At a time when Americans are pondering how to celebrate Thanksgiving safely amid the country’s worst surge in coronavirus cases, many families will be faced with yet another complicating factor: the return home of students.

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Public health experts are discouraging nonessential travel and gatherings of multiple households for Thanksgiving, fearing those activities may further spread a virus that has sickened more than 11.5 million and killed in excess of 251,000 in the U.S. On Thursday, the Centers for Disease Control and Prevention recommended against traveling for Thanksgiving.

a group of stuffed animals sitting on top of a building: The Thanksgiving turkey leads off the parade on Central Park West at the Macy’s Thanksgiving Day Parade in New York.

© Robert Deutsch, USA TODAY
The Thanksgiving turkey leads off the parade on Central Park West at the Macy’s Thanksgiving Day Parade in New York.

Colleges and universities have reported 252,000-plus cases since the pandemic began, according to a New York Times tracker. Returning students – whether they lived in dorms or off-campus housing in the fall term – “exponentially increase the risk (of infection),’’ especially if they take some form of mass transportation to get back home.

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That’s the assessment of Dr. Teresa Bartlett, senior medical officer for the claims management firm Sedgwick, who advises companies about medical strategies and safety practices. Naturally, her work has been focused on the pandemic for the past several months.

Like other specialists in the field, Bartlett is concerned that holiday gatherings, combined with pandemic fatigue and the need to move indoors as the weather gets colder, will exacerbate what’s already a major national spike in COVID-19 cases.

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The U.S. recorded more than 1 million new infections in the first 10 days of November and has logged upwards of 100,000 daily cases since Nov. 3, after never before reaching six figures in a day. The current daily average for the month stands at 130,000, a surge that has strained health care systems in many parts of the country and prompted some states – including California, Washington and Michigan this week – to tighten COVID-related restrictions. More than 30 states have imposed mandatory mask requirements.

Decisions on whether to share a turkey and stuffing with friends and relatives are now fraught with peril.

“You need to really seriously consider the risk vs. reward,’’ Bartlett said. “And I recognize people are fatigued of it and they just want to see their family, but add a glass of wine with the Thanksgiving dinner and people’s judgment kind of goes out the window after that, and maybe they’ll hug or get closer to what they should. It’s scary, the potential of what could happen here.’’

That’s why Dr. Eric Cioe-Peña and his wife are eschewing get-togethers with their numerous relatives in the New York City area. Normally, they would split Thanksgiving and Christmas, sharing one of the holidays with his family members and the other one with hers.

Cioe-Peña, an emergency room physician and director of Global Health at Northwell Health in New Hyde Park, New York, wants to model the behavior he’d like to see in his patients.

“We’re going to have to make sacrifices,’’ he said. “My wife and I decided this year’s going to be nuclear family and we’re not inviting anybody over.’’

Dr. Anthony Fauci, the nation’s foremost authority on infectious diseases, and Dr. Robert Redfield, director of the CDC, have already warned about the potential for a proliferation of infections from holiday parties, even if they’re small and only among relatives.

Memorial Day get-togethers were partly blamed for the dramatic increase in COVID-19 cases the U.S. experienced early in the summer. Events like an August wedding in Maine that led to more than 175 infections and a September Sweet 16 party in Long Island, New York, that was linked to 37 positive tests have highlighted the danger of relatively small social functions turning into super spreader events.

Health officials are increasingly pointing to small gatherings as sources of multiple infections, some of which have led to deaths.

“All along there have been issues about attending weddings, funerals, religious gatherings and other events that are part of our normal life,’’ said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “They bring people together and potentially become vectors for the virus. As many public health experts mention, the virus is attending these events and can be transmitted from person to person.’’

The CDC last week updated its guidance about holiday celebrations with advice on how to reduce the risk of infection. The tips for in-person gatherings include commonly known mitigation measures such as holding events outdoors, limiting their size and length, having participants wear masks and maintaining social distance. The CDC also encourages hosts to request that guests avoid contact with people from outside their household for two weeks before the activity.

The impracticality of some of the safety measures – it’s hard to fit everybody at a table 6 feet apart, or to eat a meal outdoors in the late November chill – combined with defiance and pandemic fatigue will likely lead many to ignore the suggestions.

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“I know there will be plenty of families who mock this kind of advice and say, ‘That’s ridiculous. We’re going to get together and enjoy Thanksgiving like it’s supposed to be and no one’s going to tell us otherwise,’’’ Woolf said. “That may give them a sense of independence, but then the virus gets to Grandma and she ends up in the hospital on a ventilator, and then you live with the guilt.’’

Woolf and other experts recommend virtual events, with families from separate households sitting at their Thanksgiving tables at the same time and connecting through a video platform like Zoom, which might give a sense of sharing the meal. If members of different households will be congregating inside, opening windows would at least improve ventilation and could help diffuse the virus, reducing the chances of contagion.

The need for in-person contact can be a powerful draw, and even more so among those who have avoided traveling to see relatives as the pandemic has stretched over months.

Craig Smith, an associate professor of psychology and human development at Vanderbilt University, said isolation over long stretches of sheltering in place can lead to a profound sense of loneliness and disconnection, particularly for those who have young children and are trying to balance parenting with work. Missing out on family gatherings would only aggravate those feelings.

“Thanksgiving and the Christmas holidays are especially tough because, on top of the normal need to interact with friends and family, they are lifelong rituals for people of sharing those particular days and those particular meals,’’ Smith said. “So for many people, there’s going to be a palpable sense of loss when they’re unable to get their whole family together, but the risks of course are enormous.’’

A recent study indicates the risk of catching the virus on planes is minimal because of their high turnover of airflow and use of HEPA filters. Plus, the CDC has strongly recommended that all passengers traveling on public transportation – including airplanes – and the onboard personnel wear face masks to avoid spreading the virus. The agency also endorsed the removal, whenever possible, of anyone who refuses to comply.

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Those developments may prompt travelers eager for a family embrace to book a Thanksgiving or Christmas trip. Medical professionals still urge caution, noting that exposure to the virus could occur at several stages of a trip and insisting it’s best to avoid mingling with members of households from different areas, especially those from places with high infection rates.

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“People should carefully weigh the risk of travel and risk of disease at the destination before deciding to go,’’ said Dr. Jeff Goad, who teaches epidemiology, public health and travel medicine at Chapman University. “Certainly, older individuals and those with pre-existing medical conditions should only travel if absolutely necessary.’’

One of the emerging options for travelers and others who want to visit loved ones is getting tested for the coronavirus in advance, which could provide some reassurance but also a false sense of security because tests don’t always detect the virus during the incubation period.

Dr. Peter Chin-Hong, an infectious disease specialist at the University of California-San Francisco who has studied the impact of small gatherings on virus transmission, said this approach is gaining popularity, especially with the use of inexpensive antigen tests.

Chin-Hong points out these tests are less sensitive than the costlier PCR tests, which are regarded as the gold standard, and better at detecting who’s infected than discerning who’s not with total certainty.

He still advices advises limiting the size of holiday get-togethers and offers a list of things participants shouldn’t do, like “huddling closely together at the end of the night as one large group to sing Christmas carols’’ or “debuting your French horn for the guests’’ because wind instruments can create aerosols.

For those determined to travel to see friends and/or relatives, Chin-Hong suggests getting the test done three to four days before the trip and sticking strictly to a safety protocol before they meet, adding, “A negative test is only one strategy, and safe practices for COVID prevention should still be maintained as a multimodal strategy to keep us all safe during these trying times.’’

This article originally appeared on USA TODAY: ‘It’s scary’: Family members returning home bring higher COVID risk for Thanksgiving gatherings

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