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Experts advise churches to hold shorter, outdoor services. Luis Alvarez/Getty Images
  • A number of COVID-19 outbreaks have occurred at churches throughout the country.
  • Experts say indoor church services are high risk for COVID-19 because people sit close together and many times don’t wear masks when they sing, pray, and talk.
  • They advise churches to hold shorter services and, when weather permits, to have their gatherings outdoors.

For the second time in a week, the U.S. Supreme Court has sided with churches over state-imposed COVID-19 restrictions on indoor worship.

On Thursday, the justices threw out a lower court order that upheld California’s restrictions.

The challenge had been filed by the Pasadena-based Harvest Rock Church and Harvest International Ministries over limiting attendance. They argued it was a violation of their First Amendment rights.

Last week, in a 5-4 vote, the Supreme Court sided with churches and synagogues in New York’s COVID-19 hotspots who argued that capping attendance was unconstitutional.

The rulings come as the novel coronavirus is surging across the country, and states are dealing with record numbers of new cases, hospitalizations, and deaths.

Dr. Eric Christopher Cioe-Pena, the director of global health at Northwell Health in New York and an assistant professor of emergency medicine at Hofstra University, says he worries the rulings may create a “huge hurdle” in the public health effort to fight the virus.

“It’s very challenging. I recognize people’s right to gather for worship, but I don’t view the public health restrictions as a restriction on religious freedom,” he told Healthline.

“It’s important to remember that the virus doesn’t care why you’re gathering. It’s not going to give you a pass because you’re gathering to worship,” Cioe-Pena added. “It’s potentially going to result in increased cases, increased hospitalizations, and more deaths.”

“Public health laws are ones that aren’t usually challenged in such a way until very recently” he noted. “In the same way we’ve asked people to kind of figure out how to connect with family members in other ways that are safer, run their businesses in ways that are safer, we need houses of worship to do the same thing.”

This week, health officers in San Diego are warning parishioners of COVID-19 outbreaks at three separate campuses of the Awaken Church.

They have advised anyone attending services at the locations between November 15 and November 22 to get tested, quarantine, and watch for COVID-19 symptoms.

As of Wednesday, San Diego County had tied 64 cases to the three outbreaks.

“We continue to implore the public of the very real danger of indoor religious services, the danger of the spread, and of the increase in cases and what it can lead to,” San Diego County Supervisor Nathan Fletcher said at a news conference.

California is not alone.

North Carolina health officials are investigating an outbreak that began last month at the United House of Prayer for All People in Charlotte and spread to the community.

So far, more than 200 people have tested positive, and 12 have died.

Massachusetts epidemiologists have tied 36 COVID-19 clusters and 316 confirmed cases to places of worship in that state since the beginning of the pandemic.

Last month, more than 200 confirmed COVID-19 cases were traced to the Crossroads Community Church in Fitchburg, Massachusetts.

Experts say outbreaks have occurred at churches, in part, because of the personal behaviors that congregations often engage in.

“The members know each other. They enjoy seeing each other. They hug, they kiss, and they spend a fair amount of prolonged time in close association” said Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine in Tennessee.

“In many religious services, people speak in unison. They often sing and have choirs,” he told Healthline. “Those energetic ways of projecting your voice and exhaling can potentially enhance transmission of respiratory droplets.”

“Sometimes people are not wearing masks when they speak or sing, and a lot of these churches are older and have poor ventilation,” Pena added.

“Add to that, the congregations are over-represented by older persons,” Schaffner said. “You have a relatively high-risk group in very close association for prolonged periods of time, exhaling very vigorously. It’s tailor-made for the transmission of the COVID virus.”

Some health experts have suggested there may be safer ways to worship during the pandemic.

“While I think in general it is ideal for folks to hold off on gathering these days, I also recognize that there are valid reasons why people choose to do so,” said Lucy D’Agostino McGowan, PhD, an assistant professor of statistics at Wake Forest University in North Carolina.

“I think it is really important for folks to find creative ways to stay connected with their faith-based communities,” she told Healthline.

McGowan and Eleanor J. Murray, ScD, an assistant professor of epidemiology at Boston University School of Public Health, have put together a guide to help churches reduce their risk.

“This can be done virtually. For example, virtual small group meetings, virtual livestreamed services, or virtual one-on-one sessions with a religious leader,” McGowan said. “If religious services are held in person, there are several ways it can be done in a safer manner.”

“Outdoor services reduce the risk of transmission,” she added. “Whether indoors or outdoors, the risk of transmission can be reduced if members stay at least 6 feet apart from people they don’t live with. Wear a mask throughout the duration of the service.”

“Holding shorter services is safer than longer services” she noted.

“While all these measures can make gathering in person safer… They are not risk free,” McGowan explained. “There is really no substitute for postponing large gatherings, especially with cases increasing as they currently are in the U.S.”