There is, in many instances, an overlooked danger with drive-in church: if one family member who has Covid-19 unaware gets in a car with their family for drive-in church, then everyone in the car is likely nearly guaranteed to be infected with Covid-19 by that family member before closing prayer, likely a 99% risk in some scenarios even though no one leaves the car.
The one family member that is infected but unaware — without symptoms or with only very mild, unnoticed ones, for example — makes up a large portion of people with Covid-19, as up to half are asymptomatic. It can take as many as 14 days or more after one becomes infected for a symptom to emerge (if ever).
The unaware family member may be “not very” contagious in most circumstances, but, even then, being with them in the small, confined space of a car cabin for such a long time, particularly a non-moving one, likely changes the equation to a near-guarantee of contagion for everyone else in the car in several common scenarios for drive-in church. This is true, too, for other scenarios in which they spend a prolonged time in the car cabin. The extent of asymptomatic contagiousness generally is an unknown and under investigation.
There is a very good chance the whole family avoids infection by that unaware member at home, even a family not engaging in extraordinary measures — like not engaging in constant social-distancing in-home. Independent scientific studies by the Centers for Disease Control and others found just a 3.0 – 10.5% household secondary attack rate for Covid-19 symptomatic. One found several household members “continuously exposed during … isolation of their household member with confirmed COVID-19” were not infected.
In-home presents risk, of course, but by no means is it inevitable that all family members will be infected in-home if one member is infected unaware and, often, no other family member will be infected.
The infected one may never become “contagious enough” to infect others in normal, periodic interactions; the rest of the family’s immune systems might be able to handle “lower amounts” of virus intake spread over time; a noticeable symptom might arise and the infected one can isolate before infecting others; etc.
Two Harvard professors and the chair of the engineering department at Portland State explain that in-home, it is “not as easy to spread COVID-19 from one person to another. In the car, it’s a whole different ball game.”
This drive-in church peril is a danger for all. Christian African-Americans are especially susceptible, though, because of the disproportionate spread and impact of Covid-19 in African-American communities and because of the great value they place on church, as discussed below.
Long, Continuous Time in a Non-Moving Car Can Make Catching the Virus Easy
First, more on the danger. The cabin of a non-moving car is a worst-case-type environment for virus transmission from one person to another — enclosed space, in spitting-distance, mouths aligned, tiny air-volume, breathing same air, sometimes air recirculating, low air-flow, closely surrounded by surfaces on which Covid-19 lives, little space for expelled virus droplets to disperse, immobilized people, and nowhere to escape virus droplets expelled by coughing, sneezing, singing, or otherwise.
The risk of infection in a car is a near guarantee, 99%, after just about 45-60 minutes of continuous time with a person already infected with the flu in some scenarios, per a peer-reviewed study by researchers and doctors at Queensland University of Technology. The situations analyzed suggest outcomes for some common drive-in church scenarios. Covid-19 appears as contagious as flu, and likely more so. Some situations present lower risk, but the risk increases with more time in the car.
In contrast, the household transmission rate of Covid-19 of just 3.0 – 10.5% symptomatic, as reported in three early studies from the Centers for Disease Control, National Institute for Health and Korean CDC, and World Health Organization, is much lower.
In other words, they found the vast majority of household members exposed to another with Covid-19 did not become infected and develop a symptom. In-home can involve periodic exposures, allowing virus particles to land elsewhere or to die or fall to the ground before they are ingested or for immune systems to work, for example, such that a sufficient volume of virus particles is not ingested in a requisite time to give rise to infection.
African-American Christians: More Likely to Go to Church …
One reason African Americans are generally especially susceptible to this church-related danger is that they are, on average, more religious by many measures than others, per Pew Research, including more likely to go to church.
About half of black adults in the United States attend religious services at least once a week while about one-third of white adults do. And 41% of black adults said their faith has grown stronger during this pandemic, more than twice of white adults.
