The Centers for Disease Control and Prevention (CDC) released a study on Tuesday, May 19 which found that two individuals spread COVID-19 to at least 35 people at a rural Arkansas church in early March.
The first positive case of COVID-19 in Arkansas was confirmed by Gov. Asa Hutchinson on March 11.
On March 16, the Arkansas Department of Health was notified of a couple who tested positive for COVID-19 from a rural county of approximately 25,000 people. According to the CDC report, an outbreak in the rural community was likely sparked by an infected couple who attended several church-related events during March 6 through 11. The CDC report does not identify the church or county, but the details of the outbreak match those of the a mid-March outbreak reported at the Greers Ferry First Assembly of God in Cleburne County.
Through contact tracing, investigators used the pastor and his wife of the rural church who first tested positive for COVID-19 in the county as index cases in the study. Both had attended the three-day children’s church program between March 6 to 8 which was led by two guests from another state.
It was later found out that the two local individuals who attended the children’s program had onset symptoms on March 6 and 7. “These are considered the primary cases because they likely initiated the chain of transmission among church attendees,” the study states. The two guests from out of state developed respiratory symptoms on March 9 and 10. They tested positive for COVID-19, “suggesting that exposure to the primary cases resulted in their infections.”
Neither of the two primary cases reported traveling outside the area or having contact with other confirmed cases.
The pastor’s wife, 56, developed a fever and cough on March 10 while the pastor, 57, developed similar symptoms on March 11. However, before his symptoms had developed, the pastor attended a Bible study group on March 11.
There were 35 confirmed COVID-19 cases among 92 people who attended events at the local church during March 6 through 11. The age-specific attack rates among people under the age of 18, between 19 and 64-years-old, and over 65-years-old were 6.3 percent, 59.4 percent, and 50 percent, respectively.
Three individuals died and seven had to be hospitalized. All deaths and six out of seven hospitalized were individuals over the age of 65, consistent with other data indicating that older people have a higher risk for hospitalizations and deaths related to COVID-19.
An additional 26 positive cases occurred in the community, including one death, due to contact with people infected at the local church.
After becoming aware of similar nonspecific respiratory symptoms among members of their congregation, the pastor closed the local church on March 12. They were tested for COVID-19 on March 13 and received their positive results on March 16.
The couple also provided a list of church members and guests who registered for or might have attended related events to help contact tracers.
According to the authors, the study confirms what is already known about the virus — large gatherings pose a risk of COVID-19 transmission. However, it highlights the need of faith-based organizations to “work with local health officials to determine how to implement the U.S. Government guidelines for modifying activities during the COVID-19 pandemic to prevent transmission of the virus to their members and their communities.”
On May 4, the Arkansas Department of Health issued a COVID-19 guidance for places of worship during phase I of reopening Arkansas. Although they are strongly encouraged to continue to offer services via online platforms, services can be held in-person with social distancing measures and informational signs for congregations.
Image courtesy of the CDC