The Association Between Singing In A Choir And The Risk Of Acquiring COVID-19

Last Updated: May 20, 2020

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Purpose

There are approximately 3.5 million Canadians singing in 28,000 choirs and advice is needed onhow they can safely resume their recreational and social function in the recovery phase of the pandemic. This note provides a summary of the research evidence and jurisdictional experiences on the risk of acquiring COVID-19 when singing in a choir.

*The full version of the Briefing Note including the Appendix can be accessed in the PDF file at the top of the page*

Key Findings

Supporting Evidence

This section summarizes the scientific evidence and lessons learned from international and Canadian jurisdictions regarding the association between singing in choirs and the risk of acquiring COVID-19

Scientific Evidence

  • No direct evidence is available on the association of singing in choirs and risk of acquiring COVID-19. However, research suggests that there is substantial probability that both droplet transmission and airborne transmission via aerosols of infections manifesting in the respiratory tract, including COVID-19, can occur through both normal speech and singing.

International Scan

  • There have been COVID-19 outbreak cases in the community in the US and Germany, where transmission of COVID-19 following choir practice was likely facilitated by the act of singing.
  • Guidance from the choir community in the US states that there is no safe way for singers to rehearse together until there is an effective testing and treatment protocol in place.They note that there is no spacing solution for singing groups that would eliminate risk, and masks do not provide safe methods for singing in groups.
    • Moreover, guidance for school administrators from the Centers for Disease Control and Prevention suggests cancelling or modifying choir classes.
  • Germany’s public health institute, the Robert Koch Institute, cautioned that droplet transmission of COVID-19 can be emitted particularly far when singing. Germany is to set out guidelines for holding religious services during the pandemic, with a list of strict restrictions expected to include a ban on singing.

Canadian Scan

  • Guidance from Health Canada advises Canadians against gathering in groups to prevent the spread of COVID-19 within communities. While there is no recommendation specific to singing or choirs, the guidance states that the risk for COVID-19 may be increased for certain settings, including gatherings in spiritual and cultural settings, theatres, festivals, and conferences.
  • Guidance from the Public Health Agency of Canada suggests that singing activities could contribute to the spread of COVID-19.
  • The government of Alberta indicates that any gatherings with fewer than 15 people mustnot include activities that could promote disease transmission. This includes singing, even at religious gatherings, because it may promote the transmission of the virus through respiratory droplets.

Ontario Scan

  • No information identified.

Methods

The COVID-19 Evidence Synthesis Network is comprised of groups specializing in evidence synthesis and knowledge translation. The group has committed to provide their expertise to provide high-quality, relevant, and timely synthesized research evidence about COVID-19 to inform decision makers as the pandemic continues. Through the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, the following member of the Network provided an evidence synthesis product that was used to develop this Evidence Synthesis Briefing Note:

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