Considerations for Reintegrating Into the Dance Studio
As restrictions are being lifted many dancers, teachers and companies have reached out with questions on how to safely bring dancers back to the studio. Dr. Kat PT and Dr. Davenport MD have worked to combine their knowledge of the dance environment and the current understanding of COVID-19 to provide information for you to assess how the virus may spread in your location, and some ideas on how to mitigate the risk. These questions along with the guidelines from your state and local governments can be taken into account when determining what measures you may want to take prior to allowing dancers back into your location.
Disclaimer- This information is meant to be used for educational purposes only and is not intended to be used as guidelines. During this time people are on different ends of the spectrum in regards to this virus, completely paranoid to those who don’t think this virus is real. There is still a lot that the scientific community does not know about this virus and everyone is vulnerable to contracting the virus and suffering from mild to severe symptoms.
What we know about the COVID-19 virus
How is it transmitted
Droplet transmission
Biggest issue is to try and block anything that could be coming out of the mouth and nose
Can still be transmitted if you are feeling “normal”
Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering (1)
Found that droplets from speech were the same as from coughing and sneezing
large droplets fall quickly to the ground, small droplets can dehydrate and linger as “droplet nuclei” in the air, where they behave like an aerosol and thereby expand the spatial extent of emitted infectious particles
This is why it is recommended that we maintain the 6 foot distance
Two important aspects of the virus to consider:
The amount of virus particles a person is exposed to can affect how likely they are to become infected and, once infected, how severe the symptoms become.
Infectious dose- The amount of virus necessary to make a person sick.
Some viruses take as little as 10 virus particles to cause an infection
Viral load- measure how well the virus is replicating in an infected person
What we know about COVID-19
The infectious dose is unknown so far, but researchers suspect it is low.
Much is still unknown about this virus and the viral load alone is not a clear predictor of disease outcome.
it would make sense that high infectious doses will lead to higher viral loads, and higher viral loads would translate into more severe symptoms. But there is no clear picture yet.
What COVID-19 affects
Affects the lungs→ leads to decreased oxygen exchange → body will send oxygen to the most vital organs first: brain, heart, ect
Very concerned about the low levels of oxygen
Breathlessness is caused by build up of CO2
This is what your body senses
Has been explained that like being dropped off on the top of Mt Everest
Low oxygen symptoms may be
Initial symptoms may be tingling in fingertips
Might be slightly more difficult to complete the same physical activity that was previously easy
Lips may have a slight blue color
Be good about monitoring yourself daily
What is an asymptomatic carrier
Someone who carries the virus but does not show symptoms
This is why face masks are being emphasized
Is there a specific age group that is showing to be more asymptomatic carriers
Anyone can be asymptomatic
No one group is specifically more susceptible
Younger population may have mild to no symptoms but still cause infections in others
Of course, nothing except strict social distancing is going to guarantee zero transmission. Think of this like sex education. Abstinence is the only 100% guarantee to avoid pregnancy, but you can drastically reduce your risk with different options for contraception.
Only way to prevent the spread of this virus is through strict social distancing.
What are things that we can consider to mitigate the risk of spreading the virus during reintegration?
Treat yourself and anyone you meet like an asymptomatic carrier
When thinking about safest practices in your workplace, you should assume that you are an asymptomatic carrier and could therefore infect your dancers.
You should equally assume that your dancers are asymptomatic carriers and could therefore infect you and your family.
This thinking is not to make you paranoid, but is a mind set when reviewing each action in your workday and figuring how to decrease the risk of infecting each other.
Go through your workday and identify times where breathing each other’s air is particularly common.
For dancers, think about partnering work, or choreography where you have to be in close contact with another dancer.
These are the times in your workday when you need to think about blocking air transfer (like the plastic barriers now up at grocery stores and wearing face masks), and/or positioning differently.
Want to consider social distancing measures when in class: barre, center, waiting to go across the floor
The second way this virus is spread is through touching the virus and then touching your face (hence “wash your hands” and “don’t touch your face”).
Go through your workday and review places/times where you may touch something and then touch your dancers and vice versa.
Think about ways you can decrease the times you touch another person and/or a public surface.
Continue to use disinfecting procedures ( episode 2 or COVID-19 blog post)
Screening process?
What are screening measures that may be taken
Have you run a fever in the last two weeks
Do you have a cough or breathing problems
Have you had increased fatigue
Have you been traveling or around people outside of your family unit
Dr. Davenports clinic screening questions
Ask a series of questions (as above)
Do you have a known exposure or test
Taking temperature when someone comes in and asking the questions again
If you notice someone coughing a lot in class is this due to the increase in exercise and deep breathing or could it be something more?
Many different kinds of coughs
Viral
After eating something
After exercise
Is this a normal cough that you have vs one that you have when you are coming down with a cold/virus
Be honest with yourself
If you are not sure always err on the side of caution and think of yourself as an asymptomatic carrier
Does the individual who wants to return to class live with a high risk individual?
