A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead

A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead

3/30/2020 5:48:00 AM

A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead

The deadly outbreak among members of a choir has stunned health officials, who have concluded that the virus was almost certainly transmitted through the air from one or more people without symptoms.

MOUNT VERNON, Wash. — With the coronavirus quickly spreading in Washington state in early March, leaders of the Skagit Valley Chorale debated whether to go ahead with weekly rehearsal.The virus was already killing people in the Seattle area, about an hour’s drive to the south.

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But Skagit County hadn’t reported any cases, schools and business remained open, and prohibitions on large gatherings had yet to be announced.On March 6, Adam Burdick, the choir’s conductor, informed the 121 members in an email that amid the “stress and strain of concerns about the virus,” practice would proceed as scheduled at Mount Vernon Presbyterian Church.

Advertisement“I’m planning on being there this Tuesday March 10, and hoping many of you will be, too,” he wrote.The Mount Vernon Presbyterian Church in Mount Vernon, Wash.(Karen Ducey / For The Times)Sixty singers showed up. A greeter offered hand sanitizer at the door, and members refrained from the usual hugs and handshakes.

“It seemed like a normal rehearsal, except that choirs are huggy places,” Burdick recalled. “We were making music and trying to keep a certain distance between each other.”AdvertisementAfter 2½ hours, the singers parted ways at 9 p.m.Nearly three weeks later, 45 have been diagnosed with COVID-19 or ill with the symptoms, at least three have been hospitalized, and two are dead.

The outbreak has stunned county health officials, who have concluded that the virus was almost certainly transmitted through the air from one or more people without symptoms.“That’s all we can think of right now,” said Polly Dubbel, a county communicable disease and environmental health manager.

In interviews with the Los Angeles Times, eight people who were at the rehearsal said that nobody there was coughing or sneezing or appeared ill.Everybody came with their own sheet music and avoided direct physical contact. Some members helped set up or remove folding chairs. A few helped themselves to mandarins that had been put out on a table in back.

Experts said the choir outbreak is consistent with a growing body of evidence that the virus can be transmitted through aerosols — particles smaller than 5 micrometers that can float in the air for minutes or longer.The World Health Organization hasin aerosols, stressing that the virus is spread through much larger “respiratory droplets,” which are emitted when an infected person coughs or sneezes and quickly fall to a surface.

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Advertisementstudy published March 17in the New England Journal of Medicine found that when the virus was suspended in a mist under laboratory conditions it remained “viable and infectious” for three hours — though researchers have said that time period would probably be no more than a half-hour in real-world conditions.

One of the authors of that study, Jamie Lloyd-Smith, a UCLA infectious disease researcher, said it’s possible that the forceful breathing action of singing dispersed viral particles in the church room that were widely inhaled.“One could imagine that really trying to project your voice would also project more droplets and aerosols,” he said.

With three-quarters of the choir members testing positive for the virus or showing symptoms of infection, the outbreak would be considered a “super-spreading event,” he said.Linsey Marr, an environmental engineer at Virginia Tech and an expert on airborne transmission of viruses, said some people happen to be especially good at exhaling fine material, producing 1,000 times more than others.

Marr said that the choir outbreak should be seen as a powerful warning to the public.“This may help people realize that, hey, we really need to be careful,” she said.***AdvertisementThe Skagit Valley Chorale draws its members from across northwest Washington and often sells out its winter and spring concerts at the 650-seat McIntyre Hall in Mount Vernon.

Amateur singers interested in choral music tend to be older, but the group includes some young adults. Last year, Burdick worked some hip-hop into one number.The next big performance on the group’s schedule was in late April, peak tourist season, when the annual Skagit Valley Tulip Festival attracts more than a million people to view brilliant hues in meadows surrounding Mount Vernon.

The festival would soon be canceled, but nothing had been announced yet and the choir was continuing to prepare.Carolynn Comstock and her husband, Jim Owen, carpooled to the March 10 practice from the nearby city of Anacortes with their friends Ruth and Mark Backlund.

