Jan Fischer Bachman recently interviewed Dr. Kathryn Jacobsen for Messenger. A professor of epidemiology and global health at George Mason University, Jacobsen has provided technical expertise to the World Health Organization and other groups. Her research portfolio includes analyses of emerging infectious diseases, and she frequently provides health and medical commentary for print and television media. She is a member of Oakton Church of the Brethren in Vienna, Virginia.
Q: How worried do we need to be about coronavirus?
A: The virus that causes COVID-19 only started affecting humans a few months ago, so we’re still in the early stages of trying to understand the virus and the disease it causes.
We knew early on that coronavirus was quite contagious, because we saw how quickly it spread through cities in Hubei province in China, on cruise ships, and in small towns in Italy. We could also see that it caused severe illness and death in a lot of the people who contracted it. While the case fatality rate is highest in older adults and among people with various types of existing medical conditions, COVID-19 can also be fatal in healthy young and middle-aged people.
More recently, we’ve started learning about how the virus can damage the lungs, cardiovascular system, kidneys, and other organs. Some young adults with coronavirus are having strokes, and we’ve become aware that some children who contact the virus become critically ill. A lot of church members are in high risk groups, but anyone who contracts the virus is at risk of an adverse outcome.
Q: Why did coronavirus become a pandemic?
A: As scientists gathered more data about cases, we discovered that many people with the infection have mild symptoms or no symptoms at all but are still able to pass the virus to other people. If everyone who contracted the virus got sick enough to stay in bed for a few days, we could easily identify cases and isolate them. But that’s not what happens with coronavirus.
Some coronavirus carriers feel good enough to keep doing their normal routines, and everyone they encounter is at risk of getting infected. That’s how the virus was able to spread across the globe so quickly. One infected person who feels completely healthy could attend church and inadvertently infect up to dozens of other churchgoers.
Q: Are some places safer than others?
A: If there are not a lot of coronavirus cases in the general population in a particular place, the likelihood of someone at church being contagious is relatively low. However, we aren’t doing enough population-based testing to know the actual rate of disease in many places. If we only test people who are so sick that they might need to be hospitalized, we are missing a lot of cases. And if we look at case counts rather than rates of disease, rural areas will look less affected than cities even if they have a higher per person rate of disease.
We know that coronavirus cases are still occurring in every state. New cases are still being diagnosed in most counties. The stay-at-home orders were intended to buy time to build up testing and treatment capacity. They slowed the rate of new infections, but they didn’t drop the transmission rate to close to zero.
As businesses reopen and more people are interacting with one another, we expect that the number of infections is going to increase. Places that haven’t had a lot of cases yet may end up having outbreaks a few weeks after their stay-at-home orders are lifted. By the time an outbreak is detected, many people will already be infected even if they are not yet symptomatic.
Q: How soon can congregations or small groups start meeting in person again?
A: It is difficult to answer this question because the risk of coronavirus is not uniform across states and counties and cities, and because the public health control measures that governors, mayors, and other officials have put in place are not the same everywhere. The threat from coronavirus will persist until we have an effective vaccine, but most churches are not going to want to wait that long to resume meeting in person.
When church leaders are making decisions about when and how to reopen, they need to consider the wellbeing of their congregations and their communities at large. One contagious person can make many other people sick. The likelihood of one person in a small group having the virus is low, but if there is one infected person in the group the likelihood of others becoming infected is high. Those infected people may be older adults or people with chronic health issues that put them at risk of serious complications from COVID-19, or they may live or work with people at high risk of complications.
We don’t want churches and small groups to become hotspots of infection in their communities. We don’t want church members to become infected at church and carry the virus into nursing homes, factories, shops, and other workplaces. We don’t want to add to the burden being shouldered by healthcare workers, and we don’t want to play a role in contributing to more loss of life.
Q: How do we keep our churches clean?
A: The CDC’s initial recommendations for preventing coronavirus infections focused on disinfecting surfaces. Cleanliness is still important, and churches will need to continue to sanitize doorknobs, handrails, faucets, and other surfaces that are frequently touched.
But we’ve also learned that the virus may stay suspended in the air longer than we initially thought it did. In rooms with poor ventilation systems, virus particles may spread across the room and be breathed in by other people. The CDC recently published a case investigation that concluded that one call center employee had infected almost 100 coworkers in other cubicles on the same floor of an office building. People with coronavirus infection expel the virus when they talk or sing or even just sit in a pew breathing.
The CDC is now recommending that most people wear some type of face covering when they are away from home, even if they feel healthy, so that if they are infected some of the viral particles they breathe out will be trapped in the fabric. The recommendation to wear face coverings in houses of worship is likely to be in place for at least several more months.
Q: What if we just meet for a short time?
A: The longer people sit together and breathe the same air, the greater the likelihood that a contagious person will infect others. But there probably isn’t much difference between a 50-minute worship service and a 70-minute service. Either way, that is a long time to be sitting in a sanctuary or classroom with poor ventilation.
Q: What if the congregation meets outside?
A: That’s definitely safer than meeting inside. Outdoor gatherings still need to follow the physical distancing guidelines. We don’t know exactly how far apart household groups need to be to avoid sharing germs. Six feet isn’t a magic number. The safe distance might be 10 feet. It might be farther, depending on factors like wind and humidity. So ask people to bring their own chairs and sit farther apart than seems necessary. No handshakes or hugs. No shared food and drinks. No passing of hymnals or other objects.
Q: Can we just keep meeting online?
A: Of course! A lot of churches have gotten used to meeting virtually, and for many churches online gatherings will remain the best option for worship, Bible study, and other church activities for at least a few more months.
Even after statewide and local restrictions on group gatherings are eased, churches in hotspot areas and churches with a lot of older members will want to consider whether staying online is the best way to protect the church body. Online is the best default option until a local church has evidence that it can open with minimal risk to members and visitors.
Q: How quickly can we get back to normal?
A: Let’s try to be patient. Let’s be considerate about the fact that many pastors, church musicians, and other church leaders are in risk groups, have household members in risk groups, or have other reasons to be anxious about returning to the sanctuary or fellowship hall when COVID-19 cases are still occurring locally. Parishioners can choose to stay at home, but pastors will have a hard time practicing social distancing once church buildings reopen.
And let’s remember that the decision about when and how to reopen churches isn’t just about churches. We don’t want church gatherings to contribute to spikes in cases that might harm local businesses and overwhelm healthcare facilities. We don’t want church meetings to seed outbreaks in surrounding areas. To be a good witness to our neighbors, we have to think about how to help slow the transmission of coronavirus in our communities at large.
In a few months, we’ll know a lot more about the science of coronavirus and the specific actions we can take to operate safely. Until then, we should be cautious about how we move toward a new normal.
Faith, Science, and COVID-19
There will be a Moderator’s Town Hall on June 4, 2020, at 7 p.m. Eastern on “Faith, Science, and COVID-19″ featuring Dr. Jacobsen and Annual Conference moderator Paul Mundey. To register, please visit tinyurl.com/modtownhall2020. To be added to the mailing list for the Moderator’s Town Hall and receive updates, please email your contact information to firstname.lastname@example.org.