Faye Flam

Masks at Thanksgiving? Here Are Some Better Ideas

Thanksgiving 2021 should be the reward for abstaining from 2020 celebrations until Covid-19 vaccines rolled out. Why not? The virus is still very much around, but times really have changed.

Remember those 11th-hour pleas from the US Centers for Disease Control to cancel last year’s gatherings as a big fall surge was building? They were reasonable, then: Big holiday celebrations pose some of the worst risks of viral transmission, with lots of people mixing in badly ventilated houses for long periods of time.

And here we are again. Cases are up in some states. But vaccines have arrived. Imperfect though the vaccines are, they’re plenty good enough to justify adopting a new strategy to avoid making this Thanksgiving another festival of confusion and stress.

Call it harm reduction, a term used during the AIDS epidemic to describe ways to help people have love and relationships while reducing the risk of spreading a menacing virus. It worked because people need relationships. Essential human connections are at stake.

Harm reduction can’t just mean masks, which simply don’t work at dinner parties. Masks interfere with people’s ability to hear, to be heard, to feel connected, and to eat. It’s futile to urge their use at the holiday table.

What are the experts doing? In a survey published by STATnews, epidemiologists and other experts were divided. A little over half said they’d host or attend a multigenerational Thanksgiving dinner. But 16 out of 28 said they’d advise elderly relatives to steer clear.

The answers say little about the safety of holiday gatherings and a lot about whether family functions are important to the epidemiologists surveyed. And the thought of excluding elderly relatives just seems mean.

A harm-reduction approach would look at who is most vulnerable and consider what would minimize their risk while allowing one and all to enjoy the human connections that most people need. Anyone can get severely ill from Covid-19, but for younger, healthy, vaccinated people, the risk is down in the same range as flu and other common infections that don’t warrant turning life upside down or skipping holidays.

Older people, people who’ve had cancer or organ transplants, or those on immune-suppressing drugs are at more risk, so let’s focus attention on how to help them be safer. Many of us cherish those people the most. We know we don’t have them forever.

One way to reduce risk is to open windows during Thanksgiving dinner. That might require turning up the heat. It’s worth the extra fuel and cost. Going outdoors for dinner is great for people in the parts of Florida or Louisiana where the evenings are still warm and cases are still low. A big patio feast there is a lot less likely to lead to tragedy than an indoor gathering in Minnesota.

Last year, when I researched holiday plans for this column, an expert who had long favored harm reduction said her family takes a Thanksgiving hike. That’s a fine activity, but the people I know who are at the greatest risk of dying from Covid-19 aren’t up for clambering around trails in the cold.

Many people would enjoy connecting through more, smaller gatherings, or even one-on-one meetings with the people they love, staggered over the whole holiday season.

Crowded holiday gatherings, after all, are partly tradition and partly an artifact of an era when more people were tethered to jobs offering limited time off. Some people cram so many friends and relatives into their precious few holidays because they have to, not because they want to.

Employers could help by giving people the chance to connect in ways that are safer than big gatherings. The gift of time and flexibility could mean a lot.

Rapid Covid tests can also reduce risk. They’re not perfect, but they’re pretty good at flagging people who are in an infectious stage, thereby warning them against inadvertently carrying the virus to a visit or gathering. Tests can’t avert all disasters, but can avert most.

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The most obvious way to reduce risk is to be fully vaccinated, which now means going for additional shots. A lot of confusing guidance on who should and shouldn’t get boosters is giving way to a consensus that extra doses confer the strongest immunity for everyone. So far, only a minority of Americans have taken advantage, but states and cities are loosening rules and offering encouragement, and US regulators are widening access.

Moderation isn’t normally associated with Thanksgiving, but for this year, maybe it should be. Most Americans face little risk of severe consequences of Covid-19, but too many are still dying because they’re vulnerable, or unvaccinated, or both. So it’s time to replace fear with moderation and mindfulness.