- The coronavirus pandemic has caused a cessation of tango activities worldwide.
- An epidemiologic model is presented to elucidate the factors involved in the spread and control of the coronavirus (SARS-CoV-2) responsible for Covid-19 disease.
- In this model, a population is divided into several distinct disease states:
- Susceptible individuals, who have not been exposed to the virus
- Infected / Infectious individuals, who have been exposed to and are shedding the virus, consisting of two classes:
- Asymptomatic: Infected with the virus, but not having disease symptoms
- Diseased: Infected individuals having Covid-19 disease symptoms
- Deceased: those who have died from Covid-19
- Immune: individuals with antibodies against the virus, recovered and protected from disease, no longer Infectious
- The model also takes into account several interventions:
- Social Distancing, which reduces exposure of Susceptibles to Infectious individuals
- Treatment: assists Diseased individuals in recovery to the Immune state
- Vaccination: induces immunity in Susceptible individuals, transitioning them to the Immune state
- This model provides a framework for discussion of the risks of SARS-CoV-2 transmission and the means of limiting its spread.
- In this model, a population is divided into several distinct disease states:
- The role of diagnostic testing in controlling the spread of SARS-CoV-2 is also addressed.
- Viral detection tests identify individuals who are infected and shedding the virus.
- These tests have been used primarily to confirm Covid-19 cases (Diseased individuals).
- These tests can also be used in Contact Tracing to identify individuals at risk of infection due to contact with a confirmed Covid-19 case.
- Confirmed cases and their Contacts are Quarantined.
- There are a high number of false negatives associated with these tests, resulting in the release of Infectious individuals into the social environment.
- Antibody tests identify individuals who have recovered from SARS-CoV-2 infection.
- In populations with a low prevalence of infection, there are numerous false positives associated with these tests, providing false security to test positives if they reenter the social environment.
- There are insufficient data to determine whether presence of antibodies protects against subsequent infection, or how long any such protection would last. This diminishes the value of any Immunity Certificates based on detection of antibodies.
- Most estimates that have been made of infection or disease prevalence, based on viral detection diagnostics, as well as inferences regarding herd immunity, based on antibody testing, give a biased view of the spread of SARS-CoV-2 in a population, due to small sample sizes and nonrandom sampling.
- Viral detection tests identify individuals who are infected and shedding the virus.
- Social Distancing limits the spread of coronavirus, but causes a depression in economic activity. Government executives, while making efforts to contain the spread of SARS-CoV-2, are motivated by economic and political pressure to reopen the economy, which relaxes Social Distancing measures. Under most circumstances this also leads to an increased spread of the virus.
- It is expected that resumption of tango and other social dance activities will follow a certain pattern.
- At first, only small social gatherings (≤ 10 people) will occur (e.g., private dance lessons and small classes). It is likely that dancers will be required to bring a partner and dance only with that partner. Face masks and use of hand sanitizer are likely to be required.
- Sometime thereafter, somewhat larger social gatherings (e.g., up to 50 people) will occur, including larger classes and smaller social dances. Partner exclusivity requirements may still exist. Tango dancers may organize private or semi-private milongas to limit attendance and thereby protect dancers against itinerant dancers who may bring coronavirus into their restricted milonga environment.
- Tango festivals, marathons, and encuentros will only occur after widespread herd immunity is achieved, most likely through vaccination, or through the spread of virus to infect most members of the population. This is unlikely to occur until at least 2022.
- The reopening and persistence of social dance events is dependent on the willingness of dancers to participate under various conditions of risk, as well as the anticipated profitability for event organizers.
- The criteria used by individuals in deciding whether to resume social dancing will be different than those used by government executives. The costs and benefits of reengaging with social dancing will differ depending on demographic factors.
- Older individuals, at greater risk for Covid-19 disease, will be more hesitant to resume social dancing. If partners are required for dance events, dancers without partners will be excluded. Even if partners are not required, in most dance communities, women are more numerous than men and will be more reluctant to resume dancing.
- With respect to tango, more younger dancers on a less crowded floor may lead to more expansive and exhibitionist dancing, which would further inhibit the return of older, more traditional dancers. However it is likely this outcome would be temporary.
- Fear of physical contact as a risk factor for disease transmission will limit participation in social dancing, in tango in particular because of its reputation for physical intimacy, and especially for Traditional Tango dancing in a maintained embrace with cheek-to-cheek contact.
- Recruitment of new dancers to tango will be more difficult because of the associated close physical contact.
- Some milongas will fail because of lower attendance. Some tango communities will become extinct for the same reason.
- Despite the disruption of tango activities worldwide due to the coronavirus pandemic, tango as a social dance will recover, although it may remain at lower numbers for several years. Delay in the development and distribution of a Covid-19 vaccine could be a significant factor having a negative impact on the recovery of tango communities worldwide. Start-and-stop reopening and retraction of economic activity due to repeated outbreaks of Covid-19 would deny dance communities the stability they need to survive.
- The primary reason tango will once again become an integral part of the social dance scene is that tango offers to many people around the world a much needed emotionally safe physical intimacy that is desired and is therapeutic.
The impact of the current coronavirus pandemic upon tango social and instructional activities has been extensive. As a result of the implementation of Social Distancing to limit the spread of the virus (SARS-CoV-2) that causes the disease Covid-19, tango social events (milongas, festivals, marathons), instructional opportunities (classes, practicas, private lessons), and concerts and shows have been cancelled worldwide (Tango in Times of Pandemic). There has even been evidence that large scale tango gatherings have been the source of SARS-CoV-2 infection (Tango Marathon Directory). Not only has there been a social, educational, and emotional impact upon tango dancers, but the financial impact has been devastating for many tango instructors, performers, musicians, and event organizers who depend upon tango for their income. The economy of Argentina, in particular, has suffered from the loss of tango tourism (Reuters).
