With Americans about to celebrate a third Thanksgiving since the start of the COVID-19 pandemic, infectious disease doctors say it may be safe to celebrate with slightly more relaxed rules this year.
“It’s important to just recognize we are in a very different place from two years ago. This population is getting more and more immune,” said Dr. Peter Chin-Hong, an infectious disease physician at the University of California San Francisco.
“The most important thing is having balance. This is a tough time. It's important to see our family and our loved ones if we can," said Dr. Rupa Patel, a research associate professor at Washington University School of Medicine.
With multiple viruses circulating this fall including COVID-19, influenza and RSV, infectious disease specialists agreed that basic lessons learned during the pandemic can go a long way in preventing the spread of disease. That includes frequent hand washing, cracking a window for better circulation, staying home when sick and staying up-to-date with COVID-19 boosters and flu shots.
“What [the public] can do is balance risks and benefits. And there is no simple formula,” said Dr. Gregory Poland, director of the Mayo Clinic's vaccine research group in Rochester, Minnesota.
When it comes to testing before family gatherings, infectious disease experts interviewed by ABC News universally agreed that anyone with cold and flu symptoms should seek a COVID-19 test. Even people without symptoms should consider testing if someone at their gathering is vulnerable to serious illness, including people who are unvaccinated, immune compromised or the elderly.
“Live life, but stay home if you feel sick,” said Dr. Whitney Minnock, director of pediatric emergency medicine at Corewell Health William Beaumont University Hospital.
Always test with symptoms
Experts were split on the need for asymptomatic testing but many agreed that it’s no longer necessary to test before every single gathering, travel or major event.
For most people in most situations, “you don't need to test unless you have symptoms,” said Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response. With tests no longer free through the federal government, frequent asymptomatic testing may no longer be possible for many families.
“If you are symptomatic, test obviously,” said Dr. William Schaffner, a professor in the division of infectious diseases at Vanderbilt University Medical Center. “This is a communicable disease. No one, as I say, wants to be a dreaded spreader.”
People with any symptoms of any viral illness should stay home. If staying home isn’t possible, people with symptoms should wear a high-quality mask, the experts said.
“I think the right guidance is to isolate for as long as you can, until your antigen test is negative,” Varma said. “Alternatively, wearing a high-quality mask, an N95 mask, and going about daily activities, including potentially being on a plane if you have to, are a reasonable way of minimizing harm to other people.”
Consider testing around the vulnerable
Because many people can spread COVID-19 without showing any symptoms, experts said it’s a good idea to test in situations where vulnerable people might be exposed.
“If you are going to be around people who are more vulnerable ... you might want to [test] so that you can prevent that from happening,” said Chin-Hong.
Added Patel: “I think the responsibility of testing is … where am I going, who is the audience and where have I been?”
Similarly, people who are members of those high-risk groups should seek COVID-19 and flu testing at the first possible symptom because treatments work best when given early.
“If you're in a high-risk group and you develop any kind of symptoms, please be tested, both for COVID and for influenza, because we have treatments for you. We can help prevent your needing to be hospitalized,” Schaffner said.
Take other steps to reduce risk
Although COVID-19 is still serious, it is a risk that many Americans are willing to adopt to resume a semi-normal way of life, according to Varma.
That said, everyone can take concrete steps to minimize risk, including vaccinations and basic prevention tips.
“I think this is the winter that people are going to get together,” said Chin-Hong.
Dr. Amy Arrington, a medical director at Texas Children’s Hospital, said it's “important to continue the things that we have learned work,” including new COVID-19 booster shots.
“You also have to remember that your actions affect other people,” said Anne Rimoin, Ph.D., professor of epidemiology at the UCLA Fielding School of Public Health. “As we move further and further along out of the most acute phase of the pandemic, it doesn't mean that risk mitigation measures aren't worthwhile.”
Even for the vaccinated, COVID-19 infection isn’t always trivial. Many patients will go on to experience long-COVID, or lingering symptoms that can last for months after infection.
“The evidence is increasingly compelling that long COVID can present serious, long-term health consequences,” Rimoin said.
“I think there's definitely a light at the end of the tunnel but I don't think we're there quite yet,” said Arrington. “I hate for us to just loosen the reins [and] go back to a totally pre-pandemic way.”
Added Minnock: “If we head into the holidays and everybody is scared, that is not good for mental health. I plan on being with my family this Thanksgiving. But some important precautions will be part of our celebration.”