The epidemic of coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide, causing over 133 million infectious diseases.
SARS-CoV-2 spreads through respiratory droplets when an infected person coughs, sneezes, speaks, or breathes. In some cases, it can be spread by singing. Earlier reports have shown outbreaks involving singing groups.
Currently, a team of researchers in the Netherlands and Sweden have shown that singing allows airborne diffusion through infectious droplets or aerosols over long distances over 1.5 meters during singing events.
Survey posted on preprint server medRxiv*, Researchers explained that SARS-CoV-2 infections in six singing events across the Netherlands from September to October 2020 had an incidence of 25-74%.
Aerosol infection at a song event
Previous studies and media have described multiple outbreaks with high incidence among singing groups between March and September 2020 in the Netherlands.
These reports suggest that there is a potential high risk of singing due to SARS-CoV-2 infection. However, it was unclear whether the reported outbreaks were due to frequent and long-term social contact before, during, or after the song event, or whether the song itself was a risk.
Since March 2020, SARS-CoV-2 has become widespread along with other public health measures, and singing group practice in the Netherlands has been discontinued.
When the government began to lift restrictions due to a decrease in the number of cases, group singing was allowed in July 2020, as long as certain recommendations were followed. These include following ventilation guidelines, singing in a zigzag, and using a room with forced ventilation.
During this time, universal masking and wearing masks in public places were not yet mandatory.
In the Netherlands, about 1 million singers joined a choir of 24,000 and about 70% of the ensemble resumed practice in September 2020. From then until October 2020, the weekly incidence and number of cases of COVID-19 surged. Country, from 31.4 to 391 per 100,000.
In this study, the team sought to clarify the correlation between resumption of singing practice and a sharp increase in COVID-19 cases.
From September to October 2020, they investigated six clusters of COVID-19 cases among those who attended the singing event. Four groups were reported to be involved in choir rehearsals. One is a choir performance and the other is an ensemble of songs during worship in the church.
The team collected data through phone or email, and online surveys to reach the findings. After collecting and analyzing the data, the team discovered that most singing group members were sent at the singing event.
In the above five events, with the exception of those who lived together and traveled with them, the positive cases had little or no contact outside of the event. About 10 people lived together, 7 of whom were infected with COVID-19.
Cases of COVID-19 that may have been identified at each singing event from September to October 2020 will occur by the day of onset of symptoms or the day of a positive test.
In addition, at least one member of the singing group reported onset of symptoms from day 0 to day 3 after the event. This indicates that they are contagious during the event and supports previous studies showing higher levels of shedding before symptoms develop in terms of SARS-CoV-2 infectious dynamics. ..
If a superspreader is present at the event, the song allows indirect contact and droplet propagation within 1.5 meters. One factor that may have affected the infection is the airflow that expels respiratory droplets over long distances.
The team recommended further research to determine the role of airflow when singing in groups and the propagation dynamics of SARS-CoV-2. Phylogenetic analysis Serological tests should be performed to identify cases of potential cause or susceptibility.
The team concluded that multiple transmission routes could have caused the outbreak in five clusters. It is also possible that singing aerial transmission has partially contributed to the reported high incidence rates.
Therefore, if infection control measures are relaxed and meetings are allowed, singing group recommendations are needed to prevent the spread of the virus.
medRxiv Publish preliminary scientific reports that should not be considered definitive as they are not peer-reviewed, guide clinical practice / health-related behaviors, and should not be treated as established information.
High SARS-CoV-2 attack rate associated with singing events
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