An analysis of nearly 800 nursing homes in six states experiencing the biggest surges, including North Dakota, South Dakota and Wisconsin, found that these homes are still hot spots of viral transmission and that little has been done since the spring to reduce that risk.
It is nearly impossible to compare the relative contribution of social gatherings to the number of cases in different states, or even to find a consistent definition of what constitutes a gathering.
Rhode Island, which limited private gatherings to 10 people, helpfully defined the term, including family get-togethers, birthday parties, baby showers and sleepovers. But some states also add larger events, such as weddings and funerals, into the category.
These gatherings, especially if held indoors, certainly can drive infections. In rural Maine, a wedding with 55 guests ultimately resulted in 177 cases, while a wedding in Washington State led to at least 17. Outbreaks in communities with tight-knit social networks, such as the Amish and the Hasidic Jewish population, were also powered by large social events.
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But the same cannot be said of smaller private gatherings with friends and family. In Colorado, only 81 active cases are attributed to social gatherings, compared with more than 4,000 from correctional centers and jails, 3,300 from colleges and universities, nearly 2,400 from assisted living facilities, and 450 from restaurants, bars, casinos and bowling alleys.
In Louisiana, social events account for just 1.7 percent of the 3,300 cases for which the state has clear exposure information.
“It’s important to give good public health advice about what’s coming in the holidays, no doubt about it,” said Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins Bloomberg School of Public Health. “But it is not good to suggest that they are now the preponderance of the source of spread.”