Sunday, September 13, 2020

COVID-19 Update #42

Over the past 24 hours we have become aware of multiple new cases of COVID here in Crown Heights, both in residents and those from out of town. This represents for the first time since Purim a very worrisome surge in new cases.  It is critical that those at risk for serious illness remain protected.

It is time to restart outdoor and porch minyanim, to the extent feasible. Particularly for those above age 60 or with underlying health issues (including obesity).

Indoor shuls should consider additional minyanim to allow for increased distancing, and everyone should be wearing masks.

Those above age 60 or with underlying health issues - please avoid crowded places, especially indoors. In addition, as beautiful as hachnosas orchim is, for your own safety please consider not hosting those who attend crowded indoor places, such as 770.

Those who planned to visit Crown Heights in the upcoming weeks: Please consider postponing your plans for the time being.

If anyone has any COVID-like symptoms, STAY HOME. Arrange to get tested. Follow guidelines for isolation and quarantine (which mean the same thing but refer to different scenarios), detailed as follows:  

If you have covid, or suspect you have covid, you must isolate and keep yourself separate from other people. Isolation lasts until the following 2 conditions are both met. 1) 10 days pass from symptom onset (or positive test, whichever comes first), AND 2) One is feeling better, and is without fever, for a full 24 hours.  If you suspect you have covid but have two negative tests, you may discontinue isolation, unless told otherwise by your doctor.

Someone with covid or suspected covid is considered contagious starting 48 hours prior to their beginning of symptoms (or positive test, whichever is first), and until their isolation is over.

If anyone is in close contact with someone who is considered contagious according to the above criteria, they need to quarantine. (Close contact is defined as within 6 feet for 10 minutes, regardless of mask use.) Quarantine means to be kept separate from other people, and lasts for 14 days from the last point of close contact with the contagious person. Testing negative does not allow one to discontinue quarantine. If one were to test positive while in quarantine, they would follow isolation guidelines above.

 
- The Gedaliah Society, in conjunction with Dr. Rosen

Friday, September 11, 2020

COVID-19 Update#41

Given the recent developments of continued positive cases in our community, many of which are associated with 770, and given the inherent crowded indoor mixing nature of 770, we strongly advise that all people avoid davening in 770 for the time being. There is significant risk of contracting the virus in 770 currently.  We would like to stress that even those who previously had the virus or have antibodies cannot consider themselves at no risk. Those who are older or at risk, or who live with or interact with those in this category, are particularly warned against davening there for the time being. 


Wishing everyone a very good Shabbos, 
- The Gedaliah Society, in conjunction with Dr. Rosen. 

Wednesday, September 2, 2020

COVID-19 Update #40

 We continue to see new cases in Crown Heights, including cases of community spread, indicating that the virus is spreading among us. This worrisome trend is mirrored in our neighboring frum communities in New York City, which are seeing many new cases as well, unfortunately. 


Below is a graph of cases locally here in Crown Heights, expressed as a moving 7-day average of daily cases (in order to better convey the change over time). 


As can be seen, the absolute number of cases remains low, however we are having a disturbing increase in the frequency of cases. An additional critical feature is that whereas in July the cases were all those coming from hotspot areas, our recent cases now include a handful which seem to be community spread.  


More cases of reinfection have been reported worldwide as well as here, but at this time it appears to be a rare phenomenon. The next month will be very telling, as a lot of policy is predicated on considering those who have had the virus as not likely to be infectious or become reinfected.


In addition to the above, we now have children returning from camps (many of which appear to have had outbreaks), travelers returning home, and an influx of students and guests, and therefore we will likely experience an increase in the amount of cases seen on a daily basis.


What do these facts mean for the average member of anash ,living here in Crown Heights,and what should be done about the situation?


Those members of anash who remain vulnerable (predominantly those who did not have the disease, although even those who have had the disease may have lost some immunity), and are at high risk (due to old age or underlying medical disease, including obesity) need to protect themselves. We suggest taking the following measures, knowing how difficult it will be to carry out.


