Updated May 6, 2020
We put at your disposal the translation by Adria Parravicini of the original text hosted on the Hochschule für Musik Freibrug
Original text
Translation: Adria Parravicini
First update on 6.5.2020:
Prof. Dr. med. Dr. phil. Claudia Spahn, Prof. Dr. med. Bernhard Richter
Freiburg Institute of Musicians' Medicine, University Clinic and Freiburg Higher School of Music (Freiburger Institut für Musikermedizin, Universitätsklinikum und Hochschule für Musik Freiburg).
Preamble:
The following statements represent personal estimates of the authors.
This is a snapshot that will be updated and verified according to existing prescriptions and the latest scientific knowledge.
Before moving on to specific questions in the field of music, the authors would like to stress that musicians must also follow the prescriptions and regulations issued by the State.
These measures are constantly changing as they adapt to the evolution of the Coronavirus Pandemic. (…)
Since our first risk assessment on 25.04.2020, scientific investigations have been carried out. Risk assessments for musicians and singers have been issued from various sources, which differ widely from our statements in some respects.
Our goal remains to correct our assessments based on the latest scientific results (…).
A first investigation with wind instrumentalists and singers commissioned by the Bamberg Symphony Orchestra was held on 5.5.2020.
The Bamberg Symphony Orchestra commissioned Tintschl BioEnergie- and Strömungstecknik AG to conduct a joint study with us. All the usual wind instruments in the orchestra were included in the study, as well as the recorder, saxophone and singers (both classical and folk). The study included qualitative experiments on visualizing the expiratory flow and quantitative measurements of air velocity at different distances. The results still need to be evaluated in detail, and this will take several days. As a first step, the researchers will be able to determine the exact parameters of the instrument.
Provisional result: It can be stated that at a distance of two meters from the wind instruments and singers there is no difference with a normal air current.
(…) After a detailed evaluation of the measurement results, a separate version can be drawn up for each wind instrument and singer in the next update.
It remains important that musicians follow the recommendations regarding social distancing, contact restrictions, limits on the number of people in a group in one room, as well as hygiene rules and the use of masks in public spaces. The contact restrictions by the political leaders of the Federal Republic and the Länder have been extended - in a modified form - until 6.6.2020 (measure announced on 6.5.2020).
Musicians from all walks of life should pay close attention to symptoms such as fever, cough or loss of smell and taste and, if they have them, should avoid contact with other people as far as possible, as this may be Covid-19, even if a positive test is not available and until proven otherwise. In our opinion, voluntary quarantine should be possible in the event of symptoms, even without proof of infection. In the event of a proven infection, entering the country from abroad or having had contact with another infected person, the current quarantine rules must be observed. In any case, if a person has symptoms, they should be seen by their family doctor.
In the case of music classes with children and adolescents, tutors should be deeply convinced of the importance of not sending them to class with the first suspected symptoms of Coronavirus, even if these are very mild. Also university students, and of course teachers, who should not in any case teach classes in these circumstances. Elderly people or those with immunosuppression should take extreme precautions when practicing music.
(...)
Basic information on the transmission routes of the virus
The main transmission of viruses that cause respiratory infections occurs through droplets and aerosols produced by coughing and sneezing, which are received by other people through the mucous membranes of the nose, mouth and the conjunctiva of the eyes. Since Covid-19 primarily affects the respiratory tract, these are also the main channels of infection: the air we breathe, saliva and secretions from the respiratory tract. (…)
The transmission of the Coronavirus, which triggers Covid-19, occurs mainly through aerosols that carry viruses through the air. An aerosol (in German, a word invented from the ancient Greek “á´n´p”, in German “air”, and the Latin solutio (solution)) is a heterogeneous mixture of particles suspended in a gas.
(...)
In addition to transmission of the infection via droplets and aerosols, contact transmission is also possible. Transmission of the virus via contaminated surfaces, especially in the immediate surroundings of the infected person, cannot be ruled out, (…).
Specific aspects of danger in the field of Music:
Singers and wind instrumentalists - General aspects:
Given the airborne routes of transmission of the virus, singers and wind instrument players are still wondering whether respiratory activity when singing or playing a wind instrument poses a higher risk of infection.
The sound is produced, in both groups, by the air stream of expiration. This air stream produced during expiration is characterized, physiologically, by being periodically interrupted (except in the case of the flute) by the lips (when speaking, singing or playing a brass instrument) or by the reed of the embouchure (woodwind instruments except the flute). As a consequence, the amount of air that comes out of the mouth of the instruments is not affected by the sound.
singers or the pavilion of the instruments mentioned is not large. Current investigations with the Bamberg Symphony under Dipl. Ing. Schubert of the Tintschtal Company support this assumption.
During the process of sound creation, wind instrument players and singers may experience significant mucus production. On the one hand, it is not uncommon to observe that when singing or playing a wind instrument, more mucus is produced, which is then released from the respiratory system through coughing or clearing the throat. In addition, due to the overload of the respiratory system during prolonged performance, this mucus production may increase.
In our opinion, respecting the rules of distancing is very important. Based on the results of our latest research, it does not seem necessary to maintain a distance of 3 to 5 metres. A distance of 2 metres seems to be a sufficient minimum distance for wind instruments and singers, since, in our research, at this distance there is no additional movement of air in the environment. It is important that musical performance takes place in large rooms, such as concert halls or churches, and that frequent and regular ventilation takes place every short period of time.
