Trump's Oklahoma rally is extremely risky, and not just for the people going

Rally-goers have been asked to sign a waiver and "assume all risks related to exposure to COVID-19."
But the event is risky for more than just those participants, since they could spread infections among the broader community, causing a further surge in cases .
Attendees are "endangering not just themselves but everyone they contact in the one to two weeks afterward," one expert said.
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President Donald Trump will hold his first campaign rally in four months on Saturday in Tulsa, Oklahoma.

But nearly 800 Oklahoma healthcare professionals have signed a letter urging the mayor of Tulsa to cancel the rally .

That's because large, indoor gatherings can be the sites of coronavirus superspreader events in which a small number of individuals infect a disproportionately large number of other people and cause a local outbreak.

"Allowing our city to be one of the first places in the world to host an indoor gathering of this magnitude is not a political matter, it is a public-health matter," the letter said. "As our city and state COVID-19 numbers climb at a rate previously unseen, it is unthinkable that this is seen as a logical choice."

The rally is slated to take place inside the BOK Center, an indoor venue that seats more than 19,000 people.

"These are exactly the sort of events that the coronavirus loves large, indoor, mass gatherings where people are shoulder-to-shoulder and so they need to be avoided," William Schaffner, a professor of preventive medicine at Vanderbilt University, told Business Insider.

Trump Rally Carolyn Kaster/AP Photo

Even if attendees are willing to accept a risk of infection, other members of their surrounding communities are also put at risk by the event, since people who contract the virus at the rally are likely to pass it along to others.

"The virus has no political affiliation, and will spread beyond the rally," Schaffner said.

The rally creates ideal conditions for coronavirus transmission

So far, superspreader events all share a few key characteristics: They involve indoor gatherings in which a lot of people from different households are in close, extended contact.

Research has found that the risk of coronavirus transmission is higher indoors in poorly ventilated spaces where lots of people have sustained contact . That's because it primarily spreads via droplets that fly through the air when an infected person coughs, talks, sings, or sneezes.

"We know in these rallies people chant and cheer, politicians lead call and responses with the audience. When people yell, they exhale more vigorously, so if there's an infected person there, they can spread droplets to many people around them," Schaffner said of Trump's planned rally.

A recent study found that talking loudly can produce enough droplets to transmit the coronavirus and that those droplets could linger in the air for at least eight minutes. Vigorous singing , too, has been linked to the virus' spread.

Tulsa officials have said they expect about 100,000 people to attend the rally (though the president tweeted that nearly 1 million people had expressed interest). Typically, Trump speaks for about 90 minutes during rallies, though the doors for Saturday's event open at 3 p.m. local time, four hours ahead of the 7 p.m. start.

"Participants are going to be in there for at least several hours. That in and of itself makes it a high-risk activity," Schaffner said.

trump rally colorado Michael Ciaglo/Getty

Given that attendees are let in on a first come, first served basis, people are already queuing up .

Attendees could endanger everyone they come into contact with after the rally

The rally falls under the CDC's "highest risk" category for gatherings.

So before registering for the event , attendees are asked to sign a waiver that prevents them from suing the Trump campaign or BOK Center should they contract the coronavirus.

"By clicking register below, you are acknowledging that an inherent risk of exposure to COVID-19 exists in any public place where people are present," the disclaimer says.

But attendees aren't the only ones who face risk.

"People going to the rally are endangering not just themselves but everyone they contact in the one to two weeks afterward," Marm Kilpatrick, a disease ecologist from the University of California, Santa Cruz, told Business Insider.

The rally could help the virus cross state lines

Tennessee restaurant reopening coronavirus Jason Kempin/Getty Images

Tulsa hospitals are preparing for the possibility that they will fill with more patients because of the rally, though for now officials say hospitals there have room .

"People will bring an infection home with them and perhaps spread it to others at their home, work, local bar, or church generating further cases. And some of those will be people who are in higher-risk groups for severe coronavirus infection and may need hospitalization," Schaffner said.

Trump's rally comes as the number of daily coronavirus cases in Oklahoma is consistently increasing. On Wednesday, the state reported a record-breaking number of new cases: 259, which represented a 3% spike from the day before.

oklahoma coronavirus Sue Ogrocki/AP

"Even one person who is shedding virus can transmit it to those around them and can provide the infection that will propagate further into the community," Schaffner said, adding, "the distribution could be very substantial if infectious people travel across state lines and set up satellite outbreaks in their home communities."

Attendees will not be required to wear masks

Current CDC guidelines encourage event organizers "to prepare for the possibility of outbreaks in their communities" following mass gatherings.The agency recommends that such events involve social distancing and that attendees wear cloth face coverings and when talking, singing, and shouting.

On its website, the BOK Center says it will check attendees' temperatures upon entry and provide masks. But attendees won't be required to wear them , Ronna McDaniel, chairwoman of the Republican National Committee, told Fox News . Event staff, however, are required to wear personal protective equipment.

A Legoland employee performs temperature checks. Paul Hennessy/SOPA Images/LightRocket/Getty Images

Meghan Blood, a spokesperson for ASM Global (the company that manages the venue), told Business Insider on Wednesday that the BOK Center is proceeding with the rally because it is allowed to do under Oklahoma's "Open Up and Recover Safely " guidelines for venues.

The state allowed such venues to reopen starting May 1, and the guidelines say "it is at the discretion of business owners or local officials to determine when and if social distancing measures should be applied."

So far, there are no reported plans to facilitate or enforce social distancing at the rally; campaign officials did not respond to Business Insider's request for comment.

"These are the sorts of activities that give public-health people and clinicians caring for patients a lot of heartache," Schaffner said. "They stand in contrast to the recommendations that we open up carefully. This not careful. This is carefree."

Connor Perrett contributed reporting.

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