With Thanksgiving around the corner, we sat down with Dr. Michael L. Loftus, the chief medical officer at Jersey City Medical Center, to ask him some questions about the safety of gathering with friends and family during a pandemic.

Q: What do you advise people to do about Thanksgiving gatherings?

A: Thanksgiving is a holiday with many cherished traditions, that unfortunately also brings together many of the most high-risk behaviors related to COVID-19, such as gathering indoors, removing masks and eating with others, and often talking loudly and closely with loved ones. These activities are really all part of what we have been discouraging in order to prevent the spread of COVID-19. 

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That being said, it's a difficult situation to accept for many. Thanksgiving is one of my favorite holidays personally. My family and I have talked about what we're going to do because we’d normally host, but we're choosing not to this year. We're going to set up a Zoom and do a virtual family gathering. We personally felt that the risks are simply too difficult to fully mitigate. If it really came down to it and I have to give one recommendation, it would be to find alternative ways to share the Thanksgiving holiday without doing it physically together. Gathering together is an unfortunately a high-risk activity at the moment. 

Q: A poll conducted by Ohio State University has found that 38 percent of Americans say they are likely to participate in gatherings of more than 10 family members this holiday season, and a third would not ask others to wear masks at holiday gatherings. What advice do you have for people who want to get together?

A: First, Gov Murphy recently announced that indoor gatherings would be limited to 10 people due to rising case numbers. However, 10 people is still a fairly large grouping depending on the physical space that those 10 people are using. If you absolutely must get together, there are ways to somewhat reduce the associated risk by following all of the safety guidelines – wearing a mask at all times, adhering to social distancing and performing hand hygiene. The traditional Thanksgiving gathering is indoors around a table, and involves a meal. Unfortunately, that is one activity that you can't really do with the mask on. If two people are both wearing masks, even if one of them has asymptomatic COVID-19 and is unaware, the risk of that spread is dramatically reduced because both sides are wearing masks. If one side takes that mask off the risk goes up. So it's challenging. 

If you are thinking about having a gathering, try to compromise in a way that allows you to see your loved ones while minimizing risk. Think about the time and the timing of how you get people together. The way that we think about risk also involves the overall time of a potential exposure. So if you can do an event that's shorter or keep people apart except for short periods of time, you help reduce the risk.

The length of time that's stated by the CDC is 15 minutes, but the shorter you are in the close presence of someone who may have COVID-19, the lower your risk. Think about ways to minimize the time that people are in any of those high-risk situations, close to one another. 


 
Q: Are there ways to minimize risk?
A:
If you’re planning to gather, aeration and airflow is a really important part of reducing risk. Can you hold the event outside, potentially, if weather permits? Can you do something that might be less traditional, but safer? For example, could you do a buffet style dinner, where people are able to spread out and distance when eating? It’s best to have well ventilated spaces with good air movement and spaces with more square footage so that the social distancing can be maintained in a way that reduces the risk overall. Hosts should also make every effort to limit the number of people who may gather. Could you consider a small gathering and potentially use something like a Zoom or a WebEx or other virtual platform to connect with others but keep the gathering smaller as a way to potentially mitigate the spread of COVID-19? While people should also continue to practice hand hygiene after touching surfaces and doing that frequently, respiratory transmission remains the primary mode of spread, so masks and distancing are the most important pieces of prevention.

Q: Is it safe to travel?
A:
We certainly discourage people from unnecessary travel regardless of Thanksgiving because it’s a high-risk behavior that has the potential to bring people from other areas with higher prevalence of COVID-19 to family gatherings that may expose others.

Q: What can guests do before they arrive?
A:
You can make sure that guests are not engaging in risky behaviors in the time before they come to a gathering. Make sure your guests are not going out in groups and are quarantining before they come over. The problem is that the gestation period for COVID-19 is long and so any risky behavior in the week leading up to a gathering is going to increase the risk for the whole group. Anybody with any sort of symptoms – be they stuffy nose, fever, especially cough – should absolutely not attend a Thanksgiving gathering. Do not travel or join a gathering if you have any symptoms that could potentially be related to a respiratory illness. 

Q: What about getting a COVID-19 test before the gathering?
A:
The more information you have the better. But it's really important to remember that a negative COVID test is only a snapshot in time. It is only true at the moment that that test was taken. If you're getting tested beforehand, remember that any risky behavior between when you're tested and when you gather with others is an opportunity for transmission to spread. We have certainly seen cases where people tested negative and then in the 48-72 hours between when they were tested and when they visited others, they developed symptoms and tested positive. So it is a really valuable piece of information, but it should not be relied on instead of all the other safety precautions that need to be in place.

A: What about college students returning home?
Q: If college students can be tested before coming home, again that is valuable information. If they are negative and they stay in the house, that’s fine. But if they go out with their friends after their test, you could be at risk the next day. Remember, New Jersey has issued an incoming travel advisory to all individuals entering from states with a significant spread of COVID-19. If your child attended a college in one of those states, they should quarantine for 14-days after leaving that state. 

Q: Any final recommendations?
A:
It's important to remember that the whole Thanksgiving holiday is a pool of risk and there are some activities that are higher risk and some things that are lower risk. It's important to think about all of the safety recommendations that are in place and do as many as you possibly can to protect both you and your loved ones. This is an unusual year. It's such a cherished holiday because of the emotional well-being and personal connections that come from spending time together. It's a holiday where people gather and share and eat and that's something we all desperately want right now, but it's also unfortunately a very risky situation given the rapidly rising case counts despite the attempts that we are all making to prevent spread of COVID-19.