COVID – 19 info (so far)
So I have been doing as much research as possible over the last few months, trying to stay up to date on the latest research on COVID-19 to understand what the best practices for flute and recorder lessons might be for staying safe and healthy during this pandemic.
I am now going to try to write a bit of a summary of what I have found out (so far) to the best of my understanding, acknowledging that as research continues things will probably change.
*Edit 2021.08.24* Hooray for vaccinations! Fully vaccinated individuals are less likely to become infected when exposed to COVID-19, and if they do become ill, they will probably have less severe symptoms. That means you might end up with a prolonged nasty case of bronchitis, but you won’t have to be hospitalized. This, combined with the fact that vaccinations are not available to the majority of school age students (yet) means that we still need to understand the need for exposure reduction protocols (masks) and ventilation, as described below.
There are two questions that need to be answered before we really know how to stay safe:
- How much of the virus do you need to be exposed to before you become ill?
- How do droplets and aerosols that may contain the virus travel through the air?
The general idea at the moment, is that the longer you are exposed to the virus, or the higher concentration of virus you are exposed to, increases the risk of serious illness. This is why outdoors is much safer than indoors. Indoors, especially in poorly ventilated spaces, there are opportunities for the amount of virus to build up over time. So the best practice is to limit the length of time and the number of people you are in contact with when you are indoors. And because the virus will build up over time if a series of people use the same space one after the other, we have to think of total usage, not just the few moments that one person is in the space.
The virus is in the water droplets and aerosols (very small vapour particles) that are emitted by people when they breathe, talk, sing, or play wind instruments. Interestingly enough, recent research as of August 22/20 (see links to U.Cincinnati and the Speaking / Singing study links below) seem to be showing that there is not much difference in aerosol emission between instruments and speech when all are at the same volume, but when anything gets louder, that’s when the aerosol emissions go up. So talking loudly to a large group may be of as much concern as playing a wind instrument. There are also individuals who are “super-emitters” and produce more aerosols than average – many of these studies are using fairly small test groups or individuals, so if any one person is such a “super-emitter” it will skew the results.
We don’t know how much virus is carried by what size of droplet, and we don’t know how much virus is needed to cause illness. To further complicate things, as the aerosols hang in the air the water evaporates from them, potentially making the concentration of virus higher as the droplet shrinks. Large droplets fall to the ground after about 2 metres, which is why that is the recommended social distance, but the aerosols can hang out much longer and travel farther, as they behave more like a gas. A good image is to think of a smoker, and how the smoke travels after it is blown from their mouth. This image also demonstrates why masks are recommended, and plastic face shields are not recommended as PPE without also using a mask (and shows how ineffective a plexiglass shield on its own is as protection against aerosol spread) .
So a music teacher, who normally sees a series of students in their home studio or school classroom over the course of several hours, is not just considering the contact with one student in one lesson, but the accumulated contact over time from many students and parents. This accumulated contact can build up a high concentration of potentially infectious aerosols in the air of the teachers’ studio, no matter what “safe” distance they remain apart. And in the case of a home studio, the teacher also lives in the house, and continues to breathe that air after the lessons are done for the day.
Most homes and classrooms are not equipped with high volume HVAC systems that can provide complete fresh air exchange quickly enough to control this situation. Some recommendations have been made regarding leaving rooms empty for a specified time between users, but in most homes and schools (especially in the winter) this would just recirculate the air, not exchange it for fresh. Open windows help a lot, but again, there are limitations to this practice during severe winter weather! A music teacher, who has a limited number of hours of the day available for lessons, will not find it economically feasible to take 30 min between each lesson for air exchange, even if air exchange was possible in their teaching space.
