On November 10, the Centers for Disease Control (CDC) updated their official Thanksgiving safety guidance , in response to the fast-rising coronavirus cases and hospitalizations across the country. The third wave everybody's been expecting this winter is here...right in time for the holidays.

The CDC has been issuing safety guidance for holidays and gatherings since this summer, with varying levels of clarity. For example, aspects of the Halloween guidance from the CDC had some parents understandably confused —trick-or-treating, an outdoor activity where it's easy to socially distance, was classified as "high risk," in the same category as a big indoor party, even though surfaces (like candy wrappers) are no longer considered the primary mode of coronavirus transmission.

But with new evidence suggesting that current virus transmission levels are being driven up— way up —by the rise of indoor dining in restaurants as well as by small indoor gatherings , it's a little easier to see why the CDC is raising the red flag on the traditional family Thanksgiving gathering.

Here's what's considered low-risk and what's considered high-risk for Thanksgiving this year, and how to evaluate (and lower) your family's risk of getting sick, whatever you decide to do for the holiday.

First and foremost, know that you are the decision-maker for your family—and it's okay if you don't feel ready to take risks right now.

It's unclear how many people are still seriously considering whether or not to have a big traditional family Thanksgiving dinner this year, with relatives from all over gathered around the table for turkey and trimmings. After all, most of us recognize that there's a pandemic happening, and we want to protect our beloved grandparents and elders from illness. A small-scale Thanksgiving dinner, with immediate family only, seems like the default plan for most families—and in a pandemic year, it's certainly the safest choice.

But in the absence of an organized national response to the pandemic, it's up to individuals to decide what feels right and safe for them. If your family includes even a single immunocompromised or older individual, your tolerance for risk is probably going to remain low—or close to zero. Likewise, if you are pregnant or the parent of a newborn infant, you are going to want to remain cautious about your potential exposure to COVID-19.

On the other hand, if you live in an area where cases are low and declining, hospitalizations are low and declining, the public health system is stable and social distancing is taken seriously—and no one in your family belongs to an at-risk group—you might decide that getting together with friends and family for Thanksgiving is a risk you are willing to take, with reasonable precautions for yourself and others.

If this is the case, you're taking the position that's right for you. If you decide you're not ready , then that's what's right for your family. You know your family's particular situation best. (For help with potentially-tricky conversations, see our expert guides to discussing the holidays with family members this year , and helping kids navigate holiday changes ).

Start quarantining now if you're planning to see family for Thanksgiving

If part of your plan for Thanksgiving this year includes traveling to see family, inviting family members outside of your immediate family to your home or visiting with relatives who are not in your immediate family, start tightening up your "bubble" now . The two week period for self-quarantining before Thanksgiving starts on Thursday, November 13, and it's advisable to restrict your unnecessary contacts for the two weeks before the holiday.

According to pediatrician Dr. Kelly Fradin, when making choices about your activities, there are seven factors to remember.

  1. Keep your "bubble" small. By keeping our activities confined to our own small social circle or pod we decrease the likelihood of introducing new infections to the group.
  2. Stay outdoors. If you've always embraced the adage that there's no such thing as bad weather (only bad preparation), great! But if not, this is the year to stock up on appropriate apparel and stay outside even when rain or snow come. Outdoor time is particularly important for those involved in virtual school.
  3. Mask up. When doing something indoors or not distanced, it's especially important to wear a mask. Children can do it! Changing masks frequently can improve comfort.
  4. Clean hands. While we know most transmission comes from breathing the same air as others infected with coronavirus, clean hands will also prevent transmission of other diseases that can cause false COVID-19 alarms, such as common colds and flu.
  5. Protect the parents. Please remember for most families the risk of bad outcomes from coronavirus is much higher in the parents.
  6. Track the numbers. Once a week check in with your community dashboard. Know the numbers required to keep things open in your community and consider how the numbers in your area might impact your family plan.
  7. When in doubt, check it out. If anyone in your family has symptoms , please isolate yourself and get the test. It's worth the extra caution to protect our communities.

How to evaluate (and minimize) potential risks for Thanksgiving

The CDC's Thanksgiving guidance highlights specific considerations for holiday gatherings :

Community levels of COVID-19: What's the rate of virus transmission where you're going? What's the rate of virus transmission where everybody has been? If the numbers are high, so is the risk of infection. "High" seems to mean different things to different people, but whether you're looking at cases per capita, positive test rates, hospitalization rates or just the number of cases, the news isn't pretty in most places in the U.S. right now .

