Welcome to the weekly newsletter of Igud HaRabbonim, the Rabbinical Alliance of America, in which we share news for and about members, including communal news, announcements, publications, Divrei Torah, press releases and media mentions.
In this newsletter:
• Chaplaincy Commission Update
• Rav Dr. Aaron Glatt: Covid Update
• New Publication: Igud Divrei Torah for Shavuos
• Divrei Torah: Shavuos
• Baltimore Jewish Life: Chevra Kadisha Appreciation
• Hamodia: Rav Mirocznik Appointed to Council
• Upcoming Yahrtzeits 7 Sivan-14 Sivan
• New York State Guidelines for Religious Gatherings and Funerals
• Rabbinical Alliance of America Announces Proclamation Appreciating Chevra Kadisha During the Covid Pandemic
• Tosfos Yom Tov Sivan 5780
Please let us know about your family simchos and l"a aveilus, book publications and career changes or milestones, so we can share as chaveirim our life events. Send updates to email@example.com.
From the desk of Rabbi Leonard (Yehuda)Blank MS, BCC
Director of Chaplaincy Commission and External Affairs
Rabbinical Alliance of America/Igud HaRabbonim 917-446-2126 firstname.lastname@example.org
May 28, 2020
On behalf of the Chaplaincy Commission, Rabbi Michael Chazzan, Rabbi Yochanan Ivry,
Rabbi Tziphania Kreiger and Rabbi Simcha Silverman want to wish our readers a wonderful Yom Tov of Shavuous.
Another Yom Tov, another Shabbos, many outdoor minyanim are occurring, many shul minyanim are happening, every week we read about a renewal of normalcy one way or another. Yet, it does not appear everything is back to normal. I will not go into that as you can read for yourselves from the various rabbinic publications, organizational communications and so on. Aside from the many shops that are still closed, there are many items you still cannot purchase- anywhere because they are just
not available. The many shailos and challenging circumstances Rabbanim deal with continue often daily with ever changing policies, procedures, halachos and so on. Chaplains you might think are having an easier time of it, but the many issues they deal with continue day in and day out. Parents of children with special needs are having a difficult time. Families with relatives who are ill, elderly, and have other issues to contend with. Yet, with all that is said, somehow, we seem to rally on as difficult as it might be and find the strength to enter the Yom Tov and Shabbos with determination, kedusha and meaningful happiness.
For all who are facing day and night difficult challenges, it would be nice to wake up to a new day where everything is once again better again. It could happen. Whether or not you are able to or permitted to attend a minyan on Shavuous, whether you are able to stay up and learn or say Tikun, please enjoy your dairy delicacies Thank you. Sincerely, Yehuda Blank
Please read the following flyers.
OHEL Children’s Home and Family Services
TTI Testing and Training International
CAHE Center for Allied Health and Education
They are time sensitive.
Below is an update on the Covid situation from Rav Dr. Aaron Glatt, RAA/Igud’s Director of Halacha and Medicine Commision, dated May 27, 2020 (the situation changes day today).
COVID-19 Update May 27, 2020
Rabbi Aaron E. Glatt, MD
I wish everyone a safe and enjoyable Shavuos. This update is extensive – read at your own risk.
We very much look forward to having minyanim iy”H this coming week, starting with Ma’ariv Wednesday evening. In addition, Long Island officially started the first phase of reopening its economy today after more than a two-month shutdown. I will discuss these issues and commonly asked questions on our motzei Shabbos 9:40 PM shul zoom, Meeting ID: 980 3243 6809; Password: 5TFRBM.
We want to stress and remind everyone that NO ONE should feel obligated to attend such minyanim, especially anyone with an absolute contraindication or their own personal health concerns about catching COVID-19. Our poskim have strongly stated that even if you have a yartzheit or are saying kaddish or always have previously attended minyanim, you should not in any way feel pressured or obligated to attend minyan.
What new studies of importance were published this week?
Several new papers provide important additional data on optimally managing COVID-19.
1) A new article in Gastroenterology revealed that one third of patients with COVID-19 had GI symptoms at the time of presentation! 22% of patients had diarrhea; 16% had nausea; 9% had vomiting; and 7% had abdominal pain. GI lab abnormalities were present in almost two thirds. This has colored my concern regarding people using someone else’s bathroom, and why I have been recommending that sharing bathrooms is a potential transmission concern.
Fortunately, GI symptoms were actually associated with lower rates of death and ICU admission.
