A big part of the challenge is that Covid-19 spreads before people start showing symptoms. So anybody can show up feeling the picture of health only to unwittingly spread the virus to those they come into close contact with - Katherine Harmon Courage
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Determining what’s safe—and what isn’t—in the era of the Delta variant is forcing all of us to become our own personal risk managers.
Little about making decisions now is straightforward. Covid-19 public safety requirements, mask rules and vaccination mandates differ from place to place. Science indicates vaccines provide strong protection against hospitalization and death, but the Delta variant raises the risk of breakthrough infection, although it isn’t clear how much. Unlike earlier in the pandemic, businesses are open, activities have resumed and many social gatherings are back on—which means we have a lot more choices to make.
“If you feel confused, you’re in very good company,” says Donald K. Milton, professor of environmental and occupational health at the University of Maryland School of Public Health.
Some things are still clear, doctors and scientists say. People who are vaccinated are far less likely to get seriously sick and die from Covid. Outdoor activities are safer than indoor ones. Wearing a well-fitted mask protects you and others around you. Monitoring local infection and vaccination rates will help you assess risk in a community.
But it can be baffling when your neighbors and friends take the same information and make wildly different choices. Scientists are finding that individual differences in risk tolerance explain at least part of that phenomenon.
Here’s how doctors and scientists recommend evaluating common scenarios, and how to mitigate risk in each.
Working in the office
If you’re certain your colleagues are vaccinated and the office is well ventilated, the risk of infection at work is relatively low, says Linsey Marr, professor of civil and environmental engineering at Virginia Tech who studies airborne transmission of viruses.
If you work in a cubicle in an open-plan office, Dr. Milton suggests getting your own air purifier with a HEPA filter and wearing “the most comfortable, tightfitting good-quality mask” you can find. Cubicle partitions impede ventilation, Dr. Milton says. And since most workplaces recirculate air, Dr. Milton says even people with individual offices should wear masks because they are probably still sharing air with others.
Ask your employer if they are setting the ventilation system’s dampers all the way open to allow as much fresh air inside as possible. Look for between three and six air changes per hour, he says, referring to the number of times the air in a room is replaced by fresh air.
Attending a dinner party
For vaccinated people, “I think it’s fine” to go maskless at gatherings with family and friends who are also vaccinated, says Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital in Boston.
He recently attended a wedding—part indoors and part outdoors—that required all guests to be vaccinated if they were eligible. Because of that requirement—and the fact that the wedding was in the Northeast, where vaccination rates are higher and infection rates are lower than many other areas of the country—he felt comfortable having his 2-year-old granddaughter there, even though she’s too young to be vaccinated. “It is a risk-benefit calculation,” Dr. Kuritzkes said. However, he said he’d be more cautious if he lived with someone who was immunocompromised and potentially at risk of serious illness from a breakthrough infection.
Gregory Poland, director of the Mayo Clinic’s Vaccine Research Group in Rochester, Minn., says it is best to keep groups small when going maskless indoors, even if all are vaccinated. Dr. Poland limits the circle of people he sees indoors without masks to those who take similar precautions to him and his wife.
(They go to public indoor spaces only when they need to and then always wear masks.)
Dr. Poland recently skipped a visit to the house of one couple who eat indoors at restaurants and attend church maskless. “Their risks become my risks and those risks are unnecessary,” he said. Dr. Marr said she wouldn’t eat indoors with a vaccinated friend who she knew spent time unmasked with unvaccinated adults.
Dining indoors at a restaurant
The risk of dining indoors isn’t worth it right now, some doctors say. “Why do it?” says David Alain Wohl, a professor of medicine in the division of infectious diseases at the University of North Carolina at Chapel Hill. “Right now I feel like the risk of acquiring Covid-19 may be the highest we’ve ever seen in this pandemic,” says Dr. Wohl, who now doesn’t go anywhere indoors without a mask unless he’s in a space with only his wife and two children.
After San Francisco began requiring proof of vaccination for indoor dining, Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco, began dining inside again. She believes that the risk of becoming infected from a vaccinated person who has no symptoms is low.
Going to a concert or sporting event
For concerts and sporting events, local vaccination and infection rates are less helpful because these kinds of activities “draw people from all over,” says Dr. Marr. “I would definitely wear a mask in those situations because you’re in a crowded indoor environment for a long period of time,” she says. Also, people yell and cheer. “We know you can release more virus with loud talking,” Dr. Marr says. Even if vaccines were required for attendance, Dr. Marr says she would still wear a mask at a crowded event because she lives with an unvaccinated child.
With Delta, Dr. Marr recommends masking at crowded outdoor events, like baseball games, football games or street fairs, too. “I have seen anecdotes of outdoor transmission occurring more now with Delta,” she says.
Dr. Marr reminds people that this confusing—and scary—time will end, likely when the current Delta surge passes and more people, including children, are vaccinated. “I’m hopeful things will be better in a couple of months,” she says.
Source: Andrea Petersen, Dine In? Go Out? Learn to Be a Better Covid-19 Risk Manager, The Wall Street Journal, September 5, 2021.