COVID Recommendations

At the November 10 Session Meeting Pastor Andrew requested the formation of a COVID-19 Task Force to address Christ Church’s (CC) response to the pandemic and to be available when rapid answers were needed to address the changing status of the disease and governmental regulations. Since that time several CC staff members have asked questions of the committee. These questions and the answers to them are below organized by date. If no question is included it means the committee chose to address an issue for which no question was received.

Task force committee members:
Janelle Stutzman, Kristen Ward, Greg Meibeyer, and Bryan Burke

December 2, 2020

Quarantine Update

Today the Centers for Disease Control (CDC) added additional quarantine options for those exposed to COVID-19. The CDC continues to promote the older recommendations because they work best to prevent the transmission of COVID-19. Pragmatism and new scientific knowledge are the driving forces behind the two new options. First we’ll discuss the original, older quarantine recommendation and then cover the two new options.

The older recommendation requires an exposed person to quarantine for 14 days after their last known exposure. The thought process can be confusing because exposure can be a one time event or it can be a continuing event.

The one time exposure is fairly straightforward. After a one-time exposure to a person with COVID-19, the exposed person should remain in quarantine for 14 days. A negative test during this 14 day period does not shorten the quarantine time because the exposed person can get their first COVID-19 symptoms up until day 14.

The continuing exposure is more confusing. Remember, quarantine begins at the time of the last exposure. Let’s take the case of a COVID-19 infected mother, diagnosed on day 4 of her symptoms, and her healthy son. The mother will shed the virus for 10 days from the onset of symptoms. Since she will continue to care for her son on days 4 - 10 of her illness, she’ll expose him to the COVID-19 virus for six more days. Since quarantine begins at the time of the last exposure, the boy will have to be quarantined for 20 days. The last six days of the mother’s illness, plus the fourteen days of quarantine from the time of last exposure, equals 20 days.

Two New Quarantine Options

Both the CDC and the Kent County Health Department (KCHD) continue to stress the 14 day quarantine remains the best option to decrease the spread of COVID-19. Two factors have driven the CDC’s approval of these two alternative quarantine options. First, scientific evidence shows the number of cases of COVID-19 which occur in the last half of the 14 quarantine days are less than in the first half. Second, the CDC realizes a 14 quarantine can cause physical and mental health problems, as well as reducing compliance because of the long length of time. In addition, the prospect of a 14 day quarantine may dissuade recently diagnosed people from naming contacts and made dissuade contacts from responding to contact tracing if they are called by contract tracer outreach personnel.

Importantly, neither of these two options can be used without the approval of the local health department. The KCHD has approved only option 1, the 10 day option, though we’ll explain option 2, the seven day option, below.

Also very importantly, if either of the two new shorter quarantine choices are made, the use of routine precautions should extend through the complete 14 days from the person’s last exposure to COVID-19. These precautions include mask use, social distancing, hand and cough hygiene, environmental cleaning and disinfection, avoiding crowds, ensuring adequate ventilation, and self-monitoring for COVID-19 symptoms. Therefore, though these new options make quarantine less onerous for those who must do it, we do not feel these people should attend CC until the entire 14 period has passed. Attending CC would not be avoiding crowds.

New Quarantine Option 1

Quarantine can end after day 10 without testing and if no symptoms have been reported during those 10 days. With this strategy, the residual post-quarantine transmission risk is estimated to be about 1% though the statistics have an upper level confidence of 10%. Translated into English, the CDC believes the risk to be 1% but doesn’t have enough data to completely rule out the possibility the risk could be as high as 10%.

New Quarantine Option 2 - NOT APPROVED BY THE KCHD

Quarantine can end after day 7 if a diagnostic specimen tests negative within the last 48 hours of the quarantine - between day 5 and day 7 - and if no symptoms have been reported during those 7 days. Easy access to COVID-19 testing, and a quick turnaround on those tests, is essential for this option to work. Regardless of when the test result is received, the quarantine must last the full 7 days. More concretely, if a test is done on day 5, and returns negative on day 6, the quarantine must extend through day 7. With this strategy, the residual post-quarantine transmission rate is estimated to be 5% but could be as high as 12%.

