Not sure what to do about Thanksgiving plans? Your questions answered - CBC.ca

Keep it local. Keep it small. And if possible, move it outdoors.

Despite the fact that more than 80 per cent of eligible Canadians are now vaccinated against COVID-19, infectious disease specialists from across the country agree that people still need to be careful this year about gathering to celebrate Thanksgiving this weekend.

One important aspect to keep in mind is that the COVID-19 situation is different depending on where you are. It is important to check local public health guidelines and to be aware of how much COVID-19 is circulating in your area.

CBC News has received many questions from readers — on everything from whether a gathering of fully vaccinated people is safe, to mixing unvaccinated kids with vaccinated seniors and eating from shared dishes — and we're going to answer the most common ones with the help of three physicians from different parts of the country.

A list of current indoor gathering limits by province and territory can be found at the bottom of the story. You may click on the links provided for full details, including guidelines for outdoor private gatherings.

Is it safe for fully vaccinated people to hold holiday gatherings with other fully vaccinated people? 

For the most part, yes. But the key is still to keep those gatherings small, especially in provinces where case numbers are still very high, such as Alberta.

"We have to recognize that the bigger the gatherings get that there is an element of risk, even with vaccination, because of the incredibly high rates of transmission in the community," said Dr. Stephanie Smith, an infectious disease specialist and professor at the University of Alberta in Edmonton.

In Ontario, Dr. Zain Chagla, an infectious disease physician and associate professor at McMaster University in Hamilton, says limiting gatherings to the fully vaccinated means there is a lower chance of anyone attending having COVID-19 to begin with.

If someone does have COVID-19 and doesn't know it, he adds, they would be less likely to transmit the disease at the event, while fully vaccinated guests would have "an incredibly lowered risk" of catching it.

WATCH | While vaccines help, delta variant means precautions needed for Thanksgiving: 

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Dr. Eileen de Villa, Toronto's medical officer of health, says with the delta variant still circulating widely, public health precautions are still necessary if people are gathering for Thanksgiving and through December. 1:12

Can unvaccinated kids visit with vaccinated seniors? 

One thing that parents should be aware of is that if there is COVID-19 transmission happening in their unvaccinated children's schools, the risk that a child might be infected is higher, and a non-symptomatic child can transmit disease.

Dr. Scott Halperin, a professor of pediatrics and microbiology immunology at Dalhousie University in Halifax, suggests that parents try to avoid taking their younger kids out to places like the grocery store during the week or so before gathering in order to limit their exposure.

"There's enough time now for a week in advance to start just controlling your young child's exposure in order to be able to be comfortably getting together with a larger groups of family members."

He says if there have been no cases in schools where school-age unvaccinated children are attending, it's perfectly reasonable for those children to be with their grandparents.

A multigenerational family is seen preparing for a holiday gathering earlier this year. Mixing unvaccinated children with their vaccinated grandparents on Thanksgiving this year may carry some risk, depending on the rate of COVID-19 transmission in a local community. (Jeff Stapleton/CBC)

However, if there has been an outbreak, Smith says it would be better to know whether a young child has been exposed before taking them to visit seniors.

"Everyone has to kind of look at their individual risk," Smith said. In Alberta, or in other provinces where case numbers are still very high, she advises against too much intergenerational mixing.

"If it was my grandmother and I had children that were unvaccinated, I would probably recommend that if she wanted to come and visit that you can try to arrange something that's outside and that you try to maintain that distancing."

What about unvaccinated kids mixing with unvaccinated kids from other families? 

If you have unvaccinated children from different families mixing, the key thing to be aware of is the risk based on what's going on in the local community — whether there are school outbreaks and how many cases there are.

"Both sets of parents really need to be very upfront and honest about what's going on in their community and what type of exposures they've had," Halperin said, "and to try to minimize exposure ... prior to them getting together with their cousins from several hours away."

And Chagla says that in that situation, it's important not to include anyone with even the smallest symptom — even if it's a young child with a runny nose.

Infectious disease specialists say it's important to know the level of exposure unvaccinated children have had to COVID-19 before getting together for Thanksgiving. (Alex Soloducha/CBC)

What about inviting people who are unvaccinated? 

"This is definitely an issue," Chagla said.

"If people choose to have gatherings where people are unvaccinated," Smith said, 'they have to realize that there is a greater risk."

All three doctors agree that getting together for the holidays is not "essential" and that there is no reason to feel obligated to invite anyone who is choosing not to get vaccinated against COVID-19. 

"People have a right to decide whether they want to be immunized or not, except if it's putting other people at risk," Halperin said.

"One of the things we like to do is to take responsibility. We certainly insist on hosts of dinner parties making sure that people drink responsibly and don't keep serving alcohol to somebody who's going to be driving home."

He says the person hosting Thanksgiving should be aware of the risks of having an unvaccinated person in their home and the level of risk to their immunized guests. 

WATCH | New Brunswickers limited to their immediate households this Thanksgiving: 

No private Thanksgiving gatherings in N.B.

