Coronavirus, Public Health, & Jewish Law
Rabbi Professor Avraham Steinberg, MD
Chairman, Talmudic Encyclopedia
Motzei Shabbat Parshat Ki Tisa
March 14, 2020 - 18 Adar, 5780
Beit Knesset Yazdim, Jerusalem
Invited by: Rishon L’Tzion, Rabbi Yitzchak Yosef Shlita
With the consent of the Kahal Hakadosh here, and all around, I wish you a Shavuah Tov.
Please G-d, may we hear good news of salvation and comfort.
We are sending blessings for health and a complete recovery to all the Coronavirus patients here in Israel and world-wide. May they soon recover, along with all the other people who are ill. We are in the midst of a global pandemic, proclaimed by the World Health Organization due to the huge number of people affected by this virus.
This is not the first time that we have experienced epidemics. The Tanach recounts to us many epidemics and plagues. These epidemics were ended by prayer, and by incense (קטורת). The Zohar HaKadosh says that during an epidemic you must pray in general and specifically say the passages of the Torah and Talmud that discuss the Ketoret and the passage “Pitum HaKetoret” from Chazal. And we hope that together with other interventions, which I will discuss in a moment, will be effective to stop this pandemic.
Interestingly, one of the deadliest epidemics that occurred in the Middle Ages was called the Black Plague. This epidemic, also known as the bubonic plague, killed millions of people around the world, and the Jews were the least affected.
This provoked the anger of the Gentiles. They believed that the Jews knew all kinds of witchcraft and magic to prevent the spread of the disease and only used this knowledge to save themselves. But it turned out that what protected the Jews were the hygiene requirements in the Torah. For example, washing hands before eating, washing hands after the toilet, Mayim Achronim at the end of the meal and every time a person touched an unclean place they had to to wash their hands. And though these practices stemmed from Torah commandments, and Chazal, it was actually the act of maintaining hygiene that protected the Jews, during a time when the nations of the world did not maintain these hygienic practices. So in this case, these Mitzvot protect and save us, not only because they are Mitzvot, but because these Mitzvot have the protective effect of hygiene.
About 150 years ago, there was a massive epidemic in Europe, the cholera epidemic. In our own language, it can be translated as the ‘sick-bad’ (חולי-רע). The disease comes from a bacterium that causes terrible diarrhea that cannot be overcome. And this epidemic too, felled a huge number of people. At that time, the Gedolim, Rabbinic leaders, spread a message far and wide to adhere to what the authorities were recommending in order to stop the epidemic. Rabbi Yisrael Salanter, the founder of the Mussar Movement, stood on the Bimah on Yom Kippur and ate in front of the community and commanded everyone, even the healthy ones, to eat to protect themselves from the disease. Because the risk is much greater if the onset of this disease occurs while a person is exhausted and dehydrated from fasting. He commanded them all to eat and did so, in practice, because it was an epidemic . Although there are those who question whether he really ate, or he just said to eat. However, the idea was so important that even a healthy person was instructed to break their fast on Yom Kippur fast to spare the public.
Around that same time, Rabbi Akiva Eiger, who also lived during the cholera epidemic, wrote a letter that has been recently published in many places. In this letter he instructed communities to limit gatherings to no more than fifteen people. Today we are limited to a hundred, and soon it may be limited further to fifty, he limited it to fifteen. He even said to place a state policeman at the entrance to each synagogue, Talmud Torah and other Jewish institutions to ensure that no more than fifteen people enter at once. He ordered them to listen to everything the doctors say, because that is what will save the masses.
And what is behind these rulings is the understanding of Rabbi Shlomo Zalman Auerbach. I was privileged to be a frequent visitor in his home, and to discuss many new issues with him relating to medicine and Halacha. Rabbi Shlomo Zalman Auerbach defined a material difference between a potential risk to life for an individual versus a potential risk to life to the general public. The Gemara says that it is allowed to extinguish a burning coal on Shabbat if it is in the public domain. While, if there is a burning coal on the floor in a private residence on Shabbat, it is forbidden to extinguish it, as the prohibition to extinguish a fire is forbidden according to the Torah (Issur D’Oreita).