At some yet undetermined point in the future, the coronavirus pandemic will be brought under control and it will be deemed safe to relax Social Distancing measures and resume normal activities, including tango social dancing. The purpose of this post is to evaluate the long term impact of the coronavirus pandemic on tango activities. The focus here is on the United States, the country with the most Covid-19 cases, but this discussion is relevant for all countries where tango is danced and there is significant SARS-CoV-2 infection.
Epidemiologic Model of SARS-CoV-2 Transmission
The factors affecting the spread of a pathogen can be understood within the framework of an epidemiologic model. Any population can be defined with respect to a particular disease by the division of the members of that population into several different compartments representing different disease states. The basic SIR Model (Wikipedia) includes 3 compartments – Susceptible, Infectious, and Recovered; this can modified for specific diseases to represent the dynamics of movement of individuals between disease states. Presented here is a model for the movement of individuals within a population between disease states for SARS-CoV-2. (See another model (Nature).
Prior to exposure of a population to SARS-CoV-2, all individuals in the population are Susceptible to infection. Upon exposure of the population to the virus, some proportion of the population (beta: β) becomes Infected. It is believed that these individuals can shed virus shortly after being Infected, without having disease symptoms (Discover), i.e., they are Asymptomatic. At some point, some proportion of those Infected (delta: δ) develop clear symptoms of disease, i.e., they are now classified as Diseased. This time between initial infection and the development of disease symptoms is the Incubation Period, estimated to be 5 days (median), with 97.5% of those developing symptoms doing so within 11.5 days (Science Daily). There is some proportion of individuals (alpha: α=1-δ) that does not become Diseased; it has been estimated that 25% of those infected with SARS-Cov-2 remain Asymptomatic (NPR) ; therefore approximately 75% (= δ) of those who are infected with SARS-Cov-2 develop Covid-19 disease symptoms. However, some studies (e.g., British Medical Journal) have asserted that as many as 78% of SARS-CoV-2 infections are Asymptomatic. Nevertheless, at any point in time, depending on the recency with which SARS-Cov-2 has invaded a population, 50% or more of the Infected individuals may be Asymptomatic (NPR). Children and young adults are more likely to remain Asymptomatic than older individuals and those with underlying health conditions (CDC). Notably, the ability of SARS-CoV-2 Infected individuals to transmit virus to other individuals when they are Asymptomatic increases the difficulty in controlling the spread of the virus.
Some proportion (mu: μ) of Diseased individuals die from Covid-19. The probability of mortality for Diseased individuals, usually reported as the “case fatality rate”, increases with increasing age and the presence of underlying medical conditions (such as cardiovascular disease, chronic respiratory disease, diabetes, and cancer) (Worldometer). There are also geographic differences in the case fatality rate, which could be due to such factors as community living conditions, quality of medical care, and public health reporting criteria, as well as genetic differences in the strain of SARS-CoV-2 (Chicago Tribune). The World Health Organization (WHO) estimate of the worldwide case fatality rate is 3.4% (Worldometer). This is an underestimate of mortality for Covid-19 cases because it does not take into account the final outcome for hospitalized patients, as well as unreported cases who die at home, but is undoubtedly an overestimate of the “infection mortality rate” (probability of mortality once infected) because it fails to take into account Asymptomatic Infected individuals, as well as symptomatic individuals who recover at home; it has been estimated that the infection mortality rate is less than 1% (CEBM), although this estimate also varies according to age and presence of underlying medical conditions.
The application of Treatment to Covid-19 cases can, in theory, improve the probability of recovery, depicted in the model by the parameter rho (ρ). Recent randomized clinical trials have shown some promising results for the antiviral remdesivir (JAMA) (Pharmacy Practice News), and remdesivir has received US Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for the treatment of Covid-19 (FDA). There is also some evidence that transfusion of plasma from patients who have recovered from Covid-19 to patients with moderate to severe symptoms can be effective in decreasing the risk of mortality (PNAS).
There is a belief that recovery from Covid-19 provides some degree of immunity to subsequent infection (Immune status), as well as terminating the shedding of the virus and therefore transmission to Susceptible individuals (Lancet). This assumption is based on the detection of anti-SARS-CoV-2 serum antibodies in Covid-19 recovered individuals. Individuals who remain Asymptomatic also eventually acquire some degree of immunity and therefore cease being Infectious (Nature). The model parameter alpha (α = 1-δ) designates the proportion of infected individuals who remain Asymptomatic (and develop immunity), compared to those who become Diseased (sometimes designated post hoc as “pre-symptomatic”). It is not known how long anti-SARS-CoV-2 immunity persists, but it is assumed that it persists for some time (Science Alert). However, the World Health Organization has warned “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection”. (WHO)
Vaccination against Covid-19 would, in theory, provide a route to Immune status for Susceptible individuals that bypasses the Diseased state. The model parameter sigma (σ) represents the proportion of Susceptibles in the population who transition to the Immune state via Vaccination. At the present time, there is no effective vaccine against Covid-19, although numerous vaccine candidates are being evaluated worldwide (WHO). It is expected that 12-24 months will be required before a safe and effective Covid-19 vaccine will be available (AAMC), i.e., not until 2021 or 2022 (NIAID). It is not known whether a Covid-19 vaccine would provide lasting immunity (US News & World Report).
In the absence of safe and effective treatments and vaccines against Covid-19, the most effective strategy recommended to limit the spread of SARS-CoV-2 is Social Distancing (CDC). This includes the recommendation that individuals Shelter-in-Place (at home) and only leave their homes for necessary activities such as grocery shopping, pharmacy visits, and medical appointments. Of course, some individuals are employed to provide these essential services and therefore some proximity between individuals will occur. Under these circumstances, maintaining a distance of at least 6 feet / 2 meters and wearing facial masks and gloves reduces the probability of transmission of SARS-CoV-2 transmission. Frequent hand washing and sanitization of objects brought into the home complement Social Distancing measures.
