Want safe church re-openings? Follow CDC guidelines, infectious disease expert says

Denver Newsroom, May 24, 2020 / 11:35 am

Timothy Flanigan, M.D., worked to combat the deadly Ebola outbreak of 2014.

If someone asks him, "Is it safe for me to go to Mass?" Flanigan has one answer: "Are they following the guidelines the CDC has provided us to decrease the risk of transmission?"

In his view, it is the wrong question to ask whether it is safer to go to Home Depot than to go to church.

Rather, the U.S. Centers for Disease Control guidelines for group gatherings are paramount.

"The question is: can I follow the CDC guidance just as carefully, in each setting, in order to decrease transmission of coronavirus? Can I maintain safe distancing? Can I maintain good hand hygiene? Can I ensure that I am not ill?" said Flanigan, a professor of medicine at the Warren Alpert Medical School of Brown University.

"Following that guidance is so important for all of us to do," he told CNA May 21. "Whether it's in a mall, whether it's in a supermarket, whether it's in an office building, whether it's in a meeting."

The novel coronavirus, technically known as Covid-19, has killed over 94,000 Americans and infected more than 1.5 million since January, the CDC reports.

Flanigan is also a permanent deacon in the Diocese of Providence, Rhode Island. He is part of the Working Group on Infectious Disease Protocols for Sacramental and Pastoral Care, a project of the Thomistic Institute at the Pontifical Faculty of the Dominican House of Studies in Washington, D.C. The group has put out guidelines on the sacraments pastoral care and the restoration of public Masses.

In 2014, Flanigan was in the Liberian capital of Monrovia. There, he helped Catholic clinics and the local Catholic hospital to increase safety amid the extremely deadly Ebola epidemic. His comments to CNA came before President Donald Trump's May 22 announcement that he would direct the CDC to issue new guidance for churches to re-open.

The CDC has clearly said that the primary mode of transmission is through the aerosolization of droplets, Flanigan said.

"We know that these droplets occur certainly when people cough, when they sneeze, when they sing, when they talk in a loud voice. There is more projection of these aerosolized droplets," he explained.

CDC guidance for people in groups is the same whether they are at a large store, a meeting, a workplace or at Mass.

"Their guidance says it is most important that we socially distance, that we're six feet apart. That's very important. That we don't touch each other, because when we touch each other or when we share items,we come in contact with these droplets, and then when we touch our nose, our eyes, or our mouth, that gives the virus the ability to enter into those mucous membranes and cause infections."

The CDC recommends that anybody with respiratory illness or an active cough should stay home.

"They recommend the use of masks in public spaces, and different states have different guidances," said Flanigan. Wearing masks is helpful to decrease the spread of respiratory droplets and makes the wearer more aware.

"We generally don't touch our nose and our mouth in the same way when we are wearing a mask," he said. Flanigan also noted the importance of good hand hygiene, the use of different hand sanitizers, and guidance on cleaning services for venues.

"That guidance can help us significantly at decreasing the risk of transmission of coronavirus and other viruses associated with respiratory illnesses," he said.

For Flanigan, the question is: "is the CDC guidance being followed when a group of people get together, for whatever those reasons are?"

"There is no reason to prohibit church services when you don't prohibit other gatherings," Flanigan added.

As states and localities gradually lift limits on economic and social life imposed to hinder the spread of the coronavirus, the courts are now considering the question of whether churches are being treated more strictly than similar venues.

A federal judge said the North Carolina governor failed to prove churches were more at risk and temporarily blocked restrictions For his part, Gov. Roy Cooper said different rules were justified because religious services posed greater dangers of spreading the novel coronavirus.

Coronavirus restrictions have tended to enjoy broad public support, though some churches, business owners and workers have protested.

On May 20, the Catholic bishops of Minnesota said they would allow parishes to resume public Masses, and to defy a statewide order prohibiting religious gatherings that exceed 10 people.

"An order that sweeps so broadly that it prohibits, for example, a gathering of 11 people in a Cathedral with a seating capacity of several thousand defies reason," they said.

