This Is Us Season 5 Episode 1 revolves around the Big Three's birthdays.

In the present, the Big Three are dealing with COVID-19 related quarantines as well as the rift between Randall and Kevin during their 40th birthday.

Everyone but Randall heads to the cabin, where Madison falls over a suitcase and worries about the babies' health. She and Kevin go to get checked out without telling anyone. Meanwhile, Deja invites Malik over to celebrate their anniversary on Randall's birthday, while Tess is upset not to be going to the cabin.

The Randall situation is complicated by the racial tensions after George Floyd's death. Randall is able to talk about it with Malik but not with his family, and eventually confronts Kate about her reactions to it.

Meanwhile, in the distant past William discovers that Laurel has OD'd soon after Randall's birth and runs away with the baby when the lead EMT suggests calling the cops and social services. William recalls his relationship with Laurel after leaving Randall at the fire station.

And Jack panics while Rebecca gives birth, while in the present Rebecca's cognitive impairment leads to a crisis.

To find out what happens, watch This Is Us Season 5 Episode 1 online.