Risk Management Plan for Face-to-Face Music & Theatre Instruction for Fall 2020

risk management
Administrators and teachers must make their own decisions regarding risk mitigation for their specific situation, in accordance with the local school, school district, state, and national published guidelines by governing bodies. This article was last updated on July 14, 2020, and will continue to be updated as more information is made available.

Introduction

Approach

This assessment applies the concept of risk management with the aim of identifying specific risks related to COVID-19 in the field of music and theatre and offering risk-reducing measures.1 Two core beliefs underlie this work: (1) a belief that the greater the number of risk-reducing measures, the more the risk of infection can be reduced; and (2) a belief that until we have more refereed research on the spread of airborne infection specific to music making and theatre productions, we must over- rather than underestimate the possible risks in case of doubt. In this way, by combining risk-reducing measures, we can lower the overall risk of infection as much as possible. Residual unquantifiable risk, however, will always remain according to the ALARP (as low as reasonably practicable) principle.

Assessed risks may change throughout the summer and into the fall as new information emerges. As such, this assessment will continue to receive updates. Administrators and teachers must make their own decisions regarding risk mitigation for their specific situation, in accordance with the local school, school district, state, and national published guidelines by governing bodies. This risk assessment may help better equip each of those groups to make more informed decisions in the areas of Music & Theatre.

COVID-19

Drawing from CDC Coronavirus (COVID-19) resources2,3,4 and research findings5,6,7,8,9,10,11 (including—owing to their timeliness—preprint/early release/awaiting peer review, as well as peer reviewed), a summary of today’s understanding about COVID-19 follows.

Coronavirus disease 2019 (COVID-19, i.e., the name of the disease) is a viral respiratory illness caused by a new coronavirus. COVID-19 is thought to spread mainly through close proximity from person-to-person, including through airborne droplets and aerosols as a dominant route. Some people without symptoms may carry the virus and contribute to spreading it. Information suggests that SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2, i.e., the name of the virus), spreads more efficiently than influenza, but not as efficiently as more highly contagious diseases, such as measles. Touching a surface or object that has SARS-CoV-2 on it and then touching the mouth, nose, or possibly eyes, may also transmit the disease. Older adults and people who have severe underlying medical conditions, like heart or kidney disease or diabetes, seem at higher risk for developing more serious complications from COVID-19 illness, and people in their 60s and older are generally at higher risk for severe illness from COVID-19.

Aerosols

Aerosols and their infectiousness remain widely discussed owing to the numerous factors involved, such as “the frequency of different respiratory activities, the number of particles produced per activity, and the pathogen load size distribution of different sized particles.” For example, pertaining to influenza, “the risk of acquiring influenza is determined by both the concentration of the Influenza A virus infectious particles (not their total amount) in the air and the immune status of the exposed individuals.” Questions of why some expelled particles carry pathogens and why some do not remain unanswered.12

Breathing, speech, loud speech, singing, coughing, and sneezing, all expel airborne particles, more or less in the order listed from least particles shed to most.13,14,15 In their seminal investigation into the role of singing in the spread of tuberculosis, Loudon and Roberts showed that the percentage of airborne droplet nuclei generated by singing is six times more than that emitted during normal talking and approximately equivalent to that released by coughing.16 The flow field from a cough can extend more than 2 meters/6 ½ feet from a subject; farther depending on how the room air currents generated by the cougher spreads the cough particles throughout the room, along with the spread from the breathing of others in the room.17,15,18 “By definition, aerosols are suspensions in air (or in a gas) of solid or liquid particles, small enough that they remain airborne for prolonged periods because of their low settling velocity.”19 The half-life of SARS-CoV-2 in aerosols has a median estimate of 1.1 hour.20 In other words, half the particles drop out of the air after that amount of time, and half of what remains drop out after another 1.1 hours.

