By Dr. Irwin Redlener
Dr. Redlener is founding director of the Center for Disaster Preparedness at Columbia University’s Earth Institute, a pediatrician, husband, father, grandfather, and Upper West Sider. He is a public health analyst for MSNBC.
Thanksgiving 2020 will surely be like no other in U.S. history. We are drifting increasingly into unprecedented territory as COVID-19 is raging out of control. The U.S. will certainly soon see a new, frightening milestone of 200,000 cases every day. Hospitalizations are increasing at a rapid pace, with many states experiencing severe, acute shortages of medical personnel.
Eventually, if we follow the new rules, get lucky with safe, effective vaccines and develop medications that can tamp down COVID-19 symptoms so we don’t need to be treated in a hospital, there is good reason to be optimistic about returning to normal traditions for Thanksgiving 2021. But for now, we are literally endangering our communities and our loved ones by pretending that we can hold a traditional Thanksgiving celebration in 2020. We just can’t.
That said, there’s still a lot we can do to enjoy this holiday season. A little creative planning around sharing virtual time with loved ones, cheering each other online, celebrating prior to the traditional date and finding ways to share the experience with laughter and affectionate connections can make a big difference – without endangering each other, especially those of us who may be particularly vulnerable to getting seriously ill from the coronavirus.
Here are some guidelines culled from experts, including the Centers for Disease Control and Prevention (CDC):
Household members only; all other guests join us online!
I strongly recommend that unless there is some safe way to include someone who is not living in your home now, stick to those who do. At this stage, if you are planning on a Thanksgiving dinner on or before the actual date of the holiday, Thursday, November 26, it is already too late to allow safe quarantining of potential guests traveling from elsewhere for the full recommendation of 14 days.
If someone had a known exposure to another individual with Covid-19, they need to be tested at least once (twice is better) starting 5-7 days after the exposure. If the previously exposed person has recent proof of antibodies to the Coronavirus (serology testing) they are probably safe to join the festivities. (Keep in mind that while tests are very helpful, they are certainly not foolproof.)
More than 250,000 college and university students have tested positive for COVID-19. Unless they meet the criteria above, I recommend that college students not living at home should not join the festivities in person – especially if there is anyone in the household who might be at higher risk. Remember that it’s not just older folks who are at risk. Increasingly we are seeing younger and younger people getting sick, particularly if they have other risk factors like diabetes, breathing problems (think asthma or emphysema), a compromised immune system, or being overweight.
If you are thinking about having dinner that includes people who do not live with you on a day to day basis, enforce mask-wearing, extra attention to hand hygiene, distancing, and good ventilation – meaning, for most of us, windows open!
Essential frontline workers – think hard about extra risks
If one of your primary household members fits one of the categories we call “front-line” or “essential” workers, you need to think about extra precautions that might be necessary. Are they careful about always using appropriate personal protective equipment (PPE) when they are at work? Are they regularly tested for the coronavirus? If so, how often? Ideally, they should be tested 4-5 days before the gathering and 24 hours prior, as well.
Better yet? Invite them to join the virtual celebration this year while the epidemic is raging out of control.
Travel? Maybe not this year…
If it is deemed essential that you travel for the holiday – and think about the word “essential” – or have a traveler visit you, this should be seen as something to be allowed only with serious caution.
College students returning from school, visiting an ailing or aging relative, having a sibling coming from out of state for the big dinner can pose a real threat of passing COVID-19 to a vulnerable person.
Air and rail travel should be avoided.
The safest means of getting from here to there is by car, with windows open!
Where and how to eat?
This where “cautious flexibility” needs to be our guiding principle.
Keep the dinner gathering short; keep the number of courses to a minimum.
Masks on except when actually eating or drinking for everyone if non-household members are joining.
Do everything possible to eat outside – layered clothing and outdoor heaters are recommended.
What about those who must be excluded from the in-person experience in this extraordinary year?
Create a “large as you want” gathering at a specified time after the main meal. But sign onto a virtual video platform, like Zoom, BlueJeans, Microsoft Teams, or other available systems. Have a master of ceremonies. Tell jokes and ask the kids to send a funny greeting to cousins or other loved ones. Consider inviting a surprise guest! Think about a well-liked, often missed, person, couple, or family who do not usually join for the traditional dinner and invite them to join the virtual celebration.
At the end of the extravaganza, have a toast – and vow that we’ll all do everything we can do to make sure that next year’s Thanksgiving is more like the ones we once enjoyed.
Record the session – and make it memorable!
In conclusion: This is our time
Like the rest of the world, America is experiencing an extraordinary and lethal crisis. This is not about conspiracies, a political agenda, or a person’s perspective on the role of government or taking a stand. This is about recognizing that the global pandemic has reached into our communities and our families with deadly force.
And, yes, it is about patriotism in its truest sense. People may rightly claim that they should get to decide how much risk they personally want to assume in their own lives. That’s always true. People skydive, ride motorcycles, and participate in all manners of extreme sports. That’s fine.
But if we defy wearing masks, keeping our distance from others, or taking precautions recommended by experts who know how to prevent the spread of the coronavirus, we are not just taking a personal risk. This is most-costly defiance that endangers others who, as a consequence, do not get the benefits of a community-wide strategy to keep all of us healthy. That is not patriotism or liberty. It is reckless and selfish. And it is not who we are as Americans.
Many generations before us have had to endure great hardship and suffering. Thousands of American soldiers were severely wounded or perished in Iraq and Afghanistan fighting terrorism. We lost 58,000 people in Vietnam during an existential crisis that tore us apart as a nation. In World War II, 407,000 Americans died in combat.
So, think about this: it is very likely that Covid-19 deaths may well exceed 500,000 before we have complete control of this scourge.
Yes, it is hard and disruptive to our normal way of life to do what we need to do. But we can’t let up. We must care for each other and allow our experts to guide our policies. We have to endure and be a good example for our children.
Like it or not, it is our time to deal with a crisis we never asked for and never expected.
We can do it.
You can follow Dr. Redlener on Twitter @IrwinRedlenerMD