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Rule number one in epidemiologist Emily Gurley's house: Don't freak out.
As the Delta variant drives US COVID-19 cases to their highest levels in nearly six months, Gurley's family hasn't locked themselves in again. Instead, they've made small adjustments to their daily activities.
"I'm asking my kids to wear masks everywhere," Gurley, who works at the Johns Hopkins Bloomberg School of Public Health in Maryland, told Insider. "Maybe a month ago, transmission was just so low here, if you go in the restaurant, it's fine. Eat inside. Whereas now I'm like, 'Hmm, maybe rethink that a little bit. Eat outside if you can. If you're going to be inside, put on a mask.'"
Though all members of Gurley's family are fully vaccinated, data from the Centers for Disease Control and Prevention shows that vaccines don't prevent infection or transmission as well as they did before Delta's rise. The shots do, however, still reduce the risk of getting COVID-19 eight-fold, and of hospitalization or death 25-fold. But the CDC now recommends that even vaccinated people wear masks in high-transmission areas - which is most of the US.
Insider spoke with a few vaccinated health experts about how their own behavior has changed since that recommendation came out. Most had never stopped wearing masks indoors to begin with. But some are now avoiding indoor areas where unvaccinated people may be present. They're not canceling travel plans just yet, though.
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Gurley said most of her social life takes place with vaccinated friends outdoors.
"The idea of getting together with friends for a drink and having a hug with close friends is fine, and we've done that - particularly in the setting of low transmission, which we've enjoyed for some time where I live," she said.
She's also planning to take a domestic trip in a few weeks, which requires a plane ride.
"I'm not flippant about being affected at all, and I want to take precautions, but at this point in time, I'm not planning to cancel my travel," Gurley said.
She is, however, avoiding gyms - especially any that doesn't require masks. Gurley said she's read too many reports of COVID-19 outbreaks in these settings.
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Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco, tweeted last week that he has stopped dining indoors and attending his regular poker games with friends, even though the group is vaccinated. Wachter hasn't canceled any existing flights yet, but he isn't booking elective trips right now, he said.
These considerations are based on the fact that Wachter is 63 and got his Pfizer vaccine over the winter.
Pfizer announced last month that antibodies produced by its vaccine may start to wane after six months, though the shot still offers good protection against serious illness. The vaccine is also slightly less effective against Delta: Studies from England and Scotland indicate that Pfizer's shot reduces the risk of a symptomatic Delta infection by 88%, down from 95% for the original strain.
So Wachter said he's returned to layering a cloth and surgical mask indoors, and donning an N95 mask on planes.
"If I had gotten comfortable with being inside without a mask in a place where I wasn't sure that everybody's vaccinated, I would now be uncomfortable," he told Insider in June.
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Vivek Cherian, an internal-medicine physician in Baltimore, said all of his decisions revolve around protecting his two young children, who aren't vaccine-eligible yet. The kids have outdoor playdates with their classmates, Cherian said. But his family is steering clear of trips to the mall, and both he and his wife wear masks in any public indoor setting.
"If I spread it to my kids and they happen to be one of those unlucky ones, frankly, my wife and I would never forgive ourselves," he said.
Their family is planning to move to Chicago soon, so they're searching for a new school that practices a similar level of caution.
"We really had our mind set on one school and then all of a sudden it struck me: 'Hey, let's ask about the masking policy,'" Cherian said. The school informed him that masks were a violation of kids' autonomy, he said.
"We were just kind of shocked when we heard that," Cherian said. "So that literally went from our number-one school to completely off the list."
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Ruth Carrico, a professor of infectious diseases at the University of Louisville, pays attention to the airflow when she enters a room. If the building isn't keeping doors open or feels stuffy, "those are buildings that I'm like, 'You know, this is not for me. We're not going to be meeting here,'" she said.
Carrico said she does this even though she's fully vaccinated, and regardless of how many daily COVID-19 cases there are in her area.
"My actions are going to be consistent because I know even if the rates are low, when I'm interacting with people, I may still come in contact with someone who is either ill and asymptomatic, or ill and who has not begun yet to show symptoms," she said. "So the risk of the disease to me is the driving force."
That doesn't means she's hiding at home all the time, she added. Carrico said she gets together with other vaccinated people and shops at the grocery store - but she wears a mask in public and washes her hands frequently.
"I've lost five people that I know that have either been healthcare workers or friends that have gotten this illness and not survived," Carrico said. "So the impact of this is very real to me."
