Will COVID, flu, RSV be an uninvited guest at your Thanksgiving table?

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We’re heading into our third COVID Thanksgiving, but for the first time since the pandemic started we’re thinking more about turkey, Black Friday and football than a killer virus. Google search traffic says so.

But before you get too relaxed and immerse yourself in cranberry sauce recipes, we’re here with a little help from the experts on how to keep COVID – and this year, its respiratory virus cousins influenza and RSV – from showing up at your Thanksgiving gathering.

First off, sorry to be the spoilsport, but COVID is on the rise again. And it’s rising faster in the Bay Area than the rest of the state.

“The simplest way to say it,” Dr. Mark Ghaly, Secretary of the California Health and Human Services Agency, said this past week, “is that in every category that we track, whether it’s test positivity, case rate numbers, wastewater surveillance, clinical surveillance, hospitalizations, we are seeing increases for RSV and COVID.” Flu is also at moderate or high levels in most of the state, according to the most recent weekly report.

But compared to the last couple of years … Dr. Monica Gandhi can put that into perspective.

“2020 was awful, and we really didn’t gather,” said Gandhi, a professor of medicine at the University of California-San Francisco. And while vaccinations were widely available by the end of 2021, the original omicron variant was identified over Thanksgiving weekend that year and would go on to cause the worst surge ever.

This year? Gandhi is traveling to Utah to be with her siblings and parents, a family full of doctors. They’re all vaccinated for the flu and boosted to the max for COVID, and while they are taking some precautions, “we are all just thrilled to see each other,” she said. “This is really a different year.”

Still, depending on your comfort level and the age and health of those coming over for your feast, there are a variety of precautions to consider, according to the experts.

Check the current COVID rates

Right now, the Bay Area’s case rate is not only higher than the state’s, “it’s going the wrong direction” said Dr. Bob Wachter, chair of UCSF’s Department of Medicine, while looking at San Francisco’s most recent COVID data. Wachter has recently stopped dining indoors again, but he said the current situation is “not super scary,” in his book.

Statewide, case rates bottomed out at around 6.4 new COVID cases per 100,000 residents in late October. The rate has now increased to 9, a 40% jump in three weeks. In the Bay Area, those case rates have risen from 7.8 to 10.5, a 35% increase since the end of October.

COVID rates are still significantly lower than they have been during surges in the past – daily case rates reached over 300 during the omicron peak in January.

If you are traveling outside of the Bay Area or California for your holiday celebrations, you can always check the CDC’s COVID tracker page to see the rates where you are heading.

Vaccinate

We know, you’ve heard this one before. Seasons and surges come and go, but doctors continue to give one main piece of advice when it comes to COVID: Get vaccinated and get boosted. Vaccination is the best way to protect yourself from getting severely ill with COVID or the flu, they say.

But only 3.8 million people in California, just 13.3% of people, have gotten the latest booster as of early November. That means only 1 or 2 out of every 10 guests at your table – or passengers on your plane – are likely to have received it.

Vaccinations for COVID, as well as those for flu, do not prevent all transmission, but “they both shorten the course of how long you are going to be sick, and they can certainly make your course less severe,” Ghaly said.

According to the most recent data from the California Department of Public Health unvaccinated people are 2.5 times more likely to test positive for COVID than those who have received the initial vaccine series, 2.7 times more likely to be hospitalized, and 3.1 times more likely to die.

Mask

Have you gotten lazy about wearing your mask? Now might be the time to restock your backpack, purse or car.

Masking at indoor social events in the week before Thanksgiving will lower your chance of getting sick and spreading it to people at your gathering, as will wearing a mask at the grocery store, on the plane or in the office. Ghaly also encouraged people to remember to do the basics: covering coughs and washing hands frequently.

Test

If you know you were exposed, or are trying to be extra cautious, you can take a rapid test the day you are gathering with family members.

Wachter said his family is having 12 people over for dinner. “We will ask everyone to test a couple hours beforehand,” he said.

Isolate

Even if that COVID test is negative, be careful: If you have symptoms like a cough, stuffy nose, sore throat, fever or muscle aches, you likely have some sort of viral infection that you can pass on to other people, especially in close quarters. So if you’re sick, you’re not welcome at Wachter’s dinner table. “We will ask anyone who feels crummy to stay out.”

Gandhi agrees. “My biggest advice is stay home when sick.”

While missing out on a family gathering could be disappointing, the slight cold you feel could be RSV, which could send an infant or an elderly family member to the hospital.

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