While there is some controversy over whether it is an ember of wood, which is then a prohibition of the Torah, or it is an ember of metal, which is only forbidden by Rabbinic authority, however even Rabbinic prohibitions are forbidden prohibitions on Shabbat if it is in a home. But the ruling is, if the coal is in the public domain, it can be extinguished. Because we are talking about the public domain, it is not significant if it is an ember of wood (Issur D’Oreita) or ember of metal (Issur D’Rabanan), as both are allowed in the public domain.
And what is the explanation provided by Rabbi Shlomo Zalman Auerbach? It is that if I am alone in my personal space (four cubits), I can be careful. So if I am a healthy person and I see a burning coal, I am not blind, I see it, I know it is dangerous, so on Shabbat I can walk around it and not get hurt. But in the public domain, while it is true that I can be careful and not get hurt, there may be others who can get hurt. For example, an old man with a cane who can’t walk around it, or a blind person who doesn’t see it or a mentally challenged person who may not understand that the burning coal is dangerous -- each of these people may get hurt from the burning coal in the public domain.
This means that matters regarding a potential risk to life of the public are more severely defined than those relating to an individual. And with regards to these epidemics, a person can say to himself, "Nothing is going to happen to me, I'm healthy and strong, I know how to get along." However, he may spread the disease and many may become ill, and likely there will be those among the many, who the disease will kill. So it is imperative for everyone, even if they think they will be fine, to obey the regulations.
Because in truth, with regards to this virus, the coronavirus, the world is dealing with a disease that we don’t really know or fully understand. It's a new virus. We don't know how it behaves, we don't know what else it can do and we don’t know how long it will continue. And in the meantime, it has infected people all over the world. There is almost no place where this virus has not reached, as people, in fact, move from place to place and spread the virus to locations around the world.
This virus is one of the most contagious viruses or infections that we know. If can infect through any contact within a two-meter range. Even when I talk, I emit all sorts of particles. These particles can contain the virus and they will enter whoever is in front of me, and they will immediately be infected, and will continue to transmit it. And while we don't really understand this virus, we have learned that young, healthy people who become infected with this virus, are likely, but not definitely, to have mild flu-like symptoms. Because the virus belongs to the influenza virus family.
However if a person, the carrier of this virus, whether or not he shows any signs of the disease, and even though it may be a mild disease, does not behave according to the regulations, he will spread the disease. And once the disease is spread, it will harm elderly people, whose ability to cope with this disease is much more difficult. And, it will also harm people whose immune system is compromised.
There are all kinds of diseases that can permanently damage a person's immune system. And a person who has a weak immune symptom, cannot cope with this virus. For the elderly and those with a weak immune system, this virus enters their respiratory tract, they stop breathing, and need to go to intensive care to be put on a respirator. Without a respirator, they will surely die, and even may not survive on the respirator. If there is a large number of people who need care, the health system will collapse
There are not enough ICU beds, and respirators, to treat the thousands. We know how to treat a few but not thousands.
Those who have been charged with leading the country and the world in these matters are professionals who understand the public health issues involved. They have come up with policies after significant consultations with a large number of knowledgeable people and many rounds of discussion. They weigh the opinions and ultimately a decision is made. The decision is for the public good. The regulations need to be heeded even if many members of the public think it won't happen to them, or believe the restrictions are too stringent and should be lightened or they personally want to go outside or attend large gatherings and meet people.
Whatever the regulations are, it is a Torah-based obligation to listen to them. This is based on the edict “guard your health" (ונשמרתם מאד לנפשותיכם). First of all, I have to take care of myself. But even more serious, someone who makes someone else sick is possibly transgressing the prohibition against pursuing a person to kill them - Rodef.