The KCHD did not approve option 2 for two reasons. First, rapid testing of the type needed to make option 2 work is not available locally. Second, option 2 carries a higher risk, and given the current state of the pandemic in Kent County did not seem wise at this time. 


 

November 24, 2020

The Covid Taskforce responded to Susan's inquiry if it would be ok for one person to sing into a microphone during a worship service by saying they felt it would be ok and safe to do that and comparable to one person speaking.

If a person has had COVID-19, may they attend CC without wearing a mask?  

The question is a reasonable one, since some well known viruses do induce lifetime immunity. Others, like the flu, do not. We do not think it would be prudent to work under the assumption that most COVID-19 victims have long term immunity when the fact is simply unknown.

Therefore, we recommend we continue to recommend mask wearing for the following reasons, both in small and large group settings.

  1. Since the disease has been around such a short period of time, no one knows if COVID-19 induces long term immunity in the people who have had it. Reports exist of people who have had COVID-19 more than once.  
  2. Even if the request was supported by known medical fact, we are concerned about visitors and CC members who see other people in the congregation who are not wearing masks. Especially for the visitors, how are they supposed to be able to tell someone who has recovered from COVID-19 from someone who doesn’t believe masks work or who feels masks are an infringement of their civil liberty? Certainly for a mask-wearing visitor to see others without masks has the potential to be unsettling, or worse. If the visitor believes masks should be worn, and they see CC members who are not wearing masks, they may very well never visit CC again.
  3. We are concerned, too, for those in the congregation who may have a heightened and borderline unreasonable fear of COVID-19. For these folks to see others who are not wearing masks could induce great anxiety. The Committee feels a case can be made for wearing masks in this situation as an act of love for our brother or sister in Christ.

If a person has been immunized against COVID-19 can they attend CC without wearing a mask?

We are too early in the game to know the answer to this question. We don’t know when the vaccine will be available. As we understand it a person needs two vaccine doses, given a month apart, to achieve immunity. When will the vaccine arrive? How rapidly will it be available for people who are not essential workers? How many people will take the vaccine? For some of the same reasons listed to explain the mask question, we believe makes should continue to be worn by those who have been immunized.

Now for the longer answer. We are in the middle of a worsening pandemic right now. The winter is expected to be rough. New cases in Kent County have increased more than ten-fold over the last eight weeks and the average number of new cases daily now stands at 689. In addition, Kent County’s daily death rate from COVID-19, 6.43, is the highest it has been to date. Given these facts the KCHD issued a Public Health Warning which places KCHD under their Highest Risk category. Their plan is to keep Kent County in the Highest Risk category until the new case daily average goes below 165.

The committee recommends we continue with our current CC small and large group safety practices at least until Kent County falls below the highest risk category. When that great day arrives we can reassess whether any of our safety practices should be changed.


 

 NOVEMBER 23, 2020

ISOLATION & QUARANTINE

The COVID-19 Task Force wants every Christ Church member to understand the difference between isolation and quarantine. If you do not understand it you could unintentionally endanger one of your family members if you see them over the Thanksgiving Holiday. Even for medically trained people the 14 and 10 day time lines can be confusing. Many folks want to do the right thing but the right step to take can be hard to know. Here’s the best explanation we can give.

Isolation refers to sick people who are positive for COVID-19. These folks should isolate themselves for 10 full days. At the end of the 10 day period they must also be feeling better and be without fever for 24 hours. They do not have to be entirely well. If ten days has passed, they are getting better, and they’ve been without fever for 24 hours they can go about their normal activities.

Quarantine refers to healthy people who have been exposed to someone else who has COVID-19. Quarantine can be confusing because quarantine can be due to an isolated exposure and it can also be due to an on-going exposure.

