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Thanksgiving Covid tips for meals that include unvaccinated guests

Big gatherings can feel nerve-wracking, especially if you know some folks around the table this year won't be vaccinated.
Illustration shows Thanksgiving scenes, Covid-19 spores, floating masks and syringes.
You can control your risk by asking people to prove that they aren’t infectious just before the get-together through rapid tests.Chelsea Stahl / NBC News

Thanksgiving is around the corner. And for many of us, it is a welcome respite — a chance to get back to pre-pandemic routines and practices and connect with loved ones. Staying home feels so ... 2020.

But big get-togethers can still feel nerve-wracking, especially if you know some folks around the table this year will be unvaccinated. So what is the risk, really, of a “mixed” Thanksgiving get-together?

Although the risk equation can feel complex — and even daunting — many parts of it are under our own control.

As a scientist and physician, I think about risk in gradations of gray. Before any get-together, I ask myself: What’s my risk of being exposed to SARS-CoV2? What’s my risk of catching it? And if I do catch it, what’s my chance of getting really sick?

Although the risk equation can feel complex — and even daunting — many parts of it are under our own control.

The first and best way to reduce both risk of exposure and risk of infection, of course, is to require that everyone who comes to your Thanksgiving celebration is vaccinated. Vaccination isn’t 100 percent perfect — the sneaky delta variant can cause breakthrough infections — but it decreases your risk of any infection by at least 70 percent and up to 90 percent, depending on what kind of vaccines you received and whether you’ve received a booster. (These numbers can vary depending on your own medical history.) Vaccines also significantly decrease the risk of severe disease, hospitalization, death and long Covid for almost everyone. Vaccines are like putting your kid in a car seat. If you’re in a car crash, your little one may get hurt, but the chance of injury and death is a lot lower if they’re belted in. Same thing here. Vaccines work.

It is unfortunately too late for anyone to finish their vaccination series before Thanksgiving at this point. Folks may be unvaccinated because they’re too young (or, for 5- to 11-year-olds, haven’t yet completed their primary Covid-19 vaccination series), because they have allergies (a vanishingly small number; current statistics suggest that very few people with allergies to other vaccines, foods or medications have reactions to the Covid-19 vaccines) or because they have concerns about the vaccines. I do still encourage you to talk to the unvaccinated, after the celebration, about the safety and efficacy of vaccines to make your next get-together a little safer.

Regardless, changing the number of people at your celebration can mitigate some risk. Especially if your family has a lot of unvaccinated folks or if your local number of Covid cases is high, you may want to scale back on numbers to keep everyone a little safer. This can be tough in some extended families, but know that it’s a choice.

You can also try to mitigate the chance of transmission of this airborne virus should someone who is infectious be present. These are the “non-pharmaceutical” measures we’re all familiar with: eating outdoors or opening the windows; considering a high-quality air filter; asking everyone to mask up whenever you’re indoors. You may even want to purchase a CO₂ monitor to help you keep track of how good the air filtration is. Each of these actions decreases the chance that the airborne virus will actually make it into your nose and lungs.

The last way you can control your risk is by asking people to prove that they aren’t infectious, just before the get-together, through rapid tests. Personally, I’m encouraging friends and family to rapid-test before any indoor, large get-together, even if everyone attending Thanksgiving is vaccinated. And it’s easy! You can buy a bunch of rapid tests (which take 15 minutes and can be done entirely at home) at your local pharmacy and then ask everyone to test themselves immediately before the celebration.

One important caveat about rapid testing: Just like a pregnancy test, a negative Covid-19 test today doesn’t guarantee a continued negative test tomorrow. It may just be too early for the test to have turned positive. So please don’t count on a test that was completed three days ago or yesterday or even that morning. And remember that although this mitigation measure is helpful, it isn’t sufficient.

Last, I urge folks to think about not just risk presented by the Thanksgiving meal itself, but also by all the other activities around the celebration. For real-life risk mitigation, I encourage people to use the, which approximates the risk of infection — and provides ways to lower risk — in a variety of scenarios. (The app is the product of Brown’s Center for Digital Health, where I work.)

And what am I doing? I’m having a small-ish family get-together. Most of us will be vaccinated (and the older adults have received booster shots), but some kids haven’t completed their first two shots. Although I work in the ER, I take precautions there. And none of the attendees will be going to high-risk get-togethers the week before Thanksgiving. And we will all take a rapid test Thanksgiving morning.

Here’s to turkey, to family and to celebrating another year.