'I don't know what to do': Even Wisconsin's health experts aren't always sure when to wear a mask. We asked five how they decide.
Madeline HeimOn a recent conference call between local health officers from around Wisconsin, they discussed whether they, as vaccinated health leaders, should still be wearing their masks.
Even though the Centers for Disease Control and Prevention released new guidelines last month that said fully vaccinated people could safely go maskless in most public settings, the decision is so subjective that one county's health officer might still wear a mask inside the grocery store while another leaves theirs at home.
The health officers couldn't agree on a single best approach, said Kurt Eggebrecht, the former health officer for the city of Appleton.
In Wisconsin, cases, hospitalizations and deaths have dropped off sharply from what they were last fall. Still, an average of 104 residents a day tested positive in the last week, and just 43% of the state is fully vaccinated against the virus, according to the Wisconsin Department of Health Services. No young children have been vaccinated.
We asked five Wisconsin health experts what's going through their minds as they head out, and they weren't all on the same page, either.
If you've been wondering what to do at this ethically and socially awkward time, don't feel bad: You've got some well-informed company. Here are their thoughts.
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Kurt Eggebrecht, former health officer for the city of Appleton
Eggebrecht, who retired from his post June 4, said he's all-in on the CDC guidelines, and goes without a mask except in the specific situations where he is asked or required to wear one — and he told his fellow health officers so on that conference call.
It's important that, as a trusted health official, his community sees that he's been vaccinated and that he's confident in the effectiveness of the shot, he said.
(The Pfizer and Moderna vaccines in clinical trials both reduced illness and death from the virus by more than 90%; the Johnson & Johnson vaccine did so by about 72% in the U.S. New, real-world data is also showing the vaccines cut transmission of the virus down, too.)
He keeps masks stashed in his pocket or car in case he needs one while out and about, but has otherwise returned to being able to smile at the people he greets. His first unmasked visit to church felt strange, he said, but it helped to understand how much he was protected.
Amanda Simanek, associate professor of epidemiology, UW-Milwaukee
Simanek joins plenty of other Wisconsinites in belonging to a "mixed vaccination status" family at the moment — she, her husband and their oldest child are fully vaccinated; her 5- and 10-year-old are not. Although coronavirus cases seem to be milder in children, it gives her a different outlook on the next few months than those without young kids.
As an epidemiologist, she said, she's also concerned about protecting people at a population level, not just at an individual one. That means looking out for people who haven't been vaccinated yet not because they don't want to, but because they don't have the resources to make it happen.
Even in places where she personally feels safe, she said she tends to exercise more caution around masking because she thinks, "Well, if everyone throws caution to the wind, this isn't going to work."
"If me being cautious for longer contributes in some way to continuing to slow transmission of this infection," Simanek said, "I'm willing to do that."
Simanek urges people to be empathetic over the next few months when deciding when and where to mask. We're in a much safer place than we were last summer, she said, but these decisions will require thoughtful conversations.
Dr. James Conway, infectious diseases expert at UW-Madison's Global Health Institute
Conway said he's constantly got a calculator running in his head with the different variables he uses to decide whether to throw on a mask.
If he's outside, he won't wear one. (This, at least, is something experts can agree on: The virus doesn't spread much outdoors.) If the grocery store is crowded, he will. If a business has mask rules, he'll honor them. At restaurants, he goes mask-free at his table but will decide to wear one while entering if it's especially busy or if others are doing so.
He also considers vaccination and transmission rates in the community. In Dane County, which in May had the highest vaccination rates of any large county in the U.S., he said he feels safe. That variable changes when he visits other places.
"For most people, it's black or white — masked or not masked," Conway said. "It's very challenging to think about these areas of gray that we're being forced to live in right now."
Malia Jones, social epidemiologist at UW-Madison
Like Simanek, Jones has young, unvaccinated children — and when she takes them places indoors, she continues to mask up to model that behavior for them.
When she's on her own, "it's a mess. I don't know what to do," she said. Though she feels confident that the vaccine is protecting her, she worries about the message she sends to service workers if she walks in unmasked. She usually makes the decision based on signage on the store's front door, or what most other people are doing inside.
She said she will often put her mask on halfway through a store if she decides it's necessary, or conversely take it off if she feels comfortable. She also has a button that says "I'm vaccinated" pinned to her purse.
To Jones, though, the CDC guidance was an unwelcome shock. She said she felt it was a betrayal of the tenets of public health.
"The goal is to protect everyone, and particularly the most vulnerable, with policies and guidelines that cocoon the vulnerable people in protection," Jones said. "It’s a group project."
Some people are still struggling to access the vaccine — nearly half of unvaccinated adults in the U.S. said they worried about missing work because of side effects, according to a May Kaiser Family Foundation poll. Others with compromised immune systems may not build up as strong of a response to the virus from the vaccine. For those people, she doesn't feel the guidance had their best interests at heart.
Patrick Remington, director of UW-Madison's preventive medicine residency program
Remington said he went into a coffee shop unmasked last week, told the masked barista behind the counter that he was fully vaccinated and asked whether it was OK that he didn't wear one.
She told him it was fine, but for him, asking was important. He didn't want her to have to guess whether she was at risk around him.
Remington, a former CDC epidemiologist, recommends those quick conversations as a way to tackle masking choices over the coming months. He's asked at restaurants, in businesses, when visiting a friend's home — the question even allowed him to share some information about the effectiveness of the vaccine with a person who said they hadn't gotten the shot yet.
Proof that we're in a nebulous spot: The choices he'd make about it as an individual aren't the same as what he'd recommend to an organization. Remington is a member of a Madison ski club that has opted to still require masks at their indoor facility.
He carries masks with him wherever he goes in case the person on the other end of the conversation asks him to put one on. He also said it's important to remember that while we're making progress on beating the virus, we're not out of the woods yet.
"It's the end of the fourth quarter," Remington said. "We just have to keep our eye on the ball."
Contact reporter Madeline Heim at 920-996-7266 or mheim@gannett.com. Follow her on Twitter at @madeline_heim.