The isolated exposure is easier to understand. From the day you were exposed you should quarantine for 14 straight days. If you get a COVID-19 test during this 14 day period, say at day 7, even if you test negative you should still quarantine the entire 14 days. You can get the disease at any time from day 1 through day 14 so a negative test somewhere along the way does not mean you can come out of quarantine. 

The continuing exposure is harder. Let’s take the case of a mother infected with COVID-19 and a healthy son living with her. The mother is contagious for 10 days beginning with her first symptom. (She was contagious 2 days before the onset of her symptoms too.) If she was diagnosed on day 4 of her illness, she’ll shed the virus for 6 more days. The child must quarantine for 14 days after the mother is no longer shedding the virus. Therefore from the time of the mother’s diagnosis until the child can come out of quarantine is 20 days: the six days which cover the last 6 days of the mother’s illness, plus the 14 day quarantine after the last known exposure, equals 20 days.

If any of these scenarios is true for you please don’t see anyone during that time, Thanksgiving or not. 


 

NOVEMBER 18, 2020

Can we safely sing inside?

We recommend singing be restricted to outside only. Here’s why. No question exists that singing inside without masks presents a real danger. Singing inside with masks has been inadequately studied to know whether it is safe. One study exists which suggests it is safe and intuition might lead one to think that masks would prevent the spread of the particles produced by singing. Given the current local rapid growth in the number of COVID-19 infections and deaths - so severe that Spectrum Health has converted regular ward space to ICU space and sent doctors who practice exclusively office based medicine to man these converted ICUs under the supervision of trained ICU docs - we do not feel one study and intuition are enough to base a recommendation to approve indoor singing. When the pandemic wanes - pray for a vaccine and for people to take it - the issue can be re-addressed.

Can youth activities be resumed?

Because most of the young people are home-schooled, and see each other often in school and social settings anyway, we recommend Youth activities be resumed with the following requirements.

  • Social distancing, mask use, and hand hygiene should be maintained.
  • Any drinks which are provided should be in individual bottles - bottled water, etc.
  • Any snacks which are provided should be in sealed containers,
    similar to our communion practice.
  • Ask parents to keep sick young people at home.
  • Ask on arrival if the young person has been sick in the last 10 days.
  • Deny entrance if the young person appears sick.

With that said, Youth Leaders should consider whether an activity can be accomplished well by Zoom. If so, Zoom is recommended.

How should other small group activities (C-groups, Bible studies, etc.) at church be handled? 

We think we should continue with the recommendation, but not the requirement, that all the church’s small groups and meetings should consider using Zoom rather than in-person meetings. If small groups continue to meet in person we recommend they consider using the church’s larger rooms, rather than continuing to meet at home, so social distancing can be more easily accomplished. We also recommend similar precautions as those listed above for Youth Group meetings - mask use, social distancing, hand hygiene, staying home if you feel unwell, denying entrance to someone who appears sick, and using only drinks in individual containers and food with sealed individual portions, similar to our practice with communion. We recommend the avoidance of food and drink prepared by one family and offered to everyone in attendance.

The committee has been in contact with the Kent County Health Department’s (KCHD) church advisor, who advises a renewed emphasis on small group COVID-19 safety practices. In their experience most people follow the recommended safety precautions when in businesses and large groups. In smaller groups the natural tendency is to relax one’s guard. This relaxation may be one of the leading causes of the recent upsurge in COVID-19 cases across Michigan and the U.S.

The KCHD church advisor also stressed churches should use Zoom to accomplish as much of their ministry and work as possible. CC has taken big steps in this direction.

When should we stop worshiping in the sanctuary and go back to virtual worship only?

We believe this decision should be made using three factors - number of infected people at the previous Sunday service, the number of sick people being admitted to our local hospitals and their ICUs, and governmental requirements.

