Singing In Nurseries 

Singing is one of the most inclusive musical activities – all you need is your voice. Throughout time, singing has united people through anthems and war cries, become a way to express religious or romantic devotion, and process emotion, whether in celebration or mourning. Many nurseries use singing for as an activity as well as an activity transition, helping both verbal and non-verbal children to manage themselves. However, at the moment, singing is still under intense scrutiny due to SARS-CoV-2, otherwise known as Coronavirus or Covid-19.

The focus on singing is due to the concern over particle that attack the respiratory system. However, although some venues created a 3-metre social distance, this is now thought to be unnecessary based on a previous study on tuberculosis, also an airborne condition that affects the lungs. This study found that although 6 times more particles were generated during singing than talking, larger particles dropped to the ground, so were not actually transmitted. So they may not result in infection at all.

However, despite the risk, singing can manage panic and disruption, and promote physical, mental and social health in times of crisis (Gupta, 2020). Increasingly, the arts in general and music specifically, has been recognised for not only its health but medical benefits, as evidence shows that it can reduce high blood pressure and cortisol levels, symptoms of many conditions including heart and lung disease, as well as mental health, like anxiety, stress and depression. This is why the government requested studies from music and physics specialists.

Media

A few March choir rehearsals around the world hit the news (McKie, 2020), with one American choir rehearsal resulting in 20 possible and 32 confirmed covid cases from 61 people, (3 hospitalised, 2 deaths); and a Berlin choir with 102 infected (3 hospitalised, 1 death) from 130 people. Currently we understand that transmissions were either due to the increased production of respiratory particles or interpersonal behaviour – hugging, kissing, sharing cups and standing near each other – all common preschool behaviours.

The science behind the guidance

In June, Dr Naunheim et al (2020) summarised the available data on respiratory particles in the transmission of SARS-CoV-2. With the virus in the respiratory tract, it is assumed that transmission occurs through aerosols (air-based droplets) which survive on surfaces, with no clear source of infection. Particles are produced through speech, sneezing and coughing, but these do not guarantee spread or infection. Compared to normal-volume speech, both louder and whispered speech increased aerosols. Microphone use reduced the potential for transmission, but it is not yet known whether different voice types, registers or styles affect aerosol production.

Transmission appears to occur from person to person after close contact, and while a 1-metre physical distance reduces the infection risk by 82%, being in close quarters does not guarantee infection. There is also no specific guidance for minimum room ventilation, although open doors and windows appear to disperse more particles than mechanical ventilation. High temperatures and humidity also appear to decrease infection rates, and other coronaviruses show that while high quality (N95, surgical) masks completely protect against SARS-CoV-2 infection, cloth masks effectively reduce the initial impact (correlated with an improved recovery rate) of the virus when used with several layers of water-resistant fabric. Eye protection has not been identified as necessary or beneficial as yet, but it has been beneficial in other outbreaks.

High risk groups include those with obesity and diabetes as they have specifically been correlated with worse outcomes, and the increased infection in black and Asian communities is linked with historic inequalities rather than a genetic predisposition. These factors must be accounted for in risk assessments (Performing Arts – Working Safely during Coronavirus (COVID-19) – Guidance – GOV.UK, 2020).

Government guidance

UK government guidance (Department for Education UK, 2020) prevented indoor group singing from March until 15 August while researchers trialled safer ways to sing. Initially, only trained singers were permitted to sing (training in breath control reduced particle production) to groups outdoors, but people within groups could not sing at all, along with wind instruments. This is changing as more research becomes available.

One of the leading organisations for music teaching, the Incorporated Society of Musicians, summarised the government guidance (Easing the Lockdown, 2020), recommending a return to previous activities as far as possible, subject to a clear risk assessment that covers:

• group risk of infection
• room layout
• cleaning and hygiene arrangements
• parent communication
• timing of measures