Large gatherings pose a risk for SARS-CoV-2 transmission. High transmission rates have been reported from hospitals, long-term care facilities, family gatherings, and a choir practice. This public health investigation focused on the transmission of SARS-CoV-2 among persons who attended church events during March 6–11 in rural Arkansas.

During March 6–8, a church in rural Arkansas hosted a 3-day children’s event which consisted of two separate 1.5-hour indoor sessions (one on March 6 and one on March 7) and two, 1-hour indoor sessions during normal church services on March 8. 94 church members registered for this event and 92 were were successfully contacted and included in this analysis.

Among these 92 church attendees, 35 (38%) developed laboratory-confirmed COVID-19, and 3 persons died. The highest attack rates were in persons aged 19–64 years (59%) and ≥65 years (50%). Children represented 35% of all church attendees but accounted for only 18% of persons who received testing and 6% of confirmed cases. An additional 26 cases linked to the church occurred in the community, including 1 death.

The authors suggest that faith-based organizations should work with local health officials to determine how to implement the U.S. Government guidelines for modifying activities during the COVID-19 pandemic to prevent transmission of the virus to their members and their communities.