Does a student live at home with a grandparent
Dancers who may have other jobs-
are you working in an environment where have more exposure to the virus
May not want to go into a dance class/rehearsal where you could spread the virus further
Everyone is at risk
Even young healthy individuals were in the hospitals on ventilators and ecmo
What PPE may be required
What is happening during medical visits
Everyone is slightly different
Screening patients
Requiring patients to wear a mask
Provided if a patient does not have one
Provider is wearing N95 and face shield
Frequent washing hands
Wiping down all surfaces
Spacing out appointments to decrease people in waiting room
How can you best sterilize and reduce transmission
Continuing to encourage telehealth
What is happening during exercise-
Continue to focus on social distancing
wearing a Buff gaiter or other moisture-wicking face covering may help cut down on droplets being spread to others because of heavy breathing, coughing, and sneezing
The CDC guidelines recommend wearing cloth face coverings, not surgical masks or N-95 respirators, which should be saved for healthcare professionals. Instead, these cloth face coverings can be made from household items like a bandana, T-shirt, or pillow case. (see link at end of show notes)
Masks should fit snugly over the nose and mouth, not be touched once placed on the face, and washed or discarded immediately after each use.
Does the dancer need to be wearing a face?
N95 can be challenging to talk through and breath through
Very different from most masks that people are used to wearing
A mask that really prevents is difficult to breath through and may not be an option for the dancer but maybe for the instructor
Try the mask on at home and make sure that you can work with it
You have to work harder to project through the mask when speaking and breathing
One you put a mask on DO NOT move it
Many virus particles live on the outside areas of a mask including
A mask is to protect those around you, especially if you are an asymptomatic carrier or have contracted the virus and are not yet showing symptoms
The use of face masks will reduce the amount of virus released from pre-symptomatic and asymptomatic individuals.
Dance specific considerations for masks
Need to look at your environment and risk
Face mask that is saturated in sweat is not going to do its job
Dance teacher who may be older may have difficulties projecting through an N95 mask
Mask specific questions to ask
When is mask wearing needed or appropriate
What kinds of movements are appropriate at this time
A lot of modifications may be needed to mitigate risk
If a teacher needs to be in a mask can they have someone else demonstrate so they are not exerting as much energy
Gloves
Not really necessary- you are already touching so much the best thing to do is wash your hands with soap and water
Eye covering
Will be very challenging to use in a dance setting
For daily use out an about town, may not be practical for the dance environment
Studio Spacing
Barre
At the barre can your students stand at least 6 feet apart and maybe on opposite sides of the barre?
May want to mark this with tape
Barre work tends to be less strenuous and not working up as much of a sweat
This may be where you can implement some use of PPE,
Face masks
Wiping down the barre before and after each use
Center Work
For stationary center work can your students maintain 8-10 feet distance.
Sneezing and coughing spread larger droplets with bigger force, but so will forced exhalation (think Graham work, conditioning with forced exhalation)
May consider more normal breathing instead of forced breath cues at this time
Across the Floor
When traveling air droplets become suspended, if you are traveling right behind someone you are in the slipstream where these droplets are suspended. To avoid contact you need to allow even further distance.
Less contamination can occur if you are working out next to someone and not behind them
This study recommends maintain 4-5 meters or 13-16 feet between individuals who are running behind each other
Consider increased time between students moving across the floor
Air exchange
May need full time for air turn-over
Maybe classes need more time in between classes, and not just back to back classes
Music
If the music is loud the instructor will have to project their voice over the music
If they are not wearing a mask
Increased droplets into the air
Droplets will travel further
If they are wearing a mask
Have to talk over mask and the music
Less droplets into the air
This is all information to consider when determining if you have enough space to safely bring people back.
If you do want to have dancers back in the studios
Can you offer smaller classes?
Maybe 3 or 4 dancers in the physical location
Class is live streamed for other members of the class
Can you rotate your students through during the week
Studio/Classroom Considerations
Is there space for dancers to place their bags so that they do not touch each others stuff
Maybe have squares marked off on the floor
Recommend leaving shoes outside of the classroom
No specific research or recommendations on shoes
If you use street shoes or sneakers as part of your program may want to have dance utilize an indoor only pair of shoes
Make sure the young dancers are not wearing ballet shoes outside and then walking into the studio for class
Modern and contemporary techniques require dancers to be on the floor and you don’t want something to be dragged in on a pair of shoes
Following general guidelines of floors being a high touch surface shoes should be left outside of the classroom.
Can you have cleaning supplies available and have the dancers help disinfect high touch surfaces such as barre’s
Additional hand sanitizer available
Once entering the rooms,
After using high touch surfaces
Dressing Rooms and Bathrooms
Want to avoid areas where people can congregate
Is there enough room for social distancing and appropriate sanitizing measures in your dressing rooms?
Ask dancers to come already in dance clothes
In your bathrooms make sure that you can maintain social distance both inside and outside (decrease overall bathroom capacity)
Tape off waiting lines
Close a few stalls to decrease amount of people in any given space
Lobby areas/parents waiting
Is there appropriate social distancing space for parents waiting
Can parents wait in the car, or observe through zoom rather than just outside of the window
Have available hand sanitizer in lobby area
Continue all cleaning and disinfecting recommendations
Remember that everything is changing day to day, stay up to date with current guidelines by CDC, WHO and your local government.
Additional Resources:
United State Olympic and Paralympic committee
NCAA-
DanceUSA
CDC-
BLOGS-
References:
Anfinrud, P., Stadnytskyi, V., Bax, C. and Bax, A., 2020. Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering. New England Journal of Medicine,.
Blocken, B., Malizia, F., Van Druenen, T. and Marchal, T., 2020. [online] Urbanphysics.net. Available at: <http://www.urbanphysics.net/COVID19_Aero_Paper.pdf> .