Revised Recommendations for Religious Congregations

May 15, 2021

Dear Congregation Leaders, As of May 15, 2021, Religious Leaders should consider the following guidance in response to the ongoing COVID pandemic. Perception has shifted among many that COVID is no longer a significant threat to the health and safety of Americans. However, this past week 85 cases were diagnosed in Calvert County. Across the state, close to 700 people are hospitalized, including 200 in ICUs. Almost every one of these hospitalizations have occurred in unvaccinated people. Fatality rates remain concerning. Although deaths have decreased compared to this past winter, twice the number of Marylanders have died of COVID this month than typically die from breast, colon, and prostate cancers combined. Those 60 and older, younger individuals with chronic health conditions, and members of minority races and ethnicities continue to suffer more severe consequences. The newer variants are infecting children and young teens more often than the original strain. 2% of hospitalizations are in this age group. Many of the recommendations from March continue to apply. State mask mandates have been lifted for those who are fully vaccinated in indoor settings. At this point, 88% of seniors in Calvert have received at least their first COVID vaccine dose. Among all adults, only 59% have received at least one dose and 47% have completed their vaccinations. Very few teens and no children have been vaccinated at this point. This means that many of your parishioners remain susceptible to illness and can spread COVID. Depending on the makeup of your congregation, more than half of those attending services may be unvaccinated at this time. All of the currently approved vaccines have proven to be extremely effective at preventing serious infection, hospitalization, and death. Congregation leaders should encourage their parishioners to get inoculated. Vaccination is the most effective way for each person to stay safe at home, work, and in worship with their fellow congregation members. Vaccines are now available for everyone age 12 and up at multiple locations across the county, including through the health department and many pharmacies and physician offices. Although we are getting closer to a “return to normal”, not enough people have been fully vaccinated and virus transmission rates are not low enough to rescind all COVID precautions. Although the Governor has lifted restrictions on occupancy and face coverings (for those who are fully vaccinated), consideration should be given to continued measures that decrease potential for virus transmission. This is particularly important, especially in indoor settings, as long as COVID transmission rates and hospitalizations remain substantial. All changes from earlier guidance or particularly important passages are in bold, italic font: Encourage congregants who are at high-risk of COVID complications to continue to worship in their homes (possibly viewing or listening to a live stream or recorded service) if they have not completed their vaccination series. Those who have completed their vaccination series can attend services in-person.

People at high-risk include anyone age 60 or older and those with chronic medical conditions including diabetes, long-standing high blood pressure, COPD, kidney disease, sickle cell disease (sickle cell trait is not a high-risk condition), congestive heart failure, a recent history of chemotherapy, and any condition that requires immunosuppressant medications. 2) If services are held indoors, face coverings should be worn by everyone over age 2 who is not fully vaccinated. Fully vaccinated is defined as at least 2 weeks since receiving the final dose of a vaccine series. Consideration should be given to a continued requirement for all attendees to wear face coverings if it is not feasible to distinguish members remain unvaccinated. Congregations can consider a “vaccinated” section that does not require face coverings or social distancing between families, but this may not be practical. This would automatically exclude families with children under age 12 until the FDA approves vaccinations for this age group. 3) It is extremely important that word be sent to congregation members that anyone with any illness or anyone with a sick member in their household should not attend service for at least 10 days. Even if a person feels well, they could have contracted COVID from an ill family member and be capable of infecting others. Anyone with travel to areas that put them at higher risk for virus exposure should not attend services for 10-days after return to Calvert. Eating inside restaurants and attending events with large numbers of people are particular concerns. 4) Singing by soloists or choirs should only include those who are fully vaccinated. Fully vaccinated is defined as more than 2 weeks after the final dose of someone’s inoculation series. Because vaccinations are not 100% effective, it is still safest for singers to be a distance away from the general congregation. Due to the projection of respiratory particles while singing, a 25-foot separation between the vocalists and the general congregation is recommended. It is also important to maximize ventilation in the congregation hall by opening windows and doors and/or having the HVAC system on continual fan setting (see section 8). Congregations can consider having a separate section for fully vaccinated members who wish to sing as part of their general worship. Those who have not yet become vaccinated should not sing in communal settings. Humming for brief periods may be considered as an alternative. Face masks should be worn at all times. Singing dramatically increases the risk of transmitting COVID. If someone is an asymptomatic carrier of the virus, singing increases the amount of virus they exhale and at least doubles the distance the virus carries through the air. If the service takes place outside, the singers should ideally be downwind from the congregation. 5) If possible, services should still be held outside. This helps dissipate viral particles much more effectively than indoor settings. I realize that the weather in Southern Maryland is not always conducive to outdoor events and some congregations may not have the physical space or equipment to hold services outdoors. If outdoor services are feasible, members of the congregation should be encouraged to bring their own fold-up chairs.

