For many of us, our biggest holiday concerns used to be long lines at the airport, backups on the interstate, defrosting the turkey in time, or averting family arguments. But, today, the risk of COVID-19 is overshadowing nearly everything else.

With U.S. cases of COVID-19 closing in on 11 million people and 250,000 deaths, many Americans are asking themselves the same thing: Is it safe to travel over the holidays? And if you do get together, what precautions should you take?

No one wants their holiday gatherings to turn into superspreader events. Read on for medical experts’ advice on how to host or attend holiday gatherings this year.

Should you gather in person?

In a recent interview with WebMD, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, noted that the risk of gathering depends on the level of infection in different communities. In areas where the infection rate and test positivity are very low, says Fauci, “if you do things with a good to modest degree of care, you may be able to congregate indoors for Thanksgiving or for a religious holiday.” However, in areas where the level of infection is higher, Fauci says you’ll need to take extra precautions.

According to the U.S. Centers for Disease Control and Prevention, gatherings with people who are traveling from different places pose a higher risk than gatherings with people who live in the same area. This is especially true if either community (the gathering location or the starting location) has higher COVID-19 infection rates.

To check the infection rates across the U.S., see the CDC’s color-zone map of infection rates and click on “Cases in the Last 7 Days” to get a current picture.

One other thing to consider: will there be any attendees who are more vulnerable to COVID, such as elderly relatives or people with underlying conditions? It’s best to have them attend virtually. Or, to minimize the risk of infection for all your loved ones, make the entire gathering a virtual event.

What are the risks?

Even if you’re not traveling far for the holidays, getting together in a group setting presents risks—especially if you’re gathering indoors, where the risk of transmission is highest. In addition, indoor gatherings with poor ventilation pose more risk than those with good ventilation, such as those where you can open windows or doors.

Eating adds another layer of risk, because it requires taking off your mask. Through coughing, sneezing, throat clearing, or even talking, an infected person can expel the pathogen into the air to be breathed by others at the table.

And, while getting tested for COVID-19 in advance is a good idea, it’s not foolproof. People can become infected between the day they test and the day their results arrive. People in the early stages of infection can test negative at first but still be infectious later, even if they never show symptoms. You could also get infected while traveling and potentially infect other people at your destination.

One other thing to consider: will there be any attendees who are more vulnerable to COVID, such as elderly relatives or people with underlying conditions? It’s best to have them attend virtually. Or, to minimize the risk of infection for all your loved ones, make the entire gathering a virtual event.

How to travel safely

The CDC says that travel increases the chances of contracting and spreading COVID-19. “It would be taking a calculated risk,” says Vin Gupta, MD, a pulmonary critical care doctor and assistant professor of health metrics sciences at the University of Washington. “So if I, for instance, couldn’t ensure that I wasn’t harming my family, and if I knew I couldn’t take the strictest precautions, then I wouldn’t go.”

But if you do need to travel, how can you do it safely? Gupta and other experts offer the following tips:

  • For at least 3 days before you travel, minimize public activities. If you do go out, mask up and practice social distancing.
  • Make sure you have no COVID-like symptoms for at least 2 weeks before traveling.
  • Pack hand sanitizer with at least 60% alcohol and keep it within reach.
  • Drive, if you can, to limit interactions with other people. Mask up when you’re outside the vehicle and make as few stops as possible.
  • Stay at least 6 feet from anyone who is not from your household.
  • Use disinfecting wipes on handles and buttons at the gas pumps before you touch them.
  • Pack your own food and water, or opt for takeout or drive-through food instead of sitting in a restaurant.
  • If you travel by plane or bus: travel during off-peak hours, wear a well-fitting mask, and use disinfecting wipes on the back of your seat and tray table.
  • When you get to your destination, wash your hands with soap and water for at least 20 seconds.

How to make gatherings safer

While the CDC doesn’t recommend a particular limit on the number of attendees for holiday gatherings, it says you should determine the size of your gathering based on three things: your ability to reduce or limit contact between attendees, the risk of infection, and state or local health and safety rules and regulations.

Gupta has more specific advice: “Indoor gatherings of individuals that you don’t shelter in place with, that you’re not sort of huddling with already, you should limit those to just five or less.” In other words, think small.

In addition, health experts offer the following recommendations:

  • Keep servings as separate as possible, to minimize the number of people touching the same food.
  • Because COVID-19 can be spread through saliva secretions, avoid eating directly from shared pots or sharing drinks.
  • Wear a mask, indoors and out, if you can’t maintain physical distance from others—especially around elderly guests.
  • Wash your hands frequently.
  • Wipe down common areas like bathrooms before and after you use them.
  • Wash your own dishes to decrease the chance of cross-contamination.

To sum it up, Gupta offers this rule of thumb: “The way you would operate in public, operate in private when you’re visiting family members that you don’t normally see, day in and day out, who might be vulnerable.”

Make the right decision for you

In the end, there are no easy answers. Every family and every community face different risks, needs, and concerns, and one solution may not fit every situation. Simply put, don’t take the safety of your loved ones for granted.

As you consider whether or not to gather for the holidays, Gupta offers some sobering advice: “You don’t want a short-sighted, short-term decision to impact or cut short the life of someone you deeply love and who you want to spend many more holidays with.”