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Should Your Holiday Guests Take COVID-19 Tests This Year?

Testing isn't foolproof, but it can give some families peace of mind

spinner image Coming over for Christmas dinner during the COVID-19 pandemic. Two women greet each other at the entrance of a house, with a Christmas decorated table for dinner
Roman Samborskyi / Alamy Stock Photo

People are craving visits with their friends and family and in some cases are looking to COVID-19 testing to make them feel comfortable gathering and visiting. 

But the CDC is advising against travel and interacting with those outside your household, and testing isn’t a foolproof way to guard against contracting or spreading the coronavirus. While testing can be useful when done right, it's not a guarantee of safety, so every family has to weigh its risk tolerance.

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Andrea Redican and her mother traditionally host Thanksgiving dinner for two dozen relatives at her parents' home in Garden City, New York, to kick off the holiday season every year.

So they pared down their guest list, and Redican asked everyone to get COVID-19 tests and quarantine from their test day until the feast.

"My mother will not do Thanksgiving without her grandchildren,” says Redican, 51.

Negative tests don't guarantee safety

With experts like Anthony Fauci, the federal government's foremost COVID-19 doctor and infectious disease adviser, urging people to sit out Christmas and other holidays, and with guidance from the Centers for Disease Control and Prevention (CDC) classifying large gatherings as high risk for virus transmission, testing is one option that may make families feel a bit safer about sitting down together for a holiday meal.

While testing can be useful when done right, it's not a guarantee of safety, so every family has to weigh its risk tolerance. And though many types of coronavirus tests are now available, “they're all fairly new,” says Neel Shah, an infectious disease specialist and faculty member at the University of Pittsburgh School of Medicine. They do “help detect the presence of coronavirus,” Shah says, but “the sensitivity of these tests and the specificity of these tests are still not well established."

That means a positive test can provide useful information because it “strongly suggests the presence of coronavirus,” he says, but a negative result may not certify that someone is coronavirus-free. False negatives have been reported, and timing related to exposure can also mean that tests don't pick up the virus if it hasn't taken hold yet.

"Understanding the relevance of the test and what the results mean” is key, Shah cautions.

Even with negative tests, people should take standard precautions the CDC recommends, like wearing masks, washing hands often, practicing social distancing and gathering outdoors, when possible.

Asking people to take the test can be hard

Redican's relatives all agreed to get COVID-19 tests, she says. But navigating this new social territory can cause friction.

Laura Miranda-Browne began tackling this issue early in the pandemic, when her in-laws were planning a summer trip from their home in Iowa to her home in Plainfield, New Jersey. When she asked them to quarantine and test, she says, “the first few discussions did not go well.”

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Through phone calls, FaceTime conversations and emails, the couple explained their concerns. Miranda-Browne, her husband and their 3-year-old twins have formed a “COVID pod” with their nanny and her family. The nanny is over 60 and has health issues, so Miranda-Browne is committed to taking precautions to protect everyone's health. “We're all in this together,” she says.

Eventually, her in-laws saw that COVID-19 cases were increasing in their state, she says. “That helped us convince them.” But it was a bumpy process.

Even when you're sure that these precautions are necessary, “it's really hard to ask your family to do this. It's really hard when they're angry about it,” admits Miranda-Browne, 37. She's found that older parents aren't always comfortable when their adult children make rules they have to follow.

Because the couple stood firm, Miranda-Browne's relatives have not objected to getting tested ahead of Thanksgiving dinner this year.

Travel, quarantine affect test reliability

One challenge is the need to take a test days before a holiday gathering but also quarantining between test time and the event, to avoid exposure that wouldn't be picked up by the swab.

Kelly Ubinger, 45, considered asking her family to get tested for the coronavirus in order to have Thanksgiving dinner with her elderly parents and mother-in-law. But she and her husband will both be working outside their Pittsburgh home until the day before the holiday. And their four children go to school outside their home, as well.

So as to rule out being exposed between taking the test and Thanksgiving, they would not be able to quarantine after testing. “The thing with a COVID test is that it's just a snapshot,” Ubinger says. “It tells you that you don't have COVID at that exact moment in time. … It's not really helpful."

For those leaving home for Thanksgiving, quarantining after testing will be especially complicated because travelers face exposure to the coronavirus.

Test availability also varies by state, with some states offering tests only to those with symptoms or direct, recent exposure to someone confirmed to have the coronavirus. “Availability has improved since March,” Shah notes. “So it is possible to get tested, but it's usually done only in symptomatic individuals.”

If you want to be tested, he suggests that you contact your primary care doctor or check with the CDC or your local health department to find local sites. CVS now offers testing at nearly 4,000 locations around the country. The turnaround time for results also varies widely among states.

Redican is glad that tests are readily available near her home, and she'll make sure that her brother and sister make appointments on the Monday before Thanksgiving.

"Our agreement was, you can only come if you got tested, and everyone easily agreed,” she says. And they all plan to quarantine as best as they can after taking the test. They see testing as one more precaution that might help and that can't hurt.

But knowing that false negatives are possible, Redican isn't putting all her faith in testing as she maps out changes to her family's Thanksgiving plans. Along with paring their guest list down from 26 people to 11, the family plan to keep dining room windows open and eat at place settings spread farther apart than usual. They'll also use disposable plates and utensils, rather than china and silverware they would need to wash.

One thing won't change, though: Her mother draws the line at disposable wineglasses. “My family will not drink wine out of anything other than a wineglass,” Redican says. “But I'll wash them so my mother doesn't have to.”

Navigating the New Normal of Holiday Gatherings

Editor's note: This article was originally published on October 28, 2020 and has been updated with new information regarding CDC recommendations for travel.

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