business hard and has forced adaptations like expanding the food menu at many locations and implementing extensive safety protocols to reopen. He has been working harder than ever this year.

"I'm gonna take a break," he says. "We're going to get some kind of relaxation into everybody's lives."

This year, Alling will take his wife, their three children and his elderly father-in-law (who lives next door and whom the family has been caring for) to the beach for a Thanksgiving escape. They're going to rent a house, which is pretty safe, Tan says.

"You just have to make sure the cabin or whatever you're renting has been cleaned thoroughly so there's not the risk of someone having COVID that was just there ... and it's still on the surfaces or in the air."

But what about flying?

Thanksgiving is traditionally one of the busiest times of the year for air travel. The Transportation Security Administration screened a record-breaking 26 million passengers over the holiday in 2018.

The airlines are enforcing mask-wearing more consistently than they were at the beginning of the pandemic, Tan says, and they are seating people farther apart. Same with trains.

"The planes themselves are actually very safe. I mean, their air circulation system is better than the air circulation system in many homes," she says.

A recent report in the Journal of Travel Medicine suggests that strict mask-wearing policies on planes is particularly effective. Scientists studied all Emirates airline flights from Dubai to Hong Kong between June 16 and July 5 and found that although Emirates had 58 coronavirus-positive passengers flying on eight-hour trips, nobody else on those flights got sick.

"I think your biggest risk is at the airport," says Tan, where the situation is less predictable. There are more people and fewer controls.

Precautions before you gather

Even if there's no travel involved, gathering indoors with extended family and friends can be risky, especially if there's an older or high-risk person in your group.

The Centers for Disease Control and Prevention says people 65 years and older are at higher risk for getting a severe case of COVID-19. About 80% of deaths in the U.S. from COVID-19 have been of people in this age group.

You'll need to agree on some ground rules in the weeks leading up to your feast. To be really on the safe side, you would try to quarantine for two weeks before the day, or take as many precautions as practical.

Holly Provan, a cardiac rehab nurse at Huntington Hospital in Pasadena, Calif., plans to spend Thanksgiving weekend with her family and friends in a shared cabin in the woods in the tiny town of Lake Arrowhead, a few hours drive away. To do that as safely as possible, Provan says she will stop working for a week before the trip, keep everyone in the house socially distant from others, shop exclusively online and take a COVID-19 test.

"We're making some sacrifices for that week before just to make sure we're all extra careful and that they feel safe," she says.

Sharing a cabin with another family or extended family can be relatively low-risk, says Tan, if everyone attending has been following good hygiene practices — hand-washing, social distancing as much as possible and mask-wearing — in the days or weeks leading up to the event.

And when you're not eating, ideally you should be wearing a mask. "I know it's very awkward, but that's going to be the way you can keep your family and the other family safe," Tan says.

Tan suggests one other precaution before the event: Make sure everybody has a flu shot. "You don't want to bring something else into the mix."

As for COVID-19 tests, Tan says they are not a guarantee.

"Basically what we know about these tests is it only tells you at that particular point in time what your status is," she says. The tests often fail to show when someone is carrying COVID if their exposure has been very recent. They are more accurate five to seven days from exposure, and often, you just don't know when you were exposed, she says. Plus, many people are asymptomatic.

Safer at home sweet home

The safest thing to do is stay home with the people in your own household. That's what Leigh Anne Pineda plans to do. Pineda lives in a garden apartment building with her husband and two children in Burbank, Calif. She works in a credit union, and her youngest child is asthmatic, which puts him at a higher risk for complications from COVID-19.

Although her family is nearby and has been helping with the kids from time to time, Pineda has decided to make this Thanksgiving the one holiday where it's just the four of them.

"I think it's really easy to get engulfed in all the bustle of the holiday and not really enjoy it because there's so many people and there's so much going on and you've got to say 'hi' to these people and clean up all the mess," Pineda says. This year, they're going to ignore the laundry and the dishes and just enjoy one another's company.

And they might even cook something completely untraditional. Her husband is a chef of Filipino descent and might just put some pancit and pork belly on the table. "I'm not going to lie. I'm not the biggest fan of turkey," she says.

And, she's actually looking forward to avoiding the sometimes-exhausting extended family gathering. "Now I have an excuse to stay home!" she says. [Copyright 2020 NPR]