George Delgado, MD
Many states have not allowed the resumption of religious gatherings due to perceived risk of COVID-19 transmission. It is our view that resumption of religious services can take place in a manner that does not jeopardize public health. In fact, with proper measures in place, going to one’s church, synagogue or mosque should be much safer than going to the grocery store. It certainly would be safer than going to a “big box” store like Costco that serves thousands of people per day.
One could easily compare an average supermarket, which serves 1,000 customers per day, to a house of worship, in terms of risk of contagion. Even with planned flow of foot traffic, the movement of people in the grocery store is relatively uncontrolled. The aisles are not designed to allow six-foot social distancing. People touch merchandise that they never buy. By the time a person puts an item in his or her cart, it may have been touched by several, if not hundreds of people in the three previous days (the coronavirus can survive up to three days on smooth surfaces). The cart may have had its handle sanitized but the carriage itself likely was not. Next, the items are placed on the conveyor belt which has contacted hundreds of items that others have touched. The clerk wears gloves but does not change gloves between customers. He touches nearly every item as well as money.
The house of worship, on the other hand, will likely have far fewer than 1,000 attendees and services may even be held outdoors. The participants will be stationary for all or most of their services and their movements can be very controlled, planned and prescribed, as opposed to the uncontrolled movements in the supermarkets. Worshipers will not be touching multiple items. There will be time after each service to thoroughly clean the chairs or pews that they do touch.
We can calculate the risk of contagion at the house of worship, if the guidelines listed below are followed, compared to a supermarket. A relative value greater than 1 makes the house of worship riskier. A relative risk less than 1 makes the house of worship safer.
- Being in the same building with others at any one time: relative risk is 2 (100 in the house of worship 50 in the supermarket).
- People touching multiple objects: relative risk is 0.25. People touch far fewer things in the house of worship; 1,000 people per day touch many things in the supermarket. Chairs and pews can be sanitized after each service. It is impracticable, if not impossible, to sanitize all items in a store.
- Close contact with others: relative risk is 0.25. Worshipers are stationary and socially distanced. They enter and exit in a controlled, spaced manner. Shoppers move about as they wish, even if flow is one way.
The calculation is: Risk in House of Worship = Risk in Grocery Store x 2 x 0.25 x 0.25 = 0.125, which is less than 1.
Therefore, the calculated risk of contracting COVID-19 at the house of worship is 0.125 or 12% the risk at the supermarket and no one is arguing that going to the grocery store is not safe.
The following commonsense recommendations will allow a safe return to meaningful, spiritually rich religious services for the millions of Americans who cherish their religion and do not deem it as unessential.
- Have a questionnaire that the attendees self-administer before entering. Any who have symptoms of COVID-19 or contact with someone infected should be told to not enter.
- All who enter the house of worship should sanitize their hands.
- More services should be offered to allow limiting congregation sizes. There should be no arbitrary limit on congregation size, however, as long as six-foot social distancing be maintained.
- Shorter sermons and shorter services will allow clergy to offer more services while maintaining their spiritual and physical stamina.
- If feasible, outdoor services should be offered; alternatively, houses of worship should be well ventilated, with many doors and windows open. There is less chance of contagion in well ventilated areas.
- During services, people should sit together as families, with six feet between families. Only allow seating in every other pew or row, leading to six-foot spacing.
- Face coverings or face masks should be worn by attendees. The clergy person, being at greater than six-feet away, need not wear a face covering.
- No singing by the assembly or the choir should be allowed, as singing can aerosolize the virus. Chanting by the minister should be allowed. The minister should always use a micro-phone.
- Where communion is offered, lines can be spaced with families at six-foot intervals, just like in the supermarket.
- The minister who distributes communion should sanitize his or her hands, and take great care not to touch any recipient’s mouth or hand. If an inadvertent contact occurs, the minister should re-sanitize the hands, immediately.
- No hugging, kiss of peace, hand shaking or hand holding should be allowed.
- Worship aids and prayers should be projected, if possible. Reusable prayer books should be removed from the building.
- Foot traffic entering and exiting the worship area should be designed as a one-way flow loop.
- Entrance should be in orderly stages, from front to back, in order to avoid close physical contact between worshipers.
- Likewise, egress should be row by row, beginning with the row closest to the exit door.
- After each service, chairs, benches and pews should be sanitized.
The time is right to acknowledge that communal religious worship is essential and that our people have a natural law as well as constitutional right to it. Furthermore, with the above guidelines, communal worship will be safer than a trip to the supermarket. Spiritual food is at least as essential as physical food. Its procurement is safer.