Just months after deciding to send their children to college campuses amid the coronavirus pandemic, many families are now facing another difficult dilemma: How to safely welcome students home without introducing a deadly virus into their households.
There is no universal approach to Thanksgiving this year for colleges and universities. Though some are encouraging students to stay on campus for the holiday, others are allowing them to go home for the long Thanksgiving weekend. Still more are sending students home to begin their winter break or finish their semesters remotely.
Those who are going home will be arriving from sites that, in many cases, have become hot spots for covid-19 and will be making the holiday pilgrimage at a time when cases of the novel coronavirus are surging again nationwide. To make things even more complicated, college students are often asymptomatic, meaning they could unwittingly transmit the virus, "especially during a multigenerational celebratory Thanksgiving meal," said Rochelle Walensky, chief of the Division of Infectious Diseases at Massachusetts General Hospital.
"It's not a recipe for stuffing," Walensky added. "It's a recipe for disaster."
Still, it's clear that some college students and their families will want to be together, despite the risk. "It might be safer for kids not to go home, in terms of protecting their family, but we're all very aware of the emotional toll that will take - to have families separated for the holidays," said Aaron Milstone, an epidemiologist at Johns Hopkins Hospital.
Students at colleges and universities planning to end their in-person fall semesters before Thanksgiving or switch to online-only instruction afterward may have no choice but to go home for the holiday.
Here's what experts say parents and students should be considering to reduce the chances of infecting family members, whether they return at Thanksgiving or closer to Christmas.
Milstone urged students to think of their holiday trips in stark terms. "You could inadvertently give this to someone and it could kill them," he said.
"I know a lot of young people think, 'It's not a big deal. My friends have gotten it, they all did fine. They had to stay in their rooms. No big deal,' " added Milstone, who is also a professor of pediatrics at Johns Hopkins. "But that's not the case for your parents and your grandparents."
Young people have been identified as sources of some family outbreaks, infecting their older, more vulnerable relatives who live in the same household.
Experts also point out that travel could increase students' risk of exposure to the virus, and that holiday celebrations held indoors to avoid the cold could facilitate transmission. In Canada, where Thanksgiving is celebrated on the second Monday of October, officials have blamed an uptick in case counts on holiday gatherings.
Students must take action in the weeks before they head home if they want to effectively reduce the possibility of bringing the coronavirus with them.
"People shouldn't leave campus on Monday or Tuesday before Thanksgiving and think that they can safely dine with their family without having done any quarantine or testing before they left," Walensky said.
She recommended two options for self-quarantining: Do it at school or leave campus early and spend the two weeks sequestered in their room at home.
The latter, she said, is the best solution overall. "The safest thing to do is go home two weeks before Thanksgiving, which we're almost at, hang out there for two weeks and then come out of your quarantine."
If students decide to quarantine on campus, they should do as much isolating and mask-wearing as possible in the two weeks before leaving, said Gary Simon, director of the Division of Infectious Diseases at George Washington University.
"They've got to be wearing their mask, they can't be going to party, they can't be in a large gathering," Simon said. "You go to whatever class you have to go to, and then you stay at home. That's the maximal thing you can do.
"And then everybody makes compromises after that," he continued. "If you got to go out to the store to get some food, you're going to go out to the store to get some food. Don't go to a restaurant and sit inside with your friends."
In the days before leaving campus, students should also be tested, preferably with a PCR test, the laboratory test used to diagnose the coronavirus, said Stephen Morse, a professor of epidemiology at Columbia University Mailman School of Public Health.
Many colleges and universities have been regularly testing their students, and some have rolled out special guidances for holiday travel. At the State University of New York, for instance, all on-campus students will have to test negative before they can leave for Thanksgiving break.
But experts cautioned against being lulled into a false sense of security by a single negative test. "The test is only a snapshot in time," Morse said.
The virus’s highly variable incubation period, which can extend as long as 14 days, makes it risky to rely on a negative test result, Walensky said. Consider a possible scenario in which the virus takes seven days to incubate. If a student is exposed on the Wednesday eight days before Thanksgiving and is tested that Friday, the result would be negative, she said. But, she noted, that person “could be maximally infectious at the dinner table” by Thanksgiving.
"You'd be maximally infectious just as you're kissing grandma, and that's what we're trying to avoid," she said.
Certain modes of travel can increase risk of exposure, and how people choose to go home will affect whether they need to quarantine upon arrival, experts said.
One of the safest options is driving alone, said Saad Omer, a professor of medicine and director of the Yale Institute for Global Health.
Milstone agreed. "If you're in your own car, then you're controlling your exposures," he said. On a solo road trip, people just have to focus on being careful anytime they are outside their car. Furthermore, getting gas and food or stopping to use the restroom are "very brief interactions" compared with "waiting in an airport for an hour for your flight and spending a few hours sitting on an airplane around people you may not know," he said.
If students travel by plane, train or bus, they should strictly follow safety measures such as mask-wearing and hand hygiene, Omer said. He also recommended not traveling during peak times. Avoid weekends and instead "travel at night so that you're not interacting with a bunch of people as you're traveling," he said.
If students are driving themselves, Walensky said, quarantining on campus and being tested before leaving may be enough to avoid a second quarantine once they get home. Ideally, students should get two negative tests separated by three days, she said. But if they are going to be around other travelers, Walensky said she wouldn't recommend integrating back into their households without a 14-day quarantine.
Milstone said students should also consider wearing a mask inside their homes as an added layer of protection, especially if they think it's possible that they were exposed.
"Wearing a mask around high-risk relatives is important, but it should be any relative," he said, noting that a student could infect their sibling, who in turn could spread it to a parent or grandparent.
Experts also recommended that college students follow state travel guidelines. Most states have varying restrictions in place depending on where people are coming from, often requiring a 14-day quarantine or proof of a negative test in the past 72 hours.
"Those have all been put in place with good intentions, so I would encourage people to make sure they're up to date on those recommendations," Milstone said. The pandemic, he added, "is dynamic, so checking today is not going to be the same as checking on November 22 or some period right before you leave."
As public health experts have already warned, Americans should not expect to celebrate the holidays traditionally this year. And while many college students may be looking forward to reuniting with their families, Morse urged them to carefully weigh the decision.
"If you have any doubt, don't go," he said.
Walensky encouraged people to "reach for the delayed gratification this year."