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Article Published: 04 Feb 2021

Doctors' Orders

The advice of medical professionals during the pandemic has been an invaluable boon for opera companies. As an advisor to Milwaukee’s United Performing Arts Fund, epidemiologist Laura D. Cassidy works with a number of local arts organizations, including the Florentine Opera. Susan E. Bennett, a primary care physician affiliated with Massachusetts General Hospital, heads up Boston Lyric Opera’s Health Task Force for Opera Artists. Marc A. Scorca talks to these two doctors about the health challenges the coronavirus presents to the industry and the expanded role of medical professionals in the lives of opera companies at this pivotal moment.


SCORCA: How did you get into your advisory role with Milwaukee’s per­forming arts community?

CASSIDY: It started in March of 2020 when the pandemic really hit. The leadership at MCW — the Medical College of Wisconsin — asked me to help educate people on flattening the curve. I worked with the Metropolitan Milwaukee Association of Commerce to create a health and safety toolkit. Then we started working with different businesses and doing webinars and helping them tailor their toolkit to their business. It’s not a one-size-fits-all. One of our senior vice presidents at MCW is on the board of the United Performing Arts Fund, and he asked if I would work with them. We bring them together and I meet with them every Friday. We share ideas and experiences. Some of the questions are the same, but some are unique to the particular type of venue or performance.

How many organizations participate in those Friday calls?

There are usually about 50 participants — the ballet, the Florentine Opera, the youth symphony, the Broadway series, all the different venues. Now I’m working with Summerfest, the largest music festival in town.

Did you begin working more specifi­cally with the Florentine Opera when they wanted to develop protocols to bring their resident artists back into town?

It’s been really interesting. People are working so hard to be safe and do the right thing. They’d done so much research and reading and put together protocols. What they really needed was somebody to review them, look at it with another lens, and reassure them that what they’re doing was right. So I worked with them on that. They had concerns about quarantine isolation testing. Some of the singers share a living space. If one tests positive, what do you do with the other? The singers are young, so the company asked me what’s the best way to communicate with them about the im­portance of quarantine, the importance of staying within your pod — because young people want to go out and have fun.

Maggey [Oplinger, the Florentine Opera’s general director and CEO] reported to us with great despair that some rules were broken, resulting in infection. So they had to redouble the quarantine effort to get everybody safe again. It’s one thing to develop the protocols, and it’s another thing to develop human behavior around those protocols.

Yes, human behavior is the hardest part, but it is possible to change it. I keep telling people, “Look at seatbelts; look at smoking.” The restaurants at first were like, “We can’t require masks.” And I said, “Well, you have to. You have to be leaders.” You have to lead the way and show how to do it safely. Then people will follow.

What sources do you as an epidemi­ologist review to formulate your own opinions?

Well, I of course review the CDC and WHO guidelines. And then I also talk to the experts we have within our organi­zation and with our local health depart­ments, because we have to tailor the CDC guidelines to our specific environments. I’m bringing in Milwaukee County’s health department as we talk about a performing arts safety plan. When we’re able to start operating again, we want to get our protocols approved in advance. We did this with the restaurants so that if the restaurant has a safety plan approved by the health department, their capacity isn’t as reduced as other organizations because, in theory, they’re practicing safely. If people go to a safely practicing business, that’s better than gathering in homes.

What will be opera’s greatest challeng­es — where will the speed bumps be?

The organizations I’ve worked with have been very thoughtful about their safety protocols, about controlling the flow of people, the air quality, and the disinfect­ing. It’s what people do in their own lives that spreads the disease. Having as many people as possible take the vaccine is the way we’re going to get through it. And I know there’s mistrust, there’s been so much misinformation. There are subsets of the population who just don’t trust the medical community, but getting a high enough number of people vaccinated will give us community protection. The challenge is going to be ensuring that we don’t get a large number of people who aren’t vaccinated coming to events. I personally think it’s a good idea to have to show proof of vaccine to go to any sort of large gathering, because you may be putting other people at risk: there are legal and ethical issues there.

Many of our members are talking about normalized in-theater activity by the beginning of 2022. There are plans for the fall of 2021, but everyone has a Plan B and a Plan C until perhaps next winter. Is that how roughly you’re seeing it?

