One thing to be thankful for this year: It is not Thanksgiving 2020. The vaccine was not approved a year ago, and the number of deaths per day rose sharply — by December to more than 2,000 people a day — and many Americans squatted down and skipped holiday celebrations to reduce their risk.

A recent survey showed that this year 80% of people 12 years of age and older are now vaccinated at least once, and about half of Americans plan to group 10 or more people on vacation.

Although many of us are preparing to restart our holiday traditions, COVID cases are rapidly climbing again-there are nearly 95,000 new cases every day. Experts warn that we still need to keep in mind to reduce the risk of COVID. Even if your family members are fully vaccinated, remember that your most vulnerable family members, especially those over 80 or those with weakened immune systems, still face a higher risk of severe COVID.

Nearly two years after the pandemic, we learned a lot about how to reduce the risk of contracting and spreading the virus, including simple steps to wear masks and wash hands. Let us not forget now.

Here are some tips on how to keep family gatherings safe.

Reality check: People over 80 have a higher risk of dying from COVID, even if they are vaccinated

Although the vaccine provides strong protection against hospitalization and death, breakthrough infections are a reality. Usually, contracting coronavirus after vaccination will only cause mild illness. Sometimes people test positive but have no symptoms at all. However, elderly people and people with compromised immune systems are at higher risk of severe breakthrough COVID cases.

Although it is rare for a breakthrough to result in hospitalization or death, the chance of one group is higher. As reported by NPR, CDC data in August showed that fully vaccinated people 80 years of age or older are approximately 13 times more likely to die from COVID when compared with general vaccinated people (all age groups). This is one of the reasons that getting boosters is particularly important for the elderly.

William Miller, a doctor and public health epidemiologist at Ohio State University, said: "This is something we must be aware of because people gather across generations." "Compared to grandpa and grandma who have not been vaccinated, they are protected, but They are still in danger," he said.

This is why it makes sense to take precautions during travel and the week before any celebrations with older friends and relatives present.

Miller said, "I will definitely encourage people to continue to wear masks," in crowded indoor places such as grocery stores, even if it is not mandatory. This will reduce the risk of exposure and spread of the virus. Remember that TSA’s mask requirements are valid until January 18, 2022, requiring masks to be worn on airports, commercial airline flights, and commuter bus and rail systems.

Therefore, the most important thing is that even if everyone invited to your holiday party is vaccinated, it is still important to protect your elderly or weakened relatives.

The federal health agency now recommends that all adults get a booster of the COVID vaccine six months after the last injection-this is especially important for adults over 50 or any adults with underlying illnesses or high-risk jobs. Buying one before vacation trips and gatherings can increase your immunity to COVID.

The decisions of these institutions are based on emerging evidence that immunity will weaken over time, and there is evidence that, as the name implies, a booster dose can enhance protection.

Some of the latest real-world data comes from the United Kingdom As early as September, the British government launched a boosting program for people aged 50 and above.

White House Medical Advisor Dr. Anthony Fauci said that the new analysis showed a significant increase in enhanced dose protection (against symptomatic infections). "If you look at people whose third dose of protection has dropped to about 63%, you will increase it to at least 94%, which is really impressive," he said. "This is exactly what you want boosters to do."

Fauci said that immunity starts to rebound within a few days after receiving the booster shot, although you will not reach the peak of protection within two to four weeks. He said that before attending indoor holiday gatherings, especially in places where the spread of the virus is high, "I suggest that if you are eligible for promotion, do it now."

As a risk reduction measure, you may want to require your guests to be tested for COVID before a large holiday party. A year ago, it was difficult to obtain real-time information from the COVID test due to the delay of test results and the lack of quick test options. Now, there are many over-the-counter rapid antigen tests, such as Abbott BinaxNOW or Orasure InteliSwab, which can be purchased online and in pharmacies.

Judy Guzman-Cottrill, a pediatric infectious disease expert at Oregon Health and Science University, said: "Rapid antigen testing adds a layer of protection to everyone."

