The Case for Masking in Shul


vaccine

“He said to them: Go and see which is the good way to which a man should cleave…Rabbi Eliezer says: One who considers the consequences [of his actions]…” (Avos 2:9)

We are about to embark on a grand experiment in our community. This experiment will not be a planned or controlled experiment, but a natural one born from the human tendency toward inertia. We are the guinea pigs, but we are also the ones running the experiment.

This experiment will attempt to answer the question: What happens when you take several thousand unvaccinated children, mix them together in school, send them home, and then have the entire community come together in synagogue a short time later. Since every scientific experiment contains known and unknown variables, and since we will be subjects in this experiment, it seems prudent to understand the variables. We should start with what is known currently about the pandemic, especially with respect to the Delta variant:

1.      Transmission levels in the city and state are high.[1]

2.      The Delta variant makes up nearly 100% of cases.[2]

3.      The Delta variant is more than twice as contagious as previous strains.[3],[4],[5]

4.      The Delta variant causes more severe disease than previous strains.[6],[7]

5.      The vaccine works well against Delta but is imperfect, and there have been many documented breakthrough infections.[8]

6.      Vaccinated people can still spread the infection even though they don’t get sick.[9]  

This combination creates a perfect-storm scenario. Thousands of children in our community are going back to school, and since they are unvaccinated and Delta is more transmissible, it is all but guaranteed that there will be transmission among students in the school. There have already been reports of school-based outbreaks in schools that require teachers and students to mask while indoors,[10] so we can certainly expect outbreaks in our schools where there is no masking. Students will then bring the virus home, and it will spread around the community, a process that would likely take one to two weeks before anybody realizes (at which time it is too late). Then everyone will pack close in together in shul for several hours with singing and handshaking, the highest risk scenario.

Those in the community who are unvaccinated will be at high risk of infection but may be in the early phases of disease before they have symptoms (or they may never develop symptoms) and could get seriously ill or spread the virus further. Those who are vaccinated could still acquire the virus and transmit it (although for a shorter time).[11] People who have weakened immune systems due to age or other chronic illnesses and may not have mounted an adequate immune response to the vaccine would be vulnerable to severe infection without realizing it.

All of this would be a strong argument for masking in schools. It is why all the Baltimore area public school districts are mandating masks. When I have brought the idea up to various educators, I am looked upon as if I am a madman, an idiot, or some sinister combination of both before being told that there’s no way people will wear masks. Perhaps I have more faith in the fortitude of our children, but I know when to admit defeat (sometimes). Nevertheless, I would like to propose the following short-term plan.

I would recommend that all shuls require masking through Sukkos. I know that wearing a mask in shul will be a tremendous burden for many, especially after we’ve grown accustomed to facial freedom for the past several months. I also know that masks are imperfect, but there is good evidence that they limit the spread of disease.[12] If the transmission is slowed, it will allow time to see if there are significant increases in case levels or if people get seriously ill. We can then respond accordingly while at the same time potentially preventing significant illness, debility, lost parnassa from missed work, long-haul symptoms, or worse. If it turns out that there are no major outbreaks in the schools and case rates continue to fall, the masks can go back in the cupboard, hopefully for good.

Honestly, I think the chances of an outbreak that leads to serious disease in our community are small – we have high vaccination rates and children have lower rates of severe infection – but the chances that I am wrong are significant, and the stakes are high enough to warrant taking this seriously.

You might say to me in response:

“We are not seeing a major rise in cases, hospitalizations or deaths, so why should we worry?” That may be the case now, but the present is not a guarantee of the future. Based on what I presented above, it is a reasonable assumption that we could see a spike in the coming weeks.

“Just about everyone is vaccinated, so we are protected.” The actual vaccination rates, while certainly high, are unknown, and the unvaccinated are not always forthcoming about their status for fear of stigma. There still may be enough vulnerable individuals in the community to cause a disastrous outcome.

“If someone chooses to not get vaccinated and put themselves at risk, that’s their problem.” While I do think that not getting vaccinated is foolish, I don’t think foolishness is a reason to stop caring about others. Additionally, vaccinated people who mounted a weak response are at higher risk if there is increased transmission.

“I’m low risk, so I’m not worried.” I am also low risk, but the thought that I may be responsible for getting someone else seriously ill is frightening enough. (To do so on the Day of Judgment is even worse.)

“People are just done with COVID.” I am too, believe me. The question, however, is not whether we are done with it but whether it is done with us. It clearly is not. I rounded today in a long-term ventilator facility and saw a lady in her 40s who is now ventilator-dependent, bed-bound, and alone in a nursing home. She has been there for several months and will likely remain there for the rest of her life. Her only hope of going home is to get a lung transplant, but she is currently too weak to even be considered. Every time I am out and about in the community, I am haunted by the fear that the people I see in 7 Mile Market, shul, and in the streets on Shabbos will be next in line. If all we have to do to prevent one person in the community from meeting the same sad fate is to wear a mask in shul for a few weeks, wouldn’t it be worth it?

We will soon be standing in front of our Creator, asking for another year of life. How much better to do so while demonstrating how much we value that life, not just our own but that of others as well?

May we all be written and sealed for a healthy new year.

 

 



[1] Coronavirus.maryland.gov, accessed 8/31/21

[2] https://covid.cdc.gov/covid-data-tracker/#variant-proportions, accessed 8/31/21

[3] Musser, J, Christensen PA. et al. Delta variants of SARS-CoV-2 cause significantly increased vaccine breakthrough COVID-19 cases in Houston, Texas. DOI: https://doi.org/10.1101/2021.07.19.21260808

[4] Musser JM, Christensen PA, Olsen RJ. et al. Delta Variants of SARS-CoV-2 Cause Significantly Increased Vaccine Breakthrough COVID-19 Cases in Houston, Texas. medRxiv. 2021 Jul 22

[5] Nasreen S, Chung H, He S, et al. Effectiveness of COVID-19 vaccines against variants of concern in Ontario, Canada. medRxiv. 2021 Jul 16

[6] Twohig KA, Nyberg T, et al. Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet, Published online 8/27/21.  

[7] Ong SW, Chiew C. Clinical and Virological Features of SARS-CoV-2 Variants of Concern: A Retrospective Cohort Study Comparing B.1.1.7 (Alpha), B.1.315 (Beta), and B.1.617.2 (Delta). Lancet Preprints. Published online 6/7/21.

[8] Mlcochova P, Kemp S, Dhar S, et al. SARS-CoV-2 B.1.617.2 Delta Variant Emergence and Vaccine Breakthrough. Research Square Platform LLC. 2021 Jun 22

[9] Riemersma KA, Grogan BE, Kirta-Yarbo A, et al. Vaccinated and Unvaccinated Individuals Have Similar Viral Loads in Communities with a High Prevalence of the SARS-CoV-2 Delta Variant. medRxiv. 2021 Jul 31

[10] Lam-Hine T, McCurdy SA, Santora L, et al. Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021. MMWR Morb Mortal Wkly Rep. ePub: 27 August 2021.

[11] Riemersma KA, Grogan BE, Kirta-Yarbo A, et al. Vaccinated and Unvaccinated Individuals Have Similar Viral Loads in Communities with a High Prevalence of the SARS-CoV-2 Delta Variant. medRxiv. 2021 Jul 31

[12] Brooks JT, Butler JC. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. JAMA. 2021;325(10):998–999.

comments powered by Disqus