Experts: It's normal to be wary after vaccination

SAN JOSE, Calif. — Across the Bay Area, vaccinated people are venturing onto breezy restaurant patios, visiting with small groups of inoculated friends and hitting hiking trails unmasked. The science says the risk of getting or transmitting the coronavirus in such scenarios is very low.But there's another group of residents who, even after more than a year of social distancing and mask wearing, aren't quite ready to give up their pandemic ways.Health experts say that's not unexpected. People were told for months to protect themselves from the virus, and they're going to need time to re-emerge as the threat recedes. If the idea of going back to the office or removing your mask makes you nervous, that's not an unnatural reaction."A lot of the things we do are habitual, and it becomes the thing you do," said Ellen Evers, a University of California, Berkeley professor who studies emotions, judgment and decision making. "If for a year the thing you do is put on a mask, you probably don't even give it a second thought."Even health professionals have different opinions about the best way to begin shifting behavior.Monica Gandhi, a UCSF infectious disease expert, encourages people to take small steps toward some semblance of normal, noting that social interaction is good for our mental health."I know it's hard to shake the fear," Gandhi said. "Dip your toes in the water."Gandhi's Twitter feed is full of scientific studies and analysis showing that not only are fully vaccinated people well protected against the virus but that they are also highly unlikely to pass it along to others. She's chosen to unmask outside in part to "model the effectiveness" of the vaccines. In response, she's been called an anti-masker, even though she endorsed mask wearing wholeheartedly before the vaccines became available and when transmission rates were very high.But Gandhi thinks the current messaging from public health officials and policymakers has been muddled. President Joe Biden and California Gov. Gavin Newsom, for instance, are still wearing masks in uncrowded outdoor settings."That's part of the problem," she said. "I think that's confusing for the public."Dean Fashbaugh, a San Jose resident, reads and hears all sorts of conflicting information from politicians and scientists. That information has shifted in part as disease experts' understanding of the virus has evolved. But to Fashbaugh, it's disconcerting."They say one thing one minute, another thing the next," Fashbaugh said.The 64-year-old says he checks Johns Hopkins University's data himself but doesn't trust what he sees on TV and thinks far too much remains unknown about the different coronavirus variants to resume normal life too quickly.Fashbaugh's family is going out to brunch for the first time this weekend, and he and his wife have been talking about starting to get together with other vaccinated friends."We're going to start doing that, but it's like baby steps," he said. "We're still cautious. We only have one life to live."Gandhi doesn't want to shame anyone who continues to feel more comfortable being stricter than the public health guidelines suggest is necessary."We're all in different stages of acceptance," she said.And emotions, including fear, can be really useful, Evers said. If you go for a walk in a grassy field and you see something that looks like a snake, you stop in your tracks without thinking and get ready to run. If it turns out to be a garden hose, maybe you're a little embarrassed. But if it's a snake, you might have avoided serious danger.The trouble is, she said, "We're not always extremely accurate. In this case, people are anxious about COVID and for good reasons, but it may also result in us responding to those gut instincts in a way that maybe in this case isn't the exact right response."Evers sees masking as a low-cost, minimally annoying thing she can continue to do to help those around her feel safe."Even if science says the risk is low, I'll still put on a mask," she said. "At least I'm not making other people afraid. They don't know if I'm vaccinated or not."When people start to become isolated and avoid social interaction entirely, that's when emotions can become problematic or dysfunctional, Evers said, and people should seek professional help. A recent survey from the American Psychiatric Association found that more than four in 10 adults say the pandemic has seriously affected their mental health, and parents are especially concerned about their children."While most people, including most children, will likely adapt and recover well as we emerge from the pandemic, we know from previous research that for some, the mental health impacts of this trauma and distress will continue to have repercussions into the future," the association's medical director, Saul Levin, said in a statement. "We need to be prepared to help those who need it in the coming months and years."But it's also normal for people who have been personally affected by the virus to want to return to pre-pandemic activities more slowly, Evers said, pointing out that a bunch of numbers on case and death rates are less likely to trigger an intense response than a single vivid experience.Kayla Williams has family friends who died of COVID-19, and she works for a nonprofit in San Jose that serves residents hit hard by the pandemic, so "I've been able to hear and see firsthand all the devastation COVID has caused," she said.Williams is vaccinated but still wearing a mask in most settings. But she's also open to socializing with a few friends in an outdoor setting."It's finding that balance," she said, "that I'm comfortable with."