Questions pertaining to music making and theatrical speaking remain unanswered. Related to playing musical instruments, a group of medical professionals at the university and hospital in Freiburg, Germany, observed: “As far as we know, there are still no measurements of the viral concentration in the blown-out air of wind players. However, it is known that playing wind instruments requires an intensive exchange of air in the lungs and airways with, at times, high air pressures. The extent to which the viral load is reduced by the air’s path through the instrument is currently unclear.”1 A national coalition of musical and performing arts associations is raising more than $200,000 to hire two research teams to conduct independent studies on risks of aerosol transmission by singers, instrumentalists, and actors with results expected later this summer.21 Round one preliminary (non-refereed) results for Clarinet, Flute, Horn, Soprano Singer, and Trumpet released on July 10, 2020, and among other considerations: (1) reinforced the need for distancing directives, (2) woodwind and brass players should keep their face mask over their chin while playing in order to replace it over their mouth and nose during longer periods of rests/breaks, and (3) students should not talk during rehearsal without wearing their mask.40

Ventilation

“Aerosol transmission of SARS-CoV-2 due to poor ventilation may explain the community spread of COVID-19.”36 SARS-Co-V-2 is an “indoor phenomenon”; outdoor cases are rare.8 Natural methods of encouraging airflow, such as opening doors and windows, can reduce the risk of airborne contagion transmission from person to person.22 “Of significance is maximizing natural ventilation in buildings that are, or can be naturally ventilation and ensuring that the ventilation rate is sufficiently high.”9 In older hospital buildings, “When infectious TB patients share rooms with others, opening windows and doors to enhance natural ventilation is a simple, inexpensive, and effective strategy in the fight against nosocomial TB transmission.”23 A group of medical doctors in Germany believe “that aerosols dissipate faster outdoors, that the deactivation process of the pathogens is greatly accelerated (UV, ozone, hydroxyl radicals, nitrogen oxides), and the cumulative effect thereof is a much lower risk of infection.”1

Mouth and Nose Coverings/Face Masks

Cloth masks can potentially provide significant39 protection against the transmission of particles in the aerosol size range. At a minimum, a mask can reduce 50% of emissions from the mask-wearer. Multi-layered mixed fabric masks approach filtering efficiencies as high as 90%.24 Mask wearers should keep in mind, “there is not clear evidence to indicate that cloth masks will protect you from inhaling the smallest infected respiratory droplets (those droplet nuclei) from another person. The primary purpose of a cloth mask, when worn by everyone, is to serve as a control for source emissions.”25,37 Public mask wearing “is most effective at reducing spread of the virus when compliance is high.”26 Public mask wearing “significantly reduces the number of infections.”5

Choir Superspreading Event

A community choir rehearsal superspreading tragedy made national headlines;27 mention of it here seems warranted. Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred; three patients were hospitalized and two died. Transmission was likely facilitated by close proximity during practice and augmented by the act of singing.28

Takeaways include:

  1. Prolonged virus exposure occured over 2.5 hours.
  2. Physical distancing was not observed. Rehearsal attendees sat 6–10″ apart in what seems like typical choral rows, and the only spacing was due to absences. Most members sat in their usual places.
  3. Although primarily rehearsing in a large multipurpose room, the choir also split into two smaller groups for 50-minute sectionals with one of the groups moving into a smaller room and individuals in the other group––in the larger room––sitting right next to each other.
  4. Potential for fomite transmission existed. Near the middle of rehearsal, attendees had a 15-minute snack break with food available on a table in the back of the room. Then, at the end of rehearsal, they carried their own chair to a rack, congregating around the chair racks as is customary.
  5. The median age of individuals in attendance at the March 10 rehearsal was 69 years (range = 31–83 years), indicating a population at higher-risk for severe illness from COVID-19.

Aggressive physical distancing protocols may have reduced the risk of transmission: “[I]t is not comprehensible to us how, in practice, a single person in a fixed location can infect dozens of people in a distant environment by simply singing, without ever getting close to the other person and in compliance with the rules of distance.”29

A younger demographic of choir members may have experienced a less severe attack rate. According to the American Academy of Pediatrics: “Although many questions remain, the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection. In addition, children may be less likely to become infected and to spread infection.”38

Music & Theater

Principle. Safety protocols attempt to reduce the risk of infection with SARS-CoV-2 as much as possible. A risk assessment with regard to specific questions of Music & Theatre teaching and learning should then consider the additional risk that arises in a unique way from practicing music and theatre, i.e., rehearsals.

