Advisory from the AMTA COVID-19 Task Force
April 23, 2020 02:51 PM
Does Singing, Speech, and/or Playing a Wind/Blown Instrument Amplify Viral Spread?
Emerging evidence indicates both singing and talking may be a source of viral transmission through infectious droplets. This means that the coronavirus may be emitted into the air when we exhale while singing or speaking because these activities create droplets (Atkinson et al., 2009). Logically, use of any wind (blown) instrument may also increase viral exposure risks.
Amplitude is a factor along with environmental conditions; therefore, air disturbance (wind, fans, air circulation systems, physical movement) may feasibly increase COVID-19 viral exposure risks when singing or speaking loudly, playing a wind instrument, or even breathing (Asadi et al., 2019; Service, 2020).
What are the implications for music therapy practice?
Recognizing that a) guidance varies across the country regarding precautions and b) the level of evidence for these questions are not well understood, music therapists are cautioned to take all necessary and feasible steps to protect themselves and others and ensure safety (CBMT, 2015; CBMT, 2020). At this time in the pandemic, it is strongly recommended that Board Certified Music Therapists and interns avoid direct patient contact, adhere to physical distancing at all times, use personal protective equipment as instructed and available, and shift to online/virtual services where feasible and necessary.
We recognize that many of you may be experiencing moral distress and/or moral dilemmas. There is no simple solution and each clinician’s personal, professional, and contextual needs vary. We encourage you to consult AMTA’s resources on ethical decision-making models noted as an Appendix to the Code of Ethics (See https://www.musictherapy.org/about/ethics/).
Continue to adhere to policies at your respective facilities (practice sites) and monitor the information from the CDC (www.coronavirus.gov) and authorized authoritative public health and governmental agencies. This is important because guidance on the use of masks and precautions changes quickly as the science is updated (CDC, 2020; 2016).
Appendix
References
Asadi, S., Wexler,A. S., Cappa, C. D., Barreda, S., Bouvier, N. M., & Ristenpart, W. D. (2019). Aerosol emission and superemission during human speech increase with voice loudness. Scientific Reports, 9(1), 2348. doi: 10.1038/s41598-019-38808-z. Retrieved from https://www.nature.com/articles/s41598-019-38808-z
Atkinson, J., Chartier, Y., Pessoa-Silva, C. L., Jensen, P., Li, Y., & Seto, W-H. (Eds.) (2009). Natural ventilation for infection control in health-care settings. ISBN-13: 978-92-4-154785-7. Geneva: World Health Organization.
Centers for Disease Control and Prevention. (2020). How COVID-19 spreads. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html
Centers for Disease Control and Prevention. (2016). Transmission-based precautions. Retrieved from https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html
Certification Board for Music Therapists. (2015). Board Certification Domains. Retrieved from https://www.cbmt.org/wp-content/uploads/2019/09/CBMT_Board_Certification_Domains_2015.pdf
Certification Board for Music Therapists. (2020). Board Certification Domains. Retrieved from https://www.cbmt.org/wp-content/uploads/2020/03/CBMT_Board_Certification_Domains_2020.pdf
Service, R. V. (2020, April 2). You may be able to spread coronavirus just by breathing, new report finds. Retrieved from https://www.sciencemag.org/news/2020/04/you-may-be-able-spread-coronavirus-just-breathing-new-report-finds#
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