Information published 18 March, 2020. Please check for updates regularly as the situation develops.
The coronavirus crisis is a dilemma for performing artists. Your job depends on staying well, and for many artists, usually involves what current public health advice recommends against: bringing groups of people together. Coronavirus threatens both these things, yet there are many things you can do to minimise the impact on you, whilst following public health advice to keep yourself and others safe.
This advice sheet is intended to inform performing artists in Australia about what we know about COVID-19, help you make decisions in balancing your life as performers against the risk of infection, and share links for practical advice, support avenues, and current public health resources.
How this document will help you make sense of what is happening
The situation with coronavirus in Australia is rapidly changing. New information and new statistics are released every day. On the other hand, infectious respiratory diseases are extremely common and a lot of what we know about them applies to this new threat. The obvious comparison is with seasonal influenza, another very dangerous disease we take for granted. At the time of writing, COVID-19 has been responsible for 7000 deaths amongst 180,000 proven cases. Compare this with US Centre for Disease Control and World Health Organisation estimates of between 290,000 and 650,000 deaths worldwide from seasonal flu each year, with many hundreds of these deaths in Australia.
It seems like the world has gone mad, but behind it all there are things we do know and principals of infection control that are well established. This document intends to put that together, particularly if you work in the performing arts industry.
SO, what’s different? Why the panic? Why are performances being shut down?
While the outcome for any one person catching this virus will most likely be a mildly unpleasant cough, the outcome for the country as a whole could be a catastrophe with thousands dying, and not just from coronavirus.
Over the decades our health system has grown to meet demand, but it does not have much slack. All our public hospitals operate close to capacity most of the time, and while we have some spare capacity for influenza each year (a demand mitigated by our vaccination program) this new coronavirus could overwhelm current capacities. Unless we can keep the flow of new cases to a manageable level, hospitals (and especially our intensive care and isolation beds) will fill to overflowing. It’s hard to imagine, but this is already the situation in some other countries with established public health systems, such as Italy. Doctors there are having to choose between admitting heart attack patients, or treating cancer, or dealing with serious trauma… or treating coronavirus patients. They are setting up what they call “field hospitals” which means treating patients in tents in the hospital car parks. Numbers of deaths have risen dramatically. They have had to shut the country down. The same could happen here, which is why public gatherings, like performances, are being discouraged or actively shut down to limit the spread. ASPAH understands the impact this is having on performing artists, however we also understand that these measures are required to help minimise the threat of coronavirus to all Australians
Everything we know about the virus at a glance
What is a Coronavirus?
Coronavirus refers to a family of viruses, the most well-known of which caused Severe Acute Respiratory Syndrome (SARS, 2002-2004) and Middle Eastern Respiratory Syndrome (MERS, 2012-present).
What then is COVID-19
COronaVIrus Disease 2019 (COVID-19) is the name of the disease caused by this new coronavirus. While, the virus itself is called SARS-CoV-2 in test results, the word COVID-19 can be used for both the disease and the virus.
What are the symptoms of COVID-19?
The most common symptoms are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea but these symptoms are much less common. The severity of the symptoms ranges from almost nothing to a severe life-threatening lung infection.
Who is at risk of developing severe illness?
The single strongest predictor of disease severity is age. This risk begins to rise at age 50 but, as is the case with influenza, people aged over 65 are the most at risk. The risk is also much higher in people with chronic diseases like diabetes, chronic asthma, emphysema, heart disease, kidney disease and people with suppressed immunity.
How does COVID-19 spread?
In common with most respiratory viruses, COVID-19 has two modes of spread.
- Droplets that people with the disease spray when they cough or sneeze or breathe out. It is estimated this mode of spread has a range of 1 to 2 meters and much less if the person is wearing a mask.
- Hand to face. If the virus is left on a surface (like a dressing table, a music stand or a door handle) touching that surface can contaminate your hand. If you then rub the virus onto your own face it can enter your body through your nose or mouth and infect you.
How long can the virus stay alive on surfaces?
At the time of writing no one can say for sure, but likely anywhere from a few hours to a week, depending on the nature of the surface and the environment. If a surface may be contaminated, cleaning the surface and wiping it down with a simple disinfectant can kill the virus.
How long is the incubation period for COVID-19?
Once infected it takes 2 to 14 days for the virus to multiply enough to cause symptoms. For most, this incubation period is 4 to 7 days, but the quarantine recommendation of 14 days is likely to remain the standard.
Can I catch it from people while they are incubating the virus?
