Stephanie and Cory Lake know what it's like to spend days and nights at their daughter's bedside, watching her take in oxygen with machine support while hoping she would start breathing on her own again.
Twice before the COVID-19 pandemic hit, Odette Lake, now 7, was hospitalized with serious breathing problems, including once after a viral infection. Her health issues were exacerbated by previously unknown allergies.
Odette fully recovered both times, but the experiences left no doubt about whether her family will continue wearing cloth face coverings despite the easing of the mask-wearing rules across most of Minnesota.
"There is no mask debate in our household," said Stephanie Lake, of Minnetonka. "We will continue to wear masks in any indoor setting. And we will also not go to places that don't require masks. There is no reason for us to expose her to a virus that is very much in circulation."
Two weeks after the Centers for Disease Control and Prevention announced that fully vaccinated people can resume activities without wearing a mask or social distancing and Gov. Tim Walz ended Minnesota's mask mandate, many parents remain reluctant to let their unvaccinated children go mask-free for fear of contracting and spreading COVID-19.
Minnesota's official guidance says: "People who are not vaccinated, including children, are not required to wear face coverings indoors or outdoors by state executive order, but are at risk for getting and spreading the virus that causes COVID-19."
Minnesota's average number of new diagnosed cases and hospital admissions per day for COVID-19 have declined for five weeks, and the average percentage of COVID tests coming back positive has hovered below the 5% threshold that signals "caution" for two weeks, state data show.
Meanwhile, nearly half of Minnesotans have gotten both doses of the Pfizer or Moderna vaccines, or a single dose of the Johnson & Johnson vaccine.
The Pfizer vaccine is authorized for people 12 and older, while the Moderna and Johnson & Johnson vaccines are authorized for those 18 and older. Pfizer CEO Albert Bourla has told investors the company plans to apply for authorization for children ages 2 to 11 in September, and for those 6 months to 2 years old by the end of the year.
Public health authorities urge unvaccinated residents to get their shots as soon as possible, if they can, and to keep wearing a mask while in public. But there's no apparent way to enforce that guidance.
"Two weeks ago, both the vaccinated and unvaccinated were required to wear a mask in the grocery store. Now it is the honor system," said Patsy Stinchfield, a pediatric nurse practitioner and vaccine specialist at Children's Minnesota. "It puts us in a bit of a precarious position for kids in public places."
Kids like Odette, who are vulnerable to COVID and too young to get vaccinated, are more likely to come into contact with unmasked, unvaccinated adults in public.
As a result, Odette's parents won't take her on routine errands until she can get vaccinated. And when she does go out in public, her fully vaccinated mom will keep wearing a mask, too.
"I would never isolate her and have her be the only one who was wearing it," Lake said. "For us as a family, we will continue to mask together and we will avoid situations that have unnecessary risk."
Dr. Rachel Téllez, a HealthPartners pediatrician on the board of the Minnesota Chapter of the American Academy of Pediatrics (AAP), urged vaccinated parents to model good masking practices for unvaccinated kids.
"My 11-year-old asked me if he would be the only one in our family wearing a mask," Téllez said in an e-mail. "I told him I would still wear one to support him — I'm used to it (and it is good role modeling)."
The AAP recommends unvaccinated people, including children older than 2, continue wearing cloth face masks when in public. AAP says masks are not necessary for "small gatherings with fully vaccinated family and friends" and during water sports or activities like gymnastics, cheer and wrestling.
"Children under 12 should continue to follow previous guidelines on masking. Nothing has changed for them," Téllez said. "Teenagers (aged) 12 and up who have not completed their vaccines should follow these same guidelines."
Chris Boles of Chaska said he will not be forcing his kids to wear a mask in public unless it's required. (Masking is still required on public transit, and in cities such as Minneapolis or businesses that specifically require it.)
Boles isn't convinced cloth masks are effective, and he said they carry drawbacks, from increasing inhalation of carbon dioxide to blocking kids' view of teachers' facial expressions.
"I don't think masks do all that much, especially the cloth ones," Boles said. "I just think there's more harm than good that comes out of wearing a mask."
Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, has said that while cloth face masks provide some protection, their effectiveness should not be oversold.
In his May 20 podcast, Osterholm urged listeners to consider a guide from the American Conference of Governmental Industrial Hygienists. Citing CDC data, the occupational safety group says cloth face coverings like those worn in grocery stores add minutes of protection before potentially getting infected.
While two unmasked people can exchange the virus after 15 minutes of contact 6 feet away, the time grows to 20 minutes if one person is cloth-masked, and to 27 minutes if both wear cloth masks. If both wear basic surgical masks, it grows to 60 minutes. The time increases to 25 hours if both wear off-the-shelf N95 respirators, and to 2,500 hours if both are wearing N95s that have been fit-tested to check the mask-to-face seal.
"I have continued to recommend using any kind of respiratory protection you can use," Osterholm said. "But please be aware, if you are wearing a surgical mask or a face cloth covering, and you are in contact with someone for 20 to 30 minutes, you can get an infectious dose" if the other person isn't masked.
"The vaccine is a much more potent weapon than face cloth coverings or surgical masks," he added.