Model. For purposes of Music & Theatre planning and its impacts campus wide, a fall semester model with face-to-face instruction as a primary delivery system and social distancing requirements in place was presumed.

Delimitations. Large music ensembles, private music lessons, and theatre/dance rehearsals receive consideration. Other important areas may also need to get addressed. Among the areas not addressed at this time include: non-ensemble courses that include singing within their curriculum that may require larger classrooms, music or theatre tours, disinfecting in general, practice rooms, piano labs, computer labs, and course-specific shared materials.

Indoor Facilities

Facility usage may present a higher risk for students due to a combination of factors, including but not limited to high touch points in musical instrument locker/storage rooms, limited square footage in rehearsal spaces, and poor ventilation/lack of fresh air. As initial steps in planning, identify high touchpoints, measure the square footage of rehearsal rooms, check whether or not windows can be opened, and locate the air supply vents and return air vents, as well as noting the direction of the airflow.

To estimate room capacity with social distancing guidelines in place, use the following formula as a start.

Example #1 with 6 feet apart = 36 sq ft; multiplied by 50 students = 1,800 sq ft space required

Example #2 with 9 feet apart = 81 sq ft; multiplied by 50 students = 4,050 sq ft space required

Other methods of calculation could allow for a few more students within these spaces, depending on whether a square or circle radius is used and whether the centerline of a person to the centerline of the next person is calculated as 3 feet + 3 feet = 6 feet.

Campus impacts. Reserving the largest indoor rooms, such as the house of the auditorium, recital halls, multipurpose rooms, commons areas, chapels, or other large spaces, as well as selected outdoor spaces, for music and theatre on a daily basis for rehearsals and private music instruction may accommodate students and teachers more safely and facilitate students in meeting their academic learning outcomes in a face-to-face environment. Department members and administrators will need to address new scheduling conflicts and determine alternative plans for students, as needed.

Outdoor Spaces

Weather permitting, an open-air environment is the safest choice for music and theatre group rehearsals, private music lessons, and theatre acting/singing. Fresh air, when combined with 2 meter/6 ½ feet distancing reduces the risk of SARS-CoV-2 infection to the lowest possible level.

Sample Protocols for Further Discussion

Music Ensembles

This plan could apply to large choral and instrumental music ensembles, such as a treble choir, tenor-bass chorus, mixed choir, orchestra, symphonic band, and jazz ensemble.