  • Those at risk should be careful when opening their homes to relatives and friends who may be carrying the virus. The best, but not fool-proof, policy would be to only host those who have had the virus, exercising care at all  times, not to have larger crowds in small quarters where people have masks off while eating. Additionally, avoiding socializing with anyone who should be in quarantine or who does not feel well.
  • Shul services: Outdoor minyanim where there is spacing and fresh air are still preferable. Alternatively, find a shul with a stable minyan, not crowded, where distancing is possible. We do not consider the Kiddush, where masks are off, a safe place to be.
  • The traffic in 770, along with the physical difficulties of distancing and lack of mask wearing, make it a particularly high risk venue. We advise those who are vulnerable not to daven there. 
  • Avoid crowded indoor simchas. Studies have shown that singing/talking together loudly indoors, and even dancing together outdoors, is a most effective way of spreading the virus. 
  • Wearing a mask. Much has been said pro and against, however this is not a political/social issue but a medical one. It is clear that if all parties wear masks at all times in public there will be reduced spread of the virus. It is also true that for many, mask wearing is bothersome and seems pointless. Presented with rational guidelines perhaps smart mask wearing will take place.
    • All those that are vulnerable should wear a mask when in any public forum (except when walking down a quiet sidewalk, where the possible obstruction to vision may outweigh the minimal benefits). In addition to whatever degree the mask is protective, it also serves as a sign to others that you are vulnerable.
    • Everyone, including those who have had the illness, when in close social contact with strangers (not immediate family) should wear a mask. This is most helpful in the event that one is unbeknownst to themselves possibly infectious.
    • In any crowded indoor setting where close social contact is unavoidable, one should wear a mask. At simchas and large gatherings of people, even outdoors, masks should be worn.
    • One who is in quarantine but who needs to go out for essential purposes must be strict with themselves to wear a mask at all times in public, and not engage socially with others. 


The other side of protecting the vulnerable and not spreading the virus is the responsibility that each and every one of us has to our fellow. Please, please, if you or your children do not feel well in any slight way, even if you consider this to be absolutely nothing that would normally hold you back, these are different times and require a different action.  STAY HOME if you have even minor symptoms, and arrange to be tested. You should isolate until your test results come back. If positive, please follow your healthcare provider’s recommendations for isolation and quarantine as appropriate. It must be stressed again that isolation/quarantine requires one to stay in their place of residence all the time.  A person with mild symptoms may well be infectious. Extreme caution (going beyond your comfort zone) in order to protect others is the order of the day. In a similar vein, to protect    oneself, one should avoid socializing with others who have even mild symptoms. 


As schools return, this is also critical. If schools are to continue functioning normally, then we cannot afford to have multiple cases in any school.  Any child who is just not quite themselves should not attend school. Neither should children/teachers who are in quarantine. All of the protective mechanisms in schools will fail if sick children (or teachers) go to school, and thus jeopardize our efforts to keep the schools open.


On a closing note, failure to report illness due to COVID to those who may need to take some sort of action and protect themselves is a dangerous practice. There is no embarrassment to being ill, or inadvertently exposing others. Tell those with whom you have had contact so that they themselves don't become spreaders.  If anyone has new symptoms suspicious of COVID, or confirmed COVID, please log that here: New COVID Registry


May we only have good news and continued health. 


Ksiva Vachasima Tovah,

- The Gedaliah Society, in conjunction with Dr. Rosen  


Wednesday, August 19, 2020

Guidelines regarding those who wish to visit for the month of Tishrei

 26 Menachem Av, 5780


Visitors should only come to Crown Heights for Tishrei if they have proof that they have been previously ill with the virus.

    

Only the following will be acceptable:

  • Positive viral test (dated more than 10 days prior to arriving in Crown Heights) OR positive antibodies, as per lab reports in visitor’s name.


For Tishrei purposes, one who has not had the virus should not visit Crown Heights. Quarantine, either in Eretz Yisroel, NYC, or elsewhere, will NOT be an option. The above guidelines are in addition to local health mandates applicable while in New York, and are subject to change at any time. 


-The Gedaliah Society, in conjunction with Dr. Rosen



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We hereby confirm once again what we have written in the past not to come here unless following the conditions prescribed by the local doctors as above.


Horav Avrohom Osdoba

Horav Yosef Braun


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כו מנחם אב, תש"פ


מבקרים רשאים להגיע לקראון הייטס לתשרי רק אם יש להם הוכחה שהם חולים בעבר בנגיף.


