After a lull, COVID-19 is on the rise again in Massachusetts, with new — and sometimes conflicting —warnings and guidance emerging each day from state and national authorities. So how should we react? Should we start wearing masks? Should we stop dining indoors? We asked several infectious disease experts if they are changing their behavior while traveling, dining, gathering, shopping, and schooling. All the experts are vaccinated.
Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital, said he is “reasonably comfortable” traveling by plane and train because masks are required on board. Last weekend, he flew to Madison, Wis., to visit his daughter, and “everything went very smoothly,” he said.
Kuritzkes said travelers should be mindful of case rates where they’re heading, and the vaccination status of who they’re planning to see. In his case, he felt comfortable because Wisconsin is not a high incidence state, and because his daughter and son-in-law are both vaccinated.
“I’d be more concerned traveling to Arkansas and Missouri and Florida than I would be around New England,” Kuritzkes said.
Dr. David Hamer, an infectious diseases specialist at Boston Medical Center and professor at Boston University, said he has been on a few trips since the start of the pandemic, and has likewise been careful to choose low-risk destinations. Hamer also said he prefers short flights, since passengers on long flights are more prone to remove their masks to eat and drink.
“Long haul international flights, I still would feel less comfortable taking,” he said.
Dr. Sabrina Assoumou, an infectious diseases specialist at Boston Medical Center and a professor at Boston University, said she has thus far limited travel to locations that are reachable by car.
“If I were to need to fly on a plane for essential travel, I would wear a two-layered well-fitted mask and try to avoid crowds at gates or other busy locations at airports,” she said.
Experts concurred that there’s little cause for concern if dining outdoors. Indoors, though, they all take different approaches.
“Crowded indoor dining in a region that has high prevalence of COVID, I would be concerned about, because that’s the setting where transmission could occur,” Kuritzkes said. “You can’t eat with a mask on.”
In Boston, though, he’s comfortable dining inside establishments that allow customers to be “reasonably spaced out.”
Dr. Sarah Fortune, the chair of the Department of Immunology and Infectious Diseases at the Harvard School of Public Health, said she, too, is comfortable eating inside in Cambridge, but plans to eat outdoors on an upcoming trip to New Orleans.
Hamer said his perspective on dining has shifted amid the recent uptick in cases.
“I was feeling a little more comfortable about dining indoors at restaurants until the last couple of weeks, with case count steadily rising in Massachusetts,” he said. “Now, I don’t feel very comfortable going to restaurants if I’m eating indoors.”
Assoumou said she has not dined inside of a restaurant since the start of the pandemic, often opting for takeout instead.
Experts agreed that small gatherings with vaccinated family and friends are relatively low risk, both indoors and outdoors.
Fortune said she is hosting an outdoor party this weekend with about 20 guests, “all of whom happen to be fully vaccinated.”
Gatherings become riskier as they become larger, move indoors, and include unvaccinated individuals, said Kuritzkes. That’s when it might be smart to don a mask, or skip the event.
Sports and concerts are also safe if they’re outdoors, so long as there is good airflow, said Hamer, though “if there’s not good airflow, then it might make sense to wear a mask.”
Hamer said he hasn’t been to an indoor concert or play since before the pandemic. “If I were to go I would definitely wear a mask, all the time,” he said.
“I wouldn’t go unmasked to a concert,” Kuritzkes agreed.
Before the recent uptick, Kuritzkes said, he had begun to shop without a mask, “because everything was going in the right direction.”
Now, with cases on the rise and new guidance from the Centers for Disease Control and Prevention, he said he will resume wearing a mask at the supermarket — at least “until we see the numbers in Massachusetts quiet down.”
“I think we shouldn’t lose sight of the fact that we were really very effective in controlling the spread of COVID-19 throughout much of the time up until the winter, just from the use of masks,” Kuritzkes said.
Hamer said he has not shopped without a mask in Massachusetts “in a long time.” He has gone maskless at stores in rural Maine. But even there, concerns about the uptick have prompted him to resume use of a mask.
“Now, I believe it makes sense to be wearing masks indoors, even if one’s vaccinated, in public places like supermarkets, stores, malls, and so forth,” Hamer said. The CDC likewise seems to be “tilting the barometer” back in that direction, he said.
Parents should arrange to have their children vaccinated if they are eligible, said Assoumou. Currently, Pfizer is the only vaccine approved for adolescents ages 12 to 18.
“My children are too young to be vaccinated, so my plan is to ensure that they wear well-fitted two-layered masks when indoors throughout the school year,” Assoumou said.
“In addition to vaccination, masking, and appropriate distancing while at school, I encourage parents to reinforce handwashing throughout the day,” Assoumou said.
Camille Caldera can be reached at firstname.lastname@example.org.