How choral music can restart 'in the safest way possible' during pandemic

Normally in early July, Mark Vuorinen would be finalizing plans for the Elora Festival, the annual southern Ontario musical celebration he leads and for which his chamber choir, the Elora Singers, plays a central part. This year's event, however, has been silenced by the coronavirus.

Along with choral groups across the country, the Elora Singers have been relegated to virtual gatherings only — with an outbreak at a choir practice in Washington early in the pandemic sending shockwaves through both the music community and the wider public. 

But as Canada resumes regular services and reopens sectors, Vuorinen and other Canadian choral leaders are raising their voices to challenge the prevailing depiction of singing as an inherently dangerous activity in the COVID-19 era.

In an open letter, choral leaders from coast to coast are calling for balanced consideration as public officials develop policies on how choristers can — like fitness buffs, restaurant patrons, salon goers and daycare staffers — return responsibly and keep the risk of transmission as low as possible.

"Choir singing is not at the top of the agenda of any government.… We understand that," said Vuorinen, who serves as Elora Festival and Elora Singers artistic director, as well as president of Choirs Ontario.

"We are not in any way advocating for returning to business as usual at this time.… It's about how can we modify to make the activities that we do safe?"

Health officials urge caution

Several prominent COVID-19 outbreaks tied to choirs this spring — including in Washington state, Berlin, Amsterdam and in Yorkshire, England — have regularly been referenced in warnings from health officials.

"There's been a number of very serious outbreaks around the world that have been related to choirs or singing," Dr. Bonnie Henry, British Columbia's provincial health officer, noted during an update from Victoria on June 16. 

"Right now, it's a caution to people that this is not the time to be having your choir practice and to be very cautious."

Meanwhile, when releasing guidelines for Ontario's Stage 2 of reopening in early June, officials specifically singled out singing, whether it might take place on restaurant patios, daycares or at religious gatherings.  

The outbreak linked to the U.S. choir "was what happens when someone has the infection and people are clustered closely together, singing.… It's hard to know exactly how much transmission was related to the actual practice itself. But there was probably some, and it was probably significant," said Dr. Isaac Bogoch, an infectious diseases specialist for University Health Network in Toronto. 

"In the era that we're in, there's really no zero-risk setting. The key thing that puts people at risk are multiple people in an indoor environment, who are not wearing masks, who are not practising physical distancing measures. That would be a perfect setup for transmission of this infection."

He acknowledged, however, that the mental health benefits of singing can get "lost in the mix" amid all the coronavirus concerns.

"There's no doubt that there's going to be some very positive mental and psychological impact of singing and being together in a group, especially a group of people that might be friends who have known each other for a long period of time. There's probably tremendous psychological impact for the individuals involved and … for the audience, too."

Restarting 'in the safest way possible'

As teams around the globe work toward a vaccine, regular people are grappling with how to reduce their risk of contracting the coronavirus while also resuming life in this "new normality," according to Dr. Bernhard Richter, co-director of the Freiburg Institute for Musicians' Medicine at Germany's Freiburg University of Music.

Richter and fellow institute director Dr. Claudia Spahn have published a regularly updated risk assessment to help guide choirs and orchestral musicians in resuming activities like rehearsals and performances, which a number of European troupes have already begun. 

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"Our goal as physicians, as performing arts medicine people, is not to shut down the music sector. Our goal is how can we — as safe as possible — reopen it," Richter said.

Their assessment for the safest way to return features measures similar to those employed by other sectors that have already reopened. The recommendations include:  

• Screening of all participants before starting. 
• Physical distancing of two metres in all directions, both for performers as well as conductors and directors.
• Activities taking place outdoors ideally.
• If indoors, venues should be large in volume to accommodate spacing and with proper ventilation.
• If indoors, assemble for shorter stretches, e.g., 15-minute sessions, with breaks to air out the space.
• No sharing or physical distribution of materials, such as sheet music. 
• Hand washing and sanitizing remains of utmost importance.
• Masks to be worn by everyone, with the exception of musicians playing wind or brass instruments.  

Describing the measures as a "Plan B" that will take time to get used to, Richter — who is also an ear, nose and throat surgeon as well as a trained opera singer and musician — said the alternative would be simply not gathering to sing or play music at all.

He said that doctors and nurses wear a single mask and communicate effectively for surgeries that last many hours.

"You get used to them. You forget them. You can breathe. You can talk," he said, acknowledging that masks do tend to have a slight dampening effect.

Richter compared professional musicians learning to perform while masked to wearing hearing protection, something many felt strongly against a decade ago but which is now commonly accepted practice. He also said that artists shouldn't give up after just 10 minutes of trying.  

"Say you want to learn, for example, a difficult aria — let's say the aria of the Queen of the Night [from Mozart's The Magic Flute]. How many hours will you spend to be perfect in this aria? Let's say 100 hours or 50 hours. So wear a mask and sing 50 hours. Then decide if you can sing with it or not," Richter said.

"If you want to restart music, then you have to have measures, which enable you to do it in the safest way possible. 

 "This is very important for social life.… Music, I think, is essential for every human being."