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Carolynn and Jim, who ran a home remodeling business together, had been singing with the choir for 15 years and thought of it as a centering force in their lives. They had introduced the Backlunds to the choir.Jim Owen and Carolynn Comstock, singers in the Skagit Valley Chorale, sit outside their home in Anacortes, Wash.

(Karen Ducey / For The Times)The two couples entered the rented church hall — roughly the size of a volleyball court — and offered their hands for the disinfectant.Cushioned metal chairs extended in six rows of 20, with about a foot between chairs and one aisle down the center. There were twice as many seats as people.

Comstock, a soprano, and Owen, a tenor, took their usual seats beside each other in the third row. The rows toward the front and center filled up around them.Burdick, 49, stood facing his choir, with an accompanist to his right seated at a grand piano.

Given the anxiety over the coronavirus, the conductor decided to lead off with a piece called “Sing On.”The singers inhaled deeply, and sang the chorus with gusto: “Sing on! Whatever comes your way, sing on! Sing on!”The choir moved on to other numbers, including a popular spiritual piece written by gospel legend Thomas A. Dorsey: “If we ever needed the Lord before, we sure do need Him now.”

At one point the members broke into two groups, each standing around separate pianos to sing.When it was time to leave, Burdick’s wife, Lorraine, a contralto who also sang professionally, refrained from her custom of embracing friends.Instead, she curtsied her goodbyes.

***Three days later, Comstock felt chills. A sweater didn’t help. She took her temperature: 99.3.She and Owen canceled their plans for dinner that night at the Backlunds’ house.At 9 p.m., she got a text from Ruth Backlund. Ruth, 72, and Mark, 73, had fevers.

Burdick woke up the next day, March 14, with a fever. As his temperature rose to 103, he began hearing from other choir singers.They felt fatigued and achy. Some had fevers, coughs and shortness of breath they had heard were telltale symptoms of COVID-19. Some had nausea and diarrhea.

On March 15, Comstock, 62, noticed something odd when she made pasta. She couldn’t taste the sauce, a spicy Italian sausage. She would soon learn that loss of taste and smell was a common symptom too.When Owen, 66, first felt sick that day, he found that his temperature was below normal, a symptom that continued. The same day, the Backlunds tested negative for influenza.

Their clinic sent out their samples for coronavirus tests, which would come back four days later showing they both had COVID-19.On March 17, a choir member alerted Skagit County Public Health about the outbreak.Working from the choir’s membership roster, a dozen health officers scrambled for three days to contain the outbreak. They called every member, determining who had attended the rehearsal.

They asked each person with symptoms to list their close contacts during the 24 hours before illness set in. Then they called those people, telling anyone who felt sick to quarantine themselves.“We think it was just a really super-unfortunate, high-risk occurrence,” said Dubbel, the county health official.

Mark Backlund felt himself slipping, but not as badly as a friend a decade younger, a runner, who was rushed to the hospital with pneumonia. Both men would ultimately recover.On March 18, Burdick received a message from Nancy “Nicki” Hamilton, an 83-year-old soprano, known for her political activism and tales of international travel. She was worried about a fellow member.

Three days later, he received another call. Hamilton had been rushed to the hospital soon after he had talked with her and now she was dead.Word quickly spread among the choir members, many of them sick and left to grieve alone in their homes.Health officials said all 28 choir members who were tested for COVID-19 were found to be infected. The other 17 with symptoms never got tested, either because tests were not available or — like Comstock and Owen — the singers were under the impression that only people in dire condition were eligible.

The youngest of those sickened was 31, but they averaged 67, according to the health department.In their split-level home, Burdick and his wife kept distance between themselves for a week. But Lorraine got sick anyway.The Burdicks had been heartened to hear that another woman in the hospital — an alto in her 80s — seemed to be getting better.

