CHICAGO — Carrie Mangoubi had a plan for Thanksgiving.
She’d ask her guests to quarantine for two weeks before the holiday, or quarantine for one week and then get tested for COVID-19 right before Thanksgiving. Her family members agreed to the arrangement.
But amid travel concerns and rising cases of COVID-19, Mangoubi, 40, abandoned her plan to host the holiday dinner. She now anticipates a quiet Thanksgiving at her Chicago home with her husband and two young children.
Mangoubi isn’t the only one weighing the role that COVID-19 testing can play as the holidays approach. Many families, desperate to save Thanksgiving, are wondering whether testing can bring peace of mind to their dinner tables.
“It’s a very difficult question,” said Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University Feinberg School of Medicine. “It sounds like it should be so easy, but it’s not easy at all.”
Some medical experts say testing could add a layer of protection when combined with quarantining before the holiday. Others say families are better off sticking to other strategies, such as masks, social distancing or avoiding in-person gatherings altogether.
The Illinois Department of Public Health encourages people to get tested before and after any gatherings and to curb activities outside their homes before getting together. But at a recent event, Dr. Ngozi Ezike, director of the Illinois Department of Public Health, asked, “Do we want to sit with people at Thanksgiving, and weeks later attend their funeral?”
About 35% of 1,005 Americans surveyed in late October, as part of an Ipsos poll, said they plan to have smaller-than-usual Thanksgiving gatherings. About 5% said they plan to get a COVID-19 test before celebrating, and 5% said they’ll ask everyone attending their festivities to get tested.
‘Not worth the risk’
The state health department recommends limiting the number of guests at gatherings, maintaining six feet of distance when indoors and wearing masks except when eating and drinking.
The Centers for Disease Control and Prevention says the lowest risk Thanksgiving plans include celebrating only with those who already live in your home, or a virtual dinner with friends and family. The CDC also recommends, if people from different households do plan to gather, that everyone involved strictly avoid contact with those outside their homes for 14 days beforehand, among other measures.
Dr. Michael Lin, an infectious disease specialist at Rush University System for Health, said he doesn’t recommend testing as a prelude to holiday gatherings.
“Testing, in general, only applies to the day of your test. It tells you something about your status,” Lin said. “It’s important to know the next day or the day after you may have a different situation. I can’t use a test on one day to guarantee on another day you’re going to be negative.”
That’s part of the reason that Caroline Rohan, 46, of Deerfield, didn’t consider testing as a way to gather with more of her family for Thanksgiving. Rohan, her husband and three children plan to celebrate with her in-laws, whom they’ve been seeing regularly, but not her parents, who are older and have health issues.
“I don’t know how much you can 100% rely on it,” Rohan said of testing.
At first, Rohan and her relatives discussed whether they could host her parents if they sat two rooms away, or if they ate in the garage.
But they decided those protections weren’t enough — and her parents didn’t really want to dine in a garage.
‘No right or wrong answer’
Some experts, however, say COVID-19 testing could lessen the danger of gathering for the holidays — though they agree that it’s not a foolproof way to prevent the spread of COVID-19.
Tests can have false negatives, but if they’re combined with 14 days of quarantining, they might help families get together more safely, said Dr. Rachel Rubin, co-lead for the Cook County Department of Public Health.
Northwestern’s Murphy recommends people who choose to get tested do so as close to the event as possible — keeping in mind that some tests return results in 15 minutes and others take days.
“That’s not a perfect solution, but if you test everybody, that does give you some measure of protection,” Murphy said. “Nothing is 100% protective. There’s no right or wrong answer. It’s how much risk you’re willing to take.”
It may also be important for many people’s mental health to see their family members for the holidays, and testing can help facilitate that, said Dr. Rahul Khare, CEO of Innovative Express Care, an immediate care facility that offers testing in Lincoln Park and Downers Grove.
“There’s nothing wrong with seeing them, but do it responsibly,” Khare said.
People may want to also open a window during Thanksgiving gatherings, if they can stand the cold, he said.
The CDC also recommends hosts wear masks while making and serving food, offer single-use utensils and plates, have all guests wear masks and keep members of different households at least six feel apart throughout the event. People at increased risk of severe illness from COVID-19, and those who live with them, should avoid gathering with people who don’t reside in their households, according to the CDC. The CDC recommends gatherings be held outside when possible.
The testing process
People who want to get tested for COVID-19 before the holidays face a maze of choices — and limitations.
There are two basic types of tests. One is an antigen test, which looks for specific proteins on the surface of the virus and often returns results within 15 minutes. However, it is not considered as accurate as the other type of test, a molecular test, such as a PCR test.
Molecular tests detect the virus’s genetic material. It can take a day to a week for results, depending on the testing facility.
Northwestern Medicine requires people to get doctors’ orders for tests. Rush doesn’t require a doctor’s note, but those who want testing must talk to a nurse or doctor first, and generally must have symptoms.
Other sites, such as the 11 run by the Illinois Department of Public Health, offer tests to everyone, regardless of symptoms.
People can also take at-home, PCR COVID-19 tests, such as those sold through Osco Drug and Costco’s website.
To take the at-home tests from Osco and Costco, people have to fill out questionnaires, receive the tests, spit in tubes and then send them to labs. Results are available within a few days. The tests cost $139.99 out-of-pocket through Osco and $129.99 through Costco. Neither store is billing insurance companies for the tests, though they say patients can try to get reimbursed by submitting receipts to their insurance companies.
People should ask about costs upfront, regardless of where they get their tests. Federal law generally requires health insurance companies to cover COVID-19 tests at no cost to patients, but some people are being charged because of certain exemptions and nuances in the law.
A number of colleges, including Illinois State University, are offering COVID-19 tests to students before they head home for the holidays. The University of Illinois at Urbana-Champaign already requires students to test twice a week.
Still, getting tests for everyone coming to Thanksgiving — a grandmother with health issues, college-age cousins, an uncle who doesn’t believe COVID-19 is a serious threat — can take some logistical gymnastics. And even with testing, any indoor get-together between members of different households carries risks.
That’s part of the reason some people, such as Norma Sanders, may go it alone for Thanksgiving this year.
Sanders still goes to work in-person, meeting with members of South Side communities in her role as director of special initiatives for the Greater Auburn-Gresham Development Corporation, which works to revitalize those communities.
She’s much more exposed to the outside world than other members of her extended family, who have been hunkering down in their homes since the pandemic started.
“I am the only one who’s out almost every day,” Sanders said.
She’s kept her distance from her relatives even after testing negative for COVID-19 in recent months.
She doesn’t plan to change that behavior for the holidays.
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