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.
But Skagit County hadn’t reported any cases, schools and
businesses 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.
“I’m planning on being there this Tuesday March 10, and
hoping many of you will be, too,” he wrote.
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.”
After 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 has downplayed the possibility
of transmission in 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.
But a study published March 17 in 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.
***
The 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.
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.
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.
(Los Angeles Times)
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