Q&A With Rabbi Aaron E. Glatt, M.D., on the Coronavirus Pandemic

Since the onset of coronavirus in the New York area, one of the leading voices advising on the
Jewish community’s response has been Rabbi Aaron E. Glatt, M.D., who serves as associate Rabbi of Congregation Anshei Chesed in Hewlett and of the Young Israel of Woodmere, as well as being Chairman of Medicine and Hospital Epidemiologist at Mount Sinai South Nassau, a Professor of Medicine at the Icahn School of Medicine at Mt. Sinai and a spokesperson for the Infectious Diseases Society of America.

As the virus increasingly takes its toll on the health and daily lives of Americans, and myriads throughout the world, Hamodia spoke with Rabbi Dr. Glatt to address some of the questions that have arisen in recent weeks.

Covid-19 seems to be spreading at an alarming rate in New York and in the Jewish community. Besides the official numbers, which represent a fraction of cases, every day people hear of more and more who are sick in the community, some seriously, R”l. Is the rate of transmission on a par with what happened in China, or has something occurred to accelerate it?

I think this is identical to what happened in Italy and now in other parts of Europe. We can assume it is what happened in China, but it’s hard to know because the data there was not completely publicized. What is most important is to realize that this is what will happen everywhere if the guidelines put in place by medical experts and encouraged by our Rabbanim are not taken seriously and followed to the greatest degree possible.

With the highly contagious nature of COVID-19, in addition to recommendations such as frequent hand-washing and social distancing, how much do regular efforts to boost immunity — like a healthy diet, sufficient sleep, Vitamin C supplements and the like — help people’s bodies to fend off the virus?

As a general statement, adequate rest, hydration, and a healthy diet will always benefit the body and put it in a better position to fight illness. This is even more so for older people, who are the most susceptible right now, and they should be careful to do these things all the time. The value of vitamin supplements is less clear according to most scientific research.

A person’s general health and immunity are important in fighting this virus once they have been exposed, but it is difficult to really say how much it protects him in the short term. Certainly maintaining good hydration and nutrition, not getting run down, and maintaining a positive attitude should increase your chances of overcoming this challenge.

Grocery stores remain a part of people’s lives that cannot be dispensed with, but visiting them raises obvious risks. The public has been told that deliveries are preferable, but as COVID-19 can be spread through surfaces, it would seem that even delivery boxes and items that have been purchased could expose people to the virus. How can these risks be minimized?

The bottom line is that one should do his utmost to have only essential contact with other people and only for limited amounts of time. We should not be spending more time in grocery stores than absolutely necessary, and should be finding ways to make sure they are not crowded. We are a smart people and should be using our seichel and common sense to find innovative ways of making this easier. Stores should restrict the number of people inside at one time and make sure there are no lines, as waiting with a large group of people is a very fast way to spread the illness.

Older people and others who are higher-risk should avoid stores altogether, and anybody who has any symptoms absolutely should not be going to public places under any circumstances. A very beautiful thing that a lot of communities have started doing is forming chessed groups that can pick-up essential items for those who should not be going out themselves.

For all of us, deliveries are definitely more ideal than having to go into a store. Packages are not a major vector of spreading the virus. I would say that people should just be careful to fully unpack the box and then wash their hands as soon as they are finished. This is a good idea in general — when you contact a potentially dirty object — wash your hands!

How long after a person’s symptoms disappear can they still transmit COVID-19?

Anybody with a fever should not be around anyone else. Once a person’ symptoms are improving, has fever below 100 for three days and seven days from the original onset of symptoms, they become less contagious. Even then, everyone should still practice maximum social distancing.

Many people who have mild COVID-19 symptoms get fever that comes and goes and then returns again. Is there a way for them to know when they are out of the woods?

The clinical course of COVID-19 can be varied and erratic; thus it’s not clear that a patient will follow a specific pattern. Every case has to be taken individually and there is no rule to follow.

How reasonable is the hope that has been placed in Zithromax and the anti-malaria drug being effective in treating the virus?

