COVID-19 cases are climbing nationally as the U.S. barrels into its second holiday season during the pandemic, with most families planning this year to gather for Thanksgiving.
The U.S. is in better shape than at this point last year, when authorities confirmed well over 160,000 COVID-19 cases every day.
The daily average of new cases stands below 100,000 and almost 200 million Americans are fully vaccinated. They can “feel good about enjoying a typical” holiday season, top infectious diseases expert Anthony Fauci said this week.
But with millions still unvaccinated and cases rising, experts are urging Americans, particularly the unvaccinated, partially vaccinated and vulnerable, to exercise caution when gathering with others.
“There is concern that the rate of infection spreading is already so high as we head into the holiday season,” said Amber D’Souza, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
“We’re definitely headed into our next surge,” she added.
Nationally, the seven-day average for new COVID-19 cases is nearing 95,000, a 33 percent increase from two weeks prior, according to data from The New York Times. In the past two weeks, cases have increased in 39 states and D.C., and they have doubled in Massachusetts and Rhode Island.
Certain areas like the Midwest, New England and the Southwest in particular are dealing with surges.
The daily average of about 48,000 hospital admissions is flat from two weeks ago, while the 1,100 fatalities per day has dipped by 1 percent.
The case upticks come as many across the country plan for intergenerational gatherings next week, prompting public health experts to call on Americans to consider safety measures for their events.
The risk of different Thanksgiving gatherings vary, as indoor events are more dicey than outdoor and including unvaccinated guests poses more danger than limiting to fully vaccinated attendees. In the end, experts said it ultimately depends on how much risk individuals want to take.
Researchers, including Joshua Weitz, a professor of biological sciences at the Georgia Institute of Technology, have developed a tool to help figure out the localized risk that at least one infected person will be at an event.
For events with 50 people, the calculator shows eight states have counties with an at least 95 percent risk level.
“Even if we are fatigued, the reality is that cases are rising, and there remains far too many individuals who are unvaccinated, and that is contributing to increased spread as well as severe outcomes,” said Joshua Weitz, a professor of biological sciences at the Georgia Institute of Technology.
“I think we should all be concerned that the things that we hold dear, that we enjoy doing may inadvertently lead to increases in cases and severe outcomes,” he added.
About 57 million people aged 12 and older remain unvaccinated and at higher risk of contracting and spreading COVID-19, in addition to ending up hospitalized or killed by the virus.
Still, experts don’t expect any potential surge to reach the levels of last year with the majority of the country having immunity against the virus.
Almost 196 million Americans are fully vaccinated, and 32 million have received a booster dose, according to Centers for Disease Control and Prevention (CDC) data. Among adults aged 65 and older who are more at risk for severe illness, 86.2 percent are fully vaccinated and 38 percent have gotten their booster.
Even with most Americans protected with the vaccine, however, the shots are not 100 percent effective, meaning breakthrough cases can still emerge. Experts also said waning immunity from the vaccine over time and high community transmission could lead to more breakthrough cases.
Although it’s too late to initiate any vaccinations to be fully protected by Thanksgiving next week, experts said hosts and visitors can still take precautions to mitigate spread during the holiday, including having attendees take rapid tests, hosting events outdoors and increasing ventilation.
Justin Lessler, an infectious disease epidemiologist at the University of North Carolina’s Gillings School of Global Public Health, said even people going to fully vaccinated events can take steps to protect attendees.
“I think that extra layer of doing a rapid test or something or other activities to try to help you make doubly sure that your dinner doesn’t become a superspreading event is – still worth doing,” he said.
Older, immunocompromised and other vulnerable people should “really consider a safety plan,” he said, while adding “but I don’t think that safety plan has to be: call off the gathering altogether.”
The U.S. has already made booster shots available to these at-risk populations in recent months, and the Food and Drug Administration expanded booster authorization for all adults on Friday.
The CDC’s holiday guidance updated last month suggests for all eligible people to get vaccinated in order to protect those who can’t, such as children, and those at risk.
For children aged 5 to 11, the Pfizer vaccine recently became available earlier this month so a vast majority will not be fully vaccinated by next week. Children younger than 5 are still not eligible for a shot.
To protect these children, Lori Handy, the medical director of infection prevention and control at Children’s Hospital of Philadelphia, recommended implementing additional “layers of protection” and ensuring that those with exposures or symptoms do not attend.
For children at risk due to medical conditions, she said it’s “time to kind of be mama bear and protect your kids for a bit more this pandemic.”
“I would recommend people be as cautious as possible,” she said. “Find ways to get joy and happiness in the holiday season, but don’t overdo it with very large gatherings where you could regret that event.”