Recommendations for Thanksgiving: regardless of where you stand

Thanksgiving, one of the most cherished American holidays, is on our doorsteps, and many of us will be denied the full breadth of the warmth that we usually get from this holiday. We are nostalgic, hurt, angry, and sad. And those of us that are getting together with family as we always have for Thanksgiving know that something is just not right, no matter how much denial is beneath the veneer. Deep down, most know that in getting together, there may be consequences to ourselves or those that we love. For most, we feel that something powerful is separating us that we cannot see or fully understand, a factor that creates its own set of psychological consequences.

Our deepest hope is to be a resource for you. Though we will give you the bullet points and access to public resources for the safest way to spend the holidays, we will also attempt present recommendations for those that are just not able to go full steam into the highest level of safety recommendations. We understand that people are at different points on their journey in evaluating the significance of the virus in their lives. If any of these recommendations find a place in someone’s holiday regimen to improve safety, we have achieved our goal.

Tier 1. These recommendations are the ideal recommendations that will optimally preserve safety over the holidays and are highlights from the CDC recommendations.

• Meet in small gatherings with the nuclear family members that are in your home daily

• Avoid travel if possible. Especially avoid air, bus or train travel. 

• Attempt to get your grocery shopping done early

• Avoid in-person shopping over the holiday, especially on Black Friday

Please refer to the CDC website for their more detailed recommendations and attendant frequent updates.

Much of the following recommendations will make more sense with a general understanding of the importance of viral load, the subject of our previous blog.

Tier 2. These recommendations are for those that will not be able to follow the most stringent recommendations.

The Trip 

• If you have made plans for travel, please re-evaluate if you were planning to travel by plane, bus, or train. The evidence suggests that despite recommendations against holiday travel, this week will be the heaviest travel week of the pandemic. If you are unable to revise travel plans, please evaluate the potential to drive to your destination if you can do so safely. If you make stops, attempt to get food in drive-throughs rather than entering institutions for food.

• Wear masks when at rest stops and in restrooms

• Wash your hands frequently and use hand sanitizer after stops before getting in the car or touching children or other passengers

Having a negative test before a trip is helpful but it does not obliterate the chance of harboring the virus. The incubation period of the virus can be anything from 3-14 days. In other words, you could have been tested before the virus showed itself in your body.One of the strongest methods of mitigating risk is to quarantine for14 days before travel after having negative tests at the beginning of quarantine and in the middle of quarantine.

When you arrive or when your guests arrive

• Stagger arrival and departure times if possible

• Have as much of your Thanksgiving festivities outside as possible, weather permitting

• Have as much food preparation completed prior to the Thanksgiving meal as possible, to avoid that last-minute rush where many are helping in close proximity

• Have people congregate with spacing and in smaller groups, in as many rooms as possible

• Do not congregate in the kitchen

• If possible, keep windows open, at least intermittently (schedule times to open windows)

• Have people take walks together outside rather than staying inside all the time, even if they have to bundle up to do so

• Eat meals at several tables, not at a single table, in order to allow people to be separated.

• Have people spaced as far as possible at dinner tables

• Use disposable silverware and plate wear

• Do not pass dishes from individual to individual around a table. Have a socially- distanced, buffet style area for getting food, and have people get food at different times

• Limit the time together. As sad as it is, this is just not the time for long visits.

We all should know, however, that though this is the first major family holiday that Americans are moving through with the pandemic, other cultures around the world have already moved through these experiences. We can learn from what they experienced and the recommendations that they have shared.

Finally, be thankful with whatever time you have together, whether in person or remotely. There are some that we can no longer reach by any of these methods.

Kimberly Gandy, M.D., Ph.D., is a Northwestern/Stanford/Duke trained physician-scientist with over 25 years of experience at the intersection of science, medicine, and technology.