Archives for March 2020

by Mendel Singer, PhD, MPH (Master of Public Health)

The consensus is remarkably broad: Rabbinical experts, leading physicians, the CDC and Hatzolos. They all agree. People should not be traveling for Pesach. People from the hard hit NY/NJ/CT area especially should not be traveling and shouldn’t be leaving home except for the true necessities. In Lakewood, Rabbinic and medical leaders are telling people not to get together for Pesach – even within Lakewood! This is very hard to do. New chossonim and kallos will be making Pesach by themselves. Families will be apart. It will be hard logistically and emotionally. It may mean using kulos you normally wouldn’t rely on. But is it really necessary? But my (fill in the blank) can’t make Pesach. Can’t? There are some cases where this is literally true. But we need to
ask ourselves – what if being together for Pesach causes, chas v’shalom, a tragedy? Hashem would know. Your family would know. Certain friends and neighbors would know. But most importantly, you would know. How would you live with yourself? After all the experts said not to do it.

We are hearing of terrible tragedies, not just sick elderly, but some healthy frum people in their 30’s and 40’s who have died. About 1/3 of cases are age 20-44, and about 1 in 5 of the hospitalization. This is all too real. Who is at risk? All adults are at risk. Some are at greater risk of death than others. How many will get infected? We are expecting several hundred thousand cases in Ohio alone. How many will die? Way too many.

But we can be very careful in the house! We can clean constantly! When a person with COVID-19 coughs, droplets travel up to 6 feet – and onto surfaces. On metal, it survives for about 2 days. And people touch things! And then they touch their face – about every 3-5 minutes, though they aren’t aware of it. If an infected individual is in the house, before they even know they have the infection, they will be leaving the virus around the house. If someone is isolated in the house, they will have touched things first before reaching their area of isolation. Someone else will interact with that person. It is very hard to contain. There are many large families where all members got the infection.

What if the visitors and the local family just all self-quarantine for 14 days? But it may be much, much longer than 14 days. During those 14 days, if someone gets infected, you now have 14 days from then. That could repeat again for each person in the house getting infected. 14 days could easily turn into a month. And what happens if you have trouble with your refrigerator/oven/plumbing around/during Pesach? How do you get it fixed?

What we don’t know can kill. How many people are infected but show no symptoms? We can’t know until we have capacity to do population testing. Can these people without symptoms transmit the infection – yes, but we don’t know how common that is. How many children are infected without symptoms and able to transmit? We don’t know. Does recovering from the virus mean you’re immune? Most likely, but we don’t know for how long. It certainly isn’t expected to be lifelong immunity. Will immunity last until the end of this outbreak, including potential second wave in the fall? We don’t know. We know some people have tested positive within a month after recovering and having tested negative, though the cases we know about haven’t had symptoms. Can they transmit? We don’t know. But we are literally learning more every day.

But maybe we will all end up getting it eventually anyway? The extreme measures we are adopting is intended not only to minimize the number of cases, but to “flatten the curve” – minimize the number of cases at any one time so we don’t overwhelm our hospitals and intensive care units. This is a real concern. In NY, Gov. Cuomo is talking about a huge shortage of ventilators in the next 2 weeks. Many other states are not far behind. Our local hospitals are very concerned. But that isn’t the only reason to try and delay cases. It won’t be that long before we know much more about the effectiveness of several promising treatments that are being tested now. Delaying cases may mean pushing cases to a time when it can be treated successfully. The stay home measures are critical to saving lives – perhaps someone you love, or even you. A vaccine is a long way off. Several have just started testing, but to know that they work and to mass produce it – probably 8 to 12 months. Meanwhile, social distancing, stay home and various other measures are our primary means of saving lives. That and washing our hands very well and often. 20 seconds, with soap.

In Lakewood they sell “Pesach meals in a box” – all 10 Yom Tov meals for a family of 5 for $349. Where there is need, people step in. Videos are posted teaching how to make Pesach at home. We can do this.

But there’s another way to look at this – a more positive way. We have a very great opportunity. By not getting together with others, by not traveling for Pesach, we can be oisek in the mitzvah of pikuach nefesh! I have confirmed this with HaRav Boruch Hirschfeld, Shlita. How many of us have dreamed of having the chance to save a life, to fulfill the mitzvah of pikuach nefesh? This is your chance. The people who do this mitzvah daily are begging you. And many have changed their plans. Yasher koach to them all!

As a professor who does public and population health, I am speaking out. My colleagues and many former students of mine are working day and night at the Cuyahoga County Board of Health or at/with the hospitals, or other community health organizations. As someone who suffers from an immune system disorder, I can’t be on the front lines with them. I am at home. Like most of us should be.

Stay Home, Save Lives. Pikuach nefesh is literally within your grasp.

Mendel Singer, PhD MPH
Associate Professor and Vice Chair for Education
Department of Population and Quantitative Health Sciences
Case Western Reserve University School of Medicine

An open letter to the Cleveland community,

What I have been seeing daily on the front lines in the Emergency Department astounds me. What I see on the streets of our community horrifies me.

I have started to see more and more out of state license plates gracing our home city. Maybe I am misjudging, but my suspicion is that there are people coming from the New York and New Jersey area for Yom Tov.

Why? Because we can’t make a Yom Tov ourselves? Because our family is pushing us? Because we think we are above the rules? The rules of law and nature?

The coronavius is not particular in whom it infects. You may have it and not know it. The cold you had last week may, or may not, have been it. Devastating effects are seen not just in the elderly and otherwise sick, but in regular people, just like “me”. And for all the numbers of people that have died of the disease that it causes, COVID-19, there is an equal number that have a high chance of being ventilator dependent. Their numbers don’t get factored into the death toll published daily by the Ohio Department of Health, but their numbers are rising exponentially.

Do you think you are more important than your neighbor, your parents, your children? Do you think you are smarter than the rabbanim who have essentially forbidden coming or having family over for Yom Tov? Are you smarter than the medical doctors, epidemiologists and military personnel who do this professionally? Come on people. Think of someone else if not yourself. Stay home. Ma’aras ayin is real and so are the numbers.

Stay home, so I can go to work and take care of those who can’t care for themselves.

I just received a phone call from the manager of a store in the Cedar Green district. He is seeing people from New York and New Jersey coming into his store. He knows they are from there because he has spoken with them on their past visits, and when they order things and leave a New York or New Jersey phone number, or when he helps carry things out to their car and they have New York and New Jersey tags, he knows that these folks are here from out of town. He asked me what I could do about it.

Last week I issued an announcement strongly encouraging people to not host company from out of town at this time especially from these states, and asking for voluntary compliance. I’m disappointed that people are not looking out for everyone’s interest. This is a public health emergency, and we must all take it seriously. Anybody who is now here from New York or New Jersey should immediately self quarantine for 14 days, together with whomever is hosting them. And part of self quarantining is not going into our stores.

I know this is a difficult time emotionally because this is a time of year that we normally spend with our family, and the holidays have great significance. That is all the more reason why we must be vigilant about staying safe. So that we can celebrate the next holiday and the holiday after that and all the ones after those.