We are now eight months into the covid-19 pandemic with little end in sight other than the promise of a vaccine ready for mass distribution sometime in the new year. This means that most Americans will need to make critical decisions about what to do for the upcoming holiday season — starting with Thanksgiving.

The challenges with a Thanksgiving gathering during a pandemic characterized by the spread of disease from aerosols are clear. First and foremost, families coming together (sometimes from great distances) could easily contribute to the disease spreading across different geographies.

Second, Thanksgiving brings family members, old and young, together to celebrate. The ability of young people to inadvertently spread the disease to their older, more vulnerable family members is very real.

Third, the primary means to stop the spread of the disease is by wearing a face mask and being socially distant, both of which are nearly impossible with an event that focuses on getting around a family table and eating a large meal together.

It is therefore an inconvenient truth that holding Thanksgiving this year may not be the best idea for many families.

The country as a whole is experiencing burn out from dealing with the pandemic for this long. This will cause many families to throw up their hands and decide to throw caution to the wind. I strongly encourage families to resist this temptation. We are at a point with this pandemic where we can see the light at the end of the tunnel. Unfortunately, that doesn’t have any impact on the ability of covid-19 to continue to kill our loved ones until we reach it.

As health experts anticipated, we are seeing increases in the number of covid-19 cases around the country. In fact, we are setting records. This is in part because we are testing more but also because the disease is clearly spreading more. It is a mathematical certainty that as the number of people that get the disease increases — so will the number of people who die from the disease — even in the light of new and improved treatments.

The calculus for most families is stark — is this Thanksgiving season so important that it is worth risking the life of our beloved matriarchs and patriarchs and other family members at elevated risk for having an extreme response to covid-19?

It is important to remember that despite our best efforts to understand it, covid-19 is still unpredictable. We still don’t fully understand why it mercilessly takes the lives of some and spares others. We also don’t fully understand why some young and healthy individuals end up spending days in the hospital with their lives dependent on a mechanical ventilator.

Some families have decided to have a “virtual Thanksgiving” where they all prepare a separate Thanksgiving dinner and connect with one another virtually. This option will never replace the embrace of a beloved family member who can provide us comfort during one of this country darkest hours, but it may just save their life.

For families set on having Thanksgiving in person, there are a number of important strategies that they should take to try to keep everyone as safe as possible:

• College students and family members who have recently traveled (especially to hot spots) should get a covid-19 test in the days prior to joining family members for Thanksgiving.

• All family members who are attending Thanksgiving should agree to limit their activities as much as possible two weeks prior to the holiday. That means avoiding restaurants, movie theaters and other high-risk venues.

• Families should avoid mass transit as much as possible. The safest way to travel to avoid the transmission of covid-19 is to travel by car with people that live in your household.

• Ask all family members attending Thanksgiving to get a flu shot.

• Ensure all family members wear face masks and avoid hugs to greet one another.

• Seat individuals who live with one another closest together at the dining room table(s).

Covid-19 has taken much from all of us. None of us are happy about the restrictions it puts on our daily lives. If you are lucky enough to have a family not yet impacted by the disease, say a prayer this Thanksgiving for other families that haven’t been so lucky and will have an empty chair around the table this year.

Dr. David Dausey, an epidemiologist, is executive vice president and provost at Duquesne University and a full professor in Duquesne’s John G. Rangos Sr. School of Health Sciences. He is also a distinguished service professor of health policy at Carnegie Mellon University.

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