COVID-19 Safety Scale and Questionnaire


Dr. Stephen Shirley, medical director for multiple nursing homes in Mississippi, in consultation with his church leadership, has devised the following helpful suggestions for returning to in-person worship for his church. It is being offered simply as a resource.

  1. COVID-19 self-evaluation safety process to determine whether an individual is safe to return to an in-person church service before an effective vaccine is available.
  2. A questionnaire, to be answered each Sunday, to determine whether you should remain at home on that particular Sunday to avoid potential disease transmission to other church members.
COVID-19 Safety Scale
If you (or someone in your household) score four points or greater, you should consider avoiding large in-person gatherings, such as church until the advent of an effective vaccine. If you score less than four, it is reasonable to attend large in-person gatherings with appropriate precautions, including face masks and some degree of social distancing.
  • One point for age 60 or older
  • One point for African American or Hispanic ethnicity
  • One point for COPD or excessive smoking or vaping
  • One point for hypertension/heart disease
  • One point for active treatment for cancer/autoimmune disease
  • One point for obesity (BMI greater than 30)
  • One point for diabetes
Questionnaire for Each Potential Worship Attendee to Ask Each Sunday
If you (or someone in your household) answer yes to ANY of the questions below, you should watch worship on Facebook or a church website, on that particular Sunday, to avoid potentially infecting other church members.
  • Do you have chills and temperature (greater than 100 degrees)?
  • Have you taken any fever-reducing medicine in the past four to six hours?
  • Do you have a cough?
  • Do you have a sore throat?
  • Are you experiencing shortness of breath?
  • Are you experiencing any acute digestive symptoms such as diarrhea, loss of appetite or vomiting?
  • Are you experiencing a loss of taste or smell?
  • Have you been in contact with someone with or under investigation for COVID-19 in the past two weeks?

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