How to navigate holiday family gatherings in the age of COVID-19

Holidays in the time of the coronavirus come with many questions and awkward conversations attached.

Is it safe to host a family gathering or attend one? Should people wear masks and social distance? How should the rules be made clear? What if you want to skip the celebrations this year?

The season may be especially rough for families, said William Doherty, a family therapist, professor of family social science at University of Minnesota in St. Paul and director of the Minnesota Couples on the Brink Project.

“I think we will not have seen anything like the weirdness of (these) holidays,” Doherty told TODAY, explaining the dilemma some might feel.

“These are the main events in family life. The only thing that compares are big events like weddings and funerals so the stakes are high. The worst thing is to be seen as ‘ruining’ Christmas or Thanksgiving for everybody.”

At the same time, infectious disease experts are worried people might let their guard down when they get into holiday mode, forgetting what’s going on in the larger world.

COVID-19 hasn’t gone away so there are difficult decisions ahead for everybody, said Dr. Marissa Levine, director of the Center for Leadership in Public Health Practice at the University of South Florida in Tampa.

“People want to go back to normal,” Levine said. “(But) if we let our guard down now, that could be really problematic going into flu season.”

Many families are already opting out: Almost half of people, 47%, polled by Morning Consult this month said their usual holiday gatherings have been canceled this year.

Consider the risk

In its guidance on holiday celebrations, the Centers for Disease Control and Prevention noted that celebrating with members of your own household poses a low risk for COVID-19 spread.

Other in-person gatherings may be riskier, depending on where they’re held, how long people are together, how many are there and where they’re coming from.

A good first step is to take inventory of your own COVID-19 risk and that of any loved ones in your circle, and decide whether it’s safe to attend or host. People who are over 60 or have underlying health issues like lung or heart disease “really should think twice about this,” particularly if there’s significant transmission in their community, Levine warned.

Check the CDC map of community levels of COVID-19 in your state and the state you may be traveling to or hosting guests from.

If there’s a high transmission rate, limit the guest list and consider staying within your own social bubble, Levine advised.

Navigating awkward family conversations

Begin having the conversation with your loved ones now and let them know as soon as possible whether you’ll host or attend so you can prepare everyone in advance, Doherty advised.

Think through what you want to do and stick to your decision: Don’t enter into “extensive negotiations,” he added. If you’re the usual Thanksgiving host and decide you won’t do it this year, for example, don’t engage in a back-and-forth between relatives who want to change your mind. “If you start negotiating, it just extends the pain,” Doherty said.

If skipping a gathering, express your regrets: He recommended saying, “I feel terrible about not coming. This has been agonizing — I wish it wasn’t so. I know it’s going to bother a lot of folks, but we came to the conclusion this is the best thing for us to do.” Explain it’s an emergency maneuver for 2020 and things will hopefully be back to normal next year.

Let people know about house rules in advance: If you will be requiring masks and social distancing, discuss it informally with your family members ahead of time, make sure they’re willing to comply and put the rules in writing — perhaps in the email that lists what everyone is bringing to the gathering, Doherty advised. You could also post the rules in the kitchen or dining room — playfully, with a light touch — to serve as a reminder.

Minimizing infection risk

Holding a small family gathering outdoors where there’s good air circulation and room to social distance is a safer way to go, but it’s also not always realistic during cold weather.

Here’s what to keep in mind:

Keep the windows or doors open if possible: Indoor gatherings with poor ventilation pose more risk than those with good ventilation, the CDC noted.

Encourage people to bring and use masks: “The problem with family gatherings is we don’t keep our physical distance, so it may be a necessary ingredient,” Levine said. “It’s really important not to discount masks.”

Practice social distancing: Space out the chairs at the dining table or prepare two dining tables and split the gathering into two groups so people don’t have to sit close together. Think twice about hugging your relatives: "I hate to say that it's a risky activity but it is," Levine said. "This may be one of those years where family gatherings (include) lots of elbow bumps." Consider staying in a hotel rather than a relative’s home if the house is cramped.

Limit the number of guests: The U.K. has implemented a “rule of six” prohibiting social gatherings of more than six people. But there’s not an absolute number that experts know is safe, Levine said, so she couldn’t specify how many people are too many to invite. “The fewer, the better,” she said. “The risk goes up as you have more people.”

Don't come if you are sick: Don’t attend a family gathering and don’t hold one if you have any symptoms. If you have had close contact with somebody with COVID-19, you also should not attend or host, Levine said.