Travel risks: While there are a number of ways to minimize your risk of coronavirus exposure while traveling, health experts agree that there's no such thing as a no-risk trip right now , especially with community transmission levels as high as they are in much of the country. ( Here's more on the specifics of holiday travel risks right now.)

Indoors or outdoors? The risk of coronavirus transmission is higher indoors than outdoors—which is why Dr. Jonathan Reiner, professor of medicine at George Washington University, told CNN to consider not having indoor Thanksgiving dinners with others who aren't in their immediate household. "If you're lucky enough to live in a part of the country where the weather will be moderate in November, do an outdoor Thanksgiving," Reiner said.

Who's coming? The lower the number of people, the lower the odds of virus transmission, and the easier it is to maintain safe physical distance between guests. And while the CDC is diplomatic in the way it phrases this delicate point, "anti-masker" relatives do indeed pose an elevated risk to others in the family: "Individuals who did not consistently adhere to social distancing (staying at least 6 feet apart), mask wearing, handwashing and other prevention behaviors pose more risk than those who consistently practiced these safety measures."

How long? Epidemiologists suggest thinking about the risk factors for coronavirus transmission in terms of "time, space, people, place." The ideal combination for lowering risk is a short amount of time, with more space between fewer people in a larger place. So, an hour in a relative's backyard, with everybody wearing masks and maintaining distance, is lower risk than an epic afternoon meal indoors with a group of families, all talking and not wearing masks.

Can guests follow safety protocols? As the CDC's guidance notes, "Gatherings with more safety measures in place, such as mask wearing, social distancing and handwashing, pose less risk than gatherings where fewer or no preventive measures are being implemented." It may feel awkward to have people wearing masks indoors and it may be tough to seat everybody far apart. But for the sake of safety, 2020 is the year to try.

What's safe for Thanksgiving 2020?

  • Thanksgiving dinner with immediate household members only. Here's how to make Thanksgiving turkey if you've never done it before .
  • Hosting a virtual Thanksgiving gathering with other families. Here's how to make a Zoom family holiday party fun .
  • No-contact food drops. In the spirit of the holiday, consider preparing and dropping off Thanksgiving dishes for relatives, neighbors and those in need.
  • Small, local, outdoor gatherings. Assuming that everyone is healthy, mask up and follows precautions , "a small outdoor dinner with family and friends who live in your community," like a cookout or picnic where everybody uses disposable plates and utensils and brings their own food, is considered "moderate" risk by the CDC.
  • What's considered higher-risk for Thanksgiving 2020?

    • Large indoor dinner parties. Attending "large indoor gatherings with people from outside of your household" is categorized as high-risk right now. While it's unlikely that people would risk coronavirus exposure from sharing food or utensils, the bigger risk comes from combining large groups of people from various communities indoors where following COVID-19 prevention best practices is difficult (it's tricky to eat turkey in a mask).

    If you do attend or host a Thanksgiving gathering this year, it's a good idea to follow as many of the below suggestions from the CDC as possible:

    Don't make it a potluck. Encourage guests to bring food and drinks for themselves and for members of their own household only; avoid potluck-style gatherings.

    Keep masks on whenever possible, and while serving and preparing food. Wear a mask while preparing food for or serving food to others who don't live in your household. All attendees should have a plan for where to store their mask while eating and drinking. Have one person who is wearing a mask serve all the food so that multiple people are not handling the serving utensils.

    Keep people out of the kitchen. Limit people going in and out of the areas where food is being prepared or handled, such as in the kitchen or around the grill, if possible.

    Use disposable plates, utensils and serveware. Use single-use options or identify one person to serve sharable items, like salad dressings, food containers, plates, utensils and condiments.

    Wash hands. Make sure everyone washes their hands with soap and water for 20 seconds before and after preparing, serving and eating food and after taking the trash out. Use hand sanitizer that contains at least 60% alcohol if soap and water are not available. Designate a space for guests to wash hands after handling or eating food.

    Maintain physical distance. Limit crowding in areas where food is served by having one person dispense food individually to plates, always keeping a minimum of a 6-foot distance from the person whom they are serving. Avoid crowded buffet and drink stations. Change and launder linen items (e.g., seating covers, tablecloths, linen napkins) immediately following the event.

    Make clean-up extra-efficient. Offer no-touch trash cans for guests to easily throw away food items. Wash dishes in the dishwasher or with hot soapy water immediately following the gathering.

    While a Thanksgiving without a huge meal around the table with all your loved ones may seem like one sacrifice too many in a year of disappointments, knowing that you did everything you could to demonstrate how much you care about your friends and family can be some comfort. Here's hoping that next year's Thanksgiving brings a return to all the traditions we love.