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However, the Catholic bishops emphasized the need for parishes to follow strict requirements established by the Church. They must limit attendance to no more than one-third of church capacity, and must follow sanitation protocols. Catholics are still dispensed from their Sunday obligation to attend Mass.

Flanigan said safety precautions are vital for any such effort.

"When bishops do the careful work, as is done in many parts of the country like Minnesota, to recommend that their churches open following the guidance of the CDC, and the state has opened up similar gatherings in similar-type gatherings, then I'd certainly support the bishops in doing this," he told CNA. "I support them for recommending an opening up, and the most important thing is doing what they are doing: following the CDC guidance."

Churches have been the focus of concern during the epidemic because of the close proximity of church attendees, socialization before, during and after services, and practices like singing. Some churches have older congregations and so are believed to be more vulnerable to extreme consequences from coronavirus infection.

A May 22 article in the CDC's Morbidity and Mortality Weekly Report considered a novel coronavirus outbreak at a rural Arkansas church from March 6-11. The report said that large gatherings pose a risk for Covid-19 transmission. Among the 92 attendees at the Arkansas church, 38% developed a laboratory-confirmed case of infection, and three died. Cases in the community linked to the church numbered 26, including one death.

The article said the case has the implication that faith-based groups "should work with local health officials" to determine how to implement U.S. guidelines for modifying their activities "to prevent transmission of the virus to their members and their communities."

While not commenting on any specific incident, Flanigan said these incidents of contagion at churches "occurred prior to the use of those guidelines."

"We know that one very significant outbreak occurred where there was a lot of contact with different church members, very close contact, a lot of physical contact, touching, different materials, passing things around," he said. "Of course this was prior to our awareness of the spread of coronavirus and prior to an understanding of how important it is that we follow the CDC guidance."

"The CDC has described outbreaks that have occurred in the setting of singing," he said. "We know that different activities can cause more aerosolization of droplets, and that has let to very specific recommendations. Unfortunately, choirs are recommended not to practice and not to sing, and not to perform in all areas. Whether it is in Mass or other choral groups or performances, for example."

He said outbreaks have been related to public gatherings, carnivals, celebrations, conferences, and public worship.

"I think it's a mistake to say 'is a conference safer or less safe than a house of worship?' That's the wrong question," Flanigan told CNA. "The CDC gives us that guidance to decrease the rate of transmission. It's just as important that guidance be followed at a house of worship, as at a conference, as at any other gathering."

"If somebody makes an arbitrary judgment that a church is not going to follow that guidance, without any evidence, that is biased and there is no evidence for that," he said.

Flanigan questioned the categories of some governors who classified religious gatherings as "non-essential," compared to more "essential" activities like grocery stores.

"Being able to come together and pray together, being able to receive the sacraments, to encounter the Lord, right there in the sacraments, is so important," Flanigan commented.

Mental health is just as important as physical health, just as important as spiritual health," he said. "We are a whole self, which has a mind, a body, a heart a soul. To be able to pray together, to be able to support each other, to be able to worship together, to be able to receive the Lord in communion, is so important for us to be healthy and to thrive."

"That is why our churches are essential," he told CNA. "That is why this whole argument of essential vs. non-essential was a mistake, and not supported by anyone. Some governors just made assumptions that church is non-essential, and that is a grave error. It is an error from the public health point of view, and it is an error from the public health point of view."

One hallmark of the Covid-19 pandemic, he said, is isolation.

"We are alone in the hospital, we are alone in our nursing homes, we are alone with our fear at two o'clock in the morning. The way we normally get our support is suddenly taken away from us," he reflected. "That alone-ness is very very difficult. The evil one can attack us, gravely, during these times."

Coronavirus restrictions have polarized some supporters and critics, and appears to have resulted in violence at times. Across the country, Several store clerks who have asked patrons to wear masks have been assaulted or killed. A Holly Springs, Mississippi Pentecostal church that filed a legal challenge against the city's stay-at-home order was burned down in an apparent arson, with a note chalked nearby denouncing church members as hypocritical.

Even as some states open up, outbreaks continue. Five of seven Redemptorists at a Houston, Texas community went back into quarantine after testing positive for the coronavirus, and after another priest died after possible exposure.