Why even a small Thanksgiving is dangerous



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We all thought we knew what kinds of places to avoid: ball fields, Sunday services, crowded cars. If we didn’t want to catch COVID-19, we would have to stay away from the crowds. It was the mantra. So we skipped the summer street parties and made the virtual church. We had a lovely little evening at home, ordering take out food and maybe inviting our closest friends and family.

But now, with COVID-19 rates on the rise virtually all over the United States, these small gatherings are accused of spreading the virus, and experts say they don’t want us to have Thanksgiving celebrations with people in outside of our family bubbles. But experts always tell us not to do the fun things that feed our souls – like eating huge meals or festively increasing our alcohol consumption – as the darkness of winter encroaches on all sides. Having 10 people around a Thanksgiving table can’t be such a risk to society, right? Surely you can’t have a big-ticket event without, at least, enough people to field a football team?

Sadly, the past month has changed the sacrifices we have to make in trying to avoid the coronavirus. Across the country, especially in the Midwest, cases have skyrocketed – some states having seen more cases in the past six weeks or so than they had all year until this point. Small gatherings have become riskier. And Thanksgiving is now a very serious threat.

This is because no matter how hard we try to pretend otherwise, COVID-19 is a disease that you get from being with other people. Technically, the size of the group doesn’t matter, said Georges Benjamin, executive director of the American Public Health Association. What matters is the likelihood that one of these people will come to the table infected.

Imagine a Thanksgiving dinner with 10 people. Unless all of these people have been in strict quarantine for a few weeks, you have no way of knowing that they are free from COVID-19. Even getting a test before dinner isn’t a great way to make sure you’re not contagious, experts told me, because the results are just a snapshot of a moment in time. “You could test negative today and be contagious tonight without symptoms until tomorrow morning,” said Donald Milton, professor of environmental and occupational health at the University of Maryland.

What is the probability that one of these 10 people will be infected? It depends on where you are. It is estimated that some states have up to an 80% chance that a person with COVID-19 will attend a gathering of 10 people. But even though there is much less chance of attending your one-on-one dinner party, the risk to the community of a bunch of dinners quickly becomes clear.

This is what has really changed in recent months. It was a slow process, said Preeti Malani, chief health officer at the University of Michigan. Over the summer, many stores, restaurants and attractions reopened, making it easy for people to find each other outside. As the weather cooled, it seems these gatherings didn’t stop, they just moved inside. “Things have started to rise, and my colleague calls it the rising waters,” said Malani.

The more infected people there are in a community, the more likely it is that the day-to-day workings of a social scene will put one at someone’s table or on the porch at a crowded party. The more frequently this happens, the more the waterline crawls. You can see it in action on Georgia Tech’s COVID-19 Event Risk Assessment Planning Tool, a website that calculates the likelihood that a gathering of a given size will include at least one person infected with COVID-19.

Hawaii, for example, has largely avoided the worst of this current outbreak. Even if you assume there are 10 times more cases circulating in the state than what has been officially diagnosed – which the folks behind Georgia Tech are recommending due to inconsistent testing and people’s ability to spread the disease. disease without showing symptoms themselves – Hawaii’s risk is still only about 6% at a gathering of 10 people. North Dakota, on the other hand, is one of the states hardest hit by this current wave of epidemics, with 1 in 1,000 residents now dead from the virus. There, the risk of meeting someone infected with COVID-19 at your small intimate gathering was around 82%, factoring in the same 10x multiplier. “In February or March, when we had very few cases, the risk was less,” said Aditya Shah, infectious disease consultant at the Mayo Clinic in Minnesota. “Now it’s so common… it’s different.”

The upcoming holiday season is also different, both literally and in the way Midwesters like me use it: as a metaphor for “bad”.

Thanksgiving does not exist in isolation. It is not something a family does alone. And it will be followed, over the next month and a half, by a series of fun-loving events, including Black Friday, Hanukkah, Christmas and New Years. Together, these two factors explode a personal risk into a community crisis.

“I think of social gatherings and their impact on a community with a fire analogy,” said Pinar Keskinocak, director of the Center for Health and Humanitarian Systems at Georgia Tech. “If you build a fire in a barbecue or a small brick fireplace, it’s contained. This is how we often think of small gatherings. But if you start a ground fire in a pine forest that hasn’t seen rain for months and many other small groups do the same, you can imagine what happens very quickly.

The risks are multiplied by dozens of dinners across town, then increase over time as diners interact with other people in shops, waiting rooms, and other small gatherings within weeks. following. This is how you get exponential growth, and that’s why experts advise against gathering a few loved ones in the house now, even though throughout the summer you’ve only heard about the dangers of parties and gatherings, demonstrations and festivals, in which dozens of people participated. hundreds or thousands of people instead of the handful that might come to your table. When there were fewer cases, it took a large gathering to make it likely that a person was infected. But the water has risen and now it threatens to drown us.

Again, the basics aren’t new, Benjamin said. The same thing happens with the flu every year, he told me. Children are exposed at school and spend the time between Thanksgiving and New Years moving it from one family reunion to another. When the holidays are over, the flu season begins to peak.

But COVID-19 is not the flu. It’s much more deadly. It’s much more debilitating in the long run. It is much easier to spread even if you don’t have symptoms or if you don’t have symptoms again. The virus is common enough now in many places that you can’t really be sure that even a small event doesn’t include a contagious person. And having many small events on the same day creates an opportunity for COVID-19 to spread exponentially and scatter from Thanksgiving tables to the community of every person who sits there. Which simply increases the risk of the next vacation.

It may seem unfair to ask people not to see their missed relatives and friends, not to let a student go home for Thanksgiving dinner, not to enjoy this little treat. It may seem inconsistent to have focused on the dangers of large gatherings all year round and started to warn against small gatherings when they feel most valuable. But this is a new phase of the pandemic. There are more viruses, in more places, and avoiding it has become more difficult. Even knowing where you caught it is more difficult. “The prevalence is so high in the community right now,” Shah said. “You have to see and treat everyone as infected.”

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