  1. Students and teachers should:
    1. participate regularly in school-wide health and wellness questioning/screening/testing;
    2. wash hands for 20 seconds prior to rehearsal or thoroughly use disinfecting hand sanitizer;
    3. avoid touching the face, mouth, nose, and eyes; and
    4. cover coughs or sneezes in the crook of the elbow.
  2. Weather permitting, choral ensembles may choose to rehearse in an outdoor location, observing the recommended distancing and facing in the same direction.
  3. Outdoor rehearsals are also encouraged, but less practical, for instrumental ensembles due to: (1) the sensitivity of wooden instruments to humidity and direct sun, (2) complex logistics requiring individual music stands and a number of chairs, and (3) the potential for wind blowing the sheet music/music stands without additional clips.
  4. Full-ensemble indoor rehearsals should move to the seating area of the largest auditorium or multipurpose room and face forward. String and wind players may need to stand during rehearsal, if practicable.
  5. In some auditoriums, doors should remain closed at all times to maximize mechanical HVAC air exchange. Opening limited exterior doors might not provide a fresh-air advantage, may prove detrimental to the HVAC system, and could pose an increased security risk.30 Consider running the auditorium HVAC system 24/7 to ensure the freshest air possible each morning.
  6. When rehearsing indoors, consider adhering to distancing greater than the standard 2 meter/6 ½ feet distance between students, such as 3 meter/9 feet radial during rehearsal. Aerosol science has many unknowns related to singing and playing wind instruments. Erring with a greater distance than normal—in the largest possible indoor fine arts space—seems a prudent risk reducing measure31 until further research findings about aerosols and music making emerge. If the auditorium seating is numbered, then each student can have their own assigned seat to preserve distancing measures.
  7. String players, keyboard players, and percussionists should wear a cloth nose and mouth covering/face mask to help limit the buildup of droplets/aerosols in the indoor air.
  8. Wind players should avoid draining condensation onto the floor; instead disposing of it in a collection container or absorbent blotting paper.
  9. Wind players should not blow through the instruments to clean them. Wind instruments should, if possible, be cleaned in separate rooms away from the teaching or rehearsal setting.
  10. Percussion instruments could be stored backstage and moved on stage for rehearsals. The house seating area could accommodate all other musicians for rehearsals.
  11. When two ensembles share the same rehearsal timeslot, the respective directors will need to collaborate to determine a workable conflict resolution that values risk mitigation.
  12. Ensemble directors may decide to meet a reduced number of students in their usual rehearsal space, provided distancing guidelines are observed. A string section, with all members wearing mouth and nose coverings/face masks, could use the standard 2 meter/6 ½ feet distance between students. As previously noted, consider a greater distance for wind players and singers, until further research findings about aerosols and music making emerge.
  13. Some professional music ensembles have started using clear barriers for individual musicians in order to mitigate risk of airborne infection. Singers have also begun experimenting with personal face shields. The degree to which these measures reduce risk of airborne infection during rehearsals and performances is not yet clear.

Private Music Lessons

  1. Students and teachers should:
    1. participate regularly in university-wide health and wellness questioning/screening/testing;
    2. wash hands for 20 seconds prior to rehearsal or thoroughly use disinfecting hand sanitizer;
    3. avoid touching the face, mouth, nose, and eyes; and
    4. cover coughs or sneezes in the crook of the elbow.
  2. If for any reason the student or faculty member does not feel comfortable teaching/learning face-to-face owing to the small size of the teaching studio and the potential for airborne infection, those private lessons should move to a virtual learning environment immediately.
  3. At any point in the semester, should the student or instructor not feel fully well, the private lessons should immediately pivot to a virtual learning environment until both parties feel well again.
  4. Weather permitting, and as feasible, private lesson instructors are encouraged to teach in an outdoor location. Certain lessons, piano among them, will not work outdoors.
  5. The instructor should wear a cloth nose and mouth covering/face mask to help limit the buildup of droplets/aerosols in the indoor air.
  6. Consider limiting face-to-face private lessons to not exceed 30-minutes in length to reduce the length of exposure in a confined space. Students registered for a one-hour lesson would, in effect, have two half-hour lessons per week, provided the lessons are held face-to-face and indoors.
  7. Weather and facility permitting, consider leaving windows open in private studios during lessons, regardless of the HVAC or radiator heating system, in order to bring in as much fresh air as possible.
  8. Private lesson scheduling should allow for a break between 30-minute lessons to promote air exchange (consider 10 minutes or longer). During the break, the office window(s) and door should be propped open fully to maximize fresh air into the space.
  9. A clear-panel room divider between the student and teacher could reduce risk by acting as a sneeze guard. Home-built products could work, provided they adhere to construction guidelines for safety.
  10. Individual faculty members may choose to add a personal air purifier to their office.
  11. Unless approved by Campus Facilities, UVC lamps are not recommended for office use at this time. According to The National Academies of Sciences, Engineering, and Medicine regarding UVC wands, pouches, and lamps sold for home use: “[T]he safety and effectiveness of these products is not known. Beware of false claims that say these products are effective or are for use on humans.”32 Far-UVC light, however, has shown promise.33
  12. Instructors may choose to teach their lessons on an A/B schedule, alternating a face-to-face lesson followed by a virtual lesson. This method of instruction allows the teaching studio to more fully complete an air exchange and may contribute to a healthier environment than face-to-face only lessons.
  13. Seek out larger spaces for teaching voice lessons. Weather permitting, the windows should be opened. Bring a coat if the temperature is cold. The Vocal Area Coordinator, in collaboration with the other voice faculty, should create a workable schedule to alternate use of the larger space as a teaching space (auditorium, recital hall, chapel, etc.). Ideally, the time spent teaching in the larger space will allow the faculty member’s studio to air out with fresh air, contributing to a healthier environment upon return to the studio. (Also see the German concept of Stoßlüftung or “shock ventilation.”)