But this past Friday, the conductor got another call. She had died. And another woman, a tenor, had been rushed to the hospital.Others felt the disease waning. Fifteen days after the rehearsal, Comstock squirted shampoo into her hand and experienced an odd and pleasing sensation.

It smelled. Like coconut.***Marr, the Virginia Tech researcher, said that the choir outbreak reminded her of a classic case study in the spread of infectious disease.In 1977, an Alaska Airlines flight returned to Homer, Alaska, after experiencing engine trouble and sat on the tarmac there for four hours with the ventilation system off.

Of the 49 passengers on board, 35 developed flu symptoms and five were hospitalized. Researchers ultimately traced the outbreak to a woman who felt fine when she boarded but later became ill.The case jolted epidemiologists into the realization that influenza could spread through the air.

Research has already shown that the coronavirus is nearly twice as contagious as influenza and far more deadly.There is still much to learn about the choir outbreak, starting with the original source of the virus.Dubbel, the county official, said she hoped that a study would be conducted someday to determine how the infection spread. But for now, her team is swamped trying to contain additional outbreaks.

Marr said that researchers will have lots of questions for choir members.Did the singers sit in customary seats, allowing them to recall their locations that evening and help reconstruct the layout of the room and its occupants?Might the 15 people who did not get sick have sat together?

By Sunday, 99 people had tested positive in Skagit County.It could be months before the choir meets again. The Backlunds, though, have started singing again — an alto and a bass together in their living room.The couple, and Comstock and Owen, would like to know if they have antibodies against the virus, so it would be safe for them to deliver meals and find other ways to help as the infection spreads.

Comstock marveled at the randomness of it all.“It’s just normal random people doing things that they love to do, and all of a sudden some people are dead,” she said. “It’s very sobering.”NewsletterMust-read stories from the L.A. TimesGet all the day's most vital news with our Today's Headlines newsletter, sent every weekday morning.

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Thoughts and prayers. Misleading and sensationalized. 28 out of 60 tested positive COVID-19. Only 3 hospitalized. Two that died were in their 80's. Don't know if they died because of COVID-19. Mt. Vernon is a small town of 35,000. They could have easily caught it elsewhere. Basically human beings don't take things seriously until a whole bunch of them die. In addition in the USA this manifests or is made worse by an anti-science fetish, pushed by Republicans and the Mass Murderer in Chief.

A review of federal purchasing contracts by The Associated Press shows federal agencies waited until mid-March to begin placing bulk orders of N95 respirator masks, mechanical ventilators and other equipment needed by front-line health care workers. Please re-write your post so it makes grammatical sense.

Can latimes not stop bullshitting the amercan people? social distancing works. Saying its airborne to create hysteria is bullshit. Do not listen to these liars Closed environments, e.g., supermarkets, are good candidates for transmitting COVID19. It’s the asymptomatic that unknowingly spread the🦠 Everyone should assume to have the 🦠 and protect others by wearing a mask outside the home. Practice physical distancing.

Jesus blood didn’t work? Better take away more rights. This stunned me too, not least because that's a massive percentage of infected in one room. Stop eating for 60-90 days to rid the body from what’s making it too weak to fight “MUCUS” every species has a diet. Are we humans to believe we are any different. The foods made the body weak the food has to be of a natural source.

DineshDSouza Their own fault. There is an assumption of personal responsibility here. Choose not to follow expert advice, too bad for you. Fix your tweet. Proofreading is important. I am an infectious diseases researcher and I pushed my beloved choir of about 200, about 75% over 60s, to cancel their last rehearsal and the concert a week later when government recommendations in the UK still did not require this action. I am so glad I did!

Way to be a bunch of assholes WHAT THE F IS WRONG WITH PEOPLE DrJenGunter Since breathing is deeper and more purposeful when one sings, it does make you wonder if the initial site of infection is a big determinate of outcome 🤔. . . Anybody got any mouse (other animal? ) studies of infection site vs severity / time till death ❓

They should’ve known better The choir got together and practiced on March 10. I work in the town where this happened. 🤦🏼‍♀️🤦🏼‍♀️🤦🏼‍♀️ C’mon people!!!! This is stupid!! JuddApatow How did people get so stupid? Of course, viruses are air borne, as are most germs when people cough or sneeze. Maybe people need a biology refresher course. I'm at a loss here.