Several professional sports leagues have set an 85% vaccination threshold for eliminating mask wearing and allowing contact closer than 6 feet. 85% vaccination is also a very reasonable level of immunity for congregations to aspire. Until vaccinations are approved for children and depending on the attendees at services, this may mean close to 100% of adults and teens need to be vaccinated prior to safely eliminating face masks and social distancing between families. 6) Keep services as short as you reasonably can. Virus transmission is a result of the proximity and duration of exposure to an infected person. The longer someone is near an infected person, the more likely they are to get sick. Given the potential for severe illness with COVID-19, it is very important to limit the time people spend in group settings. 7) When possible, consider outdoor settings for children’s gatherings. Children’s services or daycare areas should have no more than 15 people in a room, including supervising adults. If the room is small, please adjust the number of occupants accordingly. Children should wash their hands with soap and water(preferable) or apply hand sanitizer before entering the room. The newer variants such as the UK variant are just as likely to infect children as adults. Not only are some children susceptible to serious illness, but they can pass the virus to immunocompromised adults. Currently, the UK variant is the most commonly transmitted virus strain in Maryland. Children over the age of two should wear face masks whenever they are indoors. Of note, the vaccines protect against the UK variant. Consider a craft day that allows children to design or make their own masks with the help of adult volunteers. There are many online guides to making face masks for COVID prevention. Instead of grouping strictly by age, please consider assigning children from the same household to the same room. Children should attend the same room with the same adult supervisors from week-to-week. Grouping by household and keeping the same assigned rooms each week will decrease the number of children who are potentially exposed to a carrier of COVID. Space children apart as much as reasonable. Children from the same household may sit or play together. If there are several services in a day, the books, toys, or other materials used should be different for each group of children so virus isn’t transmitted via objects. Common touch surfaces should be thoroughly wiped with disinfectant after each group of children leave the room. Please give at least 15 minutes between groups to allow for cleaning and air circulation. If windows or doors can be opened between groups, please do this. 8) Regardless of how indoor services are conducted, efforts should be made to maximize the flow of fresh air into buildings, improve air circulation, and use the best quality filters that your budget can accommodate. Please consult your HVAC contractor to see what adjustments can be made to your system so that optimal air flow is circulating prior to the start of services and other activities. If windows open, take advantage the fresh air to the extent that the weather permits. Portable HEPA filter units are reasonable in smaller rooms, such as those used for children’s activities, but they are not practical for main congregation halls. Consult Consumer Reports or your HVAC consultant for brands that have proven reliable and effective. 9) Common touch surfaces in bathrooms should be cleaned with a basic disinfectant after each service is completed. Please factor this into the timing of services. 10) Consider taping a weekly message, sermon, or service for those who can't safely attend in-person services. This can be placed ahead of time on a Facebook or other social media outlet. For those without internet access, it could be placed on a phone recording. 11) No physical contact should occur between religious leaders and congregants unless all participants have been fully vaccinated. COVID-19 is more easily spread than the flu. Physical contact of any kind puts you at risk as well as those in your ministry. The exception to this is baptism of children. In this situation, as long as the religious leader is fully vaccinated and the child and family members have not been in close contact with anyone ill or diagnosed with COVID in the previous 10 days, the baptism ceremony may safely take place. 12) Good, basic hygiene should be observed. Ideally, hand sanitizer should be made available at the entrance to members of the congregation or they should be encouraged to wash their hands with soap and water immediately upon entry to the facility. All common touch surfaces should be disinfected prior to each service. 13) Finally, families continue to face financial uncertainty due to COVID impacts. Pooling resources to help area foodbanks and supplies for less-fortunate children would be wonderful. Other suggestions can be forwarded to the Interfaith Council or other congregation-to-congregation channels. God bless, Dr. Larry Polsky, Calvert County Health Officer