NC governor mostly right about indoor worship and coronavirus

North Carolina Gov. Roy Cooper eased pandemic restrictions on retail stores before doing so for churches -- a move that prompted pushback from some members of the faith community.

Non-essential stores and indoor church services were both initially forbidden to operate under Cooper’s stay-at-home order. When Cooper launched Phase One of reopening North Carolina, he allowed some stores to open but didn’t allow churches to hold services indoors.

Experts generally agree that traditional church customs such as singing, passing around bulletins and even sharing food would make worship services especially dangerous during the coronavirus outbreak. But Cooper’s critics argued for a chance to worship while being responsible.

During a press conference on May 12, Cooper said his decision was based on science.

"We know that inside it is much more likely that you’re going to transmit this virus, particularly when you’re sitting or standing in one place for a long period of time, and this is across the board. And some people are trying to compare this with retail. With retail, people are moving around and you don’t have as much a chance to spread the virus (as you do) when people are sitting or standing indoors."

Since then, a judge’s ruling has enabled indoor church services in North Carolina. A US District Court Judge allowed for a restraining order on Cooper’s rules, and Cooper said he won’t appeal.

Still, we wondered which is more dangerous:

• sitting in a building with the same group of people for a prolonged period, or

• walking around a building with an ever-changing group of people?

The answer isn’t simple. Is it possible that a church could practice social distancing well enough to prevent virus spread? Yes. Is it also possible that one shopper could linger too long around another shopper who’s infected? Also yes. 

Because of those variables, the country’s top health organizations told us they haven’t compared the two environments enough to say whether one is more dangerous than another. 

However, experts do believe that sitting in one place for a long time does pose a threat -- while shopping usually allows people the physical freedom to avoid someone who might be infected.

For this fact check, we reached out to the World Health Organization, the U.S. Centers for Disease Control and Prevention, and the National Institute of Allergy and Infectious Diseases, which is directed by Dr. Anthony Fauci.

None of the groups offered specifics on which scenario is more dangerous.

The WHO doesn’t categorize activities by risk because each scenario "depends on a range of factors, from the local transmission scenario that is occurring, to prevention measures adopted by individuals to the IPC procedures in place in these public spaces," said Ashley Baldwin, a regional spokeswoman.

Fauci’s group responded similarly: "I’m not aware that this is anything our researchers have explored," NIAID spokesman Ken Pekoc said.

The CDC hasn’t compared them either, CDC spokeswoman Kate Grusich said. "CDC has not compared locations or settings for COVID-19 transmission, so we can’t comment on these questions at this time," she said.

But the CDC does emphasize the risk of time spent around other people in close proximity. 

Kelly Haight Connor, communications manager for North Carolina’s health department, responded to PolitiFact questions on Cooper’s behalf. She pointed out several instances where the CDC warns against large gatherings of people. 

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The CDC’s webpage on social distancing says "COVID-19 spreads mainly among people who are in close contact (within about 6 feet) for a prolonged period." The CDC, which acknowledges the "risk of gatherings," also offers guidance for churches hoping to hold services during the pandemic. Recommendations include:

• scheduling multiple services, with enough time between each to allow for cleaning and disinfecting high-touch surfaces,

• promoting social distancing,

• limiting the sharing of materials,

• considering holding services and gatherings in a large, well-ventilated area or outdoors.

The novel coronavirus travels through respiratory droplets expelled when someone coughs, sneezes or talks. Without definitive studies comparing the likelihood of spread in two environments, we turned to experts for their opinion. 

Karen Hoffmann, the immediate past president of the Association for Professionals in Infection Control and Epidemiology, told PolitiFact that the ability to walk away from someone is key.

And if you do pass someone in an aisle at Target, experts believe you’re less at risk than someone sitting still in a confined space. "I would not worry about walking by someone," Dr. Amesh Adalja, an infectious disease specialist at Johns Hopkins University, told Slate. 

"Even in a health care setting, contact is defined by being near someone for a certain amount of time," Adalja said. "I would not worry about these fleeting encounters. The virus isn’t airborne—droplets need to get from one person to another."

Angela Rasmussen, a virologist at Columbia University, told us she generally agrees.

"Reports from indoor spaces (restaurants, offices) suggest that both physical proximity and duration of exposure are important for transmission," Rasmussen said in an email. "So sitting still around others in close physical proximity is probably higher risk than incidentally passing by someone in a store, but the risks aren’t quantified because there are a lot of variables that can impact this."

A recent NPR article categorized 14 different activities by their level of risk for infection. Worship services? "High risk." Going shopping? "Risk varies."

"Crowds with high density lead to substantial increase in risk," said Dr. William Miller, an epidemiologist at Ohio State University. "The major mitigating factor is that people don't mingle in a single place for long."

While churches may be able to mitigate coronavirus spread, there are multiple examples of churches failing to take precautions -- and thus becoming the source of small outbreaks.

A church revival in Hopkins County, Kentucky was linked to at least 30 cases and three deaths, according to The Courier Journal. Officials in California connected 71 cases to one church in a suburb of Sacramento, The Guardian reported.

The Washington Post recently listed several examples in a story about the dangers of worship during the pandemic.

On its Facebook page, the CDC on May 19 used a rural Arkansas church as an example of how fast coronavirus can spread in group settings. The CDC reported that two people with coronavirus symptoms attended the church in early March. 

"Of the 92 church members who attended the gatherings, 35 were later confirmed to have COVID-19, which led to three deaths. Through contact tracing, an additional 26 confirmed cases were identified in the community," the CDC’s Facebook post says. "This outbreak highlights the potential for widespread transmission of COVID-19 during in-person, faith-based events."

The CDC posted a report on the Arkansas outbreak on its website.

Cooper said shopping isn’t as likely to spread coronavirus as church services because "people are moving around and you don’t have as much a chance to spread the virus (as you do) when people are sitting or standing indoors."

The world’s leading health organizations have not offered a risk comparison between shopping and attending a worship service in part because there are so many variables. 

However, generally speaking, experts are definitely less worried about spaces where people can move freely than they are about spaces where people sit near each other for long periods of time. We rate this claim Mostly True.