When a choir practices, they get up on risers. Those on the higher levels SPIT A LOT on those in front of them. Exaggerated enunciation is required in choral singing. Perhaps sustaining a full-throated note might aerosolize mucus, as well. But just the spit would be enough. Exact scenario in Korea Lol where's their god now. Got no one but themselves to blame.

Kamkiriad They really don't grow them smart down there clarencehilljr SinatraCool What a shame . . . To quote Forest Gump “my momma always sez stupid is as stupid does” tweetlikedean Cmfundisi worrying bradjohansen Joe Mixon ? Praying for those people. People need to listen and stay home. There are people out there that don't have a choice to stay home. They are out working and helping our nation.

Alarming. Why has NOBODY ruled out the possibility of contaminated mandarins? All it takes is one. You immediately eat after peeling, generally speaking. who is paying attention ?! Idiots has to di... This happened a week before I stopped going to gatherings in NYC, and they took precautions MMMukalla Jeezus. 'Sixty singers showed up. (...) Nearly three weeks later, 45 have been diagnosed with COVID-19 or ill with the symptoms, at least three have been hospitalized, and two are dead.'

We had the same story in France few weeks ago ... it is quite difficult to understand how stupid animals we are ... sometimes. And it is not the last time we will read such story ...Stay Home!! I feel bad for these victims but if people died already they must've contracted BEFORE the lock down. use your brain people. It's the Times, they need shocking headlines to get click bait. Facts.

I thought LA Times was temporarily suspending the paywall airborne!?!? wtf. Stay woke, folks. JuddApatow Oh goodness. I'm sorry RonBrownstein This pandemic is no joke JuddApatow They told us it was airborne months ago. That has always meant that a cough, sneeze etc send an aerisolized mist of infected mucous nearly 20ft. That moves around due to air currents, fans, people walking, breathing etc and stays in the air up to 10mins.

RonBrownstein Seems that singing or shouting seriously increases the threat of airborne transmission. Doctors in South Korea believe that singing was responsible for the major outbreak in a church community there too. why do you have to write such a provocative headline? You should preface it by saying this was the beginning of the outbreak and not recently. It’s u fair and inviting hostility to the their choir community.

nischelleturner keep your family immune system strong!! I mean .... what could go wrong? 8CHBOMB 😮 🤦🏽‍♂️ I wonder what was the basis of their decision. What do people not understand about STAY HOME. I remember in early March, everyone was saying that washing your hands was good enough. No one was talking about how this could be aerosolized at that point. This is so sad.

Act of god. We have dozens of choirs in Los Angeles, last rehearsal was on March 9-10. A music director's kid was sick with flu- for months, on last day an alto came sick startling and infuriating everyone. Easily could be outbreak but nothing happened. [A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead]

So government needs to take away more rights now According to this news story, there was no order given for that community. They don’t sound too much like scofflaws as just not being cautious enough. Sad story. Is there a better way to aerosolize COVID19 than singing in a choir? I heard something about nebulizer being effective at getting people nearby sick too.

so stupidity isn't limited to college kids on the beach. Many mass COVID19 infections occur when people eat together. Asymptotic people appear to be highly contagious when the body produces saliva for eating. Saliva affects taste of food which is a symptom of COVID19. Reducing salvia production in public areas may reduce transmission.

I’m telling you, my neighborhood vibe, and what I heard, is families here don’t believe it until someone in their family gets sick. I kid you not. I’m not going to pay for your news Ignorant people pay something for their stupid actions. However, bless ALL. rhododendronfan This is terribly sad. Pay attention, people.

Ugh. PEOPLE....PAY ATTENTION! 👇🏻👇🏻 Maybe they were practicing their funeral 🎶 !

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