Thursday marks the second Thanksgiving during the coronavirus pandemic. Many grandparents are excitedly planning to see their grandchildren. Friends are dressing their dining tables for turkey and loved ones. Some people have flights booked or road trips scheduled.
But in the background, COVID-19 case numbers are inching upward across the United States and millions of Americans remain unvaccinated — leaving some people worried about the possible COVID-19 risks that could come with their Thanksgiving plans.
If you have concerns, experts say there are some important questions to ask to help weigh your risk: Will those around you be vaccinated? Have they been tested? Should you open windows when indoors?
Results from a new Axios/Ipsos survey, released Tuesday, found that among 682 U.S. adults who are planning to see people for Thanksgiving this year, 31% said that they view there to be a "large or moderate risk" in seeing friends or family for the holiday — down from 64% a year ago.
Among those planning to gather this Thanksgiving, 30% said the guests will include unvaccinated people and another 17% said they don't know whether guests will be vaccinated or not — which means that almost half of the survey respondents, 47%, could be around unvaccinated people for the holiday.
Unvaccinated people are six times more likely to test positive for COVID-19 than those who are vaccinated, Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, said during a White House briefing Monday.
"Infections among the unvaccinated continue to drive this pandemic, hospitalizations, and deaths — tragically, at a time when we have vaccines that can provide incredible protection," Walensky said. "As we approach the Thanksgiving holiday, I want to take a moment to reflect on where we were a year ago. I can remember waiting in great anticipation for the lifesaving vaccines we currently have at our fingertips."
She added, "We would encourage people who gather to do so safely after they've been fully vaccinated, as we've been saying for months now."
To celebrate safely, here are four questions to ask friends and family ahead of gatherings.
Question 1: Have you been vaccinated?
Knowing the vaccination status of the people around you can help determine whether you should take certain precautions during holiday gatherings, such as wearing a mask or keeping your distance.
Since his family members are fully vaccinated, Dr. Anthony Fauci, director of the National Institutes of Health, said that he will be spending the holidays with his family — and it's OK to ditch the masks when everyone is vaccinated.
"That's what I'm going to do with my family," Fauci told CNN on Sunday. But he added that when you are traveling or unaware of the vaccination status of people around you, then wear a mask.
"That is the safety net — is vaccination," Fauci said.
"Get vaccinated and you can enjoy the holidays very easily, and if you're not, please be careful," Fauci added. "Get tested if you need to get tested when you're getting together, but that's not a substitute for getting vaccinated. Get yourself vaccinated and you can continue to enjoy interactions with your family and others."
Someone is considered fully vaccinated two weeks after they receive a second dose of the Pfizer/BioNTech or Moderna coronavirus vaccines or a single dose of the Johnson & Johnson vaccine.
Nearly 60% of the U.S. population is fully vaccinated, but about 82 million people — more than a third of those eligible — have not yet received their first dose, a CNN analysis of CDC data shows.
Question 2: Have you been tested?
Some families might be trying to determine whether they should ask guests arriving for Thanksgiving to get tested, especially if the guest has not been vaccinated.
"I think that's a reasonable idea for that extra level of protection. It isn't a firm requirement, but I think if you want to go that extra step, particularly when you're in a region where there's a lot of infection and people are traveling, it is not at all unreasonable to tell people to get a test — one of those rapid tests — 24 hours or so before you go in an indoor setting with people," Fauci said Monday during an appearance on CBS.
"You can do an antigen test," he added. "It isn't the most sensitive of the tests, but it can tell you when you have enough virus in your nasopharynx to transmit."
CNN Chief Medical Correspondent Dr. Sanjay Gupta calls at-home COVID-19 tests "one of the best tools that we have" right now to stay safe during the pandemic.
"I don't think that we talk about them enough. I don't think we think about them enough," Gupta said in the latest episode of his podcast Chasing Life.
"Keep in mind, let's say you're vaccinated, but still want to make sure you're not potentially carrying the virus, which can happen. What you can do is you can take a rapid antigen test that can tell you fairly accurately the answer to the question you're really asking: Are you contagious? That's what you really want to know," Gupta said, adding that such a test can be bought over-the-counter for about $20.
Question 3: Should we crack open a window?
Air ventilation is important to think about during large gatherings, Gupta said on his podcast.
"We know that this virus spreads through the air. It's airborne. So, the more that you can get the air moving, the better," Gupta said.
"In fact, the way to think about it is think of the virus kind of like smoke. If there is smoke outdoors, you're going to be less likely to breathe it in, right? But indoors, if you have that same smoke, it's going to increase the chances of those particles getting breathed in," he added. "Even cracking a window a little bit can help."
Question 4: Is there anyone at severe risk who needs me to mask up?
Even when certain mitigation measures are in place — knowing who's vaccinated and who's not, testing guests and improving air ventilation — it may also be helpful to know who at the Thanksgiving table is at high risk for severe COVID-19 in order to help protect them.
Some guests who are at increased risk for severe COVID-19, due to their age or an underlying health condition, may prefer to keep their masks on and for others to wear masks.
"If everybody is generally healthy and they're vaccinated and boosted, probably it's fine for everyone to remove their masks and have a very normal Thanksgiving meal," CNN Medical Analyst Dr. Leana Wen, told CNN on Tuesday.
"On the other hand, if there are unvaccinated young children or severely immunocompromised people, you might want to have an additional level of protection— be outdoors, open all the windows indoors or get a rapid test the day of for everyone," said Wen, who is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. "That helps to ensure that everyone stays healthy from COVID and safe from COVID this Thanksgiving."
Overall, "no one wants to spread COVID to their loved ones," Dr. Tom Frieden, a former director of the CDC and current president and CEO of the global nonprofit Resolve to Save Lives, wrote in a Twitter post Monday.
"It's crucial we make sure everyone at the Thanksgiving table is vaccinated and consider other layers of protection, including masking when not eating, opening the windows, and testing for those who might have been exposed," Frieden tweeted.
These types of conversations can be difficult for some — but being open with loved ones about your concerns is the key, Gupta said on his podcast.
"I think the key is to remember to have an open conversation with those who want to spend time with over the holidays. Have that conversation now," Gupta said. "Let them know your concerns, what it might take to make you and your family feel safer and basically go from there."