Covid-19 cases are surging in many parts of the United States due to the delta variant, so what do experts believe is safe to do this summer? STAT News spoke to 28 infectious disease specialists to see what their plans are.

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Covid-19 and summer activities

For the survey, STAT News asked three dozen infectious disease experts—28 of whom responded—10 questions about their willingness to do certain activities this summer, with their possible answers being yes, no, or only if masked. Notably, the survey asked the experts only what they would do personally, not what they would advise people to do as a whole.

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One of the experts, Naor Bar-Zeev, a statistical epidemiologist at Johns Hopkins Bloomberg School of Public Health, declined to respond to any question except for one, as his answers would have depended primarily on the status of the pandemic in any given location.

"In a place where most people are unvaccinated, or otherwise at high risk, and where there is active transmission, I should act more conservatively and with greater caution, even though I am protected from disease," he said. "In a place where most people are vaccinated, and there is low transmission, one can be more permissive."

What experts largely say they will avoid

According to STAT News, only one question received a unanimous answer of "no"—whether the experts would send their unvaccinated children to school without a mask.

"As a parent and a pediatrician, [I think] that is a terrible idea," said Andrew Pavia, chief of pediatric infectious diseases at the University of Utah.

Carlos del Rio, a professor of epidemiology and global health at the Rollins School of Public Health at Emory University, said not only would he not send his unvaccinated child to school without a mask, he would also withdraw an unvaccinated child from a school that didn't have a mask mandate.

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The survey also asked the experts if they would send their unvaccinated teen to school without a mask. Of the 26 experts who responded to that question, only 2 said they would.

Ellen Foxman, an immunologist at Yale University, said she would send an unvaccinated teen to school without a mask "if the high school had a high vaccination rate/low Covid transmission rate and my family had no high-risk personal contacts. If the school required all students and staff to be vaccinated, I would have no problem whatsoever with no masks."

When it came to social engagements, 17 of the experts said they would not be comfortable going to a movie theater to see a film. In addition, most experts said they would not attend an indoor wedding or other religious service where they did not know the vaccination status of others in attendance.

When asked if they would eat indoors at a restaurant, over half of the experts said no. However, six said they would or would do so in off-peak hours, while three said they would but would wear a mask while not eating.

"I generally feel safe indoors in a restaurant as long as underlying community transmission is low and I'm eating with other vaccinated people," John Brownstein, an epidemiologist and CIO at Boston Children's Hospital, said. "However, I always prioritize eating outside where possible."

What many respondents said they would be willing to do

Nearly all the experts said they would go to a hair salon or barber, regardless of whether they knew the vaccination status of other clients—but most of those experts added that they would wear a mask.

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Similarly, a slight majority of respondents said they would attend a large outdoor concert. But again, most of them said they would do so masked.

Robert Wachter, chair of the University of California, San Francisco's department of medicine, said he'd wear a mask "if shouting people [were] at very close range." However, Jason Salemi, an epidemiologist at the University of South Florida, said he "would not attend a large outdoor concert right now" due to the high transmission levels in Florida.

And when asked about traveling either in the United States to a location experiencing a surge in Covid-19 cases or traveling internationally on a nonessential trip, more experts were "slightly more" willing to travel internationally, STAT News found—particularly if the international destination had a high vaccination rate and low Covid-19 transmission rate.

More broadly, Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security, said he believes Covid-19 is going to become endemic, meaning people will need to learn to live with it. He said being fully vaccinated means one's risks of contracting Covid-19 are fairly low.

"That fact makes me comfortable as a fully vaccinated individual without underlying health problems to resume my pre-pandemic life because I am risk-tolerant and I know that if I am to get a breakthrough infection it is likely to be mild," he said.

A J&J 'booster'?

Finally, STAT News asked the physician experts if they would recommend patients who received the Johnson & Johnson Covid-19 vaccine get another dose. Most of the respondents said no.

However, Megan Ranney, an emergency physician at Lifespan Health System, said that, though she's waiting for guidance from FDA on that point, "[I]n the meantime, I certainly wouldn't judge anyone who does get another dose." (Branswell, STAT News, 8/17)