A FOLLOW-UP TO THIS ARTICLE IS NOW PUBLISHED WITH REVISED INFORMATION BASED ON THE SITUATION AS OF MARCH 12, 2020

Note from The Dancing Grapevine: The Author, Dr. Hsu, is a physician actively practicing in both community and acute care hospital settings. She has spoken extensively with a Public Health specialist physician about this matter, particularly how the Novel Coronavirus will interact with our dance communities. 

Novel Coronavirus: An Unexpected Reality

Is this real life? Yes, it is. But, social media posts from your friends are not the best source of information. Instead, you should look for information from the World Health Organization and your local public health agencies for information about the coronavirus and the latest transmission updates in your area.

What is happening?

As of March 5th, the Canadian Broadcasting Corporation provided a fairly comprehensive global summary of the day. The novel Coronavirus is currently undergoing sustained worldwide transmission. Each area is at a different stage of transmission, and the response from each region will likely affect the outcomes for that area.

 The key words to watch for when reading about transmission in a community or region are the words “localized transmission”. This means that the virus is no longer traceable to a known contact; instead, it is “running free” in the community. At that point, containing infected people is no longer a viable management strategy by itself. 

So far, many governments are trying to implement “social distancing” at the local transmission stage to reduce the severity of the mass outbreak. This means keeping at least 6 feet (2 metres) between you and others, as well as limiting your community exposure.

What does that mean for social dancing?

Currently, it appears that for each person with COVID-19 (the novel Coronavirus disease), they infect two others. Partner social dancing, especially Brazilian Zouk, Bachata, Tango, Kizomba, and others, involve people in close physical contact. This means that transmission rate could be higher among social dancers. Social dancers also tend to travel large distances to dance events, which compounds their exposure risk. 

What should we do as a community? 

To understand Coronavirus and the public response so far, we need to be aware of a few cognitive biases innate to all humans. 

The first is “normalcy bias” during disasters. Many people tend to believe things will function as they always do. This means they underestimate the likelihood of a disaster and its subsequent effects. This is why, for example, people stay home during hurricanes or wildfires despite evacuation notices. 

The second (and opposite) cognitive bias is the “overreaction”. This means that people panic and overreact in ways that may not aid the situation. For example, the current trend of individuals buying up medical masks and depleting overall community stock qualify as an overreaction. 

 The third cognitive bias is “attribute substitution bias”. Reputable studies show that humans instinctively try to use as little mental effort as possible.  In these cases, people may base a decision on intuition or convenience instead of facts and reflection. Or, they may inadvertently answer an easier question instead of the bigger, harder one. For example, instead of answering whether it’s a good idea to go out dancing, they may respond “I’m carrying hand sanitizer”. This bias makes situations like a novel virus and a once-in-a-lifetime outbreak challenging. With information changing daily, heaps of uncertainty, and inconsistent public health messaging, many of us are at risk of ‘checking out’ of dealing with the real issues. 

The Reliable Information So Far

To simplify the search for information, below is a summary of the information that I and my professional colleagues view as accurate and reliable (so far):

  • Coronavirus primarily spreads through  respiratory droplet/secretions (sneezing, coughing). 
  • There are a few reports of contact transmission (touching things), airborne transmission (breathing it in), and asymptomatic transmission (transmission by people with no symptoms). 
  • Coronavirus is not influenza (“the flu”). The main differences are: 
    • Unlike the flu, most of the world has no immunity to Coronavirus
    • The annual flu’s case fatality rate is around 0.1%. Current World Health Organization estimates place Coronavirus’ case fatality rate at 3.4% (at the time of writing). Even though this rate may drop as more people are tested, it is not comparable to influenza.
    • This Coronavirus has only been infecting people for approximately three months. We do not know if it will improve in the Northern Hemisphere’s summer. There continues to be sustained local transmission in South East Asia, where the weather is hot and humid (more similar to our summers). 

