COVID-19 is showing no signs of going away soon. And that means we have to make special plans around Thanksgiving dinner this year, says Dr. Lynora Saxinger, an infectious diseases specialist and associate professor of microbiology and immunology at the University of Alberta.
"People are really sick of COVID, and yet it doesn't seem to be yet sick of us," Saxinger told The Homestretch.
"When you get people together for Thanksgiving, you're bringing together usually multigenerational groups, sometimes of people who've been in different areas, just kind of bringing together different bubbles, and that automatically elevates our risk. And so I think we have to have a long, hard look at who's going to be there and what their risks are and whether or not it's worth it."
Saxinger said people have to take a hard look at whether it's worth the danger, especially if older family members will be part of the mix.
"You might look at things like having maybe fewer people for a sit-down meal because meal sharing, airspace sharing, utensils sharing is all a risk," she said.
"You might have a smaller number for that and then have a larger outdoor sort of get-together gathering where people can distance with excellent ventilation because it's outdoors. So you might do some kind of a hybrid thing, or eat and then meet outside."
Saxinger said another option is to look at how food is shared and served. For example, have food individually plated, rather than use shared serving utensils. Or have one person only handle the serving utensils. And as many have already discovered, virtual gatherings are another option.
"Another option, if it's really important to your family to gather … between now and Thanksgiving, people could look at doing kind of a quasi-personal lockdown, and really strictly limiting any extra contacts that they have, so that their own personal risk is as low as it can be," Saxinger said. "So that they don't have an incubating infection that could spread at the time that people gather."
Saxinger said the final and most obvious thing is that anyone who has even the slightest symptoms should not attend any gatherings.
"We do know that people can spread infection with minimal, even no symptoms, but really minimal symptoms that usually you would ignore," she said. "So there's a whole bunch of different levels there that people can think through before deciding on what to do."
Saxinger said people could also treat the gathering as they now would treat an outing to a restaurant — wearing a mask while in common areas and un-masking while eating the food.
"If you think about the time of contact, like the time that you're in the shared airspace, particularly without a mask, minimizing that time is really important. And so, masking for the chatty parts and unmasking for the eating parts might offer some benefit," she said.
"It can be hard, because if you're gathering indoors, it's hard to distance. But if you have a small number of people — which would be preferred — making sure that you're about a metre apart from each other and making sure that the windows are open and there's good ventilation, all those things should help."
The only way to create a "zero-risk scenario" is to not gather. But still, Sazinger said, people can make their gatherings safer by hand washing, wearing masks and maintaining distance while they are together.
But as to who should be together, that's going to be up to each group.
Craig Jenne, infectious disease researcher and associate professor at the University of Calgary, told Alberta at Noon that each family situation will determine how much of a gathering is safe this year.
"Depending on age, depending on underlying conditions, we really need to worry about protecting people that are at risk, so it becomes an individual decision in the family," he said.
"Each family has a different risk of having the virus within the family. Are there kids in school, you know, is the workplace a risk of exposure for individuals or do you work privately in an office? So it's very difficult to have one rule because each family will be different."
Jenne said one of the biggest things to do differently this year is the practice of flying family members in from other areas, such as kids who are away at university — especially if those students are in a COVID-19 hotspot like some regions of Ontario and Quebec.
"If people are coming from virus hot spots back to Calgary, maybe that's something we have to avoid," Jenne said. "And then how do they get here? Do they have to fly, is that a flight that's worth taking at this particular time for simply social purposes?"
One of the most common outlooks is to scale back Thanksgiving, in hopes that things will be more manageable by Christmas.
In some parts of Canada, Jenne said, we are seeing a very clear second wave. He worries that if we ease up, and start having large gatherings, we could see a second wave in Alberta.
"Really, the next couple of months are critical to getting those numbers back down, and if we can, then it does take a lot of pressure off Christmas," he said.
"If however, we're well in the middle of a second wave and we're talking hundreds of cases a day, we will probably have to bring in restrictions further at Christmas. So, the decisions we make today really shape what our options are in the future. And it's difficult. But you have to have that debate — is it worth it now for what we might be risking in the future?"
There is a similar difficult conversation around bringing elderly relatives into the family bubble for the holiday, especially if they have been isolated in a long-term care facility.
"It's tough again. Each family's different, right? So, for example, if we're talking about a couple that have no more kids at home, perhaps really limited exposure in the workplace. So the chances of that couple having a virus and exposing it to somebody is very, very low," Jenne said.
"So with precautions, you can proceed safely. But if we're talking about picking up a grandparent and bringing them to a large family gathering with lots of school-age kids, people flying in from across the country — obviously the risk factors go up dramatically in those situations.
"So it unfortunately becomes really a case-by-case basis."