Theater/Dance Rehearsals

  1. Students and teachers should:
    1. participate regularly in university-wide health and wellness questioning/screening/testing;
    2. wash hands for 20 seconds prior to rehearsal or thoroughly use disinfecting hand sanitizer;
    3. avoid touching the face, mouth, nose, and eyes; and
    4. cover coughs or sneezes in the crook of the elbow.
  2. Follow additional hygiene protocols as determined by the Director of Theatre to include, but not limited to, the regular use of disinfecting Clorox wipes, disinfectant alcohol, alcohol spritzers, and non-latex gloves (non-latex due to the potential for latex allergies among students).
  3. Crew should wear a cloth nose and mouth covering/face mask to help limit the buildup of droplets/aerosols in the indoor air. Face coverings should not be removed and put back on again by actors, crew, or staff, due to the increased risk of infection from touching the face.
  4. Weather permitting, theatre/dance ensembles should choose to rehearse in an outdoor location when feasible, provided a suitable and safe surface for dance can be identified.
  5. Theatre/Dance large-ensemble indoor rehearsals should move to the stage of the largest auditorium/multipurpose room.
  6. Within reason, directors/choreographers should make every effort to eliminate physical contact (e.g., kissing/swordplay) and minimize close proximity on stage.
  7. Limit the number of cast and crew members to better observe best practices in physical distancing.
  8. Consider increasing understudy and swing roles in the event of illness or quarantine.
  9. Consider modifying rehearsals to avoid too many people in rehearsal spaces for a prolonged time.
  10. Schedule actor calls in a way that minimizes contact and de-densifies the rehearsal room.
  11. Create separate stations in the rehearsal room for each actor’s belongings, props, script, and hospitality items.
  12. Implement risk-reduction strategies for production work that must be done in close proximity, such as costume fittings, loading trucks, carrying heavy items, and putting microphones on actors.
  13. Use an outdoor performance venue for the early fall production, such as a gazebo.

Conclusion

In combination, these risk reducing measures may lower the risk of infection from Music & Theatre activities, a risk made greater by the increased number of aerosols emitted through loud speech, singing, and, potentially, through playing wind instruments. Individually, everyone must have the right to decide for themselves the level of personal risk they will take, yet do so without increasing the risk for others and while preserving unity within their department and educational community.

Amidst a backdrop of expert panelists wrestling with questions about how to sing safely prior to having a vaccine and effective treatment for COVID-19 in place,34 Dr. David Young, an otolaryngologist and singer who previously studied with a panelist, offered a cautiously optimistic history lesson. “We have performed and thrived amid terrible infectious diseases before. We performed during the pre-vaccine measles era. We performed during polio. We performed despite tuberculosis lurking out there, a highly contagious disease spread via aerosols that can linger without symptoms for a long time. We’ve done it before.”35

Not too long ago, if someone raised the topic of a risk assessment in music class, we might envision an instance when two enthusiastic young string players used their violin bows like swords, mimicking the latest swashbuckling pirate movie. These images conjure up remarks along the lines of: “Hey, stop sword fighting. You could poke somebody’s eye out”; consider that risk assessed. Never did we imagine a day when the very air we breathe in a music classroom could pose a risk to us, or that the emotive exhale as we turn an expressive musical phrase could pose a risk to others.

And as the world around us anxiously asks, “How can I sing?” We—the music makers and dreamers of dreams—must stand ready with a question of our own: How can I keep from singing?

