Like many Minnesotans, Kris Ehresmann has been pondering how to celebrate Thanksgiving this year during the coronavirus pandemic.

"This isn't theoretical. We're dealing with this in our families," said the infectious-disease director for the Minnesota Department of Health.

"My family is relatively small," she said last week. But if she hosts her two grown children and her father, that represents four households. On Nov. 10, Gov. Tim Walz announced new state restrictions to curb the spread of coronavirus, including no more than three households at social gatherings.

"We're weighing these hard decisions," Ehresmann said. "Our region is at really high risk."

Michael Osterholm, epidemiologist and director at the Center for Infectious Disease Research & Policy at the University of Minnesota, has made his hard decision. He won't be gathering with anyone but his partner this year.

"I want to see my kids and grandkids more than anything," he said. "But eating meals and talking is a perfect environment for coronavirus [transmission.] All it takes is one [infected] person to go into that setting and transmit it to a whole family unit. This is our COVID year. We have to do everything out of ultimate love of family. I know people who have infected [loved ones]. The guilt they're carrying around is incredible."

Cases of COVID have soared in recent weeks, and Osterholm expects that upward trend to continue as the holiday season approaches. "The timing is the worst," he said. "We will see an increase" as college students return home for the holidays and deer hunters return from sharing cabins.

The new statewide regulations announced by Walz include limiting social gatherings both indoors and outdoors to no more than 10 people. The state won't be policing private Thanksgiving gatherings, he said, but urged Minnesotans to use the restrictions as a guideline.

The Centers for Disease Control has recommended that Thanksgiving be celebrated outdoors this year. But that's a chilly order in Minnesota, where the temperature on Nov. 26 typically ranges between 25 and 33 degrees.

"That's not going to be the case in Minnesota. It's not practical," said Ehresmann of moving the holiday outdoors.

Instead, she advises Minnesotans to reduce the risk of virus transmission in other ways, with the caveat that there's no way to eliminate it entirely. "The safest thing is if everyone stays in their bedroom," Ehresmann said. "But that's not realistic for most people."

Smaller gatherings: Knowing that many Minnesotans are going to come together to celebrate the holiday, Ehresmann urged keeping gatherings small. "If your whole extended family gets together and it's a huge group, this is the year for not doing that," she said.

Even gatherings of no more than 10 people and three households carry risk; three households of two people each, or six people, is probably riskier than two households with up to 10 people. "It's the mixing not the number that's magic," said Ehresmann.

And if your family tradition involves being with one set of relatives at lunch and another at dinner, even if it's only three households total, you should reconsider this year, said Ehresmann. "More people could be exposed."

Alternative celebrating: Yes, we're all weary of Zoom meetings, but Osterholm encourages families to find creative ways of being together this year, such as virtual gatherings. Or someone could make Thanksgiving meals, deliver them to loved ones' porches and talk for a few minutes. "It's not at all what we want," he said. "It's not like last year, and we hope it's not next year. We're trying to buy time until vaccines come."

Before the holiday: If you are planning to gather with another household, talk to them in advance about COVID and how to reduce risk. "Have those conversations — talk it through," said Ehresmann. "Not everyone has the same perspective. Respect family members [who] have concerns."

Try to limit your exposure before the gathering. "In an ideal world, you and your family would agree, 'We're all going to quarantine for 14 days before Thanksgiving,' " she said. "With COVID, you are infectious two days before symptoms start. Or a person could be asymptomatic."

And if you experience any symptoms of illness do not go to Thanksgiving dinner. "One way we see a lot of spread is when someone has mild symptoms and thinks it's nothing but it turns out to be COVID — you've just exposed a lot of people."

Where to stay: If your gathering involves travel, you may be planning to stay overnight. If you usually stay in someone's home, it's best if you have your own bathroom and don't have to share one with others not in your household, said Ehresmann. "A hotel could have some advantage; our hotels are doing a good job of cleaning and letting a room sit" between guests.

Seating and serving: If you plan to host a small Thanksgiving gathering this year, instead of seating everyone at one table or having a kids' table and an adults' table, consider setting up a card table for each family group, said Ehresmann. Open windows for good air flow. Encourage everyone to bring their own food, so there's no sharing of utensils. And when not eating, everyone in attendance should wear masks and practice social distancing.

After Thanksgiving: Many families have other traditions surrounding Thanksgiving, such as Black Friday shopping and bargain-hunting together, said Ehresmann. This is the year to modify that tradition and not go to a crowded mall. Instead, order from retailers online for curbside pickup. If you want to support small businesses that don't offer online ordering, shop at a time that's less crowded, she suggested.

Weigh the risk: Gathering with loved ones, even a small group, involves risk, no matter how careful everyone tries to be. "The overarching principle, if you are in a high-risk category of severe consequences from COVID [such as being over age 65 or having underlying health conditions], you want to be very thoughtful about whether or not you're getting together," said Ehresmann.

"Anytime you swap air, there's a risk," said Osterholm. "There's so much virus in this community right now."