This is something that is still being studied, and we hope to know more over the coming weeks. At the present time, they are both experimental and should be used with caution because there are no guarantees they will work and, like all medicines, they do come with risks, so people should consult a doctor before using either. There are studies underway with these and other medications, both for treatment and potentially prophylaxis (disease prevention) but no results are yet available. I want to stress that all of the information I am providing is only fully accurate at the time I am speaking with you. This is a very dramatically changing environment and people should stay tuned for new updated information.

If a member of the household who was exposed to COVID-19 comes down with cold symptoms but no fever, or chronic cough, need they be isolated from the rest of the family?

Anybody with any type of symptoms should be concerned that they have COVID-19 and should not be leaving the house under any circumstances. This includes respiratory symptoms like a cold, cough, shortness of breath, with or without a fever. Loss of taste and smell are sometimes early symptoms, and some patients have only gastrointestinal symptoms.

In terms of isolating them from other members of the household, it is definitely ideal that they should contain themselves to a certain room and that they should have their own bathroom. But that is often easier said than done and in a household where people are in contact with each other all the time anyway, it will often be too late to isolate a person when they become symptomatic.

What are the best procedures for caring for a member of the family who is sick with COVID-19?

As long as their symptoms are mild, try to take care of them at home. If what you are feeling isn’t something that you would go to the hospital for under regular circumstances, there is no reason for you to go now. Indeed, please do not go to hospitals to get tested or to get reassured, as they are overwhelmed and you may be exposing them, as well as yourself, unnecessarily by going there. If you feel you need to see a doctor, call in advance so that they can take the necessary steps to protect themselves and other patients.

As much as the patient can keep away from others, they certainly should, but if someone else has to help them, they should be careful, do their best to keep as much distance as possible, and wash their hands well when they leave the area the patient is in. Putting a mask on the patient and caregiver when they are in close proximity is very helpful if possible.

Social distancing guidelines encourage people to stay in their homes as much as possible with only the members of their immediate family. Many people have regular cleaning help and before Pesach even more bring in an outside individual to help with Pesach cleaning. How great of an additional risk does this pose for people?

People should think about how essential their cleaning help is right now. There are people, especially older people, for whom it is something they really need in order to live hygienically. But if it’s a comfort, and you would just prefer that someone else clean your dining room rather than you, realize that you are exposing yourself to an unnecessary risk.

Medical experts in the community, including yourself, have been very outspoken about not forming makeshift minyanim as long as social distancing guidelines are deemed necessary. If people are able to arrange minyanim with proper spacing or at outdoor locations where there are virtually no common surfaces involved, does this still present a serious risk?

The reason why it’s still dangerous is because when you are dealing with a question of pikuach nefesh, which we have clearly seen this is, there cannot be any exceptions. It is very difficult to make a minyan in a perfectly safe way that really poses no additional risk, and it’s not realistic to expect everyone to follow the rules. Indeed, I have been told by several people when they did this that it in fact deteriorated quickly into potential exposures. If someone is blessed to have nine sons above bar mitzvah living together in their house — kol hakavod. Daven for a refuah sheleimah b’tzibbur for all of Klal Yisrael.

People should be looking to the Gedolei Yisrael of every stripe who have said that these are rules that we absolutely must follow to the letter. We should not be looking for ways to be “frummer” than them. No one goes and looks for a way to blow shofar when Rosh Hashanah falls on Shabbos. Our attitude here should be no different. My Rebbeim have taught me that the yezter hara sometimes dresses up like a very religious Jew with a beard and peyos.

If social distancing guidelines are followed carefully by the overwhelming majority of society, is there reason for optimism that normal life will resume in the foreseeable future?

If everybody follows them, with siyatta diShmaya, it can make a real difference. But even 50% is not going to do it, we really all need to take this very seriously. R”l, we see more and more cases in the frum community, a lot are serious, and some have already been niftar. Our community and hospitals are already overwhelmed.

We have to follow the advice we’ve been given by the medical experts and urged by our Rabbanim, and we have to be mispallel that Hashem should remove this sickness from us as soon as possible. As we have more time at home, we must use that time to daven and learn more, spend quality time with family, reach out by phone much more to elderly parents and grandparents and especially single, isolated people and do more chessed. By doing this, as well as following the medical guidelines approved by the Gedolim, I am confident this machalah can be defeated!