I’m optimistic. From what I hear, what I read, and what I believe, by the second half of 2021, we’re going to have a large number of people vaccinated, better test­ing, and some return to normalcy.


SCORCA: How did you get involved with opera?

BENNETT: My mother loved to sing and she loved opera. She took me to Madama Butterfly, but the only thing I remember about that is that my mother and the woman on the other side of me were weeping uncontrollably. Then in 1994, my youngest daughter was in the Boston Children’s Opera, which they used for the chorus of a Boston Lyric Opera run of Carmen with Lorraine Hunt. They asked me to stay backstage with the kids, to keep them quiet and to keep them from screwing around with the musicians’ instrument cases. Being back there and hearing that opera over and over and over again — it changed my brain. I became totally devoted. Then at Mass General, I took care of a lot of opera singers when they’d come in from other cities.

How did you get involved in Boston Lyric Opera’s Health Task Force?

When COVID happened, Esther [Nelson, general and artistic director of BLO] contacted me and said, “Would you be willing to get together some people to advise us?” I asked a colleague if he had any idea of whom I could enlist. He suggested David Finn, who’s a primary care doctor and a mover and a shaker. He’s the physician for the Boston Bruins. I asked a friend of mine, David Kanarek, who’s an extremely good pulmonary specialist. I asked David Hooper, who’s a very senior infectious disease doctor, on the COVID task force at Mass General. And I asked Phillip Song, who’s the head of otolaryngology at Mass Eye and Ear. Esther brought in Erin Bromage, who’s not an M.D., but a scientist — a profes­sor of microbiology at the University of Massachusetts Dartmouth.

What were some of your immediate actions?

Philip Song found someone on the board of directors at MGB [Mass General Brigham] who donated about 10 kits to do PCR testing and actually did the testing in his office. The tests usually cost 160 dollars each out of pocket. This enabled the video recording of [Philip Glass and Arthur Yorinks’] The Fall of the House of Usher to take place.

Where did your discussions lead?

We went through these first protocols that were laden with obsessive details about fomites [the transmission of infec­tion through objects]. We were off in the wrong direction, with too much time and too many resources spent on trying to prevent fomite contact. Not that it’s use­less. It is important to keep your hands clean and to not touch doorknobs and then rub your eyes and pick your nose.

With so much information flowing, so much of it contradictory, how have you developed your own understand­ing of safe practices?

I said at a meeting at Mass General that I really felt we needed to mandate masks in the office. Somebody said, “No, we really don’t think it’s aerosolized.” But it was kind of obvious to me. My God — look at what happened in Bergamo, Italy. You just wouldn’t have that kind of infection from fomites. It’s apparent that it’s aerosolization. You have a group of largely asymptomatic people between the ages of 16 and 35 who go through a period of 24 to 48 hours where they’re pouring out SARS-CoV-2 into the air. I felt intui­tively that opera singers needed to wear masks. There’s no doubt that if an opera singer is infectious and aerosolizing, no space other than a football field would be safe enough.

When I first joined your monthly Zooms, you were working on BLO’s portable Street Stage. Have you gone beyond the Street Stage to look at other forms of performance and how to make those safe?

No, because we have another surge now. We are back to April [2020], if not worse. No, there’s not going to be any perfor­mance anytime soon. I can be brave, but I also don’t want to say, “Oh, sure, everything’s fine — go right ahead. And you can hold me responsible personally.” This has been an ongoing issue with the unions for the musicians and singers. There are all kinds of liability and pro­tections that have to be embedded.

What has to occur to allow us to get back into the theater safely?

Vaccines, vaccines, and vaccines. We need to try to convince the public that vaccines are a lot safer than getting COVID. Once we have enough people vaccinated, which should be within the year, I think it’ll be safe to have perfor­mances. You can make an argument that by the fall of 2021 we could put on an opera with some safety people on hand to prove that audience members have had their vaccine. Will we be able to make certain that all of our musi­cians and singers are immunized? That may be tricky.

I want to thank you for using your connections and your wisdom on behalf of Boston Lyric Opera and the whole opera industry.

There are doctors like me all over the world who are committed to the art form and committed to the people who are compelled to make the art, despite all the reasons not to do it. These are special individuals who need protection. And right now humanity needs opera.

This article was published in the Winter 2021 issue of Opera America Magazine.