Note from TDG: If you think even 2% is “not bad”, think of it this way: 2% of a 500 person dance event is 10 people. 0.1% is not even one person. And, although the virus does affect the elderly more severely, it also is worse for people with weaker immune systems or co-morbidities (other diseases). Plus, some of our dancers are elderly, or have compromised immune systems.

This doesn’t mean 10 people at a dance event will die – but it does give a scale of what that small number actually does look like. And, even if at an event of 500 people only 50 people get infected, those people are likely to each give it to 2 other people. Those two other people may not be the generally young, healthy dancers of the community.

Coronavirus has already impacted other dance events! Some events have also made the difficult decision to cancel – including a West Coast Swing event in Singapore and Tango events in Europe. 

How Coronavirus Impacts Us

NOTE: THIS INFORMATION NO LONGER REFLECTS THE BEST PRACTICE ADVICE FROM DR. HSU GIVEN RECENT DEVELOPMENTS IN THE COVID-19 SITUATION. PLEASE REFER TO THE UPDATED ARTICLE. 

After consulting with infectious disease and public health specialists about social partner dancing, I would suggest the following:

If you are a social dancer and/or event attendee:

 Please refrain from attending social events if:

  • You have any flu-like symptoms, including fever, cough, or difficulty breathing
  • You returned from travel in the last 3 weeks or live in an area with sustained local transmission (not just a travel ban/warning).
  • You have had close physical contact with a person currently under investigation for COVID-19, or whom is a confirmed case of COVID-19

If you are healthy and do attend a social or event, please wash, wash, wash your hands. The best way is with soap and water. Second is an alcohol-based hand sanitizer with at least 60% alcohol content. If you are able to wash your hands, use soap and water for a minimum 20 seconds (long enough to sing “Happy Birthday” to yourself twice) as frequently as possible. Avoid touching your face and avoid touching other people’s faces.

Note from TDG: I saw a fantastic post from a social dancer about making a plan to wash her hands every 5 songs. Maybe go for that – or even more! Also, check out this fun hand-washing video – it’s Zoukable!

Event, Class, and Social Cancellations

Please be understanding that these are extraordinary times, and that events/classes/socials you have paid for may need to be modified or cancelled – perhaps with limited refund options or without the ability to get refunds on flights and other expenses. That is (understandably) a disappointing and frustrating experience. 

At the same time, please understand that event organizers may not be able to recuperate all their costs, and if they issue full refunds to everyone, then they may be in  a financially detrimental situation – up to and including not being able to run the event again. 

So please, be understanding and try to accept the situation as it evolves. Events may be cancelled or changed on short notice, and your travel plans may change last minute. Again, these are extraordinary times.

TDG: When speaking with Dr. Hsu, she also mentioned that for young, healthy populations (which isn’t every dance scene or every dancer), the risk is not mainly death by Coronavirus. Rather, there’s a concern about overwhelming medical systems, which would lead to poorer health outcomes across many areas – not just for the viral infection. For example, care for the flu, heart attacks, stroke, cancer, and other serious conditions with a higher mortality rate. For that not to happen, the rate of spread has to be controlled enough for systems to keep up. 

If you are a community leader or event organizer

NOTE: THIS INFORMATION NO LONGER REFLECTS THE BEST PRACTICE ADVICE FROM DR. HSU GIVEN RECENT DEVELOPMENTS IN THE COVID-19 SITUATION. PLEASE REFER TO THE UPDATED ARTICLE. 

People will be looking to you for leadership and guidance in these times. Please assume your responsibility as leaders in the community include trying to optimize the health of the community. The decisions we make will affect the health of others. Your decision whether to hold a public gathering involving people in close physical contact (some with significant travel histories) may have serious consequences in this period of active global coronavirus transmission. At minimum, please take all measures available to facilitate hand sanitizing and surface disinfecting practices at your events and gatherings.