People are most contagious just before they get sick and for the first day or so after they get symptoms. when there is enough virus to spread but before the immune system starts killing it off. It is believed that the risk of spreading the virus is quite low during the incubation period but there are many infected people who hardly get sick at all. The challenge is to strike a balance between recklessness and paranoia.
What about testing? Can’t that just work out who has it and who doesn’t?
The test used for COVID-19 is a swab test. It is taken from the back of your nose and throat and the sample is analysed for presence of parts of the virus which are unique to SARS-CoV-2.
At the time of writing the time between getting a referral from your GP and you getting a result from a swab can be a week. Taking a swab involves the collector donning full infection control gear which limits how many can be done. Add that queue to the queue for testing in the lab and it can mean a week between getting the test request and getting the results. This should become much shorter as self-testing kits and new laboratory facilities are rolled out.
No test is ever perfect, but this type of testing, called PCR testing, is very sensitive and very specific, meaning that this test is fairly black and white.
- If you have symptoms but your test is negative it pretty much guarantees that you don’t have COVID-19.
- If the test is positive, no matter how sick or well you feel, you have the virus and can infect others.
- If you have had COVID-19 and your test becomes negative it pretty much guarantees you have cleared the virus, BUT
- If you have no symptoms, a negative test cannot guarantee you have absolutely no virus. A person can be exposed and be in the early incubation period and still come up with a negative test. This means that the test isn’t a “get out of jail free card”. If you have had contact with a proven COVID-19 case or have just come back from overseas you cannot get around the 14 day quarantining by getting a test.
- This means that testing is only recommended for people who have symptoms.
Most doctors ordering the test will also request a swab for other common respiratory viruses. If one of these (especially influenza) comes back positive you may still be asked to self-isolate until you have recovered.
At the time of writing the COVID-19 test is available free of charge to anyone who is considered at risk (has a flu-like illness, AND overseas travel in the last 2 weeks or close contact with a confirmed case). To be tested in the community you will need a referral from your doctor, but unless you are at risk it may not be free ($100 to $150). All public hospital testing is free, but unless you are at confirmed risk you may not be tested due to a shortage of tests.
What should I do if I think I might have Covid-19?
If you become unwell with the symptoms listed above and suspect you may have COVID-19:
- Isolate yourself until you can be tested. This means staying at home, not coming closer than 2 meters to anyone else, not touching anything that anyone else might touch. If you share a house this will mean staying in your own room by yourself and going into the rest of the house as little as you possibly can.
- Don’t spray the virus around. Wear a mask. Cough and sneeze into your elbow or into a tissue. Wash your hands again and again and again before you touch anything.
- If it feels to you like “just a normal cough and cold” then ring your GP to arrange testing. They should have protocols in place to arrange for you to be tested safely.
- If you feel much sicker than is normal for you, and especially if you have any shortness of breath, are over 50 or have a chronic underlying illness you should ring your nearest public hospital. They can then direct you to either their casualty department or one of the new COVID-19 assessment and treatment centres where you can be safely examined, tested and a decision made about whether you need admission to hospital.
- Different states are implementing different responses. There are links below for each state and territory website.
Is there a vaccine, drug or treatment for COVID-19?
No. Unlike influenza there is no treatment for COVID-19 beyond supporting people while their own immune system learns to fight the virus – but watch this space. There is an enormous effort internationally to develop a vaccine and trials are currently underway with a number of drugs used to treat HIV, to see if they can help the sickest of the COVID-19 patients.
Fortunately, most people have a mild form of the disease and the only treatment they need is time.
How long are people infectious for after they catch COVID-19?
Most people seem to have cleared the virus by about two weeks after diagnosis. But we don’t have to guess this. If someone has had COVID-19 and then tests negative, it means there is no more virus detectable in their nose and throat and they cannot be contagious; you cannot spread what you do not have.
In Australia, people are not released back into the community until their test becomes negative, so please rest assured that if someone has been released from quarantine, they really are safe.
What can I do to protect myself and so protect those close to me?
Advice for everyone
- Get yourself vaccinated. There may not be a vaccine against COVID-19 yet but there are vaccines against whooping cough and influenza which are both serious respiratory diseases. If you are over 65 or have particular health problems, there is also a recommended vaccine against pneumococcal pneumonia. In fact, make sure all your vaccinations are up to date.
- Wash your hands. Properly. There are many videos online, the most reputable ones produced by the US Centre for Disease Control at https://www.cdc.gov/handwashing/videos.html.
- Hand sanitiser is a useful alternative but given the very short supply it may be more useful to become practised with soap and water.
- Don’t touch your face. This one is really hard, because most people touch their face unconsciously many times a minute. Do the best you can and, if you can’t help yourself, wash your hands some more.
