Abstract
Prevention behaviors represent important public health tools to limit spread of SARS-CoV-2. Adherence with recommended public health prevention behaviors among 20000 + members of a COVID-19 syndromic surveillance cohort from the mid-Atlantic and southeastern United States was assessed via electronic survey following the 2020 Thanksgiving and winter holiday (WH) seasons. Respondents were predominantly non-Hispanic Whites (90%), female (60%), and ≥ 50 years old (59%). Non-household members (NHM) were present at 47.1% of Thanksgiving gatherings and 69.3% of WH gatherings. Women were more likely than men to gather with NHM (p < 0.0001). Attending gatherings with NHM decreased with older age (Thanksgiving: 60.0% of participants aged < 30 years to 36.3% aged ≥ 70 years [p-trend < 0.0001]; WH: 81.6% of those < 30 years to 61.0% of those ≥ 70 years [p-trend < 0.0001]). Non-Hispanic Whites were more likely to gather with NHM than were Hispanics or non-Hispanic Blacks (p < 0.0001). Mask wearing, reported by 37.3% at Thanksgiving and 41.9% during the WH, was more common among older participants, non-Hispanic Blacks, and Hispanics when gatherings included NHM. In this survey, most people did not fully adhere to recommended public health safety behaviors when attending holiday gatherings. It remains unknown to what extent failure to observe these recommendations may have contributed to the COVID-19 surges observed following Thanksgiving and the winter holidays in the United States.
Highlights
After declining following a summer surge, infections due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) precipitously increased across the United States with over 1.87 million cases reported during the month of October 2020 [1]
Of 25427 participants enrolled in the Community Research Partnership (CCRP) by 30 November, 2020, 20281 (79.8%) completed the post-Thanksgiving mini-survey, 26841 of 32031 participants (83.8%) enrolled by 24 December, 2020 completed the post-winter holiday (WH) survey, and 19354 participants responded to both surveys
The percent of participants who attended gatherings with non-household members (NHM) decreased with increasing age (Thanksgiving: 60.0% of participants aged < 30 years to 36.3% of participants aged ≥ 70 years [p-trend < 0.0001]; WH: 81.6% of participants aged < 30 years to 61% of participants aged ≥ 70 years [p-trend < 0.0001])
Summary
After declining following a summer surge, infections due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) precipitously increased across the United States with over 1.87 million cases reported during the month of October 2020 [1]. With Thanksgiving approaching, it was widely reported in the news media that Thanksgiving gatherings might serve as superspreader events, further exacerbating the surge in coronavirus disease-19 (COVID-19) cases [3]. Guidelines for Thanksgiving travel and safe holiday gatherings were issued by the Centers for Disease Control and Prevention (CDC) on 12 November [4]. Despite recommendations designed to decrease the risk of SARS-CoV-2 transmission by attending celebrations only with people in the household and deferring travel, the Associated Press reported that 1.17 million travelers passed through US airports on the Sunday after Thanksgiving [5]. Predictions of a post-Thanksgiving surge proved accurate [6, 7], so the CDC again cautioned Americans about travel and gatherings over the winter holiday (WH) season [8] and encouraged a broad range of safety precautions. As emphasized by the media, the potential consequences of WH travel and gatherings might be “catastrophic” [9], a concern that again proved prescient with COVID-19 cases peaking during the second week of January [10]
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