רק הדברים הבאים יהיו מקובלים: 

בדיקה ויראלית חיובית (מתוארכת יותר מעשרה ימים לפני ההגעה לקראון הייטס) או נוגדנים חיוביים, לפי דיווחי מעבדה על שם המבקר.


למטרות תשרי, אסור לבקר קראון הייטס על מי שלא חלה בנגיף. בידוד (בארץ ישראל, ניו יורק, או במקום אחר) לא יהיה אפשרות. ההנחיות לעיל הינן בנוסף לתחומי הבריאות המקומיים החלים בניו יורק, וכפופים לשינויים בכל עת.


אגודת גדליה, ועד רופאי השכונה



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הננו בזה לאשר עוד הפעם מה שכתבנו מכבר שאין להגיע לכאן בתקופה הקרובה זולת בתנאים שנזכרו ע״י הרופאים, כנ״ל.


הרב אברהם אזדאבא

הרב יוסף ישעי׳ ברוין





Tuesday, August 18, 2020

COVID-19 Update #39

We are continuing to closely watch the situation here in Crown Heights and in our “extensions” upstate (where an additional element of risk is that there is a relatively high number of people from other communities, including hotspot states).


The number of new cases (known to us) in Crown Heights and our upstate extensions have been gradually increasing; please see the graph below (dates have been shifted minimally to protect anonymity).



What is worrisome (beyond the objective acceleration of cases) is that the recent infections include the following details:

  • Two cases of presumed reinfection. This involves people who were ill with Covid several months ago, and completely recovered. Both had antibodies but upon recent retesting had “lost” their antibodies, and now, after  being exposed to Covid, these people became sick again and tested positive. These 2 new cases are so clear in their course as to take reinfection from a probable phenomenon to a reality (albeit difficult to prove as we don't have initial viral samples to compare). At this time the symptoms appear relatively mild compared with the initial illness.  How widespread will this phenomenon  become? How severe will reinfection be? Will these reinfected individuals themselves be infectious? These pressing questions are all without answers at this time. We as a community unfortunately were the first to suffer wide community spread and are ahead of other neighborhoods on the timeline. As such we are a living laboratory with very little precedent to go on, but the above must ring some alarm bells.
  • A recent case here in Crown Heights that was acquired via community spread - that is, he had travelled nowhere, did not have obvious contact with people from hot-spot states, was not at crowded simchas (all of our known risk factors implicated in recent cases), and yet got quite ill with first time COVID. The implication here is that there is infectious virus present in the community at this time.
  • At least one or two infections are in people who have never previously been ill, but who have previously been extensively exposed  while helping take care of others in their family at home who had been ill. This is worrisome because we had hoped that such a high degree of exposure in the home would mean that their body “saw the virus” in some unmeasurable way, and would recognise it again with an immunological response, but this is now called into question.


Both the general increasing number of cases, as well as the somewhat disturbing features of these cases as outlined above, are very troublesome.  Have we been enjoying some sort of honeymoon period with no or few cases, that is now coming to an end? Or, hopefully, are these all isolated incidents, and as a community if we can take appropriate action we will remain without a resurgence?


The following are what we would consider the minimum preventive actions as we increase our level of caution.

  • Resumption of careful mask use in social settings, along with distancing wherever possible. The elderly and vulnerable should avoid 770, and any other crowded situation, where social distancing is not practiced.
  • Avoid crowded simchas, particularly those where visitors from hotspot states and countries are present.
  • Children are returning from sleepaway camps where many small uneventful outbreaks seem to have occurred. There remains the possibility that they may be returning with the virus and they should be kept away from vulnerable elderly until sure that they are well. In cases of doubt, get them tested.
  • Anyone who does not feel well should stay home, not go to shul, work or other gatherings, and should get tested immediately.

This caution is heightened by the fact that in the coming weeks we expect an influx of students into Crown Heights; we have done our very best to ensure that this happens in as safe a way as possible, and have provided guidelines to schools and yeshivas. However no system is perfect and we must add as many layers of protection to ourselves as a community as we can.


