Get ready for the most difficult months yet in this pandemic.
The fall Covid-19 surge is here, fueled by colder weather, reopened schools and pandemic fatigue. The flu season could make the coronavirus pandemic even worse.
For the next several months, new Covid-19 infections, hospitalizations and deaths are expected to keep rising as the temperatures keep dropping.
But that doesn't mean your fall and winter have to be miserable. Here's how you can stay healthy, sane, and actually enjoy these cold-weather months:
Find your social distancing crew and stick with it
You're probably sick of hearing about face masks, social distancing, and hand washing. But those are your strongest weapons against coronavirus.
Yet many Americans are ditching those precautions and letting their guard down with friends and family members who don't live with them.
Casual at-home get-togethers are fueling recent Covid-19 spikes, said Dr. Robert Redfield, director of the Centers for Disease Control and Prevention.
So Dr. Peter Hotez suggests limiting your physical contact this fall and winter to a small, select group of friends or family -- and avoiding close contact with anyone outside that group.
"Think about who you want to do your social distancing with as you head into later in November, in December, in January, and get ready to hunker down," said Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.
Have a plan to take care of your mental health
"This terrible period is not going to go on forever. I do think we're going to be in a much better place by the middle of next year because vaccines will be available," Hotez said.
But "be realistic and recognize that this winter -- this November, December, January, February -- could be the worst time in our epidemic, and plan accordingly and be smart about it. And take steps to protect your mental health," Hotez said.
"Make certain that you know a mental health counselor, how to reach them if you need them. Know how to call on family members. It's OK to feel scared and to be upset and to get depressed. That's a normal reaction to this. But get ready for it."
Know your risk of infection
The calculator, created by the Brown-Lifespan Center for Digital Health, also gives suggestions on how to decrease your risk, said Dr. Megan Ranney, the center's director and an emergency medicine physician.
Socializing outside is safer, but not always safe
Colder weather means people tend to socialize indoors, where there's less opportunity for viral particles to disperse. And that increases the risk of coronavirus spread.
So if you do have gatherings, keep them outside if you can -- perhaps with a fire pit, a warm coat or a heat lamp, said Dr. Leana Wen, an emergency room physician and visiting professor at George Washington University.
But just because you're outside doesn't mean you can abandon all safety precautions.
"Outdoors is not perfect. If you're still sitting a foot away from other people, without a mask, you can still spread it -- especially if you're in that very infectious period," Ranney said.
One reason why coronavirus is so contagious is because people who get sick from it typically are most contagious before they start showing symptoms. This means people can easily spread the virus without knowing it.
"Just because someone is close family does not mean they're safe, either," Ranney said. "Unfortunately, if that close family member has been out having a lot of contacts, they still could be sick and bring it home."
If you visit friends or family, do it wisely
"We know by now that much of Covid-19's spread is actually driven not by formal settings with strangers but by informal gatherings of family and friends," Wen said. "Some individuals may be letting down their guard with loved ones."
If you must travel for the holidays, cut out risky behavior before your trip, such as dining at restaurants indoors or getting in close contact with people who don't live with you.
It's also a good idea to get tested before seeing loved ones, so those who test positive can stay home. But don't get a false sense of security just because you have a negative test result.
"Sometimes there are false negatives, which means you have the disease but the test doesn't detect it," according to Penn Medicine.
"Because it is possible to get a negative result even when you have coronavirus, it is important to be careful even when you receive a negative result."
And even if a negative test result is correct, you may have been infected since that test was taken.
Celebrate the holidays safely
Instead of Halloween parties or trick-or-treating, the CDC suggests carving pumpkins with your family or with friends and neighbors (at a safe distance).
You can also have virtual costume contests or a Halloween scavenger hunt, "where children are given lists of Halloween-themed things to look for while they walk outdoors from house to house admiring Halloween decorations at a distance," the CDC said.
For Thanksgiving, you can celebrate by having a virtual dinner with friends or family from afar and sharing your favorite Thanksgiving recipe, the CDC said.
"Thanksgiving is a really tough one," Ranney admits. "I am going to be doing a Zoom Thanksgiving with my parents."
You can also help those at high risk for Covid-19 or those who are feeling isolated by preparing traditional Thanksgiving dishes "and delivering them in a way that doesn't involve contact with others," the CDC says.
Keep things in perspective
Yes, this fall and winter will be tough. But Covid-19 has killed more than 216,000 people in the US, and many survivors still have complications months after infection.
So remember the long-term benefits of making short-term changes.
"I think for the short term, we have to hunker down," said Dr. Jonathan Reiner, a professor of medicine at George Washington University.
"The consequences of this virus -- particularly for older folks, the people that we really want to gather with on Thanksgiving -- can be really dire. And frankly, I'd rather do a Zoom Thanksgiving with people that I love than expose them to something that might kill them."
Personal responsibility and small sacrifices now will pay off later.
"Next year's going to be much better," Reiner said. "Let's get through this, and let's get through it safely."