With COVID-19 surging last fall, most Americans kept their Thanksgiving gatherings small, often celebrating with just immediate family or household members. This year, the situation is a little different. As of mid-October, more than 56% of Americans have been fully vaccinated, and cases have been going down in most of the country.
Still, if you’re hosting Thanksgiving this year, there are some precautions you should take to keep everyone safe, medical experts say.
“We’re not out of the woods yet, but I think we’re in a much better place this year for Thanksgiving and hopefully Christmas as well,” Gregg Miller, chief medical officer of Vituity, told HuffPost. “There’s still plenty of COVID circulating around. There are still thousands of people dying every day from COVID.”
Miller hopes those numbers will improve by Thanksgiving and more people will get vaccinated, but he said gatherings can still lead to “unnecessary deaths and unnecessary infections.” Along with COVID-19, he emphasized that it’s also flu season, and that virus can also be transmitted via close contact.
The Centers for Disease Control and Prevention released holiday guidance on Oct. 15, suggesting that all people (even those who are vaccinated) wear masks when gathering indoors, among other suggestions. We asked medical experts to discuss some precautions to take to host Thanksgiving safely this year.
1. Ask guests to get vaccinated
The CDC has said that fully vaccinated people can mostly resume their pre-pandemic activities, including gathering with other fully vaccinated folks. So, asking that everyone attending your Thanksgiving feast is vaccinated is “reasonable in this environment,” especially if you’re inviting people outside your regular circle, said Joseph Giaimo, president of the American Osteopathic Association.
Bringing up vaccination status can be a touchy subject, though, Miller acknowledged. “People can choose to live how they want to live, obviously, but the safest thing for them to do would be to ask that if anybody comes into an enclosed indoor space, that they be vaccinated.”
Being frank is the best approach, he said. “I think it’s fine to say, ‘Look, my house, my rules. And in my family, we’re concerned about the pandemic.’ I think it’s tough to have these conversations sometimes, but I think they’re important conversations to have.”
Though rare, breakthrough cases are still possible among vaccinated people, Giaimo said, but the chance of severe illness, hospitalization and death are much lower when you’re vaccinated. Vaccinated people infected with COVID-19 can still transmit the virus to others, however.
2. Take extra precautions with unvaccinated guests
Do you have a family member or two who refuse to get vaccinated? It’s possible to still have them over for Thanksgiving. Take precautious by emphasizing social distancing, asking guests to wear masks and seating everyone outside or in areas with lots of ventilation, Giaimo said.
“You can isolate a little bit,” he added. “It’s not to preclude people who are not vaccinated, but it’s just taking important steps to ensure everybody’s health.”
The CDC has also suggested improving ventilation in your home when hosting visitors by opening windows and doors and placing a fan in an open window to blow air out and pull in fresh air from other windows.
Asking unvaccinated guests to take an at-home COVID-19 test a few days before the event and then on the day of could help mitigate risk, too, Miller said.
3. Pay attention to case counts and vaccination rates in your area
COVID-19 transmission and vaccination rates vary by community. Miller suggested keeping track of what’s happening in your area as you plan your Thanksgiving gathering.
“These decisions need to be made very locally,” he said.
Examine individual risk, as well, Miller said. If some guests are immunocompromised or there are children who can’t get vaccinated yet, it may change whom you invite and how you host the holiday.
“Trying to predict COVID is like trying to predict the weather,” Miller said. “You have a general sense of what the weather is going to be like in late November. These COVID forecasts are just like the weather forecasts. In general, we hope that the weather is improving, the COVID forecast is improving, but in your specific town, it might be a different story.”
4. Host the Thanksgiving gathering outdoors
Celebrating Thanksgiving outside, if the weather cooperates, can make the gathering safer, especially with a mix of vaccinated and unvaccinated guests.
“Eating outdoors is definitely less risky than eating indoors,” Miller said. “Honestly, if everybody is vaccinated, I think it’s reasonable to have a meal indoors.”
And don’t forget to follow the usual safety measures we’ve become accustomed to: Ask guests to wash their hands, provide hand sanitizer and request that people stay home if they’re sick. Giaimo said these steps will decrease transmission.
5. Avoid serving Thanksgiving buffet-style
It’s also a good idea to skip the Thanksgiving buffet this year. Instead, designate someone to plate up the meal for all the guests, Giaimo said.
“I think buffet options are probably not as desirable because you have people going back and forth,” he explained. Though COVID-19 is mostly spread through respiratory droplets, Miller said limiting contact, hand-washing and sanitizing surfaces remains important.
6. Scale back your celebration, at least a little
We don’t need to cancel Thanksgiving or celebrate with just immediate family this year, but Miller said gatherings should be more low-key than they were pre-pandemic.
“We don’t need to be as dialed back as we were last year,” he said. “But I think it’s realistic to ask everybody to think about what your normal Thanksgiving is and pull it back one step to keep it a little bit safer.”
COVID-19 will likely be around for the foreseeable future, with new variants emerging, Giaimo said. People don’t necessarily need to avoid doing things, like hosting Thanksgiving — they just need to take precautions, like wearing masks and, most of all, getting vaccinated.
“We as people need to come together, and I think these holidays are important for all of us and for our socialization, our wellness and our mental health,” he said. “Just being cautious, being respectful with each other is the most important thing.”
This article originally appeared on HuffPost and has been updated.