…. and More Likely to Stay at Church
The median length in historically black Protestant churches of just the sermon, at 54 minutes, is more than twice the average median for other categories of churches.
The more time in the car together, the higher the likelihood of virus transmission from one family member to another. More time for Covid-19-particle build-up in a non-moving car, for coughs, sneezes, and singing droplets onto people when they cannot step away, for touching surfaces on which Covid-19 can live, etc.
Disproportionate Covid-19 Spread in African-American Communities
Another reason African Americans are more susceptible to this danger is the spread of Covid-19 in many African-American communities is disproportionately high.
As of early May, in Alabama, nearly as many black people have tested positively for Covid-19 as white people, despite there being almost three times as many white people there.
In Tennessee, with white people outnumbering black people by over four to one, the confirmed infection rate for black persons is twice that of white persons, with racial data not reported for more than a third of its confirmed cases. In Georgia, with white people outnumbering black people almost two to one, the number of confirmed cases for black people outnumber those for white people by about 30%.
The more people with Covid-19 in a community, the more cars that will arrive at its drive-in church containing a person with Covid-19 unaware.
The more cars that arrive at drive-in church containing one person with Covid-19 unaware, the more cars will likely leave after closing prayer with everyone else in the car infected, when most or all of them stood a very good chance of remaining uninfected at home.
Disproportionate Covid-19 Deaths in African-American Communities
Hospitalizations and deaths from Covid-19 among African-Americans are also disproportionately high. The New York Times reports, “On April 6, Louisiana became one of the first states to release Covid-19 data by race: While making up 33 percent of the population, African-Americans accounted for 70 percent of the dead at that point. …”
“Areas with large populations of black people were revealed to have disproportionate, devastating death rates. In Michigan, black people make up 14 percent of the population but 40 percent of the deaths. … In Wisconsin, … 7 percent of the population but 33 percent of the deaths. In Mississippi, … 38 percent of the population but 61 percent of the deaths. …,” per the Times.
Increased Danger of Covid-19 in African-American Communities Not Just to Elderly
Churches often serve older populations, at higher risk from Covid-19.
Deaths of children from Covid-19 has been relatively rare, but not unheard of — even in the United States — and hospitalization and development of severe disease (hypoxia) occurred in 5.6% of children in the largest review of children with it.
Among those the CDC states are at higher risk for severe illness from Covid-19 are those of all ages with “moderate to severe asthma.” About twice as many black as white children have asthma. Pre-pandemic, black children had a 500% higher death rate from asthma and a 250% higher hospitalization rate. About 50% more black adults have asthma than white adults. This is just an example.
Both hospitalization and dying from Covid-19 can involve tremendous discomfort and suffering. Victims are often alone in the hospital, with families prohibited from visiting due to the contagious nature of Covid-19.
Government Allowing Does Not Mean It is Safe for Families
Churches, including white evangelical, mainline, and historically black, have held drive-in church despite stay-at-home orders. Most governments do not prohibit them.
Some people confuse governments allowing something relative to Covid-19 with the government expressing it is safe.
Governments not prohibiting drive-in church does not mean it is safe for families. Government orders in this time focus mainly on public-health concerns, social-distancing, and larger-scale transmission risks, not private-health concerns and inter-family risks.
That one family member might infect another is not generally a concern of the government for prohibitions. Nor is it generally a public-health concern or an immediate, large-scale threat, as the threat is limited to those in the car.
Governments are looking at the overall situation, at best, including overall economics. Politics is often involved, too. And there are constitutional limits on governments.
Governments cannot be depended on to look out for particular communities or particular families.
Up to Church Leadership and Adults in the Family
It is up to church leadership and adults to protect their communities and families.
Last week, top national leaders of seven Black Church denominations joined civil rights leaders in “calling for people to stay home until it is safe in states whose governors are lifting shelter-in-place orders.”