2) Sweden has utilized quite a different methodology to try and control COVID-19. They actually encouraged transmission to occur to a certain extent to maximize herd immunity, an approach different than most countries have practiced. Their Public Health Agency released data from their ongoing antibodies study that showed that only 7.3% of people in Stockholm had developed antibodies against COVID-19 by late April. This figure was a bit lower than expected, although a larger percentage is expected at this point in May. Unfortunately, their death rate according to Johns Hopkins University was higher than U.S. rate, and also much higher than neighbors Norway and Finland, all of which enacted strict lockdown measures. Nearly half of their 4,000+ COVID-19 deaths occurred in the elderly living in various care facilities.
An official statement from the country’s government stated: “It’s still far too early to draw any clear conclusions or comparisons connected to the coronavirus pandemic,” but “we are open with that the strategy has failed to protect the elderly living in care homes.”
3) Researchers at NYU found that inflammation and low levels of blood oxygen were associated with the worst outcomes in Covid-19 patients, even more so than advanced age and comorbidities. Indeed, 53% of hospitalized patients were younger than 65. Blood oxygen below 88% upon admission and inflammation markers in the body correlated with with critical illness. This strongly supports monitoring newly diagnosed COVID-19 patients with oximeters to measure oxygen levels as an outpatient, something we recommended early on.
4) A related study in the Annals of Internal Medicine on 2013 patients (92% who did not need hospitalization) again showed that loss of smell was one of the most prevalent symptoms. A whopping 87% reported loss of smell, and 56% reported taste dysfunction. Nearly half had these as their initial symptom, while others had non-specific symptoms initially. It is important to remind everyone of two things. A) Loss of smell can be due to many other causes, including other viruses; B) Viral load is high even early in the course of illness. Therefore, I think this has practical ramifications for use. People going to minyan and / or to other public gatherings must self-assess for symptoms and should actively check sense of smell before going out in public where they could theoretically transmit virus.
5) Two studies this week in major British journals put additional nails in the coffin of hydroxychloroquine (HCQ) usage. A smaller paper in the BMJ compared 150 hospitalized patients (148 with only mild to moderate disease) treated with or without HCQ. They concluded that administration of HCQ did not result in improvement versus standard care, and side effects were higher in HCQ recipients.
A much larger paper in The Lancet analyzing almost 100,000 hospitalized patients in 671 hospitals on six continents demonstrated similar findings. HCQ with or without a macrolide antibiotic offered no benefit in treating patients with COVID-19 and, indeed was associated with arrhythmias (more than 5-fold increase) and higher rates of mortality – 10% in control patients, versus 16% to almost 24% in treated patients.
In a Jewish medical ethics talk I gave this week at a conference, I therefore said, based upon these results that from a halachic perspective, it might actually be prohibited to take these medications for COVID-19 outside of a pre-hospitalization or prophylactic usage study setting.
Anything new regarding antibody testing? Should I get tested?
Here is a summary of the newly updated CDC Guidelines re COVID-19 antibody testing.
Recurrence of COVID-19 illness appears to be very uncommon, suggesting that the presence of antibodies could confer at least short-term immunity to infection.
Experimental primary infection in primates and subsequent development of antibodies resulted in protection from reinfection after the primates were rechallenged.
Antibody development correlates with a marked decrease in viral load in the respiratory tract.
Taken together, these observations suggest that the presence of antibodies may decrease a person’s infectiousness and offer some level of protection from reinfection. However, the CDC states definitive data are lacking, and it remains uncertain whether individuals with antibodies (neutralizing or total) are protected against reinfection; and if so, what concentration of antibodies is needed to confer protection. More to come…
Practical Best strategies to improve test usage:
MUST use a test with a very high specificity, perhaps 99.5% or greater
Alternatively, focus testing on persons with a high pre-test probability of having antibodies, such as persons with a history of COVID-19-like illness that was never proven. Our own experience has shown that some people who thought they had COVID actually had a different virus.
Where can antibody testing be especially useful?
To diagnose COVID-19 illness for persons who present 9-14 days after illness onset.
To establish late complications of COVID-19 illness, such as multisystem inflammatory syndrome in children, when COVID-19 was not previously diagnosed.
There should be no change in clinical practice or use of personal protective equipment (PPE) by health care workers and first responders who test positive for antibody.
Additional considerations on the use of serologic tests
At this time, antibody testing should NOT be used to make decisions about grouping persons residing in or being admitted to congregate settings, such as schools, dormitories, or correctional facilities. (My note – I think this will change…)
Click on this link for full guidelines:
What has been happening with already existing minyanim?