The most stringent forms of Social Distancing are Quarantine and Isolation (CDC). Infectious individuals are Quarantined, i.e., separated from the social environment, either in hospitals for severe Covid-19 cases requiring constant medical supervision, or at home for mildly symptomatic or Asymptomatic individuals. Quarantine also requires a person who has been in contact with an identified Covid-19 case to not leave the home; Isolation is the segregation of a Covid-19 case from other individuals in the home.
The logic behind the Social Distancing is that Infectious individuals, by social isolation, will transition out of the Infectious compartment before they have the opportunity to transmit SARS-CoV-2 to Susceptible individuals. Once the reservoir of Infectious individuals has been depleted, transmission of SARS-CoV-2 is terminated; the disease is eradicated within that population.
It is also important to note that immigration into and emigration out of populations can also affect the distribution of individuals in the different disease compartments within a population (unlabeled large arrows attached to each compartment in the model). Specifically, the immigration of Infectious individuals increases the risk of SARS-CoV-2 transmission for the population in focus, and emigration of infectious individuals increases the risk of SARS-CoV-2 transmission in other populations into which Infectious individuals migrate. Therefore restrictions on travel between populations become important in hindering the spread of SARS-CoV-2 from highly infected populations to populations with little or no infection.
The Role of Diagnostic Testing in Covid-19 Disease Control
Diagnostic testing for SARS-CoV-2 has received considerable media attention (NBC News), and lack of sufficient testing has been identified as a deficit in the effort to control the spread of SARS-CoV-2. However, the goals of diagnostic testing are often insufficiently elaborated and therefore incompletely understood.
There are two types of tests used in the control of the spread of SARS-CoV-2, those detecting presence of the virus and those identifying antibodies to the virus.
Most of the early testing in the Covid-19 pandemic has been conducted using a Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, which detects the genetic material (RNA) of SARS-CoV-2 in samples obtained from the respiratory tract, usually nasal, oral, or pharyngeal samples (CDC). To this point in time, this test has been used primarily to confirm Covid-19 (One Medical) in patients with symptoms characteristic of the disease [e.g., shortness of breath, cough, sore throat, fever, muscle pain (CDC)], in order to commence treatment. The RT-PCR is also able to detect SARS-CoV-2 in Asymptomatic individuals. This test has received US Food and Drug Administration (FDA) Emergency Use Authorization (EUA) (FDA) for diagnostic purposes. More recently, the FDA has given an EUA to an ‘at-home’ saliva collection test for detection of SARS-CoV-2 (FDA). The FDA has also given EUA recently to a SARS-CoV-2 antigen test (FDA) that detects viral proteins, for use in identification of infection. This test provides results more rapidly than PCR tests, but is not as sensitive for verification of presence of the virus. These viral detection diagnostics do not confirm the presence of anti-SARS-CoV-2 antibodies; i.e., they identify individuals as Infectious, but not as Immune.
Viral detection diagnostics can play an important role in a Test-and-Quarantine strategy, where individuals in the population are tested to determine whether they are Infectious and, if so, are isolated according to their presenting symptoms, i.e., either to a hospital if severely ill, or to their homes if presenting with mild symptoms or are Asymptomatic. An addendum to this methodology is Contact Tracing (CDC), where identified Infected individuals provide information on other people with whom they have had close contact since they were infected, and these people are contacted and advised as well to quarantine.
One limitation in the use viral detection diagnostics is their imperfect sensitivity, i.e., some SARS-CoV-2 Infected individuals will be diagnosed falsely as negative (e.g., a 60-70% sensitivity estimate in one study in China (Al Jazeera) indicates that 30-40% of infected individuals tested were diagnosed as non-infected).
Viral detection diagnostics could be used to provide some insight on changes in the prevalence of SARS-CoV-2 infection in a population, which is important information for developing a containment or eradication strategy. However, random sampling of the population would be needed to arrive at unbiased estimates of prevalence (Stat). In addition, it would necessary to obtain a sufficiently large sample size to minimize the (standard) error in estimating this prevalence.
Notably, since the RT-PCR is usually targeted towards identifying Covid-19 in suspected cases, in this nonrandomly selected subpopulation, the prevalence of disease is high, and therefore the percentage of false negative tests is higher than it would be in a low prevalence population (NCBI); thus, this sampling and testing methodology will release a large number of Infected individuals back into the social environment.
Detection of anti-SARS-CoV-2 antibodies is the most direct method of estimating the proportion of individuals in the population who have developed immunity (i.e., whether herd immunity has been achieved). It has been suggested that confirmation of the presence of SARS-CoV-2 antibodies could be used as a guidepost for allowing immune individuals to return to work during the relaxation of Social Distancing measures (Immunity Certification) (The Guardian). Presence of antibodies in an individual also could qualify that person as a candidate for donation of plasma for infusion into patients with Covid-19 (MIT Technology Review).
At the present time, the FDA has issued an EUA for one serological test for anti-SARS-CoV-2 antibodies, that developed by the Cellex Corporation (Biospace). Although the FDA encourages the use of SARS-CoV-2 antibody tests, caution is advised in their interpretation because the accuracy of these tests has not been evaluated sufficiently (FDA). SARS-CoV-2 antibody tests have limited utility because they could release into the social environment a significant number of individuals lacking immunity, particularly when the overall infection rate is low; e.g., for the FDA approved Cellex test, at a SARS-CoV-2 infection prevalence of 5%, 50% of test positives would be false positives (Evaluate Vantage).
The utility of SARS-CoV-2 antibody tests for providing Immunity Certification and for evaluating the course of the Covid-19 pandemic is limited not only because of population prevalence and sampling conditions, but also because it is not known to what degree or how long presence of antibodies protect against future (re)infection, disease, and virus shedding. Therefore, the WHO warns against the issuance of ‘immunity passports’ designating individuals as prepared to reenter the work force; i.e., the assumption that a positive antibody test ensures that such an individual is protected from future infection or no longer shedding virus is premature (WHO). However, one practical use for SARS-CoV-2 antibody tests is that (assuming random sampling and large sample sizes) it assists in identifying trends in the proportion of members of a population who have been exposed to the virus (Healio), which can indicate the effectiveness of Social Distancing measures and the prospects for limitation of further spread of the virus.