To the students and schools, we continue to urge compliance with the recommendations as broadly outlined in the previous update, and as disseminated in more detail to those in positions of leadership. Out of town students quarantining locally is not something we recommend, for various logistical and practical considerations. It must be addressed that the above disturbing trends in new infections raises the question of whether there indeed can be any way to safely incorporate out of town students into Crown Heights, irrespective of their prior history etc. For the time being our protocols to the schools remain in place, although we are closely watching the situation and will make changes as the need arises, to ensure the safety of the community. 


To the visitors who feel compelled to come for Tishrei, we strongly advise that only those with confirmed prior infections come to Crown Heights, and we have been in touch with the various Rabbonim and Hanhalos (both here and in Eretz Yisroel) to ensure as broad a compliance as possible. 


To our dear local community: Even with the best of policies and guidelines, it is impossible to seal all the holes in the system. The chances of succeeding  in protection of the community will depend on the community itself taking a stand, and making sure that guidelines are being followed. It behooves us to act with a heightened sense of caution; we hope and pray for the best but at the same time we must take appropriate precautions, as outlined above. 


We are learning more quite literally every day, and are in touch with medical professionals in situations similar to ours, as well as various experts in the field. Although we are many months into this, there remains a lot that is still being discovered, with profound implications for public policy. 


We will continue to update the community as more becomes known, both locally about our community and about the virus overall. We hope and pray that we only have good news to share. 


Kesiva vechasima tova!

  • The Gedaliah Society, in conjunction with Dr. Rosen 

Friday, August 7, 2020

COVID-19 Update #38

REINFECTION:


The question of reinfection (whether an individual who had COVID can contract the illness again if exposed to an infectious person) is still being closely studied in medical circles. Most agree that even though there have been cases, this is not a widespread phenomenon at this time, and at least 4 months from the outbreak, relatively very few proven cases of reinfection exist. In our community, although we strongly suspect we had at least one case, as time goes on we have not seen multiple cases as would be expected if this were a common scenario.  We hope and are optimistic that for the time being reinfection will not become an increasingly widespread phenomenon, even as antibody levels continue to wane. This optimism is borne of our observations on the ground and the increasing study of aspects of the immune system not yet easily measurable. We continue to monitor this critically important issue here and elsewhere, and are working closely with experts in the field of virology.


NEW CASES: 


Experience to date in regard to sleep away summer camps for the most part suggests that in many of the camps (to varying degrees, depending on the makeup of the campers) there was a self contained outbreak of the virus early on in the season that affected campers only minimally. The blessing has been that as of now everyone has had a regenerative/healthy summer. It should continue!


The following graph is of those new cases in Crown Heights (known to us.) We thank everybody for their input, and urge community members to continue reporting any new cases (New COVID Registry). Only with this kind of knowledge can we make informed decisions. 

(The dates have been shifted minimally to protect anonymity)




As can be seen above, we continue to have sporadic new cases in our community, with roughly 2-3 cases a week for the past few weeks. Many of these cases are associated with hotspot state travel. It would appear that for the foreseeable future new cases may appear on a fairly regular basis. The good news is that despite these sporadic cases, Boruch HaShem we have not seen any secondary cases or community spread from these infections into that segment of the population that remains at risk. We think this may be due to the degree of collective immunity that presumably exists within our community. By analogy: When most matches are wet, the few dry ones are scattered so far and wide that a fire cannot readily spread among them.


We have to operate on the assumption that despite our best intentions we will continue to have sporadic cases in our community. Therefore, in order to continue to protect our community, the proper thing would be to preserve the degree of collective immunity that currently exists.  If we were to have a large influx of people into Crown Heights who have never contracted the virus and who remain susceptible, we would be concerned that there would now be enough dry matches around that if a match somewhere catches fire, it would be able to spread, Gd forbid reaching those who remain at high risk. This is particularly relevant and worrisome in an environment like 770 for obvious reasons.


This brings us to the pressing question of how we as a community should move forward in the next month or two, when we typically expect a large number of visitors in our community, specifically for Yeshiva or other such programs, and for Tishrei.  There have been extensive discussions between medical professionals, Rabbonim, the mosdos, and other askanim. Obviously any solution will present problems for some and have imperfections, nevertheless, in order to protect the lives of those vulnerable residents of the schuna, we are prescribing the following precautions (of course in addition to any applicable local health mandates). We earnestly request that a coalition of Rabbonim, Mashpi’im, principles and those who are responsible for the institutions ensure that appropriate attention is given to the matter.