  1. The committee recommends the church go to virtual worship only if four or more members who attended the previous week’s service become sick with COVID-19. This recommendation is complicated by two factors - no one knows the right number to chose and the timing of the onset of the sick person’s illness.
    • Regarding the number chosen, intuition guides this decision. Shutting down for one sick person seems to be an over-reaction. Fifteen seems ludicrously high. We chose four because it seems like a reasonable compromise.
    • A person with COVID-19 is infectious for two days before the onset of symptoms. This means any person who becomes ill on Monday or Tuesday after the Sunday service was infectious when they attended church and should be counted against the four. If they got their first symptoms on Wednesday they were not infectious when they attended church.
  2. Regarding the stress on our hospital system and the folks practicing medicine there, the recommendation does not come with any specific number. Rather, we feel this should be a subjective response, a response which factors in our civic duty and our merciful care for those on the front lines of this pandemic. Though the recommendation cannot be quantified it does not lessen its importance. 
  3. Regarding our response to governmental regulations, we have done a good job of rendering unto Caesar the things which are his and unto God the things which are His. We recommend the church continue in the same pattern.

We recommend the congregation avoid re-using bulletins between services.

We recommend the church print an adequate number of bulletins for congregational use and provide a box for re-cycling used bulletins. Using the bulletin on an electronic device works well too.

Though COVID-19 is poorly transmitted by contact as compared to respiratory spread, no studies exist about contact transmission after an object has been handled and used for an hour, drooled on by a child, or sneezed on by an adult with hay fever. Since the cost of bulletin production is not high, since waste considerations can be addressed by re-cycling, and since we are in the middle of a large spike of infections, taking this step does not seem unreasonable.

We recommend each room have a sign which states its maximum capacity. Using the best recommendations available, using square feet/person, those numbers are:

101 - Adult SS/Susan’s office - 11
102 - 2nd grade/Debbie’s office - 6
201 - Preschool - 16
202 - 9th and 10th grade - 16
203 - 1st grade/multi-purpose - 13
204 - Other half of multi-purpose room - 13 
205 - Kindergarten - 10
206 - 11th and 12th grade/Lounge - 14
N/A - 3rd grade/library - 7
N/A - Infant nursery - 11
N/A - Toddler nursery - 167.

The committee believes a COVID-19 vaccine has the potential to allow us to resume our normal sanctuary worship pattern more quickly.

We recommend each member of CC ask their doctor or pharmacist if they have a reason to avoid the vaccine. If no such reason exists, we ask each member to consider the vaccine. We do not mean to be disrespectful to anyone who opposes immunizations. With that said, we intend to get our own immunizations as quickly as possible when the vaccine becomes available.

The following questions were received earlier this week after the publication of the newest guidelines from the Michigan Department of Public Health, which go into effect today, November 18, and expire on December 8.

Do our worship services remain safe in light of the current surge in COVID-19 cases?

We believe they do. After investigating the issue as thoroughly as we know how, we know of no church member who has been infected with COVID-19 during in-person worship and we know of only one member who attended CC while infectious. The safety measures we have put in place exceed those of any church with which we are familiar. We called the official church advisor of the Kent County Health Department (KCHD) who once again expressed her appreciation for the efforts we have made to worship safely - we called her once before a few weeks ago - and felt we could continue to do so.

The three criteria which we suggested be used to determine whether in-person worship should be stopped are greater than or equal to four people attending church the previous Sunday who were infectious with COVID-19, the degree of COVID-19 stress placed on our hospital systems and the folks who practice medicine in them, and attempting to honor governmental regulations. Given we have had no COVID-19 victims who can be traced to corporate worship, given the stress on our hospital system is no greater than it was when we answered the first set of questions we received, and given the feedback we have received from the KCHD, we feel we can continue to have in-person worship until at least one of these criteria worsen.

One of these safety measures, the open windows in the sanctuary, caused a bit of confusion last Sunday when someone wanted them closed and another person wanted them re-opened. On November 17, a cold day in the mid-30s, we conducted a test to see how best to keep the church warm with the windows open for increased ventilation.

Here are our recommendations.