Return to Normalcy in the Course of the Covid-19 Pandemic
Social Distancing can be effective in reducing the transmission of SARS-CoV-2, but it comes at a cost. Associated with Social Distancing is reduced commercial activity, causing increased unemployment and reduced income to both businesses and their employees. Decreased economic productivity can have negative political consequences for government executives. Government decision makers and economists are motivated to minimize the economic costs of Social Distancing by relaxing the measures associated with it. Because relaxing Social Distancing measures is likely to lead to increased spread of SARS-CoV-2 (Advisory Board), this decision usually comes into conflict with the goals of epidemiologists and public health officials, who aim to minimize the spread of the virus, and health care delivery system managers, who wish to minimize the hazards and strain placed on health care facilities.
From a public health perspective, an easing of government-imposed and self-imposed restrictions against social proximity is more likely to be warranted as the probability of transition of Susceptible individuals to the Infected state (β) is substantially decreased. This can be accomplished by movement of individuals out of both the Infectious and Susceptible categories, preferably into the Immune state (rather than to the Deceased state). An increase in the portion of Immune individuals can occur through Vaccination, but currently this is not an option for SARS-CoV-2. When the proportion of Immune individuals in the population increases to a certain level (e.g., ≥ 70%), “herd immunity” (Johns Hopkins) is achieved.
For epidemiologists, a minimum requirement for relaxing Social Distancing measures is that each Infected individual transmits the pathogen to less than one Susceptible, on average [i.e., Reproduction Number R0 < 1 (U Michigan) (Nature)], so that the number of new infections decreases over time.
Estimation of the proportion of the population that is Immune and determining whether R0 < 1 are undertakings requiring extensive sampling and testing of the population. In actuality, due to insufficient testing, public health officials have made (and are likely to continue to make) recommendations about relaxing Social Distancing when the number of new Covid-19 cases or number of new SARS-CoV-2 infections in a population has decreased steadily over a substantial time period, preferably also when a certain minimum prevalence has been achieved. (Ideally these data would have been collected using random sampling of the population.) Another factor taken into consideration is whether hospital ICU capacity is sufficient to handle the increased number of cases that are expected to occur when Social Distancing is relaxed.
Accordingly, official government policy regarding relaxing Social Distancing measures usually has addressed issues of health care system capacity and population trends in new Covid-19 cases. For example, in its statements the US White House Guidelines for Opening up America Again (White House) rely on establishing mechanisms for surveillance (testing) for Covid-19 cases and asymptomatic SARS-CoV-2 infected individuals, Quarantining and Contact Tracing, assuring adequacy of hospital capacity and supplies for Covid-19 cases, as well as using Social Distancing to protect the health and safety of individuals working in essential industries and in a limited commercial environment. Prior to opening up commercial activity, US States need to demonstrate a 14 day downward trajectory in the number of Covid-19 cases or percentage of positive tests. After meeting these initial ‘gating criteria’, states are advised to gradually allow reopening of businesses in stages. Phase One of reopening encourages working at home, avoiding nonessential travel, maintaining Social Distancing, and not congregating in groups larger than 10 individuals; restaurants, places of worship, movie theatres, gyms, and sporting venues can open for operation during Phase One. After meeting the criteria of an additional 14 day downward trajectory in Covid-19 cases or positive tests, states can advance to Phase Two, which allows social gatherings up to 50 people, opens up schools and bars, and removes the restriction on nonessential travel, while still maintaining a ‘moderate’ degree of Social Distancing. After once again meeting the testing criteria of a 14 day downward trajectory, states can advance to Phase Three, which opens most commercial and social activities with the exceptions of retaining Social Distancing criteria for vulnerable individuals (the elderly and those with underlying health conditions). Notably absent from these published guidelines are any mention of random sampling of populations to obtain unbiased estimates of disease or infection prevalence, or requirements of a statistically adequate sample size to obtain a precise estimate (low standard error) for these measures.
[The US Centers for Disease Control and Prevention (CDC) has recently issued a set of ‘decision trees’ for opening different segments of the economy (APHA).]
In actuality, decisions made by government executives with regard to relaxing Social Distancing measures have been influenced heavily by a combination of economic and political factors (The Guardian). Most US states have proceeded to relax social distancing requirements and expand commercial activity prior to the demonstration of a downward trajectory in cases (using whatever sampling methods were available), some instead relying primarily on having sufficient hospital capacity to catch the expected increase in the number of Covid-19 cases. (US News & World Report) (Washington Post) (Associated Press). Placing a higher value on economic recovery than public health places the lives of millions of people at risk for Covid-19 disease and mortality (USA Today).
Personal Decision Making with Respect to Covid-19 Hazards
Individuals have different criteria than government executives when making decisions about social distancing. Whereas a certain amount of disease and mortality may be acceptable to government executives in reopening the economy (The Guardian), individuals will consider the mortality risk for themselves, family members, and other loved ones with whom they come into contact in deciding whether to relax Social Distancing; i.e., in almost all cases [exceptions noted (CNN)], individuals will be more conservative than governments in opinions about relaxing Social Distancing (The Atlantic). Factors such as age, family status (married, children, elderly household members), health status, financial resources and security, employment environmental conditions, etc., will have an impact upon the willingness of a person to relax Social Distancing. For example, a young adult with lower risk of disease and mortality and fewer economic resources is expected to be willing to accept some risk of disease and mortality due to economic necessity, and therefore tolerate and engage in more relaxed Social Distancing practices; in contrast, an older person with a higher risk of disease and mortality, but having a guaranteed retirement income, is more willing to accept and participate in more restrictive Social Distancing practices.
