JTA – A year after COVID-19 first defeated Jewish communities in the United States, a scientific study confirmed something that many in the communities had long believed in: Purim week meetings served as over-spreading events.
An article published on Wednesday in the Journal of the American Medical Association Network Open, a peer-review journal open to the public, concludes that the coronavirus was spreading widely in Orthodox communities across the country last spring around that Jewish holiday. – before public health warnings were given about the dangers of large assemblies.
The article has been peer-reviewed, which means that its conclusions have been examined and accepted through a rigorous process. Now, its authors – four Orthodox Jewish doctors who conducted a study of thousands of blood samples from Orthodox Jews who contracted COVID-19 in five states – say their work has lessons as public health officials lead Americans into the next phase of the pandemic. .
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“There must be specific recommendations for each religious and ethnic community,” said Dr. Israel Zyskind, a pediatrician in Brooklyn and one of the authors. “They must be culturally sensitive, which is not something we saw with the pandemic, especially in the beginning.”
Dr. Avi Rosenberg, a kidney pathologist at Johns Hopkins University and another author of the article, said of Purim in particular: “All guidelines arrived a week late.”
“The mask’s mandate followed Purim, the national blockade followed Purim, COVID’s announcement as a pandemic followed Purim,” he said.
The article is the first publication to emerge from a research project initiated by three orthodox Jewish doctors who decided at the beginning of the pandemic to turn a tragic turn of events – the extensive spread of the coronavirus in the orthodox communities around Purim – into an opportunity to learn more about the virus through research. Through their project, which they called a “multi-institutional study of anti-CoV-2 antibody analysis” – or MITZVA cohort – they collected thousands of blood samples that would be used in 10 research laboratories for virological studies related to COVID in addition to his own article published Wednesday.
Illustrative: Yirmeyahu Gourarie performs a Purim reading of the Book of Esther for quarantined residents on their own due to the potential exposure to the new coronavirus, March 9, 2020, in New Rochelle, New York. (AP Photo / John Minchillo)
For the creators of the MITZVA cohort, the findings are an embodiment of the good deed they hoped to do last spring and a remedy for some of the negative news that some Orthodox communities received for violating public health guidelines.
“The purpose of all this effort was to make a ‘kidush Hashem’, to show that we care about our neighbors,” said Zyskind, using the term for the sanctification of God’s name. “And we went out by the thousands to do that.”
The most important finding in their article, according to the authors, is to understand how the Purim era and the lack of public health guidance at that time allowed the disease to spread widely in Orthodox communities. The study found that symptom onset in all five states studied came a week apart, suggesting that the interconnection of orthodox communities between states should be considered when responding to a pandemic.
Published a few weeks before Easter, the newspaper’s argument for public health guidance adapted to religious communities is still relevant. With millions of Americans already vaccinated, many families hope to reunite this year for Pesach Seders after a year of Jewish holidays spent in isolation. But with most of the country still unvaccinated, the risks of reuniting prematurely are significant for the unvaccinated.
A boy carries a box of Easter matzo he picked up at his synagogue in Brooklyn, New York, on March 26, 2020. (AP Photo / Mark Lennihan)
“Pesach is about to arrive and there is a desire now that we are one year into this that we must disappoint things,” said Rosenberg. “Knowing how we celebrate … the suggestion would be that the numbers are still quite high and, unless you have been vaccinated or recently convalesced, continue to moderate the celebrations at family units.”
The article also suggests that infection rates in orthodox communities in the early stages of the pandemic were higher than in neighboring communities, something the authors attribute to the highly social nature of the orthodox community. But while many in certain orthodox communities came to believe that their communities had achieved collective immunity in late spring and early summer, with many returning to normal life while experiencing few new infections, the study data shows that this is unlikely.
In New Jersey, the community with the highest percentage of positive antibody tests among the study samples, 32.5% of the samples tested positive for antibodies.
“No value on paper comes close to herd immunity,” said Rosenberg.
In fact, the study also helped to correct the misconceptions that some people had about their immunity status last spring.
“We learned in this process that many people reported symptoms, but had no serological evidence of COVID,” said Rosenberg, which means that people who thought they had COVID and probably didn’t get it again did not actually have COVID. The study also found antibodies in people who had no symptoms, pointing to asymptomatic cases.
The study emerged in the early days of the pandemic, when Rosenberg reconnected with Zyskind, his former classmate at Brooklyn College. The two were responding to similar questions from members of their community about COVID and about policies for synagogues and schools. They soon began to think about the possibility of doing COVID-related research within the orthodox community and contacted Dr. Jonathan Silverberg, a dermatologist and epidemiologist at George Washington University, who is also a college colleague.
In this October 4, 2020 photo, two women walk with children during Sukkot’s Jewish holiday in the Borough Park neighborhood of Brooklyn, New York. (AP / Kathy Willens)
They requested approval from the Institutional Review Board to conduct a study and collect blood samples over a two-week period in May. With the help of community organizations like New Jersey’s Lakewood Bikur Cholim, which provides food and other services to hospital patients and others dealing with medical issues, they were able to collect blood samples from 6,665 people in Orthodox communities in five states.
When Silverberg, Rosenberg and Zyskind were envisioning a research project for the first time, they hoped to conduct a prevalence study, which would indicate what percentage of a community had been infected with COVID. But the sample size needed for a prevalence study proved to be very large, so the trio reframed their approach.
They decided that each study participant would complete a detailed questionnaire about the onset of their symptoms (the questionnaire provided the English calendar dates for Purim and Easter as reference points), the severity of the symptoms and how long they lasted. Then, they would take two vials of blood from each participant, with one from each participant to be used for antibody testing and for the paper.
The other flasks, as well as approximately 2,000 saliva samples taken from the same participants, would be sent to 10 research laboratories for a series of virological studies related to COVID.
The three doctors say they are excited to finally publish the results of their research almost a year after it started. And with approximately eight studies currently underway using these samples, there are more articles expected in the coming months on issues such as the differences between T cell immunity and antibody immunity and the detection of antibodies in saliva.
“There are now five other manuscripts under development with data from this cohort that are really innovative,” said Silverberg. “It is a credit to the Orthodox community and its efforts to speak up and help put it all together.”