I was on multiple calls this week that provided me with totally discordant information. Some minyanim in the NYC / Long Island area that I heard about were conducted in accordance with acceptable protocols to minimize risk to participants. On the other hand, I was unfortunately shocked to hear of minyanim with participants well above the legal and safe limit, davening in confined spaces, and to hear about shul shalosh seudos also occurring, in flagrant disregard of all published guidelines. But the most troubling and scary conversation, was when a frum physician stated that his patient was a participant in a minyan, became symptomatic, and tested positive for acute COVID-19 infection. He refused to allow the minyan participants to be told because “they would kill him”. I guess the fact that he might literally kill them wasn’t a concern. Whenever any minyan does open, it must absolutely follow the strictest guidelines – or else it cannot open.
How will we know if there is a problem?
After discussion with some colleagues, we are going to try and put together a 5 Towns / Far Rockaway “early warning system”. We are asking all medical practitioners in our community to please email every time a new patient is diagnosed with COVID-19. Details of this program will follow, to enable us iy”H to detect as soon as possible any uptick in cases.
Can you provide some more details regarding sharing pools?
One of the most common questions I have been getting is sharing pools with other families not living in that household. With warmer weather coming, and lack of clarity still regarding whether there will be any summer programs available for our children, people fortunate enough to have a pool will be beseeched by many to share this wonderful resource. While the are no clear absolute evidence-based guidelines, here are some of my recommendations based upon available evidence.
As I have mentioned several times recently, the official CDC position is:
“There is no evidence that COVID-19 can spread to people through the water used in pools, hot tubs, or water playgrounds. Proper operation and disinfection of pools, hot tubs, and water playgrounds should kill the virus that causes COVID-19. Limit close contact with people outside your home in public spaces, both in and out of the water.”
Additional CDC recommendations include: Hand Hygiene and Respiratory Etiquette
Encouraging all to wash their hands often and cover coughs and sneezes.
Cloth Face Coverings
Encouraging cloth face coverings as feasible. Face coverings are most essential in times when physical distancing is difficult.
Do NOT wear face coverings in the water. Cloth face coverings can be difficult to breathe through when they’re wet.
Stay home if anyone has symptoms of COVID-19, or if they tested positive for COVID-19 and / or were exposed to someone with COVID-19 within the last 14 days.
Ensuring adequate supplies to support healthy hygiene, such as soap, hand sanitizer, paper towels, tissues, and no-touch trash cans.
Cleaning and disinfecting frequently touched surfaces and shared objects. For example:
Handrails, slides, and structures for climbing or playing
Lounge chairs, tabletops, pool noodles, and kickboards
Door handles and surfaces of restrooms, handwashing stations, diaper-changing stations, and showers
In addition, I do not recommend that more than one family unit (or “bubble”, once we eventually expand a family to include other family units not living in your house) be together in the pool area at the same time to maximize safety. I do not have a precise time interval between different units, but a half an hour seems reasonable.
There absolutely should be no sharing towels between different family units, and ideally use the bathroom before you come to someone else’s pool.
Many of these ideas are appropriate for family BBQs and minyanim as well and will be discussed more motzei Shabbos.
What about going to my dentist?
Finally, for my dental colleagues, the CDC just updated its Guidance for Dental Settings which included:
Recommendations for resuming non-emergency dental care during the COVID-19 pandemic.
Facility and equipment considerations, sterilization and disinfection, and considerations for the use of test-based strategies for patient care.
Provision of dental care to both patients with COVID-19 and patients without COVID-19. Cick Here for more info
Anyone in need of dental care should not be afraid to get it, as well as all medical care (and vaccinations for children), as healthcare workers and hospitals are taking necessary precautions to make these visits safe. Ask them if you have any concerns!
May we all enjoy Yom Tov and have a wonderful Shabbos.
Igud HaRabbonim is proud to publish this booklet of iyunim and divrei Torah on Shavuos, collected from respected members of the Rabbinical Alliance of America. Please feel free to share with others and to print out for learning on Yom Tov.
The Rabbinical Alliance of America-Igud HaRabbonim, representing over 950 American Orthodox Rabbis announces proclamation appreciating Chevra Kadisha heroic efforts during the Covid Pandemic.
The Chevra Kadisha, literally the “sacred fellowship” is the volunteer group that performs the final rites and burial preparations for the Jewish deceased. According to Jewish tradition, Jewish burial is considered a sacred duty and a great kindness, and it is an honor to be included in this group of dedicated volunteers.