The personal decision making process with regard to Covid-19 also needs to be examined with respect to the quality and quantity of information used in making decisions. Low information individuals are more likely to trust government decision makers (or at least those representing their political interests). These trusting individuals are more likely to engage in moderately risky behaviors sanctioned by government policy, believing that their trusted political leaders have their best interests at heart. They also may be manipulated by political and economic opportunists who appeal to their emotions in order to entice them into performing actions (ABC News) that are in conflict with their personal interests. In contrast, high information individuals, in making their decisions about relaxing Social Distancing, generally examine the data and diverse opinions that are taken into account (or ignored) in the formulation of government policy. The educated high information individual will recognize that there are health hazards and, at times, misinformation incorporated into government guidelines for relaxing Social Distancing. Although not necessarily the fault of the government, there exists a naïve assumption among many that when government executives relax Social Distancing measures, this indicates that there will be no or minimal increased risk of acquiring SARS-CoV-2 infection in the more relaxed social environment. However, the reality in most environments is that the number of new cases of Covid-19 will increase significantly upon relaxing Social Distancing measures (CNN).
The high information individual is also likely to understand the limitations of Covid-19 testing programs, realizing that viral detection tests fail to identify numerous infected individuals, and that positive antibody tests are unreliable indicators of immunity. A particularly well-informed high information individual will place little credence in Covid-19 public health statistics based on changing sampling methods and small sample sizes.
Therefore, the high information individual is more likely to continue practicing strict Social Distancing measures until either an effective Covid-19 vaccine or effective antiviral treatment is available, or at least until the number of newly identified Covid-19 cases within the local population has persisted near zero for a reasonable amount of time. A high information individual is most likely to maintain strict Social Distancing measures if that person is at high risk for severe Covid-19 disease or mortality (e.g., older individuals, those with underlying health conditions) and has a guaranteed source of income (e.g., retirement income).
Relaxing Social Distancing Measures for Tango and other Social Dance Related Activities
Government actions associated with the relaxation of Social Distancing measures have not been uniform across geographic regions, with local factors such as disease prevalence, population density, hospital capacity and local political and economic pressures affecting the specific courses of action taken. Some government decision makers have placed public health welfare at the forefront of the decision making and others have placed greater value on other criteria, such as stimulating the economy or promoting their own political ambitions. An assumption made here for the sake of discussion, is that government executives make their decisions based primarily on public health criteria, i.e., that Social Distancing guidelines are relaxed only when there has been a sustained decrease in new Covid-19 cases and infections, and relaxing them only to the degree that a sustained decrease can be maintained. This assumption will be the basis for making predictions about reopening social dance activities.
The actions taken by business owners in response to government relaxing of Social Distancing measures also are not likely to be uniform. Business owners need to take into account their expected income under reopening conditions, weighed against their costs of business operation, as well as any legal liability costs that may be incurred if disease spread (to employees and customers) could be attributed to practices in place and activities occurring at a particular business site.
Under the assumption that government executives are rational actors guided primarily by public health and safety, certain trends in the reopening of commercial and social activities can be predicted, based on (at least) three criteria: (1) In resuming a certain activity, the risk in transmission of the coronavirus will be low. (2) The activity is of high necessity for human livelihood. (3) The resumption of the activity has a positive stimulating effect on the economy. Taking these factors into account, it is likely that social dance activities are likely to receive low priority in the temporal ordering of activities slated for reopening, primarily because they present a high risk of transmission of the coronavirus due to the interpersonal contact and a high social density, but also because of their status as recreational rather than as essential activities, and because social dance activities have only a minor stimulating effect on the economy due to the relatively low amount of money injected into the economy. (An exception is noted here for tango in Buenos Aires),. For most social dances (tango, ballroom, swing, salsa, country & western), distinctions between dances in the degree of social distancing are likely to be ignored by regulatory officials, although differences among these dance genres will be relevant for individuals deciding for themselves whether to reengage or initiate participation in social dance activities.
The discussion about resumption of social dance activities begins with the assumption that the expected temporal pattern in expansion of dance activities follows loosely the stages of reopening envisioned in government guidelines for reopening the economy. Dance related activities such as performances and concerts also are considered within this framework. However, after elaborating a plausible framework for reopening, the discussion will return specifically to the issues raised by the addition of the physical contact involved in social dancing to the relaxation of Social Distancing.
Under the assumptions stated above, it is expected that initially, only small gatherings of dancers (e.g., ≤ 10 people) will occur; this would include private lessons and small group classes. It is likely there would be a requirement of bringing a partner to class and not changing partners during the class. An additional requirement may be wearing face masks and sanitizing hands before class, although the former may not be very well accepted, especially for tango, which has a reputation for intimacy. Musical and perhaps even dance performances may resume in clubs and restaurants where customers are separated by a sufficient distance. However, limitations on income due to reduced attendance may prevent some dance enterprises from opening.
After some time, assuming no new Covid-19 disease outbreaks in a community, moderately sized gatherings (e.g., ≤ 50 people) would be considered acceptable. Larger classes and workshops would be expected to occur, but perhaps still requiring no change of partner during a class, and still recommending use of hand sanitizer before class, and still encouraging wearing face masks. These larger instructional settings are unlikely to include inviting visiting instructors to teach, because these instructors travel between communities and also are likely to attract dancers from other dance communities. Closing communities to dancers outside the community limits the spread of SARS-CoV-2 between communities.