Meaning, one’s actions can potentially make someone else sick and the disease can kill them. It really happens. We saw it in China, and we see it now in Italy. And we see it in other European countries, and now it has started in the United States as well. And unfortunately, it's here too, in Israel. There are close to 200 people in Israel who have been diagnosed.
It is very likely that there are people who are not experiencing any symptoms, and were not recognized as being in the groups that were exposed to this virus, but they are carrying the virus and they have not been tested. Because so far, only those who have shown symptoms have been tested.
But there may be, G-d forbid, some of you, who were in a supermarket, or somewhere else, or some mall. And it may be that one of you was infected, you feel nothing, and you have not been tested. So we don't know. But what we do know is that there are already about 200 people scattered across almost the whole country, and if they don't keep themselves, in complete isolation as needed, they will continue to spread this disease. Therefore, each person is obligated, and it is an absolute obligation, to follow all the regulations exactly as directed by the Ministry of Health and the Prime Minister. And it must be emphasized that the Prime Minister, despite all the issues he is facing, and I am not going into any political matters, is spending many long hours to address this issue, because he understands as we doctors understand, that the situation is truly a public-health danger (Pikuach Nefesh L’Tzibur).
And when it comes to the public sphere, even a slight potential threat to life, is in effect defined as an actual threat to life by Jewish law. And so, if anyone was tested and is found to have the disease they must be in complete isolation. Or even someone who was exposed by being in the area of someone who has the virus, even though he may not yet be infected, he also must be in isolation. And that requires him to avoid going to Minyan, to avoid going to classes and not leave home for any reason, including even to perform a Mitzvah. Because his actions may cause others to become ill, and among those others there may be those who, G-d forbid, will not survive the situation.
And as I said, once there are thousands who need intensive care, the health system will not be able to provide everyone care. And these people will die, because others were not as careful as they were required to be.
So first and foremost, there is the law to protect yourself and, second, not to harm others, third, there is the law of "Dina D’Malchuta Dina" that you must obey the laws of the land. And in this case, the Government laws do not oppose the Torah, rather they strengthen the Torah. Therefore, public guidelines should be heeded. This is the only thing that can stop or reduce the spread of the disease.
Unfortunately, there is no vaccine against this virus as of yet, and it does not appear that there will be in the near future. Certainly there is no treatment. Only in a select few cases are there treatments or medications for viruses. We can only provide supportive care from devices and medications to help to ease the symptoms. However, these measures do not address the virus itself. And so, the only way to save us is through prevention.
The Rishon L’Tzion, Rabbi Yitzchak Yosef Shlita, who will come in a few minutes, issued a very clear directive - a Da’as Torah - stating that the authorities must be obeyed. This is exactly as Rabbi Akiva Eiger did, as Rabbi Yisrael Salanter did and as all the Gedolim, the great Rabbis, taught in similar situations. And especially with this virus that is so serious and has spread so fast and so far throughout the whole world, everyone is obligated to be extremely careful to follow the regulations.
So, as I said at the beginning of my talk, it is important to pray that G-d will help the whole world, and the people of Israel in particular. We hope and pray that we will get through this as best as possible, with the fewest number of sick people and G-d forbid deaths. And, as I also said in the beginning of my talk, according to the Zohar during an epidemic, the epidemic was stopped by the holy incense. So it is recommended to say "Kach Lecha Bi’Samin" from the Torah, and "Pitum HaKetoeret" from the Gemara. This is something that can help, in addition to everything we have said regarding being extra cautious in keeping distance and following the guidelines.
And the new guidelines may be even more stringent. I do not know what is being said now, the Prime Minister is supposed to announce another set of restrictions tonight. Each and every one of us are required to take all the restrictions as seriously as possible. Because we are talking about a threat to life in the public sphere, not only to an individual. And, as I said, in the name of Rabbi Shlomo Zalman Auerbach, a threat to life in the public sphere, is more stringently defined and even more significant than a threat to life of an individual. And that is exactly our current situation.