  • Establish baseline HVAC settings that can be adjusted as conditions change and we learn more.
  • Program the sanctuary thermostats to 65 degrees beginning 1.5 hours before the first service. (Can be done remotely.) 
  • Turn on the ceiling fans and set the AC system to Fan Only.
  • Leave the foyer and sanctuary doors closed.
  • Open the north and south side windows; leave the windows behind the pulpit closed.
  • Communicate to the congregation that the windows should be left open and also of the need to dress for cooler temperatures in the sanctuary.
  • If we do have a driving rain or blowing snow, attempt to crack the windows as much as possible without allowing rain or snow inside the sanctuary.
  • Gain feedback over the next few weeks and adjust where we can.

Can we re-open the Nursery and serve the needs of children less than or equal to three years old?

We believe it can be done prudently if the following steps are taken.

  • Offer the nursery at one service only. Can be expanded
    if the demand exists and the experiment is successful.
  • Ask parents to keep sick kids at home.
  • Have hand hygiene available at the entrance to every room used and require its use of everyone entering the room. Soap and water is preferable but hand sanitizer is acceptable.
  • Ask on arrival if the child has been sick in the last 10 days.
  • Use a non-contact thermometer to take the child’s temperature on arrival.
  • Deny entrance if the child appears sick, regardless of temperature.
  • Do not use toys which cannot be sanitized. 
  • Do not require universal participation by adult CC members. Use only those volunteers who feel safe in these current circumstances.

Regarding diapering:

  • Wash hands before and after diapering each infant.
  • Use disposable gloves and change between each diapering.
    Hand washing before and after still required.
  • Disinfect diapering area between diaper changes.
  • Ask parents to supply a change of clothes for their children who wear diapers.

With all that said, the Committee thinks this is a marvelous time for the pastors to make clear babies and children are more than welcome in the sanctuary. Especially with our lower numbers in each service, this seems like an opportunity to emphasize the importance of attending worship not just for older folks but also for the youngest members of our church family. More babies and children in the sanctuary equals less pressure on the nursery

How do we address the mental health needs of these families?

(Though the question was asked specifically about families with young children, the answer could be applied to any member of CC.)

  • Maintain contact with these families by phone, text, E-mail, or in person visit. Consider more frequent contact with those families who seem under the most stress.
  • Inform the Session member assigned to the family for those families who are most concerning. 
  • Consider asking Sarah Ingram or Miriam Engler for advice.

Do the Michigan Department of Public Health’s recent regulations have anything specific to say to churches?

No, they do not. In addition, the church will incur no penalty or fine if we take an action which leads to an untoward COVID-19 related event. The Committee still feels we should do our best to render unto Caesar the things which are his and to render unto God the things which are His. How this rendering gets put into our recommendations is less than completely clear but we are trying to do so.

What important aspects of our Christian walk will we lose if we are forced to go online for a time again? What about the effects of isolation, depression, suicide, etc? What is the balance of question 8 with question 12?

Sarah Ingram’s recent Adult Worship class on Depression seems particularly germane. Many of our Christian brothers and sisters suffer with depression, anxiety, and other psychological problems. Isolation worsens these problems and can indeed lead to many unhealthy behaviors, with suicide being perhaps the worst. In contrast the gathering together of the saints leads to mutual encouragement, certainly with our Christian walk, but also with support for the trials and tribulations of everyday life. The pandemic and the election season have been the two most notable of the many stresses which have been strewn on the path we have been required to walk during 2020. At this time, we feel a return to virtual-only worship will lead to more problems than giving CC members the option of in-person or virtual worship.

Finally, the committee wishes for everyone at CC to understand we realize nobody died and made us right. We have done the best we can to make recommendations which chart a safe course between the extremes of virtual only worship and worship as it existed before the pandemic. We have been given the task of making recommendations about a new disease, a disease about which not enough is known. As conditions change these recommendations may need to change too. We welcome advice or questions from any member of CC. We are also grateful for the providence of our recent sermon series in the latter part of Romans, with its emphasis on kindness to those with whom we disagree and on unity among church members. 

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