Those leaders stated, “We regard this pandemic as a grave threat to the health and life of our people …. [W]e encourage all Black churches and businesses to remain closed during this critical period.”
“The denominations and independent churches represented in this statement, which comprise a combined membership of more than 25 million people and more than 30,000 congregations, intend to remain closed and to continue to worship virtually, with the same dedication and love that we brought to the church. …
Our families need us. Our communities need us. We must continue to … tele-worship for however long it is necessary to do so.”
Practically, though, it is up to local church leaders and members and families to love and protect.
Rev. Darrell Hamilton of First Baptist Jamaica Plain urges that “churches must think critically about new and innovative ways to meet the needs of our congregations. We must envision a church that is unbounded by its walls, but we must do so in a way that does not jeopardize the health and safety of our congregation.”
Conclusion — Love is Patient, Always Protects …
We are all ready to get back to it immediately. But we also have a calling relative to others, to love. (John 13:34-35)
Drive-in church seemed like a good idea, an opportunity to assemble while social distancing. But, alas, it presents a mortal danger, one to the entire family, during this time. There are many unknowns with Covid-19 and the knowns, particularly for African-American communities, urge caution and care.
This does not mean we cannot worship together — online and telephone church at home offer substantial opportunities.
Being patient in this uncertain time and kindly cancelling, not holding, or not attending drive-in church is the only practical way of protecting fully against this threat to the family, leaving room for the reasonable hope uninfected family members avoid infection at home.
“Love is patient, love is kind. … It always protects, … always hopes ….” (1 Cor 13:4-7)
Prayers for all.
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Sources & Notes
For more information regarding the risks of drive-in church and additional sources used for this article, see Steve Gardner, “Drive-in Church Danger for Families: Increased COVID-19 Risk,” AuthenticTheology.com (March 28, 2020).
Also see Steve Gardner, “10 Reasons Churches Should Not Have In-Person Services for a Time: COVID-19 and Flattening the Curve,” AuthenticTheology.com (March 14, 2020) (see text and Sources & Notes section).
Also see Steve Gardner, “Drive-in Church Threat to Family: Car Cabin Maximizes Covid-19 Infection Risk to Whole Family by Unaware,” AuthenticTheology.com (April 19, 2020) (an article that contains some of the same information as this one, but does not emphasize the threat to the Black Church).
Many families don’t realize how little space and air is in a car cabin.
Up to 50% asymptomatic …: NY Times.
Asymptomatic often contagious: New England Journal of Medicine.
The asymptomatic family member may be “not very” or “barely” contagious generally (some may be more so), not yet known with certainty: World Health Organization.
At home, very good chance that a household member with the virus would infect none of the others in the home: Centers for Disease Control (CDC); National Institute for Health and the Korean Centers for Disease Control and Prevention, and the World Health Organization (WHO). See also WHO re generally risk very low from infected person with no symptoms: WHO. Changes in car.
Harvard professors, chair at Portland State regarding in home “not as easy to spread COVID-19 from one person to another. In the car, it’s a whole different ball game.”: USA Today
For Covid-19’s impact on African-American communities generally, also see: Brookings Institute; Vox ; The Guardian; WDSU; Centers for Disease Control (CDC); and Charleston Gazette-Mail; Independent (UK) (added 5/4).
Also see Christianity Today (added 5/4)
Singing can project virus particles: LA Times. See also The Guardian; Dr. Heather R. Nelson (added 5/4, 9)
Risk of infection approaches near guarantee, 99%, after just about 45-60 minutes of continuous time in a car with a person already infected with the flu in some scenarios … peer-reviewed study by Australian researchers and doctors at Queensland University of Technology …: Epidemiol. Infect. (2012), 140, 474–478. Cambridge University Press. Relevant scenarios that appear to have very high risk of transmission, per the 2012 study, include: in a non-moving car with — windows up with air-conditioning running such that air is automatically recirculated; windows up with air-conditioning running and air recirculation button on; windows up with air-fan on lowest setting. The non-moving nature of the car appears to shift the spot on the curve to higher risk, as the air ventilation from movement is not present.
