We Need to Talk About Singing During the Coronavirus Pandemic
Last week I sat though a very informative webinar from the National Association of Teachers of Singing which included experts who gave scientific presentations: What Do Science and Data Say About the Near‐Term Future of Singing and Transmission Perspective on COVID-19 and the Future of Singing. The seminar is a bit technical and pretty lengthy, so for anyone who doesn’t have the hours (!) to spare, I’ve summarized the main points from these presentations by Lucinda Halstead, MD, and Donald Milton, MD, DrPH below.
Brace yourselves, it’s not good news, and it’s taking time for me to process it. We are going to have to think differently about singing. Any singing with each other—professional and amateur, large groups and small, loud and soft, singing while playing your instrument, humming, in voice lessons, in piano or guitar lessons, in choirs, putting on musicals, at big shows, at small private events, at religious services, at school, while singing karaoke, anytime we would normally sing when we are with non-household members—is now a very risky activity.
The process of singing (even non-technical, soft, amateur singing) spreads the virus even more than a sneeze or cough.
Unlike a quick sneeze or cough, singing is a continual, ongoing expulsion of air.
That air is being drawn from deep within the lungs, where the viral load is highest, and releases droplets of many sizes into the air.
Depending on conditions, these droplets can hang in the air for hours after singing and could cause infection. (At first, experts were not sure if the virus could be spread through the air, but it is becoming clear that it can).
This dynamic also applies to humming, soft singing, and even sustained levels of talking.
This provides some insight to why 45 of the 60 Skagit Valley Chorale singers contracted the virus after meeting to practice. In Germany, whose unusually low Coronavirus fatality rate is the envy of Europe — churches have banned singing to curb the spread of the virus.
Certain measures can reduce — but not eliminate — the chance of infection.
Right now in Los Angeles, we’re all under safer at home orders, but things are slowly beginning to open up. Since people can be contagious without knowing it, we have to think about ways to keep from spreading the virus. We are all addressing many of these, which is great, because they help quite a bit in non-singing, reduced speaking situations. A few may seem extreme, but according to the experts, the situation warrants extreme protocols for singing:
Sanitizing equipment and washing/sanitizing hands. This is still one of the best ways to help lower chances of infection with our without the singing factor, but these don’t help with those droplets or particles in the air caused by singing.
Masks when we’re around others outside our household. This seems to help with regular breathing and shorter interactions. But different masks vary in effectiveness, which drops significantly during singing or loud speaking. (Slide 13 from Dr. Halstead’s presentation shows how the particles move around the mask when singing).
Face shields and plexiglass barriers keep spittle out of the eyes and face. But again, they don’t protect much against smaller droplets expelled by singing as they can easily move around barriers. Full medical safety equipment (PPE) is the only effective barrier, but it is impractical while singing for so many reasons. Any medical professional can tell you it’s hot, and hard to breathe.
Maintain 6 feet or more physical distance. Moreover, if there is sustained speaking or singing face the same direction to avoid expelling air at one another.
Improve air circulation. Open windows and direct airflow from behind to blow particles from around faces out of the room.
Specialized UV equipment can lower rates of infection, but it’s important to have it installed correctly. It is also not super practical, or available in most situations.
If you have space outside, it could be OK if a small group of singers and audience face the same direction, the wind is from behind, and 6 or more feet of physical distance is maintained.
The experts said that we cannot ensure reasonably safe in-person singing until the state of the pandemic changes in one of the following ways:
Availability of highly accurate and affordable rapid testing administered directly prior to each lesson / rehearsal
Highly effective prevention and / or treatment measures (vaccines, etc.)
Herd immunity in our community
I hate being the bearer of bad news. Learning that we cannot sing together has been a hard pill to swallow and I’m still adjusting to the implications this has for my career, live performances, student shows, etc. — but I can’t gamble with the health of my students, audiences, and the families they share their homes with.
I can say that I am grateful for the hard work being done by scientists to both understand and combat this pandemic. As they learn more, we may be able to adjust when and how we sing together. This, too, will pass. In the meantime, let’s focus on what we can do! I’m working on another post that will highlight some of the ways we can sing and share while we meet online.
SOURCES:
National Association of Teachers of Singing Webinar on singing during the COVID-19 pandemic: https://youtu.be/DFl3GsVzj6Q
Powerpoint from Lucinda Halstead, MD, (President-Elect, Performing Arts Medical Association Medical Director, Evelyn Trammell Institute for Voice and Swallowing, Depts. of Otolaryngology-Head & Neck Surgery & Pediatrics, Medical University of South Carolina) https://www.nats.org/_Library/COVID_19_Resource_Docs/Halstead_-_NATS_Webinar_may_5_2020v_final_pps.pdf
Powerpoint from Donald Milton, MD, DrPH / Professor / Institute for Applied Environmental Health / University of Maryland School of Public Health https://www.nats.org/_Library/COVID_19_Resource_Docs/Milton_COVID-19_Singing.pdf
COVID Rehearsal Guide including good academic references from Chorus America/San Francisco Gay Men’s Chorus: https://www.chorusamerica.org/sites/default/files/resources/COVIDRehearsalGuide_Seelig_Final.pdf?fbclid=IwAR3BTwEN1igfPEBBJmUBcm8zhnF6HQZTECtof7lPqS41p0bflZ7XyNGliDY
High SARS-CoV2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020, Center For Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm?s_cid=mm6919e6_w&fbclid=IwAR3vnQgUvvWNY4Ljg9fePPzxL4GQ6H2zCgKb6B6b7vDaov2_8_LTQGBZcSg