The situation in the United States has grown so critical that the CDC recommends people stay home this Thanksgiving. CDC advises not to gather with family and friends who do not live with you because of the impact this will have on the spread of COVID-19 and/or flu.

Part of communicating well is trusting the public with the truth. For that reason, I write frankly about our situation in the United States. That the public understands the dangerous place to which our current path leads is of critical importance. It may well decide how dark the weeks ahead become.

If the number of new cases and deaths in the US are proportionally similar to what we saw over the summer, and especially if the number of new cases per day continues to rise, Americans should prepare themselves for loss on a scale not seen in the US since the Civil War era.

We are already likely to see 2,000 or more deaths a day in about a month, but we could easily see more if we fail to do our part in stopping this.

That said, if you still travel or have guests, I’ve included some recommendations for lowering risk.

Why Should I Care If I’m Young and Healthy?

Hospitals in multiple states have reached such a point that they have no more staff or beds available. Whether a person seeking care has Covid or something else, we cannot treat people without resources, staff, and hospital beds.

That means the young man in a car accident may not get the care he needs in time to save his life. It may mean the mother who hasn’t felt her baby move in the womb for some time, won’t see a care provider fast enough to prevent the worst.

That is where we are right now. Americans have a much higher risk than many in the public understand, and 47% of the US population is a high risk for serious illness and death, according to the CDC this past summer.

Around 160 million Americans are obese or overweight. Nearly 30% of those under the age of 20 are obese or overweight; it’s not just adults. That changes our risk.

Obesity is one of the most common risk factors among serious and fatal Covid cases. Conditions common in the US like heart disease, cancer, diabetes, osteoarthritis, and kidney disease make a person more likely to have a serious or deadly case.

Starting at a BMI of 23, the risk for hospitalization and death increases. People with pneumonia from COVID-19 have twice the mortality rate seen with non-COVID-19 viral pneumonia, and obesity increases the risk for developing COVID-related pneumonia. Patients with obesity or diabetes ended up in the ICU at higher rates.

One study reported that the risk increases were considerable:

• Overweight: 2.45x
• Obese: 3.5x
• Morbid Obesity: 5.18x
• Diabetes: 5.49x

Among the lifestyle factors examined, only overweight/obesity associated with pneumonia considering eight lifestyle factors. The risk increase was nearly three times the norm.

Death is not the only undesirable outcome.

Whether there will be long-term consequences that follow coronavirus infection, we do not yet know. There is no way to know. About 35% of people with COVID-19 still have symptoms 2–3 weeks later, the CDC reported. Symptoms frequently last six weeks or more.

That means many more newly sick people before those infected first have recovered. That is when we face a reality where young people who could otherwise have been saved, die. We can prevent tragedy; we can save lives, but no one can do it alone. It takes all of us.

While we may never know the true case count in the early pandemic, the surge that happened this past summer was better documented. We never exceeded 500,000 new confirmed cases per week and breached 1,000 deaths a day in the weeks following. Deaths always lag, and as we find cases sooner and treat people earlier, it may look like deaths have steeply declined when they have not.

We have already exceeded 1 million new cases this past week, twice the number of cases per week, after which we saw 1,000 deaths per day. We could reasonably expect 2,000 deaths a day with the next month. How many more we lose beyond that is largely up to us.

If you still travel, here are some recommendations.

If you are considering traveling for Thanksgiving, here are some important questions to ask yourself and your loved ones beforehand. These questions can help you decide what is best for you and your family.

• Are you, someone in your household, or someone you will be visiting at increased risk for getting very sick from COVID-19?
• Are cases high or increasing in your community or your destination? Check CDC’s COVID Data Tracker for the latest number of cases.
• Are hospitals in your community or your destination overwhelmed with patients who have COVID-19? To find out, check state and local public health department websites.
• Does your home or destination have requirements or restrictions for travelers? Check state and local requirements before you travel.
• During the 14 days before your travel, have you or those you are visiting had close contact with people they don’t live with?
• Do your plans include traveling by bus, train, or air which might make staying 6 feet apart difficult
• Are you traveling with people who don’t live with you?

If the answer to any of these questions is “yes,” you should consider making other plans, such as hosting a virtual gathering or delaying your travel.

It’s important to talk with the people you live with and your family and friends about the risks of traveling for Thanksgiving. Resist the temptation to ignore this crisis. We all feel information fatigue; we want this to be over. To end this sooner rather than later, each of us will need to take personal responsibility for what we can control.

When traveling…

• Check travel restrictions before you go.
• Get your flu shot before you travel.
• Always wear a mask in public settings, when using public transportation, and when around people who you don’t live with.
• Stay at least 6 feet apart from anyone who does not live with you.
• Wash your hands often or use hand sanitizer.
• Avoid touching your mask, eyes, nose, and mouth.
• Bring extra supplies, such as masks and hand sanitizer.
• Know when to delay your travel.

Wear a mask

Wear a mask with two or more layers to help protect yourself and others from COVID-19. Wear the mask over your nose and mouth and secure it under your chin. Make sure the mask fits snugly against the sides of your face.

Stay at least 6 feet away from others who do not live with you.

• Remember that people without symptoms may spread COVID-19 or flu.
• Keeping 6 feet (about 2 arm lengths) from others is especially important for people who are at higher risk of getting very sick.

Wash your hands

• Wash hands often with soap and water for at least 20 seconds.
• Keep hand sanitizer with you and use it when you cannot wash your hands.
• Use hand sanitizer with at least 60% alcohol.

Attending a Gathering:

Celebrating virtually or with the people you live with is the safest choice this Thanksgiving.

If you attend a gathering, make your celebration safer. Besides following the steps that everyone can take to make Thanksgiving safer, take these additional steps:

• Bring your own food, drinks, plates, cups, and utensils.
• Wear a mask and safely store your mask while eating and drinking.
• Avoid going in and out of the areas where food is being prepared or handled, such as in the kitchen.
• Use single-use options, like salad dressing and condiment packets, and disposable items like food containers, plates, and utensils.

Hosting a Thanksgiving Gathering

Celebrating virtually or with the people you live with is the safest choice this Thanksgiving.

If having guests to your home, be sure that people follow the steps that everyone can take to make Thanksgiving safer. These steps include:

• Have a small outdoor meal with family and friends who live in your community.
• Limit the number of guests.
• Have conversations with guests ahead of time to set expectations for celebrating together.
• Clean and disinfect frequently touched surfaces and items between use.
• If celebrating indoors, bring in fresh air by opening windows and doors, if possible. You can use a window fan in one of the open windows to blow air out of the window. This will pull fresh air in through the other open windows.
• Limit the number of people in food preparation areas.
• Have guests bring their own food and drink.
• If sharing food, have one person serve food and use single-use options, like plastic utensils.

Consider Other Thanksgiving Activities:

Host a virtual Thanksgiving meal with friends and family who don’t live with you.

• Schedule a time to share a meal together virtually.
• Have people share recipes and show their turkey, dressing, or other dishes they prepared.

Watch television and play games with people in your household

• Watch Thanksgiving Day parades, sports, and movies at home.
• Find a fun game to play.

Shopping

• Shop online sales the day after Thanksgiving and the days leading up to the winter holidays.
• Use contactless services for purchased items, like a curbside pickup.
• Shop in open-air markets, staying 6 feet away from others, and wear a mask.

Other Activities

• Safely prepare traditional dishes and deliver them to family and neighbors in a way that does not involve contact with others (for example, leave them on the porch).
• Take part in a gratitude activity, like writing things you are grateful for and sharing with your friends and family.