‘Small events add up to a lot’: Limited gatherings quietly emerge as source of coronavirus infections – USA TODAY

Couples whose nuptials were put on hold by COVID-19 are turning to a fresh trend in the bridal industry: micro weddings. (July 29) AP Domestic

Images of packed beaches, lakes and bars have made the rounds on traditional and social media for much of the summer, drawing scorn from those concerned about the coronavirus spreading among those crowds.

Less prominent but also troubling are the growing instances of case clusters arising from smaller gatherings.

Contact tracing yields information about the sources of infections as the USA, by far the world leader in total COVID-19 cases and deaths, grapples with how to keep its population safe while propping up a flagging economy. More than 182,000 Americans have been killed by the disease.

The hasty reopening of businesses across much of the nation after the spring shutdown was largely blamed for a summer surge in infections, but social functions of various sizes among relatives, friends and co-workers may have been a contributing factor as well.

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People dont think of it in the same way as the (President) Trump rally in Tulsa, a bunch of people on the beach or in the bars, but these small events add up to a lot. Its just invisible,said Dr. Peter Chin-Hong, a professor of medicine at the University of California-San Francisco who specializes in infectious diseases.

Theres no generally accepted definition of whats a small gathering it may range from five to 30 people and the majority of these activities take place behind closed doors. That makes it difficult to garner hard data about them.

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In late July, Maryland Gov. Larry Hogan said contact tracing revealed 44% of those testing positive for the virus in the state reported attending a family activity and 23% a house party, but the size of the events was not specified.

Students gather in a parking lot at a school in Austin, Texas, on April 5, 2020.(Photo: Jay Janner, Austin American-Statesman via USA TODAY Network)

Plenty of anecdotal evidence supports the notion that getting together with people outside the immediate household, even in fairly limited numbers, can lead to a rash of infections. Chin-Hong said several of the COVID-19 patients he treated believe they caught the virus at barbecues.

Weddings have been more troublesome, including a100-guest event in San Francisco in early July that resulted in at least 10 people contracting the virus, among them the bride and groom.

Smaller events, such asfamily, office and graduation parties, have yielded COVID-19 cases as well.

In Alabama, eight of 11 relatives who went to a lake house together in July tested positive for the coronavirus.

In the Washington, D.C., area, the host of abackyard dinner in June for about 25 came down with COVID-19, as did some of her guests.

And in Houston, seven members of a family that went out for a Fathers Day meal developed COVID-19.

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Small gatherings are a concern because theres so many of them. They may account for a much greater proportion of the cases than we think right now, said Dr. George Rutherford, a colleague of Chin-Hongs at UCSF and the principal investigator for Californias contact tracing program.

Rutherford emphasized the need for those planning to attend or host functions on Labor Day weekend to practice social distancing and wear masks as much as possible, but hes even more wary of what may be in store after Thanksgiving.

Extended families traditionally convene on that holiday, often after traveling from far away, and sit around for long stretches, be it eating or watching NFL games on TV. The dinners are almost always held indoors, wherelimited ventilation makes it easier to contract the virus.

Everybodys going to be there with their belts undone and the top button off their pants, snoring and laying without masks onwatching football in some tiny little den, Rutherford said. Its not a pretty picture. There could be a lot of transmission. And Christmas is going to be exactly the same. Its unfortunate, but this is not the year for family gatherings.

Given human nature, its nearly impossible to prevent them.

Thanksgiving dinners, usually a time of family rejoicing and reunions, could be the source of COVID-19 infections this year.(Photo: Getty Images / skynesher)

Matt Lambert, an emergency room physician based in Washington, D.C., said he would advise against any gatherings bigger than 25 people, small enough for the hosts to inquire about symptoms before the event.

Those seeking to congregate for special occasions could take extreme measures, like a couple Lambert heard of who held their wedding at a zoo, where the staff enforced distancing regulations.

Even then, its hard to keep people apart.

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Were not made that way, Lambert said. You get extended loved ones together, especially at a wedding, and theres going to be some hugging going on.

Lambert said he has treated patients who contracted the virus at a dinner with only eight participants, although he noted the party was held indoors and guests sat close to each other.

The Centers for Disease Control and Prevention and the World Health Organization posted guidelines for gatherings, and Chin-Hong said relatively safe barbecues can be held ifthe hosts and guests take precautions.

He pointed out that, besides mask usage, the main determinants of risk when people assemble are the size of the group, the type and duration of the activity, where its held (indoors or outdoors), whether alcohol is served, whether there is shouting or singing and how well participants know each other.

Chin-Hong suggested inviting no more than two or three groups, each from a single household, and having them stay in their own pods,at least 6 feet apart from the other participants. The event should be outdoors, hand sanitizer should be readily available, and either a host wearing a mask should serve the food, or the members of each pod could serve themselves while maintaining distance from the rest. Anybody using the bathroom should wear a mask.

Its fine to have a barbecue if you do it in a modest way and think about these risk aspects of keeping the pods apart from each other, Chin-Hong said. Im not against barbecues at all, but you can make it safer by not having a big event. Dont try to have a class reunion barbecue right now.

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'Small events add up to a lot': Limited gatherings quietly emerge as source of coronavirus infections - USA TODAY