If you are currently in a place with no localized transmission of Coronavirus, chances are your local government is making all attempts to keep it that way as long as possible. Please consider asking artists and attendees not to attend your event if they have respiratory symptoms, a travel history in the last 21 days to an area with local transmission, or physical contact history with a suspected/confirmed Coronavirus case.

If you are currently in a place with localized transmission, please seriously consider whether organizing a gathering is responsible. At this time, one commonly-utilized public health intervention to prevent mass outbreaks in communities with localized transmission is social distancing. This means avoiding public gatherings and close contact with others. It is a well-established strategy to reduce disease transmission. Unfortunately, a  Zouk social or event is inherently incompatible with social distancing.

I want to also take this time to acknowledge that event organization is hard work, that is often financially neutral or at a loss. It is done for the love of the dance and the community. None of us ever thought we would be put in a position of making mini-public health decisions. But again, these are extraordinary times. The additional challenges lies within the fact that the virus has just started transmitting and we don’t have a complete picture – yet.

Addendum from Dr. Hsu: On further reflection, wristbands also provide a potential route for transmission if they are not adequately washed. Many wristbands also have mechanical designs that prevent them from being adequately washed. Therefore, I would advise either placing the band on the ankle or higher on the arm, rather than around the wrist, to ensure contact between the band, surfaces, and partners is minimized.

Note from TDG: Organizers – Plan now. For everything. Even if you think it won’t happen. It’s a lot better if you have an ultimately unnecessary cancellation and management plan for your event than being caught with your shoes off. Plus, having a plan in place shows attendees that you are thinking about this and care about their safety – as well as minimizes outrage if you do end up having to postpone or cancel. 

If you are a traveling artist:

NOTE: THIS INFORMATION NO LONGER REFLECTS THE BEST PRACTICE ADVICE FROM DR. HSU GIVEN RECENT DEVELOPMENTS IN THE COVID-19 SITUATION. PLEASE REFER TO THE UPDATED ARTICLE. 

I want to acknowledge that your job can be very difficult. You spend your days and weeks crossing international borders and time zones, and your work can be physically, mentally, and emotionally demanding. You are also independent contractors who have no job security. Your physical health is crucial. A lost economic opportunity due to infectious control measures is unfortunate. 

However, please view these measures as protection for you as well. Your health is your job asset. When entering new contract negotiations, consider negotiating a clause which allows cancellation on your part if you become concerned about your exposure risk to COVID-19 as a part of a work contract. 

Note from TDG – Remember that if you are travelling frequently and get infected, that can have major implications for the entire scene. Stay safe, plan your travel appropriately, and avoid unnecessary risk. 

This post freaked me out. What should I do now?

Things will get better, but they will get worse before they get better. No one knows how long it will take, or how many people will be affected. Anyone who claims to know that with certainty is misinformed at best.

The answer to what you should do depends on where you live. Listen to the public health officials in your area, and try to critically evaluate messages from popular and social media. There is a lot of false information out there on both sides of the spectrum ranging from denial/dismissal to hysteria (from normalcy to overreaction bias). 

Neither ends of that spectrum are helpful right now. Stay calm, remember your own likely cognitive bias towards dismissing complex, ever-changing information (the COVID-19 cases evolving every day), and try to sit with the inherent uncertainty of this situation. Continue your life – but perform a risk assessment of your situation. Your own risk assessment on whether to participate or host any public activity should depend on the area where you live, its transmission rates, your personal health, your profession, and your regular physical contacts’ health (such as elderly parents, roommates, children, or close friends). 

We are all in this together. And remember:

  • Do wash your hands, and try not to touch your face. It’s your best defence. 
  • Don’t hoard masks, they don’t protect you – they stop sick people from spreading their germs around, which we will all need and appreciate.

Note from TDG: Just like you, organizers are evaluating the situation and watching for further developments. What each event decides to do will largely be based on their attendance demographics, artists, and local situation. It’s impossible to know what the situation will be in a month or two. So, breathe, wash your hands, enjoy your life – but keep an eye on how things around you are developing. 

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