For the first time since 2019, Stephanie Taylor’s family is having a big Thanksgiving.

The holiday normally doubles as a reunion that includes a game of "Family Feud" and a memorial service led by her husband, a pastor, with music by her niece, a gospel singer. The gathering ballooned so much over the past few decades that they typically rent a banquet hall for 40 or more people.

Last year, they did Thanksgiving over Zoom.

COVID-19 cases were on the rise, there was no vaccine and many members of the family are in their 60s and 70s with underlying medical conditions. After much debate and planning, they’re gathering again this year.

“It was a tough decision,” said Taylor, an infectious disease specialist at LSU Health's New Orleans School of Medicine. “It’s an unusual time.”

Like Taylor, many Louisiana residents are eager to get back to the things they missed during the 2020 holiday season, when fears about the virus and its spread led many people to shun traditional gatherings, avoid travel and in some cases hold virtual holiday meals away from family.

A year ago, there were no vaccines, and infection cases were surging. During Thanksgiving week, Louisiana was averaging more than 2,000 new cases per day.

Things are different this year.

For most of the past week, new daily cases in the state have held below 400. Almost two thirds of residents older than 12 have gotten at least one dose of a coronavirus vaccine. Hospitalizations have fallen to an all-time low, mask mandates have relaxed, people are attending football games and other gatherings and many parts of daily life are settling into a new normal.

David Pekoske, head of the U.S. Transportation Security Administration, said his agency was expecting passenger travel to return to pre-pandemic levels during what's historically the country's busiest travel period. Louis Armstrong International Airport officials said Thanksgiving week travel was likely to be lower than 2019 but well above last year's levels.

But there are still risks. Infection cases are rising in the Midwest and other parts of the country, and breakthrough cases among vaccinated people can occur. Moreover, many families have members who haven't yet gotten the shot.

Public health experts agree that a gathering with precautions is safer than it was in 2020, but most people are still navigating the holidays with COVID in mind.

“We’re in a new phase of this pandemic where the recommendations really depend on whether or not you’re vaccinated and whether or not you’re spending time with someone who can’t be vaccinated,” said Dr. Britni Hebert, a Lafayette internist who’s been recognized for her work fighting disinformation during the pandemic.

Those who are fully vaccinated can gather inside without masks as long as they’re in intimate settings and not public settings, Hebert said. Masking and outdoor settings are still encouraged for those who aren’t vaccinated or can’t be vaccinated.

Hebert is planning to gather with about 12 relatives who are fully vaccinated, to ensure her 3-year-old with a heart condition is protected; he cannot be vaccinated. The gathering will be in an open-air setting, she said.

“It’s all about lowering risk and then rolling that dice,” Hebert said. “The only way to eliminate the risk is to not see anyone.”

The current risk of coronavirus transmission is low in Lafayette. Even with fewer cases and higher vaccination rates, Hebert said it’s important to take precautions.

“I think lots of people end up doing the best they can and try to plan and find themselves in a situation with more risk than anticipated,” Hebert said. “That’s human and normal.

"It’s about the risk to self and risk to others. Vaccinate and have a mask on hand. Just be mindful of keeping the risk to yourself and don’t do additional gatherings afterward unmasked with unvaccinated people. Maybe wear your mask in the week or two after Thanksgiving so we get to keep this feeling of joy and this relaxed feeling for as long as we can.”

For Taylor, the LSU Health doctor in New Orleans, the task of planning a safe Thanksgiving gathering fell to her. She is, after all, the family physician.

The banquet hall they've used in the past, a well-ventilated, large space where they could spread out, was damaged in Hurricane Ida. So Taylor’s family is removing half the seats inside the grandparents’ home in Leakesville, Miss., and erecting a tent outdoors to minimize the risk of infection. They’ve designated two people to serve the food and will wear masks when they’re not eating. Vaccination is required.

“Everyone is vaccinated who will be coming,” Taylor said. “I just don’t want the responsibility of someone getting sick and I gave the final stamp of approval.”

At Baton Rouge General, visitation is back to pre-COVID levels this Thanksgiving, and Our Lady of the Lake is once again allowing multiple visitors during normal visiting hours.

However, unlike before the pandemic, anyone looking to visit with multiple patients at Our Lady of the Lake will need to use iPads provided by the hospital to speak with loved ones virtually. 

“We know how important and impactful the support of loved ones can be for a patient’s care,” Vaccaro said. “We want our patients to be able to see their family members when in our hospital and especially on holidays.” 

Both Baton Rouge hospitals will require all visitors to wear a mask for the duration of their stay. 

“By taking precautions, we’re ensuring this can happen while keeping our patients and their guests safe,” Vaccaro said.

Public health experts said vaccination is the foundation of their safe holiday gatherings.

“If you choose not to get vaccinated, that’s your choice, sure,” said Susan Hassig, an epidemiologist at Tulane University. “It means I get to choose not to invite you to Thanksgiving.”

Hassig will be spending Thanksgiving at a small family gathering and then with a group of friends, all of whom confirmed they are fully vaccinated.

Asking those questions before the big event is key to ensuring everyone is comfortable with other people's choices.

“You need to plan for it," Hassig said. "Not just in making your airline reservations but in ensuring that it's going to be the most positive - not in a COVID sense - experience.”

Risk tolerance is personal and can change as the danger of infection increases in the community. Dr. Joe Kanter, the Louisiana state health officer, has done that mental math for his family, considering that there is not currently a strain on hospitals.

“We feel comfortable taking on a little bit more risk than earlier in the pandemic,” said Kanter, whose extended family is fully vaccinated, but includes two young children who are not eligible for the shot. “We are going out to the occasional restaurant now; we have flown a couple of times. I think we’ll continue to do that through the holidays, and we’ll take precautions, mask and distance as best we can.”

But other states are in dire situations as the delta variant surges elsewhere, and that does change the calculus for people who are hosting out-of-town visitors.

That’s kept Julio Figueroa’s risk tolerance a little lower than normal this year. He’s celebrating with just his immediate family: his wife, adult children and their partners.

“We’re not having the 25- or 30-person block party type of thing,” said Figueroa, an infectious disease specialist at LSU Health New Orleans School of Medicine. “I’m not ready for that yet, but I know other people are. Given our situation at the moment, it’s probably OK because transmission seems to be low.”

With guests who fly in from more infected areas, Figueroa would likely request testing as another precaution, ideally before his visitors get on the plane.

Although everyone will be driving into Kimberly Hood’s extended family gathering, she’s got a stack of rapid tests on hand just in case. Hood, the assistant secretary for the state’s Office of Public Health, will be having Thanksgiving with 16 people outdoors, even though she’s seeing a small chance of rain.

“We’re thankful for the ability to gather,” Hood said. “Even gathering outside, if we get a little bit wet and have to keep our distance, is better” than a Thanksgiving without family, like in 2020, she said.

Staff writer Elyse Carmosino and The Associated Press contributed to this report.

Emily Emily Woodruff at