Through all the tumult and the strife,
I hear that music ringing.
It finds an echo in my soul.
How can I keep from singing?
—Robert Lowry, 1869

References

  1. Spahn, Claudia, and Bernhard Richter. “Risk Assessment of a Coronavirus Infection in the Field of Music – Second Update of 19 May 2020.” Translated by Scott Swope and Kirk Moss. Risk assessment. Accessed June 4, 2020. https://www.mh-freiburg.de/en/university/covid-19-corona/risk-assessment.
  2. “CDC’s Response to COVID-19.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 23 Apr. 2020. https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/index.html.
  3. “How Coronavirus Spreads.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 22 May 2020, www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.
  4. “Older Adults.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 30 Apr. 2020, www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html.
  5. Zhang, Renyi, Yixin Li, Annie L. Zhang, Yuan Wang, and Mario J. Molina. “Identifying Airborne Transmission as the Dominant Route for the Spread of COVID-19.” PNAS. National Academy of Sciences, June 11, 2020. https://www.pnas.org/content/early/2020/06/10/2009637117.
  6. Liu, Yuan, Zhi Ning, Yu Chen, Ming Guo, Yingle Liu, Nirmal Kumar Gali, Li Sun, et al. “Aerodynamic Analysis of SARS-CoV-2 in Two Wuhan Hospitals.” Nature News. Nature Publishing Group, April 27, 2020. https://www.nature.com/articles/s41586-020-2271-3.
  7. Mittal, Rajat, Rui Ni, and Jung-Hee Seo. “The Flow Physics of COVID-19.” Journal of Fluid Mechanics 894 (January 2020). https://doi.org/10.1017/jfm.2020.330.
  8. Qian, Hua, Te Miao, Li LIU, Xiaohong Zheng, Danting Luo, and Yuguo Li. “Indoor Transmission of SARS-CoV-2.” medRxiv. Cold Spring Harbor Laboratory Press, January 1, 2020. https://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1.
  9. Morawska, Lidia, and Junji Cao. “Airborne Transmission of SARS-CoV-2: The World Should Face the Reality.” Environment International 139 (2020): 105730. https://doi.org/10.1016/j.envint.2020.105730.
  10. Zhou, Yunyun, Yuyang Zeng, Yongqing Tong, and ChangZheng Chen. “Ophthalmologic Evidence against the Interpersonal Transmission of 2019 Novel Coronavirus through Conjunctiva.” medRxiv. Cold Spring Harbor Laboratory Press, January 1, 2020. https://www.medrxiv.org/content/10.1101/2020.02.11.20021956v1.full.pdf html.
  11. Ruthberg, Jeremy S., Humzah A. Quereshy, Tarun K. Jella, Armine Kocharyan, Brian Danza, Nicole Maronian, and Todd D. Otteson. “Geospatial Analysis of COVID-19 and Otolaryngologists above Age 60.” American Journal of Otolaryngology, 2020, 102514. https://doi.org/10.1016/j.amjoto.2020.102514.
  12. Nikitin, Nikolai, Ekaterina Petrova, Ekaterina Trifonova, and Olga Karpova. “Influenza Virus Aerosols in the Air and Their Infectiousness.” Advances in Virology 2014 (2014): 1–6. https://doi.org/10.1155/2014/859090.
  13. Asadi, Sima, Anthony S. Wexler, Christopher D. Cappa, Santiago Barreda, Nicole M. Bouvier, and William D. Ristenpart. “Aerosol Emission and Superemission during Human Speech Increase with Voice Loudness.” Scientific Reports 9, no. 1 (2019). https://doi.org/10.1038/s41598-019-38808-z.
  14. Stadnytskyi, Valentyn, Christina E. Bax, Adriaan Bax, and Philip Anfinrud. “The Airborne Lifetime of Small Speech Droplets and Their Potential Importance in SARS-CoV-2 Transmission.” Proceedings of the National Academy of Sciences, 2020, 202006874. https://doi.org/10.1073/pnas.2006874117.
