Health experts say there’s “a lot of virus being thrown out into the air” at places like Outside Lands (pictured in 2019), where there are large crowds, singing, talking and yelling. (Kevin N. Hume/Examiner file )

Health experts say there’s “a lot of virus being thrown out into the air” at places like Outside Lands (pictured in 2019), where there are large crowds, singing, talking and yelling. (Kevin N. Hume/Examiner file )

Are outdoor events still safe? Experts warn of COVID spread at large gatherings

‘People should be very concerned’

By Sydney Johnson

Examiner staff writer

Going outdoors has been a saving grace for many during the pandemic. But the highly infectious delta variant is giving experts another reason to worry as large outside events resume across the Bay Area, starting with BottleRock Napa Valley this weekend.

“People should be very concerned,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health. “If you’re talking about a large crowd of people and no social distancing while singing, talking and yelling, that’s a lot of virus being thrown out in the air.”

The delta variant, which has been the primary strain found in the Bay Area’s recent COVID-19 surge, is twice as transmissible as the previous COVID-19 variants, according to the Centers for Disease Control and Prevention. Experts agree that being outdoors is safer than being indoors, but outbreaks across the U.S. can already be traced back to outdoor events that gather large unmasked crowds. Most recently, 178 cases have been connected to the Sturgis Motorcycle Rally in South Dakota in early August. Cases are now climbing in the state, where about 56% of people are vaccinated.

“Being outdoors obviates the issues of small droplets remaining suspended in the air, which happens indoors. But droplet transmission doesn’t go away. That requires masks and vaccination,” said Dr. George Rutherford, an infectious disease expert with UCSF.

Cases of COVID-19 surged in San Francisco in July and August and began dipping after The City reinstated indoor mask mandates, as well as vaccine requirements among all city employees, health care workers, plus patrons of bars, restaurants and other indoor establishments.

But overall high numbers of COVID-19 cases, in particular among vaccine holdouts, are giving some health professionals new concerns as large outdoor events, games and music festivals like BottleRock and Outside Lands return without universal masking and vaccine requirements.

Infectious disease experts have long agreed that being outdoors is much less risky for COVID transmission than indoors. But disease outbreaks have occurred at outdoor gatherings across the country in places such as Oregon, which announced it would require masks at large outdoor events beginning Aug. 27, regardless of vaccination status.

Exactly how San Francisco will respond to outdoor delta transmission concerns remains to be seen. But so far, city officials appear to be trending in a similar direction. After implementing a citywide vaccine mandate for indoor businesses, San Francisco Mayor London Breed has suggested that the requirement could extend to outdoor events with more than 5,000 people, as well.

Outside Lands and BottleRock are both requiring proof of vaccination or a negative test result for COVID-19 within 72 hours of the event. But masking will only be required for indoor activities at the festivals, such as the comedy tent.

Other major outdoor events are asking for even less. At Oracle Park, Giants fans do not need to show proof of vaccine or a negative test result. Attendees are only required to wear a mask indoors at the stadium.

Rutherford, of UCSF, said the 72-hour testing window is “conventional,” and has been standard throughout the pandemic. “But the proof of vaccine is vastly more important and valuable than a negative test,” he said, adding that the delta variant poses new uncertainties with negative test timelines compared to the original strain.

People who will be working to feed festivalgoers share some of those hesitations.

“How much of a difference does 72 hours really make?” said Evan Kidera, owner of Señor Sisig, one food vendor at this year’s Outside Lands. “That’s three days, a lot can happen after getting a negative result.”

Kidera said employees who are not comfortable with the large crowds will not be required to work at the event. But so far, he hasn’t had to field any major concerns among staff, who also run food trucks and a restaurant with outdoor seating in San Francisco’s Mission.

Music lovers and artists who have missed the energy of large live events must now walk a fine line between navigating the current health crisis and resuming activities that bring them joy following an isolating pandemic year.

Rutherford and Swartzberg agreed that vaccine mandates and masking together limit spread the most, shy of canceling big events altogether. There’s also the option to move events online, as the free Hardly Strictly Bluegrass recently announced.

“Hardly Strictly Bluegrass has reached the difficult conclusion that we are not able to hold the festival in Golden Gate Park this year; we can’t waver from our mission of providing the safest and most magical musical environment,” the event’s organizers posted to its website.

Swartzberg of UC Berkeley says in a best-case scenario, the timing of Outside Lands could be fortuitous if cases continue to drop over before the festival on Halloween weekend. That’s a big if.

Kidera of Señor Sisig said most of his employees have said they feel more comfortable having the safety requirements that The City recently put in place. But if the last year has taught him anything, it’s to wait and see.

“A lot can change in two months,” said Kidera, “for better or for worse.”

sjohnson@sfexaminer.com

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