Somewhat later, it is expected that the first social dance events will reappear. Social dances represent a further breakdown in Social Distancing because unlike classes, where movements of the group are coordinated by instructors, in social dances attendees are free to move around in the enclosed space. It is highly likely these first social dances will be local events, i.e., not advertised beyond the local dance community, in order to limit participation of dancers from other communities. At these social dance events, changing partners may be restricted or advised against. (In Buenos Aires, the first milongas to resume are likely to be Milongas del Barrio [Tango de Salon: The Tango of the Milonga (Part II of ‘Tango Styles, Genres and Individual Expression)], where couples do not change partners.) It is likely that personal protection measures such as wearing masks and using hand sanitizer still will be recommended or required, but face masks are still unlikely to be adopted widely, especially among tango dancers. There may be attempts to decrease floor density (e.g., by limiting the number of couples on the dance floor), but maintaining a ‘safe social distance’ of 6 feet / 2 meters or more between couples on the dance floor is not manageable; therefore, an additional challenge to Social Distancing is created here. For tango in particular, a crowded dance floor is a characteristic of the culture and an empty dance floor is likely to discourage dancers from attending milongas. For social dances of all kinds, requiring spacing in the seating areas would reduce social interaction, counteracting one of the motivations for attending social dance events. All of these considerations suggest that the demand for social dances will not be high under some set of Social Distancing restrictions. To some degree, hosting social dance events outdoors (e.g., outdoor milongas) may circumvent some of the spacing restrictions that would be imposed on indoor social dance events, and events of this type may increase in number or proportion relative to their existence prior to the pandemic.
Specifically with respect to tango, but not limited to tango, perhaps early in the resumption of social dances there may be smaller events such as private milongas in people’s homes or in relatively obscure public places, or in private rooms in public places, with advertisement primarily or only by personal invitation. Perhaps private tango clubs with a small fixed membership will form for the purpose of limiting dance contacts. These measures would provide some degree of safety against the visitor or outsider whose SARS-CoV-2 infection status is unknown, even if there is a false sense of security with respect to the infection status of known fellow dancers. These events would be more attractive to couples than to individuals without partners because the risk of acquiring SARS-CoV-2 infection is reduced when dancing exclusively with a partner, and the possibility of meeting someone with whom one could establish a relationship (dance or otherwise) would be limited in these small social gatherings. If these small social events are hosted in private homes or inexpensive venues, these undertakings could circumvent to some degree the cost demands of hosting social dance events.
Likewise, concerts and dance performance venues probably will be modified gradually to allow more attendees, most likely still maintaining some distance between attendees. Relaxation of Social Distancing is likely to occur sooner for concerts and dance performances than for classes and social dances because the former do not require physical contact between people, and movement around the enclosed space is more limited. It is also likely that outdoor performances will comprise a higher proportion of events of this type than prior to the pandemic.
Larger social dance events such as workshops given by visiting instructors and large social dance gatherings (e.g., tango festivals, marathons and encuentros), which attract dancers from other communities, are expected to be the last social dance events to reappear, probably only after the Covid-19 pandemic has ended and likely in conjunction with widespread vaccination of the populations involved. It is expected that it will be late 2021 at the earliest, but more likely 2022 or later before these events will reappear in large numbers. Greedy or foolhardy event organizers may resume these activities earlier and perhaps require an Immunity Passport for admission (which is an unreliable indicator of immunity and can also be forged), and desperate or foolhardy dancers may attend these events.
As stated at the outset, it needs to be emphasized that the condition of physical contact between individuals is a major deterrent to the resumption of social dance activities. The calendar for reopening these activities is likely to lag significantly behind the opening of other (noncontact) social activities. If dancer participation is limited, event organizers will cease hosting them, and event organizers will have their own concerns regarding providing an environment in which the coronavirus can spread. It is perhaps more likely that initially some unconventional gatherings of social dancers will emerge, such as private dance parties and impromptu outdoor dance gatherings, most likely organized and attended primarily by younger dancers. Under all of the circumstances described, physical contact between dancers and high social density are likely to result in some cases of newly acquired coronavirus infection, which would result in a reduction of these activities once again. Therefore, it is possible that a stable dance community of any kind will reemerge only after herd immunity has been achieved, which in all likelihood is not until the overwhelming majority of the population has been vaccinated.
If there is a condition which will delay indefinitely the resumption of social dance activates, it is that in which an effective Covid-19 vaccine is not developed and administered widely. Likewise, even if the number of new Covid-19 cases is reduced to near zero, but there are sporadic outbreaks, it will be difficult to maintain a persistent interest and commitment to social dancing of any kind.
Personal Decision Making with Regard to Resumption of Tango Dance Activities and the Consequences for Tango Communities
Government directives and actions of business owners are a prerequisite for the resumption of social dance activities, but ultimately the outcomes for reopening social dance activities are dependent primarily upon the participation of dancers in these activities. A person’s choice to engage in or resume dancing is based upon the perceived personal benefits and costs of this engagement. The calculations made in personal decision making regarding Covid-19 are likely to be different from those made by government executives in their efforts to stimulate the economy. The costs of social dancing have been altered by the coronavirus pandemic; perhaps the benefits have also changed, although more subtly.
The costs and benefits of participating in activities vary according to a person’s demographic status. The risk of Covid-19 disease and mortality is higher for older individuals than for younger individuals and this will be a major factor inhibiting older dancers from returning to social dance activities. A single unattached person is likely to perceive greater benefits from participating in social activities, particularly after a period of social isolation, than would a person who is married or living with a partner. Specifically with respect to tango, for single people there is the additional benefit of achieving a close physical contact with someone (The Intimacy of Dancing Tango: Therapy for Contact Deprivation in North American Society), something that may have been absent during the Shelter-in-Place phase of the pandemic. However, if partners are required for participation in social dance activities during the reopening phase, dancers without partners will be denied the benefits of new social experiences and, in tango, close contact with a person who is not a life partner; this would inhibit the return of people without partners to social dancing. Due to greater physical fitness, a younger person is likely to have more options for engaging in physical activity and therefore social dancing is less likely to be one of a limited set of choices for physical activity, as it may be for most older people. Amount of disposable income, which tends to be higher for older people, will allow greater participation in costly dance activities than would be available, in general, to younger people. More highly educated people usually have higher incomes; they are also likely to make different cost and benefit calculations. Since most social dance communities have more women than men, the benefit for participation is usually greater for men than for women. All of these factors and undoubtedly others affect an individual’s decision about returning to participation in a dance activity during the subsidence of an epidemic.
