Amid the coronavirus pandemic, planning for the holidays is more stressful than ever: Families have to consider risk factors like the health of their relatives, their ability to quarantine and more.
For families that have college-age students, there are even more questions: Is it safe to have their child travel from one area to another — or will that lead to more spread of COVID-19? Does a negative test mean they can come home? Should parents or children take any extra precautions?
TODAY Health spoke to several infectious disease experts, including one who plans on having her college-age daughter join her for the holiday, to find out just how families can gather for Thanksgiving dinner safely.
What should students do before coming home?
Dr. Lucian Davis, an associate professor of epidemiology at the Yale School of Public Health, said that in general, public health and infectious disease experts are concerned about seeing student populations move from one area to another. However, if precautions are taken before leaving campus, it can be safe for students to go home.
"We're often concerned when people come together from different groups, because that can promote spread of coronavirus from person to person," he said.
The best thing students can do is try to quarantine before coming home: If they can isolate for 14 days, that would be ideal, but other distancing and masking measures can be helpful as well.
"I think that you can sensibly minimize your risk by wearing a mask and cleaning your hands and practicing the other things that we know are important, like distancing," he said. "I don't think you can eliminate risk, but I think you want to try to do everything you can do minimize your risk."
"I think the first thing is try to minimize your contact with other people before you get back together with family," Davis continued. "That could be by minimizing contact as much as possible, isolating at school, or isolating once you get back home if possible."
However, it's important that students not rely on a negative coronavirus test. While some schools are requiring students test negative for the virus before heading out for Thanksgiving break, Davis said that the test won't catch coronavirus in its early stages.
"A negative test sort of tells you that you very likely don't have COVID on the day you're tested, but if it's incubating you could become sick later," Davis said. "Let's just say you test negative and you have permission to go home. But then once you get home, you might develop symptoms and in the period even before that you might be spreading to your family."
Suzet McKinney, Ph.D., CEO of the Illinois Medical District in Chicago and an adjunct instructor at Harvard University’s T.H. Chan School of Public Health, said that she would strongly recommend quarantining after traveling home, if possible.
"During travel time, students still need to be following masking and social distancing and hand washing protocols," she said. "When students do return home, they should be careful to do some level of quarantine at home, preferably 14 days, especially before they interact with elderly family members or other family members ... who may be at higher risk for COVID infection."
McKinney said that her daughter, who is a college student, will be doing just that: She'll travel home, then quarantine for 14 days.
"As we see COVID cases beginning to surge, we don't want to take any chances," McKinney said.
Should families take any extra precautions at home?
When it comes to risks at home, Davis said that the biggest concern is "sharing high-touch surfaces" or indoor "air spaces" where people are gathering.
"There's a lot of opportunities for exposure," Davis said.
However, it may be difficult for families to stay apart during Thanksgiving itself.
"It's going to be challenging to apply masking and (distancing)," Davis said. "The best approach is for everybody to ... minimize exposure. If you can minimize the number of people, that will minimize risk. I would encourage people to clean surfaces, wear masks when you can, practice social distancing and take advantage of natural ventilation if that's possible. Open a window, or even sit outside."
Before inviting the entire family over, Davis said that families should talk out their plans and make sure they're taking everyone's risk factors into account.
"We know that a big proportion of Americans have one or more risk factors, whether that's a chronic medical condition, advanced age, etc.," Davis said. "You do have to consider in your individual family: What are the risks? What are the adverse potential consequences? We don't want this to be a Thanksgiving that's memorable for the wrong reasons."
McKinney said that it's important to make sure that any guests you invite from outside the household are being safe in their activities.
"Think about the people that you would be inviting to your home," she said. "You want to be aware of what their activities have been because you could be careful not to open up your home to people who have not been following all of the COVID-19 safety precautions once again masking social distancing and hand washing."
However, Thanksgiving can be done safely, and Davis emphasized that for many people family gatherings are an important source of happiness and communication.
"As public health people we're always emphasizing the risks but the other side of it is that you do have to figure out what's important for your family," he said. "The risks can be controlled with some of the things that I mentioned, and people just have to make the decision to try to be as careful as possible."
McKinney said that while safe gatherings are possible, it's important to fight against "coronavirus fatigue."
"People should still be following those three safety precautions that public health officials have been advancing throughout the entire pandemic," McKinney said, referencing hand washing, masking, and distancing. "We know from past pandemics that these things can last for a while. We are strong, we can get through this, and we will get through this, but it is important that we continue to follow these safety precautions."
Should students return to college after the holiday?
While it can be safe for students to move from college to home for Thanksgiving if appropriate precautions are followed, Davis said it would be concerning to have students return back to school. Most schools have adjusted their schedules to go entirely online though the winter instead of having students return to campus for the final weeks of the semester.
"We know that mixing is what allows virus spread to happen and move from place to place and move from age group to age group," he said. "There's been a lot of concern about higher rates of transmission among college students because they are living close together ... They can transmit to older individuals, and that's where the real harm can take place."