Evidence suggests that church services following public health guidelines do not present a greater risk of spreading the novel coronavirus than other similar activities, doctors said last week.

Washing hands, social distancing, and mask requirements have helped prevent the spread of COVID-19, even in cases when contagious, pre-symptomatic parishioners took part in church events, three members of the Thomistic Institute Working Group on Infectious Disease Protocols for Sacraments & Pastoral Care concluded.

Doctors Thomas McGovern, Deacon Timothy Flanigan, and Paul Cieslak authored an article for Real Clear Science on Mass attendance and COVID-19 Aug. 19.

"For Catholic churches following [the] guidelines, no outbreaks of COVID-19 have been linked to church attendance, even though we have examples ... of asymptomatic, unknowingly infected individuals attending mass and other parish functions," they wrote. "Their attendance could have led to an outbreak if appropriate precautions were not followed, yet in each case, we found no evidence of viral transmission."

"This encouraging news should inspire confidence that the guidelines in place - based on CDC recommendations - are working to decrease COVID-19 transmission," the doctors continued. "While nothing during a pandemic is risk-free, these guidelines mean that Catholics (and public officials) may be confident that it's reasonably safe to come to Church for Mass and the sacraments."

Over the last 14 weeks, they said, approximately 17,000 parishes have held three or more Masses each weekend, as well as daily services, combining to equal more than 1 million public Masses celebrated across the United States since shelter-in-place orders were lifted.

By following public health guidelines, these Masses have largely avoided viral spread, the authors suggested.

Nick Schoen, an employee of the Archdiocese of Seattle, has initiated a contact-tracing protocol for Mass-goers in the area. Tracking individuals who have participated in church events shortly before testing positive for COVID-19, he found that none of these individuals launched outbreaks at churches.

The authors pointed to at least four examples of infected individuals attending Mass while pre-symptomatic, as well as three anointings of sick individuals by priests in poorly-ventilated rooms. In each case, they said, the sick individuals avoided infecting other people.

"During a July 3 funeral mass (45 attendees, capacity 885), two members of one household notified the parish that they had tested positive for COVID-19 and were infected and pre-symptomatic during the mass," they said.

"During a July 11 wedding (200 attendees, capacity 908), fresh air circulated from multiple open windows with the aid of fans. The following day, an attendee developed symptoms of COVID and on July 13 tested positive. The attendee was almost certainly contagious with pre-symptomatic infection during the wedding."

In April, the Thomistic Institute's Working Group on Infectious Disease Protocols for Sacraments & Pastoral Care released guidelines for reopening churches for Mass and other sacraments. These guidelines were incorporated by numerous dioceses into their protocols for reopening.

The guidelines were built on a multi-phase proposal for resumption and expansion of public Masses while remaining in conformity with public health guidelines in force in different places.

In "Phase 1" of the proposal, the institute encouraged the "Sunday obligation" to be dispensed, the elderly and those at high risk of COVID-19 to stay home, and those with symptoms to stay home from Mass. The institute also promoted social distancing, masks requirements, and the regular use of hand sanitizer.

The few churches that have reported a COVID-19 outbreak did not follow these regulations and in some cases engaged in discouraged actions such as congregational singing.

In some cases, these isolated incidents have led local government officials to restrict church services more than activities in restaurants, movie theaters, and casinos. This has prompted lawsuits alleging religious discrimination, which have often been sucessful.

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The doctors said in their article that there is no evidence that church services are higher risk than similar activities when guidelines are followed.

"To date, the evidence does not suggest that Church attendance - following the current guidelines - is any more risky than shopping for groceries. And the spiritual good for believers in coming to Church is immeasurably important for their well-being," they said.

"Indeed, for Catholics, the Mass and above all the Eucharist are central to the Christian life. In a time like this, it is even more important that the faithful be able to come to Church and receive Holy Communion."