Dancers may choose to attend social dance events depending on the social and environmental characteristics of these events. Some dancers, particularly older ones, might avoid dances with high attendance and crowded floors. They might avoid dancers with a lot of young dancers, who are more likely to be asymptomatic carriers of coronavirus. Some dancers, particularly older dancers and those preferring Traditional Tango (i.e., danced in a maintained embrace) would probably prefer smaller venues and would be more likely to initiate and seek private and semiprivate events (e.g., by invitation only), as described above.
In general, during the early stages of resumption of social dance activities, attendance is expected to be lower because many dancers will perceive the costs of resumption of social dancing to be too high to risk reengaging in these activities. It is likely that during this early period three will be a higher proportion of younger dancers at social dances than prior to the pandemic. For some social dance events, in particular ballroom dances and some milongas, which normally attract a greater share of older dancers, there may be insufficient attendance for the events to be sustained financially. In some cases, smaller venues will be sought, which is often a viable option for milongas, which require less space than, for example, ballroom dances.
When comparing social dances with respect to the rate of return of experienced dancers to the activity, it is apparent that the perceived risks of disease transmission are highest for tango among the social dances. Tango is a dance that many dance in an embrace that is maintained throughout the dance, with a significant number of dancers also maintaining cheek-to-cheek contact, with a partner association lasting for the duration of a tanda (10-12 minutes). This maintained close contact, and facial contact in particular, can promote the spread of the coronavirus. Among those dancers who return to tango, the Tango Traditionalists, who achieve and maintain the closest contact with a partner, are going to be more hesitant to return to dancing tango than those who prefer to dance in an open frame, and some of the former may modify their partner hold to be more distant upon their return to tango, abandoning the maintained embrace and cheek-to-cheek contact. Some dancers may no longer participate in dancing tango socially because with these changing conditions they will be denied the emotional satisfaction of dancing in a maintained embrace (The Intimacy of Dancing Tango: Therapy for Contact Deprivation in North American Society). Thus, the character of some milongas will change substantially – there will be more dancing in an open frame. If this is associated with more exhibitionism, even dancers who dance only in a maintained embrace and only with their partners may cease or reduce their participation in milongas (Tango Community Growth and Development: Tango Sociology, Politics, and Economics), resulting in milongas becoming even more characterized by dancing in an open frame and, due to lower floor density, most likely also more exhibitionism.
There will be variation among milongas in their probability of survival when Social Distancing measures are relaxed. Overall, milonga attendance will be reduced and milongas with lower attendance will be less likely to survive. Milongas known for a greater tolerance for exhibitionism and those favored by younger dancers will have a greater probability of survival than Traditional Milongas and those favored by older dancers.
The preference for open frame dancing and intolerance for dancing close will have an impact on tango instruction. Class instruction will focus more on movements employed when not embracing one’s partner; instruction associated with dancing in an embrace will become less common.
During the period of relaxation of Social Distancing measures, there will be a significant negative impact on recruitment of new dancers to all social dances, but this negative impact is likely to be greatest for tango, because of its public image as a dance danced closely; new dancers would be more likely to choose ballroom dancing or swing dancing, where there is some distance maintained between partners. People who participate in multiple types of dancing may decrease or cease their participation in tango in favor of other dances where contact is more limited. Another safer option might be to explore line dancing (YouTube), where there is no contact between dancers on the floor. The safest option for cautious people interested in social activities is to choose an activity that does not involve physical contact with another human being. Therefore, due to concerns about the health risks of acquiring coronavirus infection, there will be increased difficulty in recruiting new dancers to tango and some difficulty in enticing former tango dancers to return.
There will be a significant negative impact of the coronavirus pandemic on tango communities in general, but the impact will be greater on some communities than others. Communities where the number of Covid-19 cases was high are likely to have greater decreases in attendance at tango instructional and social events upon reopening of the economy. Communities at the crossroads of travel (centrally located or near major airports) will have greater decreases in attendance than those in more geographically isolated areas. Smaller communities and those that had difficulty recruiting new dancers prior to the onset of the pandemic would be more likely to become extinct (Tango Community Growth and Development: Tango Sociology, Politics, and Economics).
The last social dance events to reappear on the tango scene will be festivals, marathons, and encuentros. These events will be scarce prior to the time when and if an approved and proven Covid-19 vaccine is available and a large proportion of the population has been vaccinated, which is likely to be no sooner than 2022. If an effective vaccine does not become available, the coronavirus will remain endemic in many populations, and governments are likely to resort to cycles of tightening and relaxing Social Distancing in response to increases and decreases, respectively, in the number of new Covid-19 cases. If the duration of periods of Social Distancing relaxation are short, the activities of tango (and other dance) communities will be frequently interrupted and there will be a severe negative impact on new dancer recruitment and training, as well as increased frustration due to disruption for experienced dancers, some of whom will retreat from dance participation until a more stable social dance environment resurfaces.
The arguments stated above assume that social dancers are rational actors who objectively evaluate the costs and benefits associated with their actions. This does not take into account people who ignore or even defy the risks associated with encounters with the coronavirus in the pursuit of recreational activities (CBS News) (The Guardian). However, it is unlikely that this negligible minority of irrational actors will have a significant impact on the destiny of social dance communities upon their reopening.
The Long Term Impact of the Coronavirus Pandemic on Tango Communities
The coronavirus pandemic inevitably will have a negative impact on tango communities worldwide. Resumption of tango activities will occur slowly and in smaller numbers than existed upon the outbreak of the pandemic. Less certain are the long term consequences of this disease.
