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COVID-19 cases are rising sharply in Mass. ahead of the holidays. How worried should you be?

A coronavirus vaccination being prepared. Vaccines are seen as crucial protection as Mass. heads into an uncertain winter.Craig F. Walker/Globe Staff

With COVID-19 cases spiking in Massachusetts as Thanksgiving and other holidays approach, experts are urging people to stay vigilant and take steps to protect themselves and others, including measures such as rapid testing, masking, and limiting who can attend gatherings.

“I think we have to be very cautious. We have to be very mindful. We can’t go into the holidays pretending that COVID is behind us. Unfortunately, it’s still very much with us,” said Dr. Philip Landrigan, director of the Global Public Health Program at Boston College.

“We should be aware and cautious,” said Dr. Shira Doron, an infectious disease physician who is the hospital epidemiologist at Tufts Medical Center. “You should know there is more risk out there. You should know you need to be stepping up your game in terms of taking the precautions that are important to you.”

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The Department of Public Health on Thursday reported 3,196 new coronavirus cases, the highest single-day count in Massachusetts in nine months. Public schools also saw a sharp increase, with 3,257 new cases among students and 558 among staff members for the week that ended Wednesday, a record high for a single week.

“There’s no question that there’s a steep upward trajectory,” Doron said of the new state case data. “Obviously, that’s quite disappointing.”

Doron noted, however, that there’s “absolutely no comparison” with the situation last year at this time when the state was entering a deadly second surge of COVID-19 cases. Hospitalizations and deaths in Massachusetts, where 70.6 percent of the population is fully vaccinated, are not going up to the same extent, though she said those numbers can lag behind cases. “Don’t pat yourself on the back just yet,” she warned.

Boosters, which are now available to all Massachusetts adults, will help improve people’s waning immunity in the coming months, she said. “If you’re double vaccinated, you’re well protected. If you’ve availed yourself of the booster, you’re even better protected,” she said.

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People who are vulnerable because of underlying medical conditions should worry more than others, she said. “If you have those risk factors, you should get a booster,” she said. “Now you’re at higher risk.”

As for the coming holiday gatherings, she said a group of fully-vaccinated adults with no one who is immunocompromised could celebrate a “normal Thanksgiving.”

But people need to be aware of the higher risks if the group includes immunocompromised adults or unvaccinated adults, she said.

“That changes the equation,” she said, adding that people could consider various layers of protection, including masking while not eating, distancing while eating, opening windows, holding the gathering outside, and using rapid, at-home screening testing for guests.

Dr. Sabrina Assoumou, an infectious disease physician at Boston Medical Center and an assistant professor at the Boston University School of Medicine, said people should consider taking precautions if there are any unvaccinated people at their holiday gatherings, including children who haven’t gotten vaccinated yet.

“It’s not as if they’re at no risk of getting COVID or transmitting COVID. They can absolutely do that,” she said of children.

She said people should consider “all the different tools in the tool box” for COVID-19 prevention, asking themselves questions like, “Did you get vaccinated? Did you do a rapid test? Is there any way we can improve the ventilation where we are?”

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“There are a lot of ways we can make things safer,” she said.

Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital, suggested that people consider limiting gatherings to vaccinated people and do rapid, at-home tests before gatherings.

“People who are immunocompromised may wish to defer large family get-togethers this year. Low-tech efforts such as opening windows to allow fresh air to circulate also help,” he said in an e-mail.

Landrigan said his advice to people was “plan your holiday events carefully.”

While it’s important to get back to the normalcy of having the events, he said, people should be careful of who’s invited, and consider measures such as masking and testing.

Landrigan, a pediatrician, also said unvaccinated children are a cause of concern. “We have to be mindful of the fact that the little guys are a risk factor. I would think very carefully if I were putting together a family party and had some frail elderlies at the table … and little kids running around who are not yet vaccinated. That’s a prescription for infecting the old folks.”

The current situation is a far cry from a year ago when there were no vaccines available and Governor Charlie Baker imposed far-reaching restrictions as a deadly second surge took hold.

“Compared to last year, the world is a different place,” said Assoumou.

Assoumou said she was hoping that, as winter arrives, COVID-19 deaths in Massachusetts, a national leader in vaccinations, will continue to remain relatively low, even as cases rise higher, in an “uncoupling” that has happened in the United Kingdom.

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“Cases are going to go up ... and then we’re going to peak and it’s going to start coming down,” she said. “Hopefully, during that period, we’re still going to have that uncoupling of deaths with cases. I think in Massachusetts we’re in a really good position to see that.”

“We’re making progress, but we still have work to do in terms of getting the unvaccinated vaccinated, and getting to a better place, where we don’t need to use all these mitigation measures,” she said. “We need to keep encouraging people, ‘Yes, keep going, Massachusetts!’”

Asked about the case increases, the Baker administration emphasized the successes of the state’s vaccination program.

“Massachusetts leads the nation in getting residents vaccinated with 95% of all adults with one dose, and has one of the lowest COVID hospitalization rates in the country. This week, the Administration opened up eligibility for booster shots to all residents 18 and older and encourages everyone who is eligible to get this extra layer of protection from the virus,” a Department of Health and Human Services spokeswoman said in a statement.

Ryan Huddle of the Globe staff contributed to this report.




Martin Finucane can be reached at martin.finucane@globe.com.