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A recent report from Morbidity and Mortality Weekly Report (MMWR) from the U.S. Centers for Disease Control and Prevention (CDC) describes how two COVID-positive attendees of a rural Arkansas church impacted their congregation and community.

In the May 19 report, researchers looked at information from attendees of a rural Arkansas church from March 6-11. Two symptomatic individuals who later tested positive for COVID-19 attended local church events during this time period. They are thought to be the primary cases of COVID-19 in the spread at the church.

The church pastor and his wife also attended the church events during March 6-8, and they both developed nonspecific respiratory symptoms and fever on March 10 (the wife) and March 11 (the pastor). It is likely they were infected at the church events during March 6-8, and the pastor might have exposed other people to COVID-19 while he was presymptomatic during a Bible study event he attended on March 11.

Among 92 attendees who went to these events, 35 later developed laboratory-confirmed COVID-19. Three people eventually died. At least 26 additional cases in the community tracing back to the church cases were confirmed, with one death.

The risk of symptomatic infection among adults over 65 years old was not higher than among adults ages 19-65 years. However, of the church attendees, six of the seven individuals hospitalized were over 65 years and the three deaths occurred in individuals over 65 years, backing U.S. data indicating higher hospitalization and death rates among individuals 65 years or older.

In addition, the report shares findings that are consistent with other reports regarding COVID-19 in children. Children represented 35% of the church's attendees, but accounted for only 18% of those tested and only 6% of confirmed cases. This is consistent with other reports that demonstrate children with COVID-19 are more asymptomatic and have lower hospitalization rates. The role of asymptomatic children in the transmission of SARS-CoV-2 remains unknown. This information is an important consideration when thinking about opening public spaces, such as churches, that have high numbers of children as participants.

High transmission rates of SARS-CoV-2, the virus that causes COVID-19, have been reported from hospitals, long-term care facilities, family gatherings and choir practices. This report underscores how church events also represent a new opportunity for transmission. The report encourages faith-based groups organizing in-person operations — such as services, funerals or community events — to be aware of the high potential for transmission. Church organizers should work with local health officials to determine how to implement U.S. government guidelines for modifying said activities.

Read the full report.

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