At this exceptionally challenging juncture in history when countless members of Klal Yisrael have succumbed to the deadly coronavirus in the New York/New Jersey areas and beyond, we can only pause and remember their unique legacies.
Because the deaths of these precious neshomas came at a time when traditional levayas and shivas were strictly prohibited by the authorities due to public health concerns, we must stop and express our hakaras hatov to those who were directly involved in ensuring that the deceased received a proper burial, al pi halacha-in accordance with Jewish law and tradition.
When Chazal tell us that preparing a meis for petira and attending a levaya is a “Chesed Shel Emes” we must be cognizant of the fact that if it were not for the Chevra Kadisha whose tasks are done with their entire heart, we would not have had proper burials for the voluminous amount of people who were tragically niftar-passed away as a result of the COVID-19 virus.
“The attributes of grace, benevolence and enormous kindness can be found in all the men and women in the Chevra Kadisha who spent their days and nights preparing those who died for burial,” declared Rabbi Mendy Mirocznik, the executive vice president of the Rabbinical Alliance of America.
He added that, “In this age of Corona when too many people passed away in such a short period of time, the members of the Chevra Kadisha worked around the clock in performing taharas and provided the niftar and nifteres, the last and highest respect as they prepared them for their final destination on this earth.”
Rabbi Katz, Menahel of the Rabbinical Alliance of America said “The members of the Chevra Kadisha do our community a tremendous and invaluable service and give of their time voluntarily. They expect absolutely nothing in return. What is so incredibly impressive about them is that when a niftar arrives at a funeral home, the Chevra Kadisha does not distinguish between a great rabbi, an odom gadol, a prominent leader in our community and that of a pushete yid that passed away. They perform the identical holy work on each of them; irrespective of their status.”
Because the death of a loved one is a very sensitive time for children, siblings, parents and other relatives, the Chevra Kadisha are experienced in dealing in a very soft way to help out the family and comply with their requests. Simultaneously, these members of the Chevra Kadisha are scrupulous in adhering to halacha as they wash, dress & daven with remarkable kavanah in preparation for the person to be buried.
In the months of March and April of this year, the job of the Chevra Kadisha was exponentially expanded due to the amount of taharas that they were performing daily. On a regular Sunday, ten funerals is much more than average, however during the dreaded pandemic, over 50 bodies were brought in on a daily basis to funeral chapels in the New York/New Jersey area. The undertakers from the Chevra Kadisha were literally overwhelmed and each person worked triple shifts if not more. They tragically witnessed a new picture of devastation and summoned up the emotional and physical strength to perform these taharas in a timely fashion and with the greatest of care.
Funeral home directors found themselves in a panic as there were not enough Chevra Kadisha members to perform taharas on the exceptionally high number of those who passed away.
Moreover, the Chevra Kadisha where given new protocols, rules, safety regulations and requirements during this COVID-19 era. Special gloves, gowns, and face masks were required so the undertakers would not become infected and contract the disease from the deceased person.
Other people from far and wide also stepped up to the plate and donated their time by coming to the funeral homes with minivans and taking the niftarim to the cemetery for burial.
Rabbi Mirocznik took note of some very special people from the RAA/Igud HaRabbonim who selflessly and tirelessly devoted their time to ensuring that those who died were given proper burial rites.
“I want to express our profound gratitude to our dear member Rabbi Matis Melnicke son of HaRav Meir Melnicke. He is not only a member of the Chevra Kadisha but also volunteers his time to the Bikur Cholim. During this pandemic, he also volunteered to work with the outstanding organization known as Chesed Shel Emes which is directed by Rabbi Mendel Rosenberg; a true tzaddik gamor, ” said Rabbi Mirocznik.
He added, “Rabbi Matis not only worked around the clock but he paid for food for the undertakers who also worked around the clock and made sure that they had enough to eat so they could muster up the strength to perform their holy work.”
One of the funeral directors who wished to remain anonymous said, “I hadn’t eaten for hours, I had a headache and I felt so weak. It was Rabbi Matis who came to the rescue and made sure that I ate and drank and got back to my strength.”
Rabbi Yaakov Klass, presidium chairman of the Rabbinical Alliance of America added, “Klal Yisroel owes a great deal of gratitude to the intrepid members of the Chevra Kadisha. Each and every one of them worked L’Shem Shamayim. If not for them, we could have witnessed a nightmarish scenario of niftarim waiting days to be buried, May Hashem bless each one of these members with an abundance of brochos, hatzlacha, and may they be gezunt until 120.”