This weekend many pastors across America will face a situation they never would have imagined: preaching an Easter sermon to a congregation trapped in their homes.
We should be exceedingly grateful that the Lord has given us the technology to make remote preaching possible. But our appreciation does not dull the sense of loss that is felt when standing in your living room preaching to a video camera. Pastors have a natural longing to worship in the presence of God’s people, especially on the biggest holiday of the year. Which is why we are all wondering, “When will we be able to meet again in person?”
The short answer, of course, is that no one (other than God) knows when that day will come. While many medical experts and government officials have expressed their preferences, no authority in our country can set a definitive timeline. Yet despite this uncertainty, we can make a reasonable guess about when church buildings will reopen by weighing the relevant medical, political, and psychological elements.
In an ideal situation, the decision about when it was safe to return from a medical crisis would be based solely on medical criteria. But it appears the coronavirus will outlast both our patience and also our economic stability. While protecting public health should be a priority, it will not be the only deciding factor. Still, it’s helpful to understand how the medical criteria factors into the decision-making process.
Although the medical models have varied widely (mostly because of lack of adequate testing and data in the United States), the medical elements that weigh into the decision are rather straightforward: We need to drastically lower R0 and/or drastically increase herd immunity.
R0 describes the number of cases, on average, an infected person will cause during their infectious period. For example, measles is highly contagious and has an R0 range of 12 to 18, while influenza is moderately contagious with an R0 ranging from 2 to 3. That means the average person with the measles will infect between 12 and 18 people, while the average person with the flu will infect only 2 to 3. A new study highlighted by the CDC says the median R0 for COVID-19 in the China outbreak was about 5.7. That would make COVID-19 about twice as contagious as influenza and half as contagious as measles. Earlier estimates put the R0 from 1.4 to 6.49, with an average of 3.28 and a median of 2.79.
Knowing the actual number helps us determine when the crisis might abate. If R0 is less than 1, then the epidemic will eventually end, since it isn’t being transmitted to others at a rate capable of sustaining transmission to those not infected. If R0 is above 1, an epidemic will continue to grow—likely exponentially—until enough people have been infected that we develop herd immunity (i.e., when a high enough percentage of a community becomes immune to a disease because of vaccination and/or prior illness).
The more infectious a disease is the more people need to be immune before herd immunity can be achieved. The threshold for combined vaccine efficacy and herd immunity needed for disease extinction is calculated using the formula 1 – 1/R0. At an R0 of 5.7, we need more than 82 percent of the population to be immune; using the previously estimated R0 of 3.28 we’d need 70 percent herd immunity.
Herd immunity occurs through vaccination or prior infection. But we currently have no vaccine available, so the percentage of herd immunity right now is based solely on prior infection. Of those in the United States who have been identified through testing as infected with the virus that causes COVID-19, the case fatality rate ranges, based on age, from 1.8 percent to 3.4 percent. However, since some of those who will develop immunity will be asymptomatic or untested, we should use the infection fatality rate (IFR), which estimates the fatality rate of all who had become infected. Even if we assume the IFR is going to be around 1 percent (closer to the lowest range of the CFR), with an adult population of 209 million, achieving 70 percent to 82 percent herd immunity would result in an additional 1.5 million to 1.7 million deaths. That would be about the same number of people who were diagnosed with cancer in 2019. (NOTE: Updated and corrected to clarify the distinction between CFR and IFR.)
Before reaching that number of deaths, we must develop a vaccine. We are also helped by the fact that the U.S. population is spread over a large geographic area. This slows infections, but it also means herd immunity will not be achieved in all areas of the country at the same time. As we’re seeing now, some areas are more overwhelmed, while others have hardly been affected.
The actual rate of R0 is known as Rt (i.e., the reproductive number at time “t”). Rt shows the virus’s actual transmission rate at a given moment. The Rt rate will differ throughout the country. Because of current transmission and population density, the city of New York will have higher Rt right now than, say, the state of Montana.
Psychological and Political Factors
If medical considerations were our only concern, we could just impose a cordon sanitaire or implement “suppress and lift” policies based on the current Rt of a geographic area. But as we’ve seen, many Americans oppose such measures for a variety of reasons. Also, some people have a deeply ingrained aversion to any form of quarantine, while others are offended when fellow citizens in other parts of the county are not implementing similar precautions. All of us are also discovering for ourselves the emotional toll of the “stay-at-home” strategy. Once we are allowed to leave our homes for non-essential activities, it will be exceedingly difficult for the government to corral us back indoors.
Faced with that reality, some state authorities may decide to err on the side of caution and try to keep the shelter-in-place orders in effect as long as politically feasible. But they’ll run up against other psychological and political challenges, such as White House officials hinting that a return to normality may begin within a matter of weeks. The media have also tended to focus on when the crisis will “peak,” implying that the lockdown will ease up soon after that pinnacle is reached.
Since we don’t have adequate testing, the best metric for the peak of the crisis is the number of daily deaths related to COVID-19. Current projections—assuming full social distancing through May 2020—estimate the peak will occur this weekend, and likely on Easter Sunday. If daily deaths continue to decline for two weeks after the peak, there will be a strong push to lift the lockdown policies starting around April 27. By that date, many Americans will have been in self-quarantine for 45 days, and most churches will have ceased meeting in person for seven straight Sundays.
Soon after, the debate about when to loosen restrictions will reach a boiling point. Some state governments are likely to reopen or loosen restrictions as early as May 4; others may attempt to hold out longer. But unless the death rate begins to climb again back to the previous high, the dam is likely to break by Memorial Day (May 25). By then, churches will have not met for 11 weeks, and most Americans will have been under self-quarantine for 72 days (to put that in perspective, we are only on day 28).
Time to Prepare Is Now
Based on current projections, it appears the earliest date for a return of churches would be May 2, while the latest would be September. For most churches, the most likely return date will be May 31 or June 7.
Long before that happens, though, elders of local churches need to prepare their policy and communicate how it will be implemented. Here are some questions that will need to be addressed:
How will you decide when to reopen? — Scripture tells us that we must be subject to governing authorities (Rom. 13:1). But which authorities do we follow in this situation? If the federal, state, and local governments disagree on when it’s safe to meet, whom do you follow? You need to make this determination—and make it known to your people—before such conflict arises.
When will you reopen? — Will you hold church services the first Sunday after being allowed to do so? What if the announcement comes on a Saturday? Will your ministry team be prepared? Even when shelter-in-place orders are lifted, bans on large gatherings may remain in place. Smaller congregations may be able to meet in person, while larger church bodies may still be legally prohibited. Pastors need to prepare now to deal with how that difference might affect their church community.
What mitigation policies will you be putting in place? — Being allowed to return to our church buildings does not mean our churches are safe from the coronavirus. How will we protect the elderly, pregnant, and immunocompromised? What mitigation measures will be put in place to protect our people? What level of risk are we willing to accept to meet again in person?
These are just a few of the questions all churches must address. Whether you are a solo pastor or have a staff of hundreds, you need to make plans for how you will respond to the myriad concerns of your congregation. You don’t need to have all the answers, but your people should see that you’ve given the issue serious thought and consideration. Some of them will be putting their health in your hands, so be sure you’re using this time of lockdown to prepare for when the church doors open wide.