*Edit 2020.11.13* Here is a great article with an infographic that explains the effect of ventilation on virus spread in a variety of indoor environments really well:
*Edit 2021.08.24* Here is an article supporting the use of portable HEPA filters to reduce particulate spread in aerosols in indoor environments, which supports the use of the HEPA filters in the Cincinnati study cited below:
*Edit 2020.11.05* I have seen a lot of crazy ideas on social media recently about instrument covers and masks with holes in them (!?) to make playing wind instruments “safer”. Let’s get one thing straight: aerosols are emitted from holes. Making a hole in a mask is like not wearing a mask at all. Period. As for instrument covers – the problem there is that these concentrate aerosol levels within the cover, so you end up releasing more virus at one time into the air when you take the cover off than you would if you were playing with an uncovered instrument IN A WELL VENTILATED SPACE. Since severity of COVID-19 symptoms seem to be linked to the concentration of virus one is exposed to, I would not recommend anything that would concentrate virus particles .
This is just the ventilation question. There is also the cleaning of high touch surfaces between students, as we can also be exposed to the virus by touch. Even if you don’t touch a surface, you can leave behind potential infection when the aforementioned aerosols settle onto surfaces. Even when everyone has their own instrument, stand, music, and other supplies, we still need to consider cleaning doorknobs, railings, and consider either not permitting student use of the bathroom (toilets produce a considerable aerosol mist when flushed!) or allowing time to clean all these surface between each student. Again, not economically feasible given the amount of potential teaching time that would get used up doing this housecleaning.
Given the limitations of our physical teaching situations, and the fact that there is no information yet regarding the length or concentration of virus exposure that leads to illness, most music teachers are continuing to teach remotely for their personal safety and the safety of their students.
Personally, I am exploring these options to speed up the return to in person lessons:
- There have been some encouraging results in some studies regarding the use of portable HEPA filters with UVC sterilizing lights to reduce aerosols. I am following this thread with interest, as putting such a filter into my studio space would be quite feasible (if it does prove to reduce aerosols enough for safety).
- The detached garage in my back yard has been slated for demolition and replacement for some time. I am exploring options for turning the replacement garage into a separate teaching studio, and rebuilding with these ventilation concerns in mind.
- While the weather is mild, I want to try some outdoor lessons.
If you want to follow up on the science behind my summary, here are some links to recent studies. I also want to thank Sasha Garver and Adam Schwalje, for using their connections in the medical community to inform the musical community about the most recent research. Adam was also involved in assisting with the Preucil School of Music COVID-19 protocols and the U of Iowa music department COVID-19 protocols (click on the link for examples using HEPA filters, UVC lights, and 30 – 60m ventilation periods between room usage, along with upgraded ventilation systems to make this a practical solution).
Before citing these links, please double check any of this information! Remember that many of these studies are (at time of posting) very recent and not peer-reviewed. There is lots of ongoing research, and this is the information that I have been able to glean in my own reading. Please do not take this as a comprehensive or up to date date list (although I will add to it when I can). However, since beginning this page, I have been surprised to notice how far behind some of our government guidelines are when compared to the most recent information.
- A very good summary of why the concept of aerosol transmission has been downplayed in favour of contact precautions (hand washing, etc.) in the initial public health recommendations, courtesy of WIRED magazine:
- Here’s a really interesting new study on aerosol measurements from instruments – check the results for a good demonstration of the wide variability between individuals:
- Contact tracing study shows that children play a larger role in transmission than previously thought:
- Public Health Agency of Canada acknowledges COVID_19 aerosol spread
- Finally acknowledging in November information that was available back in May!
- Medical Express article: confirming transmission of COVID-19 through aerosols more than touch.
- U of Minnesota: aerosol spread in wind instruments
- Journal of Pediatrics: young children can carry and spread the virus
- U of Florida: identification of viable virus in aerosols of COVID-19 patients
- Time magazine article that explains this:
- Comparisons of Singing, Speaking, and Breathing:
- Facebook post from Adam Schwalje in response to media coverage of this study:https://www.facebook.com/21423247/posts/10107456769466225/?extid=tE1prhEEzeIQvdEU&d=n
- U of Iowa: example of well researched safety policies in a music school
- International Double Reed Society: Adam Schwalje, moderator:
- U of Cincinnati:
- British government summsary of current research (August 2020)
- U of Colorado:
- Peabody Conservatory: