A state advisory calls on people to eliminate non-essential and for out-of-state visitors to quarantine for 14 days.
Fresno County health officer Dr. Rais Vohra says it is important for visitors to heed the call.
"Especially if we have elderly relatives, frail relatives, people with comorbid conditions. The last thing you want is to have a Thanksgiving holiday turn into a coronavirus cluster," he says.
Vohra says the best practice is to not gather with other households at all.
"Consider doing it over Zoom. Consider doing it remotely," said Vohra. "Consider just canceling Thanksgiving and just letting your relatives know - 'Let's hope for next year'."
He says if small gatherings do take place, hold them outside, have less than three households present, and limit it to two hours or less.
He says it's also a good idea to have family members get tested ahead of small gatherings.
Dr. Kenny Bahn from UCSF Fresno says to keep in mind that testing is not a substitute for wearing a mask or keeping a social distance.
"You can be asymptomatic and be spreading. Testing is not a sure thing," said Dr. Banh.
However, if you have a high-risk condition or are feeling ill, health officials say not to attend in-person celebrations at all.
Marriage and Family Therapist Joel Murphy says there can often be guilt associated with canceling annual family plans. He recommends thinking about it as an adjustment to traditions instead.
"We have all of those expectations that come along with the season and so really being able to release those expectations," says Murphy. "Call as much as possible. Zoom, video chat, whatever it is so we can till see them and still sort of be a part of something."
Fresno County is expected to take a step backwards to the more restrictive 'purple tier' when the state releases its COVID-19 update next Tuesday.
"We will be asking some of our indoor activities to cease," says Vohra.
Vohra anticipates restaurants and gyms will no longer be able to provide indoor service by next Friday because of the county's rising positivity rate per 100,000 people as well as its high health equity metric.
"It's a very fragile time. It's a time when all of us need to take the precautions very seriously," he says.
Fresno County hopes to add four new Optum Serve testing sites to increase the number of tests - which can be done.
Sites are being considered in Reedley, Selma, one on Butler Avenue in southeast Fresno, and possibly one in Mendota.
Doctors say increased testing is especially important in our most vulnerable communities.
When completed, the new centers would allow for up to as many as 600 COVID tests.