Coronavirus or COVID19 Risk Factors: Why No In-Pub Ukulele Classes?

How risky is learning to play the ukulele in the pub, with a group of other adults?

I talked to Brendan, who is a London based Medical Doctor who advises the Foreign, Commonwealth & Development Office – the FCDO on COVID risk and has been following the pandemic closely since the start. Here’s the summary:

Things to monitor in order to determine risk are:
1. environment
2. activity
3. COVID case numbers
At the moment, this is the perfect storm –
1. the environment is an indoor pub – usually small and poorly ventilated
2. the activity is singing – which is a high-risk activity
3. the case numbers on the rise
These 3 factors make Learn To Uke, learning to play the ukulele in a pub in London pretty risky. In addition, let’s not forget that all your best intentions to keep safe are likely to slip when drinking in a pub, too.

Stay safe, BYO booze, learn ahead of time and get feedback on a live call.

Here’s the transcript of my chat with Dr Brendan:

[Lorraine] Hi Brendan, how are you? 

[Brendan] Hi Lorraine, all good here.

[Lorraine] Brilliant. So, you’re my phone a friend in this instance, because I’ve been asked by people wanting lessons – adult Learn To Uke lessons in the pub – why are we not back in the pubs when the pubs are open?

So, I’ve called you to explain why – but obviously we need to explain to other people why I’m calling you…

[Brendan] Sure. So yeah good question. I’ve got no specialist Epidemiology qualifications but I’m a Medical Doctor. One of my roles is that I advised the Foreign, Commonwealth & Development Office – the FCDO and we’ve been looking at the COVID Epidemic since it’s evolved into a pandemic from early on in Wuhan. So, I’ve been following the data and I want to look at that but also look at environmental issues and activities in that environment and put it all together and think about what’s the risk for teaching classes and small groups, so… 

Let us look at some basic graphics and tell me if it’s unclear. So this is today’s PHE dashboard (Public Health England (PHE) Dashboard showing statistics on cases of coronavirus and deaths associated with coronavirus in the UK, updated daily.)

It’s not perfectly comparable because in this first wave, a lot of people weren’t getting tested but you can see, certainly in the last few days in a week, we’re definitely heading in the wrong direction.

So if now is a time to avoid any activities that could be risky obviously very central activities like school and other other things essential for the economy and compromises are being made there.

Hopefully any negatives from that will be manageable, but you know, any roles where it’s possible to be done in a safer way – working from home or zoom ukulele lessons – you should veer towards safer [options] at this time.

So [pointing at graph] and that’s where we are in the UK right now.

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[Now looking at the European Centre for Disease Prevention and Control graphic]

That’s what’s happening in Europe and case numbers are following in the footsteps of Spain and France where they’re now registering deaths. You know, deaths happen a couple of weeks after infections.

Let’s look at some graphics of how risky is it singing in an in a pub. 

[Shows informationisbeautiful graphic]

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So this graphic shows various activities; going to the beach, outdoor things through to the other end, church etc. We’ve got low risk, medium risk, high risk. You can see that nightclub – indoor venues – indoor bar is right at the very edge of high risk and they’ve actually got a little asterisk next to church, a little caveat. Singing is very high risk – off the scale. 

[shows BMJ article –  Two metres or one: what is the evidence for physical distancing in COVID-19?]

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So you know your two meter rule? You know, we’ve all heard about two 

meter rule for coughing? If you’re singing, they reckon it should probably be more like an eight metre rule. There’s even a famous case report from the US[A] where one person infected at least thirty two other choir singers despite physical distancing. So, to be singing you probably need to be eight metres apart to be relatively safe. 

Let’s look at another graphic.

[Fig 3 – Risk of SARS-CoV-2 transmission from asymptomatic people in different settings and for different occupation times, venting, and crowding levels (ignoring variation in susceptibility and viral shedding rates). Face covering refers to those for the general population and not high grade respirators. The grades are indicative of qualitative relative risk and do not represent a quantitative measure. Other factors not presented in these tables may also need to be taken into account when considering transmission risk, including viral load of an infected person and people’s susceptibility to infection. Coughing or sneezing, even if these are due to irritation or allergies while asymptomatic, would exacerbate risk of exposure across an indoor space]

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Someone’s tried to put this all together in this chart here. You’ve got being silent outdoors in a well ventilated place with not many people for a short amount of time. That’s green. If you go to the other end of the spectrum which is singing in a poorly ventilated indoor place with high occupancy everything’s red in that [bottom right] corner. If you’re going to translate that to low occupancy [further left and up on the chart] lessons perhaps up to six people and with a six meter rule indoors you’d want a VERY well ventilated place, you’d want everyone wearing face coverings if it’s for anything more than minutes. At best in that ideal scenario, you’re scoring amber. So again, now is not the time to be doing amber activities with the trajectory of case numbers in the UK, unfortunately. So I suspect Zoom lessons are the safest thing for the foreseeable future until that second wave starts to dip and then reassess on the latest evidence then.

[Lorraine] Brilliant well that’s good because I’m sticking with Zoom lessons. Safety first, eh. Thank you very much Brendan. I really appreciate that. Is there anything else that I’ve not asked you that I should have asked? 

[Brendan] I  think anyone who’s got all the answers doesn’t exist right now. It’s a changing situation. You can argue things the other way as well. Those case numbers are a hundred thousand the ones I showed you were for over a two week period. The average person you meet on the street isn’t going to have COVID and even if you’re meeting six people the chance of one of them is very small as well. The issues come when there’s more and more people all meeting together you have a few drinks and you think [you’re OK]. That’s where face masks [are used at the] start but by the end the face masks are off you you you’re sharing a bag of crisps and it’s that slippery slope we’ve all got to watch out for. Of course young people, they’re going to get over it, but the more young people in the community who have it, the more older vulnerable people are going to have it and that leads to deaths. My forty eight year old neighbour died of COVID. It is real.

[Lorraine] Sorry to hear about your neighbour Brendan. Thank you for talking to me today. I really appreciate it, thanks.

Sorry! I didn’t mean to cut you off! What were you saying? 

[Brendan] I just wanted to end on a cheery note. There are vaccines in the pipeline and I’m sure we’ll be back on the boat or having uke lessons again soon but it’s just not now and we don’t know if it’s going to be months or longer.

[Lorraine] But fingers crossed one day soon fingers crossed. I’m not cutting you off now am I? [laughter]

[Brendan] You can cut me off now.

If you want to watch the full chat, you can do that, here:

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Citations:
Public Health England (PHE) Dashboard showing statistics on cases of coronavirus and deaths associated with coronavirus in the UK, updated daily.

European Centre for Disease Prevention and Control graphic

informationisbeautiful graphic

British Medical Journal (BMJ) article –  Two metres or one: what is the evidence for physical distancing in COVID-19?