Experts urge caution for gatherings, warn of post-holiday spike in COVID-19 cases
Heading into the holiday season, COVID-19 cases are rising across the United States, with new cases per day reaching triple digits.
In light of this surge in cases, the CDC recommended that people avoid traveling for the Thanksgiving holiday.
“It would be a shame to have avoided the virus to date only to contract it at a holiday gathering or to spread the virus to an elderly or vulnerable family member,” Donald W. Schaffner, PhD, distinguished professor and extension specialist at Rutgers University, told Healio Primary Care.
Despite the CDC’s advice, a national survey conducted by researchers at the Ohio State University Wexner Medical Center found that many Americans plan to travel for the upcoming Thanksgiving holiday.
Among 2,047 respondents, 38% reported that they were not at all or not very likely to attend or invite people to a gathering with 10 or fewer close family members.
Additionally, 82% reported that they would ask those attending gatherings with symptoms of COVID-19 not to come, 79% reported that they would only celebrate with members of their household, 73% reported that they would follow social-distancing measures before and after their event and 67% would ask those attending their gathering to wear a mask.
Iahn Gonsenhauser, MD, chief quality and patient safety officer at Wexner Medical Center, told Healio Primary Care that while the survey already suggests that a significant proportion of the population plans on attending holiday gatherings, the actual amount was likely underreported by participants.
“In all likelihood, the real, practical number is probably significantly larger than what was captured on the survey,” he said.
In addition to telling patients not to travel or gather in groups over the holidays, he said that health care providers should follow up to determine whether patients are gathering in person and “do their best to provide information about how that gathering can be made as safe as possible, with risks reduced as much as possible.”
When discussing the risks of traveling and gathering over the holidays, Gonsenhauser stressed that providers tell patients the facts about their risks and the “real human toll” the pandemic has already taken.
“They need to keep that front-and-center and ensure that their patients understand that this is real, that there are real significant impacts, that families are being broken as a result of this, lives are being lost and people are ending up with long-term health consequences that we don’t know how long will last,” he said.
Gonsenhauser also noted that it is important to inform patients about their risks during the ongoing spike in COVID-19 cases, but that “ultimately, this is the decision of individuals, and the most that we can do is provide them all the relevant information [to ensure] that they are making an informed decision and understanding their risks.”
Recommendations for those who travel, gather
“The safest option is to not travel for the holidays,” Schaffner said. “If you must travel, wear a mask and practice appropriate physical distancing.”
Gonsenhauser said that if people have in-person gatherings over the holidays, the safest option is a drive-by meeting, where people remain in their cars and talk to their loved ones from a distance with masks on.
Another option, which is significantly riskier than the drive-by option, according to Gonsenhauser, are open-air gatherings outdoors or in a tent with at least two walls open.
At these types of gatherings, individual households should be seated together, people should wear masks as much as possible and use plenty of hand sanitizer, and food should be provided in ways that reduce comingling, he added. For instance, people should avoid buffet-style food service.
Those who do choose to hold indoor gatherings should maximize the use of masks and get as much fresh air ventilation as possible, he said.
Gonsenhauser stressed that patients should be cautious and maintain these precautions throughout in-person gatherings, because while “people are drinking and eating and being merry and letting their guard down, it’s very difficult to maintain those physical distances and precautions.
“We’re all hungry for close personal contact with our loved ones that we’ve missed for the last 8 months, and when we’re together in a shared space during a holiday like this, it’s very difficult to resist the urges to be close to one another — but that’s ultimately what we have to do right now,” he said.
Preparing for a surge
Physicians should begin to plan for a surge after the holidays, both Gonsenhauser and Schaffner said.
“Given the already surging number of cases and data which indicates that holiday travel will only be slightly curtailed from typical levels, I think it is almost inevitable that we will see a surge in COVID-19 cases after the Thanksgiving holiday and then again after Christmas and New Year’s,” Schaffner said.
Gonsenhauser also noted that “primary care physicians, hospitals, health systems and public health entities should all be prepared ... to have an increase in the current trajectory of new cases and hospitalizations and deaths.”
Schaffner added that “it is unfortunate that now that a vaccine seems to be almost within reach, the colder weather and people’s patience for sheltering in place seems to be waning.”
“These holidays will almost certainly increase cases and deaths,” he said.
CDC. Trends in number of COVID-19 cases and deaths in the US reported to CDC, by state/territory. https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases. Accessed November 23, 2020.
Wexner Medical. Survey: Americans likely to attend large holiday gatherings despite COVID-19. https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/covid-holidays. Accessed November 20, 2020.
OSU WMC. Survey results. http://osuwmc.multimedia-newsroom.com/preview.php?previewpath=http://msnewsroommedia.s3-website-us-east-1.amazonaws.com/mcp/osuwmc/2020/covidholidayplans/01-Documents/03-Survey_Results/FINAL%20COVID%20Holiday%20Plans%20Survey%20Results.pdf. Accessed November 20, 2020.