For those coming to Crown Heights from out of town this Elul, to attend Yeshiva or other educational programs:


  1. Those with proof of having had the virus may come to Crown Heights and join a yeshiva or other education program.

    • Documentation of a positive viral test over 10 days prior to arrival, or having positive antibodies, suffices for proof.


  1. For those without proof of having had the virus, an alternate and more problematic solution would be for the mosdos to create an off-site quarantine option; this would be a “capsule”, where the group of students who have not had the virus can spend several weeks learning together at a site away from Crown Heights, before they can join their peers here. Obviously these students may contract COVID while in quarantine, and one would be relying on the very favorable outcomes experienced in similar scenarios at the sleepaway camps so far. The danger in our estimation would be far less than allowing 770 to serve as the “capsule”. It goes without saying that those with any underlying health conditions would not have this option available.


    • Students who have not had the virus should not be quarantining locally in Crown Heights.


*Precisely defining what constitutes “out of town” for these purposes, as well as the time course for which those criteria are relevant, is something we will be working on with the various mosdos IYH over the next few days.


*As we have all seen so frequently, this is a rapidly evolving situation which may change in the coming weeks. These guidelines are current as of today and will be updated if necessary.


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For those wishing to visit for Tishrei:


  • We implore those who wish to visit for Tishrei to consider the above discussion and the safety of the Crown Heights community.

  • We ask that only those who have already had the virus, as per the criteria above, visit Crown Heights during the month of Tishrei.


 -The Gedaliah Society, in conjunction with Dr. Rosen

Wednesday, July 15, 2020

COVID-19 Update #37

There are several additional cases in Crown Heights since our previous update. Two of these involve individuals who came to Crown Heights from a hotspot state, did not quarantine, and then several days later they became ill and tested positive for COVID. They are now in isolation, and anyone who has been in contact with them during that time has been asked to quarantine. 

This is very worrisome. Our elderly and vulnerable are attempting to resume some semblance of their normal lives, and they are relying on us to keep them safe. When individuals come to Crown Heights from places where COVID infections are on the increase, and are during the early phase of their illness (perhaps only feeling mildly symptomatic but not ill), and then shed infectious virus whilst going about “normal” activities in Crown Heights, they jeopardize the lives of those among us who are vulnerable and susceptible to the disease.  This concern has been heightened recently by at least one case of reinfection, where a healthy individual who had recovered from COVID became reinfected 3 months later, and ill again. This takes away some of our earlier confidence in community immunity and raises the question of whether those who were ill around Purim may have over time become susceptible once more.

Please please do not visit Crown Heights unless necessary, and if one must come from a hotspot state and has no choice, then the law (fully supported by medical professionals and the Rabbonim) is that they must quarantine here for 14 days (which means staying home, not attending a minyan, where vulnerable individuals may daven, not going shopping, not visiting family, avoiding simchas, etc).  We know this is inconvenient, and we hope that this dark time will be behind us very soon, but this is for the safety of all of us, particularly the vulnerable. These instructions equally apply to residents of Crown Heights who are returning from a stay in a hotspot region. 

In a similar vein, if anyone has symptoms of the virus, please do get tested and isolate yourself until you receive the results, as laid out in our previous update. If you are tested in a clinic or elsewhere and test positive, and are unsure how to conduct yourself regarding isolation/quarantine, please contact your physician or email us at chcovid@gmail.com and ensure that that you and your contacts get clear instructions. 

In all the confusion one thing is clear - social distancing and mask use in close quarters reduces infections. Continue to act with safety first always.

If you have any new COVID symptoms, please fill out this survey:  New COVID Symptoms 

We are optimistic that whatever cases we are seeing now in Crown Heights are sporadic and possible to contain, and that we will not see a widespread resurgence of cases.  However, we must do our part to protect one another and prevent even a single case, if it could be avoided by mindful behaviour. IYH may we continue to stand together as a community and stay safe and well. 

- The Gedaliah Society, in conjunction with Dr. Rosen