Global Health Epidemiologist Dr. Emily Smith has closely monitored the spread of the novel coronavirus across the state and nation over the last few months. With the recent spike in cases across Texas, Smith, who serves as an Assistant Professor of Epidemiology at Baylor University and adjunct Assistant Professor of Global Health at Duke University, shared several helpful tips for Texas Baptist churches as they consider how to care for their church members and communities during the spread of the virus across Texas.
“My job as an epidemiologist is to see a hurricane on the radar and ask the churches and people to proactively take protective measures - like boarding up their house, getting out of town, buying water, etc. Sometimes this can feel like an overreaction to people because it’s still sunny outside. But when it hits, it will cause a lot of damage unless you take proactive measures,” Smith said. “COVID-19 is the hurricane to prepare for right now.”
Research indicates that COVID-19 is unique in that it is a novel coronavirus, so it has not been seen before, it’s more infectious and deadlier than the flu or common cold, and the peak time of spreading infection is before an individual starts showing symptoms, Smith said.
“Here in Texas that’s when you start to get a sniffle or a sore throat and you think it might be allergies or you can even spread when you have no symptoms,” she continued.
Given the high propensity for spreading the virus, even unknowingly, she noted the need for caution over the coming days and weeks. Even if it feels like an overreaction.
Taking proactive measures
Proactive measures by individuals and churches can have a tremendous impact on the spread of the virus, Smith shared. Once COVID-19 hits the metro areas in the state, then it will creep into the smaller communities. Some smaller Texas communities do not have an ICU at their local hospital at all. All areas are lacking adequate testing to identify new cases quickly and appropriately.
Major cities in Texas—including Houston, San Antonio, Dallas/Fort Worth and Austin—have all seen exponential growth of the virus over the last week. In addition, many smaller communities are now seeing that type of explosive growth too. Smith noted that many areas in Texas have experienced more than 10-15% positivity rate, indicating the increase in cases is not attributable to increases in testing but rather widespread community transmission. The rate of positivity is the number of positive cases out of everyone who was tested. According to the World Health Organization, the goal is 5% and anything over 5% indicates community spread rather than increases in testing. One of the greatest concerns when the positivity rate goes over 5% is overwhelming hospitals and ICUs.
“While we wait on a vaccine, we need to do all we can to prevent reaching maximum capacity at our hospitals. COVID-19 is not the flu and can quickly overwhelm healthcare systems within a few weeks,” Smith said.
“If the positivity rate is 8-10 percent or higher in your area, I would advise you to shut down [in-person gatherings] for your church over the next 3-4 weeks,” Smith said. “A high positivity rate is not an indicator of an increase in testing, that is a misconception. We are seeing the positivity rate explode which means that we are getting more spread than people who are being tested. If we wait until cases really start increasing and take reactive measures, it will take a much longer period of time to flatten the curve, protect our healthcare systems, and keep businesses open. But, if we proactively take measures even when it looks sunny outside or it feels like an overreaction, we will have a much better chance of remaining open and protecting our neighbors. Proven proactive measures include masking, physical distancing and meeting outside. Wearing a mask and physical distancing can reduce a person’s risk to a mere 5%. That’s a strong protective measure!”
Smith noted her love for the church and in-person gatherings. Her husband serves as the Minister of Discipleship at First Woodway and she has attended church her entire life. While she recommends shutting down for a few weeks, she noted the recommendation is only until the spread of the virus slows down for an extended period of time “This is not forever! What we do today will impact what we are able to do in the next few weeks and months.” Smith said.
With the dramatic increases in cases throughout Texas, Smith advises heeding caution of meeting in-person, particularly with the high positivity rates and increases in hospitalizations. If a church were to meet in-person in the next few weeks, Smith suggested moving the gathering outdoors, under a tent, and following physical distancing measures as well as encouraging all participants to wear masks.
“We know that the risk of spread is higher in indoor spaces, so I would suggest moving online or going outside for a few weeks, which I know is hard in Texas right now because it’s hot,” Smith said.
Smith recently presented on the topic of “Singing in Church” during a webinar for the Truett Church Network and provided recommendations for churches on alternatives to choirs or in-person singing for the time being.
Care for high-risk populations
She also suggested church leaders should encourage high-risk individuals to stay at home for the next three to five weeks, or longer if cases do not go down for an extended period of time, and view services online. Smith defined high-risk groups as individuals 50 and older; anyone with underlying health conditions including diabetes, obesity, hypertension or high cholesterol; pregnant women, and others noted on the CDC website.
Recent research suggests that low-income persons are being hospitalized and dying at disproportionately higher rates because they delay receiving health care until it is too late. In New York, low-income persons and those without insurance were four times more likely to die than those with higher incomes and the same is being seen now in Texas. Smith said a way for churches to love their neighbors like Jesus encourages us to do our part to protect the most vulnerable.
Smith sees caring for these high-risk populations as a way to love your neighbor. On a recent post on her Facebook page, “Friendly Neighbor Epidemiologist” Smith shared:
“To me, my neighbors are the most vulnerable in our city. And this affects all decisions I make of where I go or do not go. As a person under the age of 50, I change my behavior for those over the age of 50. As a person with no underlying health conditions, I change my behavior for those with underlying conditions. As a person with insurance and relative wealth, I change my behavior for those without. So, as Christians please ask yourself if your actions affect those that are vulnerable and if we are using our freedom in Christ according to the Cross through self-less love. To me, that means I worship online with my family, which has been a sweet time for my little family of four, I wear a mask, and stay home as much as I can.”
Ultimately, as COVID-19 continues to spread in Texas and across the U.S., Smith encourages churches to do all they can to care for others.
“The more that you can do proactively when it’s sunny before things get bad, the better. This time in history is an incredible opportunity to share Christ’s love in ways we never have before and in ways that feel upside-down by being innovative in online church and wearing masks. For such a time as this! What if we in the church led the way?” she said.
Click here to view the Guidance for Communities of Faith protocol from May 23, 2020, provided by the Centers for Disease Control and Prevention.