"The antigen test is a quick snapshot to see if there are viral proteins in that person's nose that day," Guzman-Cottrill explained. Therefore, if a person has just been exposed to the virus and the virus is still in the incubation period, they may get a negative result one day and then a positive result the next day.

Emily Landon, an infectious disease doctor at the University of Chicago, explains that if someone has just been exposed to the virus, these tests are not 100% reliable. She said: “The test does not detect a very low level of virus in your nose, so it will not detect a real early infection.” Therefore, she recommends attending on the morning of the party or at the beginning of the party if possible take an exam.

Some families test before traveling and then test again when they arrive at their destination, depending on the risk level of the people living with them. (Note: The instructions will vary depending on the test you purchased. For example, BinaxNOW indicates that people should take two tests within three days, with at least 24 hours between the two tests to get the most accurate results.)

William Miller also adopted a security testing strategy. "It's a mentality," Miller said. This is a way to send a signal: let's ensure that access is as safe as possible.

Deciding who to invite to your home is a matter of personal discretion, but experts say that at this time of the pandemic, it is clear that a fully vaccinated group is the safest situation.

"I think it's reasonable for people to ask their guests to be vaccinated," Guzman-Cottrill said, especially if the guests include those who are too small to be vaccinated (or only the first shot) or are unlikely to have strong immunity People respond to vaccines just like people with weakened immune systems. She added: "We still really need these people to make sure we stay as safe as possible because the epidemic is not over yet."

Requesting vaccinations may lead to some emotional hurt or conflict, but Miller suggested that this decision be used as a way to protect older relatives. "I do think it is perfectly acceptable to say,'I'm sorry you didn't get vaccinated. You know, grandma is here and you are here, which greatly increases her risk,'" he said.

Another option is to require unvaccinated guests to take a laboratory-based PCR test 24 to 48 hours before the event (as long as they can get the results in time) or take a quick antigen test before they arrive with a COVID test. In addition, Langdon advises unvaccinated guests to take extra precautions in the week before the event, including wearing masks in public places and restricting contact with other unvaccinated people.

"We think that with delta variants, most people will get sick a few days after exposure, but it may take up to a week, maybe a little longer," Langdon explained. She said: "I think it makes the most sense to take preventive measures a week in advance before having close, maskless contact with high-risk groups."

Many children between the ages of 5 and 11 have received the first of the two recommended doses, but are only eligible for the second dose after the Thanksgiving holiday. Guzman-Cottrill said that immunity will gradually increase after vaccination, but it is not clear how much protection a single dose of COVID vaccine can provide for children.

"I know that many families now find themselves in this nasty state of uncertainty because their children will not be fully vaccinated before Thanksgiving," she said. Given this "marginal" state, "it is important to remember that now is not the time for these families to relax their vigilance," she said. This is not a reason to cancel multi-generational gatherings, but it reminds people to take precautions.

So, what precautions are recommended? This depends to some extent on the health and age of the relatives who will participate. "If grandma is a 70-year-old woman who has no health problems and has received two doses of vaccine and one booster, I don't think these children will pose a big risk," Langdon said.

But if grandparents are over 80 and have health problems, the risk of adverse outcomes is much higher.

If you are worried about unvaccinated children transmitting the virus to grandparents, one simple step you can take is to wear a mask, not only during the visit, but also one week in advance when in public, especially to avoid crowded indoor spaces, even if the mask is mandatory The order did not take effect.

She said she does not recommend that children leave school to avoid contact unless there are additional risks at your child's school-such as case outbreaks or lack of masks. If circumstances permit absenteeism in order to protect high-risk relatives, "then this may be a layer you want to add," Langdon said.

Another option: If you live in a mild climate and stay outdoors as much as possible during multi-generational social activities, you may choose not to sleep in the same house as your grandparents.

"Just come to the big event and stay in the hotel during the day," Langdon suggested. Or let the grandparents sleep in the hotel, she added.

Bottom line: "You have to consider the risks of the individuals involved-what will happen if they are infected with COVID," Langdon said. It's better to be cautious.