  15. Wei, Jianjian, and Yuguo Li. “Airborne Spread of Infectious Agents in the Indoor Environment.” American Journal of Infection Control 44, no. 9 (2016). https://doi.org/10.1016/j.ajic.2016.06.003.
  16. Loudon, Robert G., and Rena M. Roberts. “Singing and the Dissemination of Tuberculosis.” American Review of Respiratory Disease 98 (1968): 297–300. https://www.atsjournals.org/doi/abs/10.1164/arrd.1968.98.2.297.
  17. Lindsley, William G., William P. King, Robert E. Thewlis, Jeffrey S. Reynolds, Kedar Panday, Gang Cao, and Jonathan V. Szalajda. “Dispersion and Exposure to a Cough-Generated Aerosol in a Simulated Medical Examination Room.” Journal of Occupational and Environmental Hygiene 9, no. 12 (2012): 681–90. https://doi.org/10.1080/15459624.2012.725986.
  18. Xie, X., Y. Li, A. T. Y. Chwang, P. L. Ho, and W. H. Seto. “How Far Droplets Can Move in Indoor Environments – Revisiting the Wells Evaporation-Falling Curve.” Indoor Air 17, no. 3 (2007): 211–25. https://doi.org/10.1111/j.1600-0668.2007.00469.x.
  19. Tellier, Raymond. “Review of Aerosol Transmission of Influenza A Virus.” Emerging Infectious Diseases 12, no. 11 (2006): 1657–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372341/.
  20. van Doremalen, Neeltje, Trenton Bushmaker, Dylan H. Morris, Myndi G. Holbrook, Amandine Gamble, Brandi N. Williamson, Azaibi Tamin, et al. “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1.” The New England Journal of Medicine. Massachusetts Medical Society, April 16, 2020. https://www.ncbi.nlm.nih.gov/pubmed/32182409.
  21. Spede, Mark, and James Weaver. “Unprecedented International Coalition Led by Performing Arts Organizations to Commission COVID-19 Study.” NFHS. Accessed June 13, 2020. https://www.nfhs.org/articles/unprecedented-international-coalition-led-by-performing-arts-organizations-to-commission-covid-19-study/.
  22. Escombe, A. Roderick, Clarissa C. Oeser, Robert H. Gilman, Marcos Navincopa, Eduardo Ticona, William Pan, Carlos Martínez, et al. “Natural Ventilation for the Prevention of Airborne Contagion.” PLoS Medicine 4, no. 2 (2007). https://doi.org/10.1371/journal.pmed.0040068.
  23. Escombe, Adrian Roderick, David A. J. Moore, Jon S. Friedland, Carlton A. Evans, and Robert H. Gilman. “Natural Ventilation for Prevention of Airborne Contagion: Authors’ Reply.” PLoS Medicine 4, no. 5 (2007). https://doi.org/10.1371/journal.pmed.0040195.
  24. Konda, Abhiteja, Abhinav Prakash, Gregory A. Moss, Michael Schmoldt, Gregory D. Grant, and Supratik Guha. “Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks.” ACS Nano, 2020. https://doi.org/10.1021/acsnano.0c03252.
  25. Bromage, Erin. “What’s the Deal with Masks?” Erin Bromage PhD: May 29, 2020. https://www.erinbromage.com/post/what-s-the-deal-with-masks.
  26. Howard, Jeremy, Austin Huang, Zhiyuan Li, Zeynep Tufekci, Vladimir Zdimal, Helene-Mari Van Der Westhuizen, Arne Von Delft, et al. “Face Masks Against COVID-19: An Evidence Review,” 2020. https://doi.org/10.20944/preprints202004.0203.v2.
  27. Read, Richard. “A Choir Decided to Go Ahead with Rehearsal. Now Dozens of Members Have COVID- 19 and Two Are Dead.” Los Angeles Times. March 29, 2020. https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak.
  28. Hamner, Lea, Polly Dubbel, Ian Capron, Andy Ross, Amber Jordan, Jaxon Lee, Joanne Lynn, et al. “High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020.” MMWR. Morbidity and Mortality Weekly Report 69, no. 19 (2020): 606–10. https://doi.org/10.15585/mmwr.mm6919e6.