- Keep your distance. As mentioned before, droplet spread is limited to about 1 meter; 2 meters at most. If you are in public, try to keep at least 1 meter between yourself and others.
- Give up smoking. If you do get ill this will only make it worse, so now is the perfect time to stop.
Advice for performers
The Government may soon shut down all performances but until they do you can play your part in limiting the spread of the virus.
- Be a responsible performer. If you are performing live, even if it is at a pub or club, you should consider yourself host to a gathering of people. If it is your own gig consider offering refunds or replacement tickets to people with a cold or fever. If it is not your venue don’t be afraid to ask the organiser what they are doing to keep you and your audience safe. And don’t be afraid to use the stage to spread the word to your audience and ask them to go home if they are sick and keep their germs to themselves. You could even make this a selling point, promoting yourself as a COVID-19 responsible artist.
- If you are sick, don’t go to work. This is a really tough one. Performing artists are at particular risk of spreading all respiratory diseases, including COVID-19, to each other. Dancers lift and hold each other, actors speak and shout into each other’s faces, musicians (and especially orchestral musicians) blow their brass, reed and wind instruments over each other on stage and burlesque and circus performers do all of the above and more. Make up (sometimes shared) gets applied and removed from faces, equipment gets shared, microphones come within millimetres of your mouth and the list goes on. If you have a respiratory infection you may close the whole show. Don’t risk it.
- Stay on stage and keep the audience at bay. The government is already shutting down big shows in the interest of public health, but hopefully smaller shows can continue. You can find up-to-date information on public gatherings here: https://www.pm.gov.au/media/update-coronavirus-measures. Interacting with the audience is an integral part of any show, and while you are on stage the distance between you and them should be enough to keep you safe. Many audience members make it a point of making contact with performers before or after the gig, and many performers feel obliged to not disappoint their fans. A little disappointment is better than being shut down, so explain to your audience from the stage why you are being careful. Keep them off the stage and keep them from backstage. If you are performing at a pub or a club resist the temptation to hang around for a drink; just do your job and leave. That way you are more likely to have a job to come back to.
- Keep your “tools of the trade” clean.
- If you perform using an instrument, a prop or any other tool of the trade then wash your hands before you handle it.
- Wash/clean/wipe it down whenever possible.
- Be careful where you leave it, ideally putting it back in its case/container when not in use.
- Insist that if anyone else must handle any of your gear that they wash their hands thoroughly beforehand.
- Wherever possible, don’t share. Microphones are a particular case. With their close contact with mouths and faces they represent a high risk and should be labelled and allocated to specific performers. If they must be shared they should be thoroughly cleaned, wiped down with disinfectant and have their covers replaced with clean ones after each use.
- Musicians whose instruments are played by mouth need to be particularly careful to make sure that the mouthpieces of their instruments don’t go anywhere near anyone or anything except their own mouths. If they do, clean them thoroughly before using them again.
- If your instrument needs draining, do so carefully into a disposable container which should then be discarded thoughtfully.
- Busk with care. There is no clear answer as to whether buskers should stay at home for the duration, or if busking will be a safe alternative if your gig gets cancelled. It is possible it will be banned during this crisis. Until then, and if you must keep on busking remember:
- Distance is your friend. Set up some sort of marker with chalk or a rope one long stride away from where you will be standing and ask people not to step over the line
- Hand sanitiser is your friend. You won’t be able to wash your hands much but hand sanitiser (if you can get any) is just as good. Use it often, especially if your busking involves handling an instrument.
- Cash is your enemy. You should presume cash is covered in COVID-19. Collect your cash in a plastic bucket, not your instrument case, and leave it in there until you can get it home. Soak it in hot water and antiseptic, ideally overnight, and then rinse before use.
- Take this time to be creative. This may be a very good time to concentrate on the more creative side of your art. Writing new songs, drama and acts, choreographing new dance pieces, recording your work, and expanding your repertoire will have you well-prepared for the bonanza that will happen when venues reopen to a public desperate to have some fun again.
- Do as much as you can online. Investigate opportunities to distribute your content online. In a shutdown this may become the main avenue for entertainment with bored people hungry for new experiences exploring online more than ever.
- Consider avenues for your usual work that do not involve bringing large groups together, or minimise the need for close social contact:
- If part of your income involves teaching, could you teach remotely as a short-term measure? (E.g. Skype or other low-cost platforms)
- If part of your income involves performing, do you have any avenues for livestreaming or internet-hosting concerts as a replacement (or new gig) for a live gig that has been cancelled? Could you encourage your usual audience to support you in this way and advertise that you have taken this measure out of social responsibility?