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New Brunswick Premier Blaine Higgs has imposed limitations for private indoor gatherings this long Thanksgiving weekend to single households, with no outside guests. 1:09

What if an unvaccinated family member insists on attending?

Chagla says at that point, use controls: Make sure no one is symptomatic, open windows, gather outside and assess whether there are people at higher risk of developing severe COVID-19.  

"It's also maybe a good time ... to start talking to people and say, 'Hey, you know, I would love to have this event, would you think about getting a vaccine to make it safer.... We want to get together, it's a time for family, and so could you consider it just for this?' And sometimes even that is enough to get people over the edge and those last few holdout people to make it something that, 'OK, there's a reward to this' or 'I'm going to keep that gathering safe.'"

What are precautions that could help keep everyone safer? 

All three doctors say that no matter where you live, holding your Thanksgiving gathering outside is much safer than indoors.

But this being Canada, everyone knows that is not going to be possible for everyone.

So if you must gather indoors, open windows whenever possible, make sure there is good ventilation and try to maintain physical distancing. Wearing masks is always helpful if distancing can't be maintained, but if they are taken off to eat, their usefulness is greatly compromised. 

Should university students be tested before coming home? 

Given that many Canadian universities have mandated vaccination in residences and for in-class learning, it is probably unnecessary if the student has indeed received both doses of a COVID-19 vaccine.

Adding a rapid test the day they come home could provide added reassurance but is probably not necessary. 

What about sharing food or serving from common dishes? 

At a small gathering of vaccinated friends or family, sharing food around the table is probably fine. As the science around COVID-19 transmission has evolved, early concerns about the disease being spread through touching objects or surfaces has been determined to be far less likely.

And so as long as people have washed their hands, passing food dishes and serving from a serving spoon pose a very low risk when it comes to COVID-19. But Chagla warns that illnesses such as the common cold or influenza do pass easily that way, so it's not risk-free.

Guests pass dishes around the table during a holiday dinner. Doctors agree that the chance of COVID-19 transmission on surfaces such as food dishes is low. (Shutterstock/wavebreakmedia)

Is it safe to fly domestically to celebrations? 

The recommendations from most public health officials this year is to keep celebrations local — or at the very least, within province.

"Travel is always going to be a problem because you're mixing in airports, you're mixing on planes," Halperin said.

As well, there is a lot of variation right now in terms of case numbers and transmission in different parts of the country. Flying from a hot zone to another area of the country — and vice versa — is not the best plan this Thanksgiving season. 

WATCH | Dr. Isaac Bogoch on what to be aware of if you're flying over the holidays: 

Domestic air travel is mostly safe, says doctor

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Dr. Isaac Bogoch, an infectious disease specialist, says domestic air travel may be safer than you might think, other than at specific points when going through airports. 0:59

Should you encourage guests to stay in hotels rather than in your home?

It's probably safe to have one vaccinated family stay overnight with another. But again, Chagla says, weigh the risk. "The more time you spend with people, the more chance you'll transmit if [COVID-19] is in the room or someone has COVID-19."

Vaccination has definitely made gathering a little less risky in many areas of the country this year, but nowhere is the risk zero.

"My advice [is that] people should take slow steps and not say, 'OK, we're finally free,'" Halperin said.

"Enjoy the little bits more freedom that we can have, that vaccination has provided. Enjoy that with family, but don't go crazy. This is a long battle. We're not done with it yet."

Indoor private gathering limits by province: 

• British Columbia: No restrictions, other than in the Interior Health and Northern Health districts. 
• Alberta: Vaccinated: Indoor private social gatherings are limited to a single household plus one other household to a maximum of 10 people. Unvaccinated: Indoor social gatherings are not permitted.
• Saskatchewan: No indoor gathering limits.
• Manitoba: No indoor gathering limits for vaccinated people. Households are limited to guests from one other household when any unvaccinated person (who is eligible to be vaccinated) is present.
• Ontario: Indoor social gatherings of up to 25 people. 
• Quebec: Indoors, a maximum of 10 people from different addresses or the occupants from three households. If guests are unvaccinated, masks are strongly recommended. 
• New Brunswick: All Thanksgiving gatherings limited to one household. 
• Nova Scotia: Indoors, household members (the people you live with) plus up to 25 close social contacts.
• Prince Edward Island: Personal gatherings of family and friends to a maximum of 20 people.
• Newfoundland and Labrador: Personal indoor gatherings limited to the number of people that can fit in the space with physical distancing.
• Nunavut: Indoor gatherings are restricted to a household plus 15 people, other than in Coral Harbour (household plus five) and Kinngait (household plus 10). 
• Yukon: No formal restrictions, but it is recommended that unvaccinated people stick to six people maximum for indoor gatherings. 
• Northwest Territories: Indoor private gatherings of up to 200 people, with the exceptions of Yellowknife, N'Dilo, and Dettah, which are under gathering restrictions of five additional persons in a home at any given time – to a maximum of 10 people in the house.

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