Solo singing
In solo singing, deep inhalation and exhalation occur during the construction of the sound. Whether there is an increased risk of infection during this process has not yet been scientifically proven. Although there is no strong direct air flow during phonation of the song (as was confirmed by our latest measurements), it can be assumed that the virus spreads in the form of aerosols during singing. However, according to these latest measurements, these aerosols do not spread more widely in space than those produced by normal breathing.
However, during solo singing, saliva particles are released when pronouncing consonants, which can be a source of propagation.
Choral singing
In the case of choral singing, the physiological foundations of deep inhalation and exhalation are the same as those described above. In our opinion, and based on our latest research, it is sufficient if a distance of 2 metres between the choristers is respected. Rehearsal rooms should be as large as possible and thoroughly and regularly ventilated. The maximum number of participants must comply with current regulations.
Individual singing class
Paying close attention to safety measures (distance of 2 meters and compliance with environmental conditions such as the size of the classroom and 15-minute breaks between each student to ventilate it) the risk of infection is considerably reduced, in our opinion. However, this statement should not be taken to mean that teachers and/or students can be forced to give or receive individual lessons in person. If the architectural and organisational conditions are not adequate, classes should, in our opinion, be held in digital format.
Wind instrument players
In the case of wind instrument players, there are no studies to our knowledge that measure the viral load in the air they expel when playing. However, it is known that playing a wind instrument produces a very intense exchange of air between the lungs and the airways, partly with high air pressure. It is not yet clear whether the viral load in the air is reduced on the way through the instrument. It can be deduced that the discharge of the performer's air into the environment may carry a viral load. However, according to the latest research, the aerosol produced when playing a wind instrument does not spread in the environment more intensely than that produced during normal breathing. Due to the results of these latest measurements, it does not seem necessary to maintain a distance of 3 to 5 meters, but a distance of 2 meters would be sufficient, since at that distance, in the
According to the latest research, there was no additional movement of air in the environment.
In the case of wind players, condensation also occurs on the bells of the instruments due to exhalation, which is considered a potential material for spreading the virus. We advise against leaving the water produced by such condensation on the floor, but instead depositing it in a container for disposal. Players should also not blow vigorously through the instrument to clean it. Wind instruments should be cleaned in rooms separate from the performance/rehearsal space.
Individual wind instrument class
The risk is comparable, in our opinion, to that of individual singing lessons. The exact analysis of the above measures will be updated for each individual wind instrument and presented in the next update.
Wind ensembles
Wind ensembles may consist of different numbers of members. The maximum limit must comply with current regulations. In general, a distance of 2 metres between wind players should be observed, as, in the latest measurements, no additional air movement in the room occurred at this distance. Rehearsal rooms should be as large as possible and should be adequately ventilated.
conscientious and frequent manner.
Support measures for singers and wind instrument players
Direct transmission via saliva can presumably be reduced by installing plastic partitions. In many institutions, existing sound-proofing screens could be used as temporary barriers against saliva particles.
In the case of wind instrument and singing classes, we believe it is reasonable for both teachers and students to wear protective masks when they are not singing or playing. At this point, attention should be paid to their correct use according to hygiene rules. If masks are available for non-medical personnel, proper use of an FFP-2 mask could significantly reduce the risk of infection.
Since social distancing is a crucial measure, having a sufficiently large room can substantially reduce the risk of infection. In the summer, using open spaces can be an additional help, since aerosols disperse more quickly in the open air, thus reducing the risk of infection.
Keyboard, bowed string, plucked string and percussion instruments – General aspects
In the case of other instruments, the risk of infection by droplets or aerosols is not, in our opinion, greater than in other social situations (provided that the current safety regulations are strictly observed). The known risks remain valid. However, in our opinion, the different formations described below should be distinguished.
Keyboard Instrumentalists
In the case of pianists, there is a risk of infection by contact if several pianists play the same instrument one after the other. Before starting, each pianist must wash his or her hands for at least 30 seconds. In addition, and in our opinion, the keys should be cleaned with wipes before and after each pianist's performance.
In the case of co-encores, care should be taken to ensure that there is sufficient safety distance between the pianist and the other instrumentalist or singer (at least 2 metres for wind instruments and singers, and 1,5 metres for other instrumentalists). In addition, plexiglass screens can be installed to minimise the risk of infection from saliva particles when accompanying singers.
Bowed and plucked string instruments and percussion instruments
In the case of the transfer or joint use of instruments, the risk of infection by contact should be reduced in the same way as with pianists.
Chamber music/Music groups
In mixed chamber music formations or music groups, it is sufficient, in our opinion based on the latest research, to maintain a distance of at least 2 metres for wind instruments and singers, and 1,5 metres for other instrumentalists. Rehearsal rooms should be as large as possible and regularly ventilated. The maximum number of participants should correspond to current recommendations.
Orchestra/ Big Band
In the case of orchestras and big bands, according to our latest research, a minimum distance of 2 metres between wind instruments and 1,5 metres for other performers is sufficient. Rehearsal rooms should be large and regularly ventilated. The maximum number of performers should follow the general recommendations.
Notes:
1. There will be an update of the risk assessment following the outcome and analysis of the investigations being carried out. Such update, Unlike this one, it will be available in English.
2. In this link you can see a short video about research carried out with wind players of the Bamberg Symphony Orchestra.