The Mapleton Lions Club sponsored a community Thanksgiving dinner that was open to all residents in 2020. Credit: Courtesy of Terry Sandusky

Maine is entering the holiday season amid an unprecedented surge in COVID-19 cases, a challenge for both the state and for families safely trying to reunite with loved ones.

About 1 out of every 100 Mainers have tested positive for COVID-19 since the start of November, according to state data. A record 298 Mainers were hospitalized with the virus on Tuesday, including 96 in intensive care.

The high infection rates across Maine and the U.S. come as Thanksgiving approaches, with increased travel and family gatherings providing potential avenues for further spread of the virus. At the same time, Mainers — more than 70 percent of whom are fully vaccinated — want the chance to see family and experience a normal holiday nearly two years into the pandemic.

With that in mind, here is some advice on how to minimize COVID-19 risk this holiday season.

Gatherings with vaccinated people are far safer.

Vaccinations remain the most effective tool in fighting the virus, with unvaccinated people more than four times more likely to test positive than vaccinated people over the past few weeks. When vaccinated people get the virus, they tend to get less sick and transmit the virus for less time, studies have found.

While specific circumstances, such as an immunocompromised person for whom COVID-19 vaccines are less effective, merit consideration, public health officials have generally endorsed family gatherings among fully vaccinated people with no masks needed.

If everyone is fully vaccinated, Maine Center for Disease Control and Prevention Director Nirav Shah said last week, “that gathering can occur in relative safety, almost as if it were pre-COVID times.”

Testing is the next best option if someone is unvaccinated.

For many families, limiting gatherings to only vaccinated people is not easy. Children under age 5 cannot be vaccinated, while children between the ages of 5 and 11 may have gotten first doses but still may not be protected. Roughly 17 percent of Maine adults are also not fully vaccinated, according to federal data.

If your holiday event will include unvaccinated people, testing for the virus is the best way to ensure a safe environment, said Dr. Robert Horsburgh, an epidemiology professor at Boston University.

“Having a negative test strongly reduces the risk,” he said. “I’ve been involved in some gatherings that people have had, and that’s what they’re all doing.”

Rapid antigen tests, which can be done at home before going to an event, can provide a quick answer as to whether someone could have the virus. A PCR test a few days before the holiday works similarly. If the test comes back negative, you can have some peace of mind that a person is not infectious.

Other measures, such as masking, physical distancing and use of outdoor spaces, are still useful tools for stopping the spread of the virus, but relying on them may be unrealistic this time of year.

“Thanksgiving is about eating,” Horsburgh said.

Vaccinated people can get tested too, especially those with symptoms.

Testing is a good idea for anyone experiencing symptoms linked to COVID-19. Breakthrough infections, or virus cases in individuals who are fully vaccinated, generally have milder symptoms than the disease in unvaccinated people. Some of those symptoms, such as a cough, headache or mild fever, mirror other common illnesses, such as the flu or a common cold. A test can quickly answer whether you need to isolate if you feel unwell.

It is always better to keep gatherings smaller.

A gathering with two or three households is safer than a gathering with four or five. While Horsburgh said there is no magic number, and vaccinated people are still at lower risk than unvaccinated people, having more people increases the chance that someone might have COVID-19.

“I love my family, but I’m not having Thanksgiving dinner with all of them,” Horsburgh said.

When traveling, get a good mask.

Face coverings remain required on public transportation, including buses, trains and airplanes. Even if you are fully vaccinated, you are unlikely to know whether a nearby passenger is. Investing in a high-quality mask can help reduce your likelihood of catching COVID-19, or any other respiratory virus, while traveling.

An optimal mask has multiple layers and fits close to your nose, with little space for air to leak in or out. KN95 masks are among the most effective masks that are widely commercially available, followed by surgical masks. Cloth masks are still helpful if other options are not available, but the quality varies. Try to use a cloth mask that contains at least two layers and fits tight to your face. You can also layer masks to achieve a similar effect.

Were you vaccinated this spring? Get a booster.

While getting vaccinated makes a person much less likely to catch the coronavirus or get severely ill from it, the protection provided by the vaccines wanes over time. Mainers who were eager to get vaccinated when the shots were first approved earlier this year may now be more vulnerable, as it has been more than six months since they received their course.

Booster shots help restore immunity levels, further reducing the likelihood of transmission. All Mainers aged 18 and older are eligible for a booster if it has been at least six months since they received the second dose of the Pfizer or Moderna courses, or at least two months since they got the single-shot Johnson & Johnson vaccine.

As with the original vaccine, it may take a few weeks for the protection from a booster to kick in. Getting one today won’t help for Thanksgiving, but it will provide more protection as the holiday season continues.