  29. Kähler, Christian J. “Making Music in Times of Pandemic.” Plone site. Accessed June 7, 2020. https://www.unibw.de/lrt7-en/making-music-in-times-of-pandemic.
  30. Facilities manager, email communication with author, May 2020.
  31. Qureshi, Zeshan, Nicholas Jones, Jessica P. J. Larwood, Trisha Greenhalgh, and Lydia Bourouiba. “What Is the Evidence to Support the 2-Metre Social Distancing Rule to Reduce COVID-19 Transmission?” CEBM, June 23, 2020. https://www.cebm.net/covid-19/what-is-the-evidence-to-support-the-2-metre-social-distancing-rule-to-reduce-covid-19-transmission/.
  32. “Based on Science…Does Ultraviolet Light Kill the Coronavirus: National Academies.” Does ultraviolet light kill the coronavirus | National Academies, May 22, 2020. https://sites.nationalacademies.org/BasedOnScience/covid-19-does-ultraviolet-light-kill-the-coronavirus/index.htm.
  33. Buonanno, Manuela, David Welch, Igor Shuryak, and David J. Brenner. “Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses.” Sci Rep 10, 10285 (2020). https://doi.org/10.1038/s41598-020-67211-2.
  34. “A Conversation: What Do Science and Data Say About the Near-Term Future of Singing, May 5, 2020 Webinar.” National Association of Teachers of Singing – NATS COVID Resources Page, www.nats.org/cgi/page.cgi/_article.html/Featured_Stories_/NATS_COVID_Resources_Page.
  35. Finkelstein, Zach. “NATS Panel of Experts Lays Out Sobering Future for Singers: ‘No Vaccine, No Safe Public Singing.’” Business of Singing | Middle Class Artist | United States, www.middleclassartist.com/post/nats-panel-of-experts-lays-out-sobering-future-for-singers-no-vaccine-no-safe-public-singing.
  36. Li, Yuguo, Hua Qian, Jian Hang, Xuguang Chen, Ling Hong, Peng Liang, Jiansen Li, et al. “Evidence for Probable Aerosol Transmission of SARS-CoV-2 in a Poorly Ventilated Restaurant,” 2020. https://doi.org/10.1101/2020.04.16.20067728.
  37. Rengasamy, Samy, Benjamin Eimer, and Ronald E. Shaffer. “Simple Respiratory Protection—Evaluation of the Filtration Performance of Cloth Masks and Common Fabric Materials Against 20–1000 Nm Size Particles.” The Annals of Occupational Hygiene, 2010. https://academic.oup.com/annweh/article/54/7/789/202744.
  38. “COVID-19 Planning Considerations: Guidance for School Re-entry.” American Academy of Pediatrics, June 25, 2020. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/.
  39. Verma, Siddhartha, Manhar Dhanak, and John Frankenfield. “Visualizing the Effectiveness of Face Masks in Obstructing Respiratory Jets.” AIP Publishing. AIP Publishing LLCAIP Publishing, June 30, 2020. https://aip.scitation.org/doi/10.1063/5.0016018.
  40. Miller, Shelly, and Jelena Srebric. Rep. Performing Arts Aerosol Study: Round One Preliminary Results Clarinet, Flute, Horn, Soprano Singer, Trumpet. National Federation of State High School Associations Performing Arts Coalition, July 13, 2020. https://www.nfhs.org/media/4029952/preliminary-testing-report-7-13-20.pdf
Kirk D. Moss, PhD

Kirk D. Moss, PhD, serves as Interim Dean for the College of Arts & Humanities and Professor and Chair of the Department of Music & Theatre at University of Northwestern – St. Paul. Coauthor of Sound Innovations, he is a past national president of ASTA and has appeared as a guest conductor, clinician, or adjudicator in nearly forty states and Australia.

Get the best from SmartMusic

Discover practical music education tips, delivered directly to you!

This website uses cookies to improve your experience. By viewing or browsing our site, you are agreeing to our use of cookies. More Information

Accept