During the pandemic, the question of whether to attend a concert had an easy answer: No effing way. Now that vaccines are available, but the highly contagious Delta variant has become more common, assessing risk is more complicated. People who are vaccinated – who have received two doses and waited two weeks – have significant protection. Yes, “breakthrough” infections remain a danger for vaccinated people, although they are unlikely to cause serious illness. Still, if you attend a packed event, you might be at risk of transmitting COVID-19 to an unvaccinated child or immunocompromised person.
So, here’s the question:
All your friends are going to Foo Fighters. Should you?
Take Billboard’s choose-your-own-adventure-style quiz, complete with testimony from infectious-disease experts at top universities and hospitals, to assess your risk.
1. Want to go to a concert?
NO
The only (nearly) sure way to minimize risk of getting COVID-19 is to stay home and party like it’s April 2020. Bringing people together, indoors or outdoors, increases the risk of transmission,” says John Swartzberg, a clinical professor emeritus at the University of California-Berkeley School of Public Health’s division of infectious diseases. It’s easy for him to say, though: He’s 76 and hasn’t gone to a concert in years (although he’s sad to miss college football games).
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YES
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2. Are you vaccinated?
NO
Check the show rules: Top promoters Live Nation and AEG Live will require vaccines or a negative COVID-19 test as of early October, and a growing number of artists — including Jason Isbell, Maroon 5, Dead and Co. and Eagles –- are doing the same. “People are dying,” Isbell tweeted recently, “and we have a way to stop that.”
[Skip to item #3]
YES
Congratulations! You’ve protected yourself from infection in the most reliable possible way. “The vaccine is highly protective against serious disease, hospitalization and death,” says Jeffrey Klausner, a University of Southern California professor of population and public health. The research agrees with him – the Pfizer vaccine, for example, is 93% to 100% effective against severe COVID-19 illness and 64% to 88% effective against all symptomatic disease. Yes, “breakthrough” infections remain possible for vaccinated people (although the data suggests the probability is one in 5,000 or less), and serious illness is unlikely. If you are vaccinated, many of the other risk factors listed in this story, like attending an indoor concert or using a heavily populated indoor amphitheater restroom, are far less severe.
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3. Are you willing to wear a mask?
NO
If you are unvaccinated and unwilling to wear a mask: Please, stay home! If you’re vaccinated, it’s a reasonable risk to attend an indoor concert without mask — but it’s still a risk. As we’ve known since nearly the beginning of the pandemic, masks make you safer, especially in crowds. Centers for Disease Control data shows mask wearing reduces new COVID-19 infections.
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YES
USC’s Klausner is vaccinated, but wears a mask to concerts anyway — in Los Angeles, he recently saw Los Lobos and the Mavericks at the outdoor Greek Theatre and a small indoor indie-band show at Bar Lubitsch and was masked up the entire time. “When I go inside and go to the bathroom, or I’m in line, I mask up for sure,” he says. Although it took place pre-vaccine, an experiment focusing on a December 2020 concert in Barcelona, in which fans wore masks, wound up with zero positive COVID-19 tests afterwards, suggesting even indoors shows can be safe under the right conditions.
4. Indoors or outdoors?
IN
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OUT
“A big outdoor amphitheater, or a big lawn where people can spread out and there’s lots of airflow, is going to be better,” says Lucy Horton, an infectious-disease specialist at UC San Diego Health. There are other factors: Does the concert have a capacity limit, allowing people to spread out and socially distance? Is it general admission (less safe, because people crowd together) or reserved seating (more safe, because you’re exposed to fewer people)?
5. How are you getting to the concert?
ALONE IN CAR
Going solo, or with people in your pod, remains the lowest-risk way to get to an event. “In the pre-COVID era, I was very much pro-public transportation and environmentally friendly,” UC San Diego Health’s Horton says. “But driving your own car, from a COVID perspective, is safer.”
PUBLIC TRANSPORTATION
Be careful, especially if you are unvaccinated. Mask up. (But don’t panic: A study of public-transit systems last September, pre-vaccine, showed no link between riding subways, trains and buses and COVID-19 transmission.)
6. Do you have kids under 12?
YES
Be careful. For now, since children under 12 are ineligible for vaccines, the risk calculation of attending concerts is problematic, because, unlike in-person school classes, it’s harder to keep away from other unvaccinated children. A recent U.K. study shows that people between 5 and 49 are more likely to get a COVID-19 infection than those older than 50, and because kids are unvaccinated, they have no protection. “I don’t think I’d bring my under-12 child to a concert until they were vaccinated,” Horton says. “Maybe an outdoor event, socially distanced, masked. We don’t want to completely restrict them from everything, but we do have to protect them.” And parents who attend concerts and come down with Covid could potentially bring it home to infect their unvaccinated children: “Everyone really should be vaccinated, but for a parent with a child under 12, that’s the best way to protect your kids,” Horton adds.
NO
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7. Are you immunocompromised?
YES
Stay home.
UC Berkeley’s Swartzberg has a colleague who was considering flying across the country to go to a meeting with 250 people — but she’s 66 and lives with her 95-year-old mother. Both are fully vaccinated, but they’re at higher risk of getting seriously ill from COVID-19 due to their ages. “I said, ‘I think it’s unwise,’” he says. “It’s a no-brainer — you don’t go.” She didn’t. Studies show vaccines aren’t as effective among immunocompromised people (just 71% compared to 90% overall), suggesting this group may not feel comfortable going to a concert or other live event until well after the pandemic.
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NO
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8. Do you live in a hotspot for the delta variant?
YES
Be careful. Texas residents (9,015 cases and 9,586 hospitalizations daily, as of early October) are at higher risk of COVID-19 compared to, say, Vermont residents (169 cases and 46 hospitalizations, according to the New York Times). Also, in conservative states like Florida and Texas, governors have ensured that overall COVID-19 safety rules for events are less strict. (Although venues have figured out how to work around this.) “You’d really be taking some risk” in those states, USC’s Klausner says. “But you would reduce your risk if you were vaccinated and wore a mask.”
NO
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9. How do you use the restroom?
PORTA POTTY
Counter-intuitively, these festival fixtures can be highly gross but they’re at low COVID-19 risk. They’re usually outside and only accommodate one person at a time. Plus, says UC San Diego Health’s Horton, “Wearing your mask makes it better, because the mask blocks it when it smells.”
INDOOR FACILITY
Be careful. Indoor amphitheater or arena restrooms might line up numerous stalls in a row — the opposite of social-distancing. In general, especially for indoor venues, UC San Diego Health’s Horton recommends avoiding long restroom lines, as well as indoor eating or drinking, which, obviously, requires attendees to remove masks: “You’re potentially increasing your exposure.”
