Ask the Rev. Doctor Maria
The Rev. Dr. Maria Evans is serving as the Interim Rector at Christ Church in Rolla. She is also a pathologist, board certified in Anatomic and Clinical Pathology, a laboratory medical director, and has served on hospital infection control committees for over 30 years.
During the coronavirus outbreak, The Rev. Dr. Maria is offering her expertise to help us understand and make our way through this unprecedented experience. If you have a question you'd like to ask The Rev. Dr. Maria, send an email to firstname.lastname@example.org.
I'm hearing a lot about how singing voices spread droplets further than six feet. Is that true?
Sadly, it is.
For the last month and a half or so, additional data keeps coming in as we study outbreaks of COVID-19 that occurred among choirs and choruses. Perhaps the one most intensely studied was an outbreak in Mt. Vernon, WA when the pandemic had hit the West Coast.
Here's what we know:
1. The louder we get, the further droplets spread. Singers transmit droplets far beyond six feet (maybe even as far as 27 feet).
2. Additionally, the louder we get, the more particles are emitted in our breath in what is known as a "fluid-film burst." (Think of this like a soap bubble bursting, but the "soap bubble" is the surfactant from our lungs mixing with our respiratory secretions.) The louder we are, the more we push air from our diaphragm, and the higher the chance surfactant from our lower respiratory tract makes it to our exhaled breath to create the "bubbles."
2. Although we know COVID-19 is spread by droplets, a small percentage is aerosolized. Again, the louder we are, the more aerosol is generated, and aerosol can have a "hang time" in the air of up to three hours, but it's unclear how long the particles in the aerosol are viable. We know that people living in an apartment building in Hong Kong were widely infected because an improperly capped sewer vent spread aerosol into bathrooms throughout the building. This suggests at least some of the aerosolized particles are active, and we know becoming infected depends on the size of the dose, and the time we are in the location where the virus is airborne.
3. Remember a few weeks ago when I told you "on average, one person with COVID-19 infects two other people?" Recent studies of "hot spots" has revealed it's higher than that -- more like six other people -- and it may be more.
What this means is, we are entering a time where we should be less about "making a joyful noise" and being more about (and I'm paraphrasing), "Being still and knowing God is God." I encourage you to find the divine joy of music in your heart rather than with your voice.
The Rev. Dr. Maria L. Evans
who doubles as
Maria L. Evans, MD, FCAP, FASCP