Updated at 6 p.m. ET
The Centers for Disease Control and Prevention has removed guidance on its website that houses of worship should limit choir activities — advice that was based on evidence that group singing can spread the coronavirus that causes COVID-19.
The warning was part of new guidance for leaders of faith-based organizations that the CDC had posted last Friday. It stated that they should:
"Consider suspending or at least decreasing use of a choir/musical ensembles and congregant singing, chanting, or reciting during services or other programming, if appropriate within the faith tradition. The act of singing may contribute to transmission of COVID-19, possibly through emission of aerosols."
But that wording disappeared over the weekend, apparently because the White House had not approved it. The passage was deleted because it had been published by mistake, according to a federal official, who didn't want to be identified because they were not authorized to speak about the changes.
"CDC posted the wrong version of the guidance," the official told NPR, adding, "The version that is currently up on the website is the version cleared by the White House."
The revised guidance on singing now states only that faith-based organizations should: "Promote social distancing at services and other gatherings, ensuring that clergy, staff, choir, volunteers and attendees at the services follow social distancing, as circumstances and faith traditions allow, to lessen their risk."
The change was first reported by The Washington Post.
The CDC's initial advice to religious leaders was posted on the same day President Trump called for all 50 states to allow houses of worship to reopen, after weeks of forced closures due to the coronavirus. The president's comments came after some faith leaders said they planned to defy shutdown orders.
That earlier language is now visible only in a web archive of the agency's site.
The CDC has previously highlighted the risk of singing in choirs. Just two weeks ago, it published a report on a choir practice in Skagit County, Wash., that was deemed to be "a superspreading event." Only one person out of the 61 people who attended the March 10 practice was known to be symptomatic, researchers said. But 53 cases of coronavirus infection were later identified.
That report concluded that:
"Choir practice attendees had multiple opportunities for droplet transmission from close contact or fomite transmission, and the act of singing itself might have contributed to SARS-CoV-2 transmission. Aerosol emission during speech has been correlated with loudness of vocalization, and certain persons, who release an order of magnitude more particles than their peers, have been referred to as superemitters and have been hypothesized to contribute to superspeading events. Members had an intense and prolonged exposure, singing while sitting 6–10 inches from one another, possibly emitting aerosols."
The lead author of that report, communicable disease expert Lea Hamner of Skagit County Public Health, says she is concerned by the CDC's revisions.
"As a Public Health official, I would strongly encourage that religious services continue to happen remotely or in cars," Hamner told NPR via email, "and large group gatherings not take place unless strict safety measures are put in place such as physical distancing, wearing face coverings or masks, providing tools for excellent hand hygiene, and not attending while ill."
The CDC's guidance on choirs had been part of a section titled "Promote social distancing" – a section that has now been cut from eight entries to five.
In another change, the first entry in that section now includes a reference to the First Amendment, which guarantees the freedom of religion and speech. Here's how the sentence now reads, with the newly added phrase in bold:
"Take steps to limit the size of gatherings in accordance with the guidance and directives of state and local authorities and subject to the protections of the First Amendment and any other applicable federal law."
The CDC has also come under scrutiny in recent days for other revisions to its website.
The agency changed the prominence of its guidance about surface spread of the coronavirus, saying that the main means of transmission is person-to-person. As NPR reported, the CDC said "usability improvements," such as a new headline on its page about preventing viral infection, caused confusion about whether its guidelines have changed about how the coronavirus spreads.
In clarifying the agency's guidance, a CDC spokesman said the agency's language about transmission had not changed.
NPR's Selena Simmons-Duffin contributed to this report.
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