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How Risky Are Holiday Gatherings? Here's What Health Experts Say About COVID-19

The risk level is the estimated chance (0-100%) that at least 1 COVID-19 positive individual will be present at an event in a county, given an event with 10 people.
The COVID-19 Event Risk Assessment Planning Tool is a collaborative project led by Prof. Joshua Weitz and Prof. Clio Andris at the Georgia Institute of Technology, along with researchers at the Applied Bioinformatics Laboratory and Stanford University.
The risk level is the estimated chance (0-100%) that at least 1 COVID-19 positive individual will be present at an event in a county, given an event with 10 people.

As COVID-19 cases surge statewide and the holidays are approaching, many Montanans may be asking themselves how risky it is to gather with friends and family. MTPR’s Aaron Bolton is here to talk about what academics, infection modeling, and public health officials are saying about that risk.

Corin Cates-Carney: So we’ve been hearing a lot in recent days and weeks about the pandemic in Montana getting worse - cases numbers are rising fast, hospitals and health care workers are stressed out. Thanksgiving is just a week away, can you take the temperature for us of the pandemic in the state.

Aaron Bolton: Yea. I spoke with Erin Landguth who is an associate professor at the University of Montana’s Center for Population Health Research. She says that, as public health officials all over the country and in Montana feared, we’re heading into the winter with rising COVID-19 cases.

Here’s what she had to say about what her model suggests could happen in Montana.

"What we’re seeing now is new infections will peak around mid to end of December. Then hospitalizations always lag infections. So hospitalization numbers will peak at some time at the end of the year to mid-January."

She says modeling suggests the state’s total death count could reach 1,500 by the end of January.

Cates-Carney: 1,500, that’s nearly three times the number of people that have died due to COVID-19 so far in Montana. What’s the use of having these kinds of projections?

Bolton: She says modeling plays a role in terms of estimating how bad things could get so hospitals and local and state health officials can plan ahead. 

Cates-Carney: Got it, so it helps with some of these big picture public health or hospital planning. Most of us don’t do that kind of work. Is there some value to these projections, modeling, to people going about their lives, trying to figure out out what to do, who to see, or not see, during the pandemic?

Bolton: Projections don’t really help the average person make daily decisions about how risky it is to, say, get coffee with friends or have someone over for dinner, but academics have been increasingly focused on helping people understand the real-time likelihood of coming in contact with someone who has COVID-19. 

Georgia Tech has created one of these risk maps, which is based on a rolling average of cases at the county level and group sizes. Stephen Beckett is one of the researchers that helped build the map and he says people need a practical tool to help them make good decisions about when gatherings are just becoming too risky.

“We like to think of it as a weather map in some senses. If there was a high chance it would rain, you would bring your umbrella. If there’s a high chance someone might bring COVID to your event, you might rethink attending.”

Cates-Carney: This is a time of the year when people are thinking about gathering with friends and family for the holidays. Say someone is thinking of going to a Thanksgiving dinner in Missoula, 10 people are going to be there. What does this Georgia Tech model say about the risks?

Bolton: That model says there’d be a 28 percent chance one of those 10 people being COVID-19 positive. If, say, a few more people decided to tag along and the group turned out to be 15 people. Risk of someone there being positive is 39 percent. The larger the gathering the greater the risk. 

Location matters too. In Yellowstone County, which is seeing more cases. A gathering of 10 people there would carry a 36 percent chance of one of those 10 people being positive for COVID. 

Cates-Carney: Should people just not gather at all?

Bolton: The safest thing to do is to only gather with your immediate household. But public health officials know not everyone is going to follow that recommendation.

A recent Ohio State University survey found that the vast majority of Americans plan to put precautions in place at in-person Thanksgiving gatherings such as mask wearing and social distancing. But the survey also found that two in five plan to attend a gathering with more than 10 people and a third of those gatherings won’t have precautions in place such as masking.

University of Montana health economist Bryce Ward says it’s also good to think about who you’re gathering with and what precautions they may be taking in their day-to-day lives. He says these models assess the risk based on the assumption that the virus is randomly distributed in the community, but the decisions we make as people can increase or decrease the risk of getting infected. 

“If you can imagine a video game, right? If you could crack it open and look it into it, we’d all basically be saying, ‘Oh, here’s somebody who their family has been very locked down the whole time.’ If you brought that family over to your house, it’s very unlikely that they’re bringing COVID with them, versus another family, they’re going to work, the kids are going to in-person school, they’re going to social events, they’re going to restaurants. Their risk score is much higher.”

Cates-Carney: You said earlier these models, even when they offer an actual percentage for risk in group gatherings, they can’t be applied to every person; we all live different lives. How are public health officials looking at these tools and what do they have to say about risk heading into the holiday season?

Bolton: Public health officials have been screaming from the rooftops for months telling people not to gather, but they do say understanding the risk of gathering in-person is important and these models are one part of mitigating risk. 

Cindy Farr is the incident commander for the Missoula City-County Health Department explaining that harm reduction is a big part of her department’s messaging ahead of the holidays.

“It’s the same as preaching abstinence. We know preaching abstinence in sex education over the years doesn’t work. We know just because we’re telling you the safest thing for you to do is not come in contact with anyone else, we know that people cannot sustain that for long-term. It is important to think about harm reduction techniques.”

Bolton: Bottom line, health experts say if you’re feeling sick at all, don’t gather with others. You can avoid in-person gatherings and video call people from the dinner table, but if you gather, health experts say guests should wear masks and social distance as much as possible. Gather outside if weather allows. You can also try to increase ventilation inside your home by cracking some windows. One of the most helpful tools is to have that conversation with your guests or host about their day-to-day decisions to make sure they haven’t been engaging in risky behavior.

Health officials also say try to only gather with one other household.

Cates-Carney: Aaron, thanks for sharing your reporting. 

Aaron graduated from the University of Minnesota School of Journalism in 2015 after interning at Minnesota Public Radio. He landed his first reporting gig in Wrangell, Alaska where he enjoyed the remote Alaskan lifestyle and eventually moved back to the road system as the KBBI News Director in Homer, Alaska. He joined the MTPR team in 2019. Aaron now reports on all things in northwest Montana and statewide health care.
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