Windows down or cracked in a non-moving car, particularly if the wind is not up to a relatively significant speed throughout, appears to add some ventilation, but not an enormous amount. The air-fan and windows can present additional risk in that, if the air or wind is blowing from front to back and it is a person in front who is infected, the air or wind can blow the virus articles into the faces of the people in the back, for example. That is, rolling a window down is prohibited many places, probably does not help much unless the wind is blowing at a great clip, and can hurt in some instances if it blows particles from the infected person into the faces of the non-infected in the other seats or in other cars.
This is in addition to risks associated with not social distancing: exiting cars to hug; need to use the bathroom at the church or nearby facilities; communion or giving material touched or breathed on by multiple people; those actively serving in the service getting near or touching virus droplets; etc.
There are many unknowns relative to Covid-19, making the specific percentage difficult to infer from the 2012 flu study for various scenarios.
Covid-19 just as contagious as flu, likely more so: New York Times; Business Insider. Thus, it seems likely that the risk is at least as high as that presented in the 2012 study, likely higher. Again, this is not certain, but appears likely.
Risk of infection in home generally much lower. Household transmission rate (household secondary attack rate) of Covid-19 of just 3.0 – 10.5% symptomatic, as reported in three independent studies …: Centers for Disease Control, National Institute for Health and the Korean Centers for Disease Control and Prevention, and the World Health Organization. The three studies found a household-transmission rate for covid-19 of only 3.0 – 10.5% for secondary attacks, apparently that result in symptoms, suggesting a possible overall household secondary attack rate of 6.0 – 21%. That is, these three independent studies suggest that only about 1 or 2 out of every 10 members of an infected person’s household came down with covid-19.
A submitted and accepted paper (does not appear to be in final, peer-reviewed form yet) reported that household secondary transmission of covid-19 “developed in 64 of 392 household contacts (16.3%). The secondary attack rate to children was 4% comparing with 17.1% to adults. The secondary attack rate to the contacts within the households with index patients quarantined by themselves since onset of symptoms was 0% comparing with 16.9% to the contacts without index patients quarantined. The secondary attack rate to contacts who were spouses of index cases was 27.8% comparing with 17.3% to other adult members in the households. … The secondary attack rate of [covid-19] in household is 16.3%. Ages of household contacts and spouse relationship with index case are risk factors for transmission of [covid-19] within household.” https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa450/5821281 (April 17, 2020) (added 5/9)
There are many unknowns, but possible differentiating factors can be identified between car and home. If the infected person is within spitting distance with no break in a worst-case-type environment for a long time, then even a “less contagious” person can infect others, as the delivery of virus can be efficient and concentrated for a long, continuous period, which can overcome an immune system. The non-stop, close exposure in a car can allow even “barely contagious” (low-emitting) infected persons to infect everyone in the car.
In-home often involves only periodic exposures, allowing immune systems to work and virus particles to die, for example, before a sufficient volume for infection is present. In-home, one can quickly step away from a high-emission event, such as a cough or sneeze, while they cannot in a car. In-home, one can sometimes detect a symptom before being “highly contagious.” Even sleeping in the same bed, during times of shallow breathing in a wide-open room, can allow for infection avoidance.
Thus, even if someone in the house has Covid-19, studies and experience indicate it is not inevitable that everyone in the house will be infected, but if the household enters a car for the time of drive-in church, in many situations everyone will exit having been infected with Covid-19.
African Americans, on average, more religious: Pew Research. See also Christianity Today
About half of black adults in the United States attend religious services at least once a week while about one-third of white adults do: Pew Research.
41% of black adults said faith has grown stronger during pandemic …: Pew Research.
Median sermon lengths: Pew Research.
