Images of packed beaches, lakes and bars have made the rounds on traditional and social media for much of the summer, drawing scorn from those concerned about the coronavirus spreading among those crowds.

Less prominent but also troubling are the growing instances of case clusters arising from smaller gatherings.

Contact tracing yields information about the sources of infections as the USA, by far the world leader in total COVID-19 cases and deaths, grapples with how to keep its population safe while propping up a flagging economy. More than 182,000 Americans have been killed by the disease.

The hasty reopening of businesses across much of the nation after the spring shutdown was largely blamed for a summer surge in infections, but social functions of various sizes among relatives, friends and co-workers may have been a contributing factor as well. Public health experts sound the alarm as the Labor Day weekend approaches.

“People don’t think of it in the same way as the (President) Trump rally in Tulsa, a bunch of people on the beach or in the bars, but these small events add up to a lot. It’s just invisible,” said Dr. Peter Chin-Hong, a professor of medicine at the University of California-San Francisco who specializes in infectious diseases. There’s no generally accepted definition of what’s a small gathering – it may range from five to 30 people – and the majority of these activities take place behind closed doors. That makes it difficult to garner hard data about them. In late July, Maryland Gov. Larry Hogan said contact tracing revealed 44% of those testing positive for the virus in the state reported attending a family activity and 23% a house party, but the size of the events was not specified.

Plenty of anecdotal evidence supports the notion that getting together with people outside the immediate household, even in fairly limited numbers, can lead to a rash of infections. Chin-Hong said several of the COVID-19 patients he treated believe they caught the virus at barbecues.

Weddings have been more troublesome, including a 100-guest event in San Francisco in early July that resulted in at least 10 people contracting the virus, among them the bride and groom.

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