Thanksgiving is right around the corner -- and if public health agencies have their way -- celebrations this year promise to be extremely different from past years, as the coronavirus surges in states across the country.
Infectious disease experts are warning of a convergence of Covid-19 and influenza as the temperature drops and colder weather sets in. The United States is already seeing an uptick in infections.
The US Centers for Disease Control and Prevention recently released guidance on holiday gatherings and what Americans need to be aware of before traveling, hosting or attending parties -- or just gathering with family and friends over the Thanksgiving holiday.
The main guidance, according to the CDC, is assessing the levels of Covid-19 infections in communities to determine whether to postpone, cancel or limit the number of people at a celebration or whether to attend certain activities. If there are high infection rates, the agency recommends limited gatherings.
"Some people in this country are going to be able to have a relatively normal type of a Thanksgiving, but in other areas of the country, it's going to be, 'You better hold off and maybe just have immediate family, and make sure you do it in a way that people wear masks, and you don't have large crowds of people,' " Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, said in a recent interview with CNN.
"What we're starting to see now -- and we can't run away from it -- we're starting to see in the Midwest and the Northwest, an uptick in test positivity, which tends to be a predictor that you're going to have surges," Fauci said.
But if Americans are going to celebrate Thanksgiving, the trick, Fauci said, is to do it as safely as possible.
Low risk holiday activities
The lowest risk for contracting the highly infectious virus or spreading it is simply celebrating Thanksgiving in your own home with members of your household and/or virtually with extended family, the CDC said.
"Understanding that everyone has this traditional, emotional, understandable, warm feeling about the holidays -- and bringing a group of people, friends and family together in their house, indoors -- that's understandable," Fauci, a member of the White House Coronavirus Task Force, told ABC News during an interview Thursday. "But we really have to be careful this time, and each individual family evaluate the risk/benefit of doing that."
People can prepare holiday food for non-household family members -- especially those at higher risk of contracting Covid-19, and neighbors -- and deliver it without contact. They can also host a virtual dinner as a means of mitigating any risk.
Also shopping online instead of heading to malls and stores for holiday sales the weekend after Thanksgiving is a safer way of grabbing those deals.
The CDC suggests watching sports events, parades or movies from home as another low-risk holiday activity.
Moderate risk holiday activities
If you are going to host a Thanksgiving dinner, the CDC recommends organizing an outdoor event with family and friends from your neighborhood.
"Gatherings with more preventive measures, such as mask wearing, social distancing, and hand washing ... pose less risk than gatherings where fewer or no preventive measures are being implemented," the CDC advises.
Holiday activities with moderate risks for catching the coronavirus include visiting a pumpkin patch or orchard where people are using hand sanitizer before touching pumpkins or picking apples, wearing masks and social distancing.
Attending outdoor sports events, even with coronavirus safety measures in place, still poses a moderate risk of infection.
High risk holiday activities
High risk holiday activities include those where the probability of catching or spreading the coronavirus is greatest, the CDC said.
Large, indoor gatherings, dinners or parties, especially with people from outside your immediate family, pose the highest risk.
"Indoor gatherings generally pose more risk than outdoor gatherings," the agency said. "Indoor gatherings with poor ventilation pose more risk than those with good ventilation, such as those with open windows or doors."
Gatherings that last longer are more dangerous than those that are shorter. And the more people, the higher the risk.
"You may have to bite the bullet and sacrifice that social gathering, unless you're pretty certain that the people that you're dealing with are not infected. Either they've been very recently tested, or they're living a lifestyle in which they don't have any interaction with anybody except you and your family," Fauci said this week during an interview with CBS News.
Shopping in crowded stores and malls before or after Thanksgiving is another high-risk activity.
Attending crowded public events, such as races or parades, is not recommended.
Using alcohol or drugs can cloud judgment and increase careless behavior as well, the CDC said.
Traveling during the holidays, on planes or public transportation, increases the chances of catching and spreading Covid-19 because it increases exposure to the virus, the CDC said in its holiday guidelines.
"Staying home is the best way to protect yourself and others," the agency said.
But if you do plan to travel, take as many precautions as possible. Wear a mask, engage in social distancing by staying at least six feet away from others, wash your hands frequently, avoid anyone who is sick and avoid touching your eyes, nose or mouth.
"We've got to be careful," Fauci said during a recent discussion at American University. "You've got to take it as an individual case. It depends on where you are and where you are traveling."
Fauci, who lives in Washington, DC, said he'll be celebrating the holiday this year with his wife at home, and virtually with his three daughters, who all live in different cities with varying coronavirus infection rates.
"They themselves, because of their concern for me and my age, have decided they're not going to come home for Thanksgiving, even though all three of them want very much to come home for Thanksgiving," Fauci said.
"That's one family's decision. Otherwise we would love to be together," he said.
"We decided to make it a very, very close family type of thing," he added. "That was my decision. I'm not going to criticize people who do it differently, but look at the individual situation in your own family and make a decision that way."
The CDC's holiday guidelines are not meant to replace any local or state mandates on the pandemic, the agency said.