More time in the car, the higher the likelihood of virus transmission from the unaware person to another member of the household in the car. More time for Covid-19-particle build-up in a non-moving car, for coughs, sneezes, and singing expelling droplets onto people, for: Epidemiol. Infect. (2012), 140, 474–478. Cambridge University Press; USA Today.
Surfaces on which Covid-19 lives: WebMD.
Spread in African-American communities disproportionately high: NY Times.
Covid-19 data for Alabama, Tennessee, and Georgia.
Hospitalizations and deaths from Covid-19 among African-Americans are also disproportionately high: New York Times.
Even Children: The Independent from the Washington Post.
Largest review of children with Covid-19: The Lancet.
Suffer alone in the hospital and die alone: New York Times.
Higher risk includes asthma: CDC.
About twice as many black children as white children have asthma: CDC.
Black children had 500% higher death rate from asthma and 250% higher hospitalization rate: CDC; also see Vox.
Many church leaders have become so focused on social distancing, legalities, or having services, they have missed what the in-car environment means for families and virus transmission. Many have not thought about it or mistakenly thought the government not prohibiting it means it is safe.
National leaders of 7 different Black Church denominations …: Religion News. The denominations represented include the African Methodist Episcopal Church (AME), African Methodist Episcopal Zion Church (AMEZ), Christian Methodist Episcopal Church (CME), Church of God In Christ (COGIC), National Baptist Convention of America, International, Inc., (NBCA), National Baptist Convention, U.S.A. Inc. (NBC USA), and Progressive National Baptist Convention, Inc. (PNBC). Other, like the Churches of Christ, do not have national leaders and are governed only at the local level.
April 24 statement of those leaders: National Action Network.
Of course, these observations do not apply just to drive-in church. Few scenarios, though, involve such large numbers of people in non-moving cars for so long.
Much is unknown about covid-19, including precise evaluation of transmission risk in various settings.
Choosing to put people in a non-moving car for a long time on the basis that they were all probably going to be infected at home anyway appears unsupported by evidence.
We are talking about a family member who is infected but unaware getting in the car —- so they are asymptomatic or have unnoticed (e.g., very mild) symptoms — so they are not coughing, sneezing etc. much if at all. So often “not as contagious” in the house. Up to 50% of people have covid-19 asymptomatically! But if you seal yourself up in a place in which you are within spitting distance from them without a break, mouths aligned, breathing the same tiny volume of air, likely singing (which can emit and project particles like coughing, btw), nowhere to step away quickly if a sneeze does occur, lets the virus particles build up in the car cabin, very short distance to travel to the other person’s open and aligned mouth, for such a long time, etc., etc., etc., it makes it much, much, much, much easier for that person to infect everybody in the car— likely virtually guaranteed, 90-99%, in many cases. Does that help?
Would it be better if people were to sit outside their vehicles ex. (In chairs beside their cars), while still practicing 6 ft between social distancing?
Unfortunately, I think the answer is overall no, it wouldn’t be better. It might be a bit better for the family relative to exposure to that 1 unaware family member, but it would likely be worse for the entire church and could be worse for that family overall.
Drive-in church safe?
Not safely! Christian African-Americans especially susceptible to overlooked danger w/drive-in church that can infect whole fam w/Cov-19 before last Amen. Harvard profs: in-home,“not as easy to spread COVID-19…. In … car,… whole different ball game.” https://tinyurl.com/yablo4fb
Christian African-Americans, at drive-in church, especially susceptible to overlooked danger that can infect whole family w/ Covid-19 before last Amen. Harvard profs: in-home, “not as easy to spread COVID-19 …. In … car, … whole different ball game.” https://tinyurl.com/yablo4fb
Updated: 5/3 — moved percentages cites into introduction, with accompanying cites and editing; 5/5 — edited intro to make change of equation clearer; 5/9, 10 — non-substantive grammar, word-structure, paragraph simplification, other edits.
Scripture is from the NIV.
Picture is from Pixabay.