Representatives of health departments across the country said this week that they are concerned that the protests in response to the death of George Floyd may lead to an increase in the amount of COVID-19 cases, due to the large number of people in attendance at the gatherings.

“Because many people were not social distancing and not all were wearing masks, we should expect to see an increase in cases in about seven to 10 days,” said Dr. Deborah McMahan, the health commissioner for Allen County, Indiana.

Typical elements of a protest — such as chanting, shouting and singing — are thought to have the same effect as a sneeze, which spreads respiratory droplets farther than talking at a normal volume. And despite many participants wearing masks, many images from protests across the country display people in close proximity to one another.

“(Gatherings) such as protests may offer many opportunities for person-to-person contact and therefore pose an elevated risk for COVID-19 transmission,” said Melanie Myers, public information officer for Huron County Public Health, in Norwalk, Ohio. “It is known that COVID-19 spreads easily, therefore, there is a possibility that Huron County could see an increase in cases as a result of the large gathering.”

A Black Lives Matter protest was held in Norwalk on Saturday. Myers said the health department was not aware of how many people attended the peaceful protest, but a reporter from the Norwalk Reflector told Ogden News that it was about 75 people.

Carrie Brainard, the public information officer with the Mid-Ohio Valley Health Department in Parkersburg, West Virginia, said that 200 people were at a protest on Sunday in Parkersburg, and that with any large gathering, there is concern that a spread of COVID-19 may occur.

In Lawrence, Kansas, what was estimated to be thousands of people held a peaceful protest Sunday night — even though public health guidelines in the county prohibit mass gatherings of more than 15 people.

When asked if health leaders were concerned that the protest might lead to a spike in COVID-19 cases, Lawrence-Douglas County Public Health Director Dan Partridge responded that the health department is “prepared to handle whatever comes in the future.” Partridge then added that there is an “inherent risk” in reopening the community.

Of the four health departments Ogden News reached, only McMahan, in Indiana, recommended that protesters self-quarantine.

“Anyone who attended a protest and did not take appropriate measures … should assume they were exposed to COVID-19,” said McMahan. “They should avoid being around family members, friends and colleagues who might acquire the virus and have the potential for more serious outcomes.”

The other health department representatives suggested people simply follow health guidelines and call their health care provider if symptoms arise.

“We are not asking participants in Sunday’s protest to do anything we wouldn’t ask of anyone else, which is to be smart and safe, including contact your health care provider if you are feeling symptomatic and otherwise take those other measures day to day, such as practicing social distancing and wear a mask if you do go into public,” Partridge wrote in an email.

Brainard and Myers both noted that their respective health departments are concerned that the ability to contact trace will be more difficult if an outbreak took place at a protest. Usually, anyone who has been in contact with a confirmed case of COVID-19 will be identified by asking the ill individual about his or her recent activities and the people around them.

“Unfortunately, there is no way to contact trace individuals who may have been at the same event as an ill individual that is not known by the ill individual,” Myers said. “At this point, it is important that community members recognize that there is community spread of COVID-19 and each individual should take proper precautions recommended by the Centers for Disease Control and Prevention (CDC) and the Ohio Department of Health (ODH) while in public to prevent the spread.”

All three health department officials recommended certain practices for future protests in the age of COVID-19, including practicing social distancing, wearing a mask, and having hand sanitizer available. Brainard said protest organizers might consider having hand sanitizer available, and Myers recommended avoiding those who appear to be ill.

Instead of chanting and singing, Myers recommended that protesters use non-verbal action such as noisemakers, drums or written signs.

McMahan said that in general, the health department has noticed that, within the past two weeks, people gathering in public spaces have become lax on precautionary measures.

“We do not want anyone to think COVID-19 has gone away,” she said. “It is very much still in the community and affecting many vulnerable populations, so protesting without utilizing the appropriate safety measures is taking on an unnecessary risk.”