Director of the Janette Ogg Voice Research Center and Associate Professor of Voice (Baritone) and Voice Pedagogy David Meyer, D.M., co-authored “COVID-19 After Effects: Concerns for Singers,” a second paper published on Aug. 10 in the Journal of Voice. Dr. Meyer served as the senior author for the article and the publisher agreed to make this article freely accessible to the public during the pandemic.
The article examined the risk of contracting COVID-19 and how this risk typically centers on three possible outcomes: (1) avoiding COVID-19 altogether, (2) contracting COVID-19 and recovering from it and (3) contracting COVID-19 and dying from it. Another outcome that must be considered is contracting COVID-19 and living with its aftereffects.
These aftereffects can include reduced lung capacity, chronic fatigue, and intubation injuries, and can have long-lasting and potentially devastating effects for anyone who needs their voice.
Discussions about COVID-19 often look at three possibilities: 1) avoiding infection, 2) contracting and recovering from COVID-19 and 3) contracting COVID-19 and dying. Another possibility must be considered: contracting COVID-19, surviving and living with permanent aftereffects. These aftereffects can be devastating, especially for those who rely on their voice.
Studies suggest that COVID-19 spreads through airborne particles. These are divided into two categories: droplets and aerosols. Droplets are large particles produced by coughing or sneezing. These carry a large viral load, but they quickly fall to the ground. Most concerning are medium-sized aerosolized particles between 1 and 5 micrometers. These float in the air for hours, reach the lower airways with a higher viral load per particle and carry a higher probability than airborne particles of infecting a susceptible host. These medium-sized particles are produced in large quantities during speech and singing.
Respiratory aftereffects of COVID-19 can cause long-lasting lung disease, even in those with mild infections. Some of these lung lesions will gradually heal or disappear. Many will harden into scar tissue called pulmonary fibrosis that stiffen the lungs and causes shortness of breath. This reduction in one’s ability to breathe can be permanent and life-changing.
Chronic fatigue following COVID-19 infection appears to be common as well, affecting over 53% of individuals. Other aftereffects include intubation and cough-related injury, vocal fold paralysis and paresis, and sensory neuropathies of the larynx. Many of these result in irreversible damage to the voice.
Entirely eliminating voice-related transmission of COVID-19 is unlikely. Rehearsing online is the safest option by far. In-person options carry greater risks. These risks are reduced when rehearsals are outside and when the singer is alone or in very small groups. And it goes without saying, always wearing cloth face masks while speaking or singing in the presence of others.