- If part of your income involves selling recorded performances, could you focus on this and publicise to your followers that this is a way they can support you whilst you are unable to perform as usual?
Should I wear a mask to protect myself?
It’s hard to think of a performer who could work with a mask on their face, but with rising numbers of people in the community wearing masks, you may be wondering if this is something that you should do.
Masks are standard pieces of safety equipment for health professionals dealing with infectious patients, along with goggles, caps, gowns and gloves. In order to prevent people from inhaling airborne viruses they must be used properly, replaced regularly and disposed of hygienically; therefore, there is not much evidence to support their use in healthy people outside of healthcare settings.
So, should you wear a mask protect yourself? If you are currently healthy, the World Health Organisation says no, especially given the worldwide shortage of masks and the important role they play in stopping infected people spreading their germs. Ultimately the choice is yours but hand washing, not touching your face and keeping some distance will make a much bigger difference to staying healthy.
What about touring?
If you had plans to tour overseas you are probably already cancelling them. The combination of travel bans, quarantining and the risk you may not be allowed home makes overseas touring impossible at the moment.
If you are touring in Australia, the greatest risk you face is that your venues will all be shut down. Until then there is no reason to think that your risk will be any greater than if you are doing gigs close to home. In fact, it is likely that there will be less virus in regional centres than in the major cities and that your tour group may be a bigger threat to them than they are to you. Again, promote yourself as a COVID-19 responsible group but make sure you walk the walk.
With this in mind, there are a couple of extra things you can do while on tour to keep you and your audience safe:
- Make your accommodation safe. Hotel and
motel rooms are generally cleaned quite thoroughly between guests. Even so some
extra precautions won’t hurt:
- Before you unpack wipe down with antiseptic the basin and vanity top in your bathroom, the bedside tables and any other flat surfaces. These may have been contaminated by the previous guest.
- Take your own pillow and use it instead of the one provided.
- Keep yourselves to yourselves. It may be boring and inconvenient, but you should limit yourself to your venue and your accommodation. Eat in. Avoid restaurants and bars. Don’t go to the cinema.
- If you get sick, go home. Touring involves living in close quarters and long trips locked together in cars and buses. If one of you catches the virus there is a very high risk that the whole tour party will have the virus. You may not feel that unwell, but do you really want to be blamed for a coronavirus outbreak at one of the towns you visit? If one of you gets sick with a fever and cough, then two-week quarantine should be applied to the whole group unless that sick person tests negative.
But the show must go on, mustn’t it?
Unfortunately, at least until we have a vaccine, maybe not. There is every possibility that further closures of public events may occur whilst we continue to respond to the coronavirus situation. At the time of writing the government has already announced rolling out money to affected businesses to help them maintain the salaries of their employees who cannot work because of the virus. If you are an employee of a performing arts company, ask your company and/or union how this impacts you, and if you will still be paid even if you cannot perform.
If the closure of live performance venues happens, you will not be alone, as it will likely also mean the shutdown of the whole recreational services industry. Depending on how coronavirus unfolds in Australia, further closures may well extend to restaurants, pubs, clubs, cinemas and all but essential services. This will involve millions of casual workers, not just performers and their crews.
The government is yet to legislate their plan for support for casual workers. It is likely that any financial support for casual workers will be rolled out through Centrelink and if you are experiencing financial hardship due to the virus, contacting Centrelink now may be of value.
In the meantime, try to remember that you are not alone and that this will pass. ASPAH thanks you for doing your part to help support your fellow artists and community. While no one can predict the future, it is expected that over the coming months this infection will reach a large part of the Australian community and that with that will come spreading immunity that will protect more and more people. Eventually we will have a vaccine to protect everyone else and COVID-19 will join influenza as a dangerous but manageable threat so we can all get back to normal life.
Useful Websites and references:
World Health Organisation- https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
Australian Federal government- https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert
New South Wales government- https://www.health.nsw.gov.au/Infectious/diseases/Pages/coronavirus.aspx
Victorian government- https://www.dhhs.vic.gov.au/coronavirus
Queensland government – http://conditions.health.qld.gov.au/HealthCondition/condition/14/217/838/novel-coronavirus
Western Australian government- https://ww2.health.wa.gov.au/Articles/A_E/Coronavirus
Tasmanian government- https://www.dhhs.tas.gov.au/news/2020/coronavirus_update
South Australian government- https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+topics+a+-+z/novel+coronavirus
ACT government- https://health.act.gov.au/public-health-alert/updated-information-about-covid-19
Northern Territory government- https://health.nt.gov.au/health-alerts/novel-coronavirus-covid-19