As Thanksgiving nears, many families are grappling with how to celebrate the holiday.

But a new national survey by the Ohio State University Wexner Medical Center shows many Americans plan on attending large holiday gatherings despite spiking COVID-19 cases and hospitalizations.

Nearly two in five people say they will probably attend a gathering with more than 10 people and a third do not plan on asking guests to wear masks, the study shows.

“We’re going to look back at what happened during this holiday season and ask ourselves, ‘Were we part of the solution or were we part of the problem?’” said Dr. Iahn Gonsenhauser, the Wexner Center’s chief quality and patient safety officer, in a news release. “When you’re gathered together around the table, engaged in conversation, sitting less than six feet apart with your masks down, even in a small group, that’s when the spread of this virus can really happen.”

Gonsenhauser suggests canceling in-person gatherings for the holidays and instead having a virtual dinner.

If people are hosting in-person celebrations, he recommends having a plan and communicating that plan to guests. He urges people to wear masks at all times, separate seating arrangements by household and having only one or two people serve the food. If people are taking their holiday meal outdoors, he suggests people follow the same precautions they would if they were indoors. If people have out-of-town guests coming, Gonsenhauser recommends staying up to date with COVID-19 rates in both areas.

“If you have someone in your household who’s high risk and you’re in a low incidence area, you’re going to want to think twice about having a celebration where people are coming from an area where there’s a lot of virus in the community,” Gonsenhauser said in the release.

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