In this regard, with respect to Buenos Aires, Jantango states (Tango Chamuyo), in agreement with her friend Elba Pateiro’s perspective:
She feels that the milongas will not reopen, and social tango is gone forever in Buenos Aires. We don’t know the future, but I tend to agree with her. I always said that when the milongueros are all gone, there won’t be anymore social tango in Buenos Aires. We didn’t know that a pandemic would change everything.
This is a pessimistic projection. Tango was able to survive in Argentina through a series of military dictatorships and the rise of rock and roll during the period from the late 1950s to the mid 1980s (Atlas Obscura). [Tango previously had survived the 1918-19 ‘Spanish influenza’ pandemic (CDC) (NCBI), as did other social dances worldwide.] The governments of Buenos Aires and the national government of Argentina have made a large economic investment in tango, officially in the annual International Tango Festival and World Cup, still advertised to take place in Buenos Aires in August 2020 (Buenos Aires Government), and businesses in Buenos Aires benefit financially from this festival as well as from tango tourism all year around. However, one may question whether, in the absence of older Argentine dancers, the keepers of Tango Tradition, returning to milongas in the same numbers as prior to the pandemic, the character of tango in Buenos Aires milongas will change. One possibility is that many milongas in Buenos Aires will resurface, but primarily as meeting grounds for tango dancers from around the world, with significantly lowered participation from porteños, the remaining few being primarily tango entrepreneurs (instructors, taxi dancers, gigolos, etc.). Perhaps worse yet, the milongas of Buenos Aires could become living museums preserving the urban folklore of a past era that tourists and some Argentines may wish to recapture in some superficial form, but with an environment lacking the true spirit of the tango of the Golden Age, much as folklore shows around the world entertain and sometimes seek active participation from tourists.
However, this is still an extremely pessimistic forecast for the future of tango in Buenos Aires. Holding someone close in an embrace is something inherent and natural in Argentine culture, and this will inevitably return when the health environment once again becomes favorable. The coronavirus pandemic will either create herd immunity within 3-5 years through infection and recovery of the population, or a vaccine or effective treatment will be developed sooner. Milongas will return, perhaps fewer and with lower attendance and perhaps in a somewhat different form (e.g., more Milongas del Barrio or in private clubs), but tango dancing in its traditional form (embrace one’s partner, dancing to Classic Tango music) (Evolutionary Tango versus Traditional Tango – Part I: The Nature of the Tango Culture War) offers too many rewards to dancers in a contemporary world (The Intimacy of Dancing Tango: Therapy for Contact Deprivation in North American Society) for it to fade into extinction.
What will happen to tango communities around the world is a different question. Although tango is expected to survive the coronavirus pandemic and reassert itself as a prominent magnet within the social dance culture, it is not known to what degree the composition and character of tango communities, as well as their distribution, will change. Demographically, one might expect fewer older than younger dancers to return to dancing tango, certainly initially, due to the possible reemergence of Covid-19 (or fear thereof) and the greater risk of disease and mortality for older individuals, or even because some older dancers no longer will be able to dance due to health issues, but this does not take into account the dedication dancers have to their social activities. Younger people are often exploring different activities and because they are more physically fit in general, they will explore a wider range of activities, and their interests often change over time, so perhaps their interest in tango will wane during the pandemic period, when they seek and find rewards in participation in other activities. Educational, relationship, and child rearing responsibilities might also draw young people away from tango, as they did before the pandemic. Dancers without partners may hesitate to resume dancing tango. Tango communities are likely to have difficulty recruiting new dancers, at least initially. There are so many factors affecting decision making regarding the resumption of tango activities, it is difficult to predict precisely what will happen with respect to the composition of tango communities after the pandemic subsides. However, it is very likely that community sizes will be smaller and that some tango communities will cease to exist. From this smaller network of somewhat smaller communities, tango dancing eventually will experience a resurgence, maybe not as large as that of the early 21st century, but it will once again expand in popularity throughout the world.
The remaining question to be addressed is whether the character of tango dancing will change after its resurgence. This is also difficult to predict at this point in time. Basically, the outcome depends on the commitment of returning dancers to become involved once again in dancing tango. One perspective is that Tango Traditionalists are more committed to tango and therefore are more likely to return to tango and the character of milongas will become more traditional, in general, upon the resurgence. A very different perspective is that Tango Traditionalists, who tend to be older, will fear a return to tango due to concern about the reemergence of Covid-19 (or some other deadly pathogen) and that the tango resurgence will be fueled primarily by younger dancers, who tend more towards exhibitionism in their dancing. A third possibility is that the conditions of the coronavirus pandemic will fade into distant memory and, in the tango reemergence, the character of milongas will return to an environment quite similar to that that existed before the pandemic. In examining these possible outcomes, the possibility of tango becoming almost entirely an exhibitionist dance in milongas worldwide appears to be the least likely of these three outcomes, mainly because many Tango Traditionalists are deeply committed (many would say addicted) to their involvement in tango dancing, to the rewarding therapeutic effect they receive from the tango embrace (The Intimacy of Dancing Tango: Therapy for Contact Deprivation in North American Society). It is also this therapeutic effect of the embrace that will once again eventually attract new dancers to tango, once coronavirus fears subside. It may take a decade or more before this state is once again achieved, but something as rewarding as tango will not fade into history.
Living in the midst of the coronavirus pandemic and all of the fears and uncertainties it creates, seeing the way forward clearly is clouded by the high stakes of the disease dominating the earth at this time. Taking a step backward, it should be apparent that this moment in which time has seemed to come to a halt is only a brief period in the history of the world and its people. There is no doubt that this is a highly significant moment which may have far reaching economic and political consequences. However, human character changes slowly, and some aspects of human character remain the same. Tango speaks to a universal aspect of human character – the desire to connect with another human being. Something this fundamental to human nature will not go away. Because tango satisfies a basic human need, it will be part of human culture for some long time to come.