As I write this, my heart is very heavy. I just spent the second Sunday morning of Lent in my living room with my wife, watching a livestream of the worship service from my church. The church was empty because this past Friday, the King County Public Health Department in Washington state sent a notice to faith-based organizations, recommending that they cancel all gatherings with 50 or more people. Pretty much all churches in the Seattle area have already stopped their in-person worship services along with most other church activities.
ワシントン州のジェイ・インスリー知事（写真：Office of the Governor of the State of Washington）
Since the evangelical church that I attend has over 1,500 worshipers in four services each Sunday, we livestreamed our worship services. As this article was being prepared for publication, Gov. Jay Inslee took it further, banning gatherings larger than 250 people in three metro counties, and WHO declared COVID-19 a global pandemic.
But my heart is not heavy because I could not gather with others to worship (as much as I appreciate corporate worship). It is heavy because I can see where the COVID-19 epidemic is going to take us, while most of those in our society and churches do not. Seventeen years ago, I was working for the World Health Organization (WHO) in Beijing when the SARS coronavirus epidemic broke out in China.
I was thrust into leading much of WHO’s support to China and worked 24/7 for over three months to help contain that epidemic. I saw firsthand the effects of SARS on the people of China, the extraordinary social distancing efforts undertaken by the government, and the cost that the society paid to contain that epidemic.
After working for WHO and then the Bill and Melinda Gates Foundation in China, my wife and I moved to Seattle in 2015 to lead the foundation’s work to control tuberculosis in several countries. For a quarter of a century, I’ve answered a calling as a follower of Christ to stop the spread of diseases and work to eliminate them, and now I heed that calling to speak to my brothers and sisters in Christ to take this epidemic seriously and respond.
When COVID-19 first surfaced publicly in China in January, this was not an issue for most churches in the Seattle area. But it generated a lot of anxieties among local Chinese churches because Chinese Spring Festival was happening and their members were going to and coming from China. Church members were extremely concerned about being infected by a traveler from China, and the number of Sunday worshipers declined by half. The leadership of a large majority–ethnic Chinese evangelical church asked me to help guide their church’s local response.
Subsequently, the large American evangelical church I attend, which draws congregants from a wide geographic base, made the same request, along with a smaller neighborhood church deeply engaged in its local community through service programs like Scouts, childcare, and youth work.
From working with these churches, each with diverse approaches to kingdom engagement, I learned that a robust church response requires a proper understanding of how COVID-19 spreads and harms, how to protect ourselves and others from being infected, and how to properly assess the risks we face in our communities.
First, it is hard to know whether you have COVID-19 or just the common cold. Eighty percent of people with COVID-19 have mild symptoms like fever, cough, runny nose, and general tiredness, which matches the common cold. This means a person may be carrying and transmitting the virus without knowing it.
Second, you don’t have to be around an infected person to get infected. Infected people can cough and generate respiratory droplets, which then land on nearby surfaces. Or people with the viruses on their hands can deposit the viruses onto a door handle when they open the door. Because these viruses can stay alive on surfaces for at least several hours, people who touch a surface with the viruses on it and then touch their nose or eyes can become infected.
Third, about 20 percent of infected people develop a more severe illness and may need to be hospitalized; 3 percent of all those infected die. However, the virus is particularly aggressive among the elderly and those with chronic illnesses, resulting in a death rate several times higher for these vulnerable individuals.
Therefore, this virus is particularly difficult to control because it causes complacency among the vast majority of people who have the infection, which facilitates its transmission from person to person while causing the greatest harm to the most vulnerable individuals.
Adding to the difficulty is the fact that we currently do not have enough test kits to diagnose this infection. Right now in Seattle, there are barely enough tests for those admitted to the hospital with pneumonia. Though more tests should become available soon, we need to make testing so widely available in Seattle that anyone who wants the test can get it. Only then can we shine a light on the real size of this outbreak, which is what is needed to contain it.
First, we know it is possible to protect ourselves and others from being infected. However, the approaches are so ordinary that we underestimate how effective they can be: Wash your hands frequently, avoid touching your face, be friendly but don’t shake hands, keep away from sick people, and stay home when you are sick.
You don’t have to be afraid when you hear someone coughing near you. If that person is not coughing directly in your direction and is within six feet, the viruses can’t get to you because they are in large respiratory droplets that fall to the ground. The virus does not float and circulate in the air.
Second, the virus can be beat. All around the world, there are many examples of COVID-19 entering a community and then never gaining a foothold—all because people apply basic public health principles. There is nothing sexy about rapidly identifying and isolating infectious cases and their contacts. But it works. However, it needs to be applied aggressively and effectively right at the start.
Unfortunately, what we see over and over is that the response is late. By the time the virus gains a foothold in the community, beating it requires much more aggressive social distancing. I believe this virus is already firmly established in many of our communities. Even so, many churches are reluctant to act. By the time an outbreak spirals out of control—like the ones in China, South Korea, and northern Italy—extreme social distancing measures, like locking down cities or regions, become necessary. But the social cost of such extreme distancing will be high, not to mention the economic cost.