Volume 64 Number 56 
      Produced: Sat, 21 Mar 20 16:24:38 -0400


Subjects Discussed In This Issue:

Corona outbreak (2)
    [Martin Stern  Martin Stern]
Drinking during Davening 
    [Chaim Casper]
Hand shake 
    [Joel Rich]



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From: Martin Stern <md.stern@...>
Date: Sun, Mar 15,2020 at 07:01 AM
Subject: Corona outbreak

Orrin Tilevitz wrote (MJ 64#55):

> Martin Stern wrote (MJ 64#54):

>> 
>> In my opinion, the reaction to the current corona virus epidemic verges on
>> mass hysteria. The way it is spreading is precisely what one might expect
>> given that, initially, there were no immune persons.

In off-line correspondence with Orrin, it appeared that he thought, when I
referred above to "mass hysteria", I was referring to the political leadership
and the medical profession. In case anyone else got that impression, I want to
emphasise that I was referring to the general public.

>> I read today that the World Health Organisation have stated that about 80% of
>> patients experience only mild symptoms and recover completely within a week
>> or so. The quoted mortality rate is 3%, but is probably much less since many
>> people who were infected had no significant illness and so were not recorded
>> as having been infected. I suspect it is, in reality, less than 1%, much the
>> same as ordinary influenza. Almost all those who have died had underlying
>> medical conditions - again like influenza - so, while everyone should take
>> reasonable precautions, there is no need to panic.
>> 
>> As time passes the pool of susceptible people will diminish and the rate of
>> spread will go down. It is certainly nowhere near as serious as the 1348-9
>> Bubonic plague epidemic which killed off over 50% of the population in many
>> parts of Europe though, from the way people are reacting, one might get the
>> contrary impression.
>> 
>> This is not to say that there is not a significant part of the population
>> with underlying health problems which might be at risk of serious illness or
>> for whom it might even be fatal. Surely it would make more sense to isolate
>> them - by restricting, for example, hospital visiting - until the epidemic
>> abates -  rather than isolate everyone who may have come into contact with
>> someone who has become infected. I think the latter policy would be
>> counterproductive because it would slow down the build up of herd immunity in
>> the general population, which is what protects everyone from many other
>> diseases.
> 
> I didn't read David Ziants's initial posting because I was in Israel,
> experiencing first-hand an effective public response to the disease (unlike in
> the U.S.).  I am also - like Martin, I believe - not an epidemiologist, and
> have no medical background.

Orrin is correct that I am not an epidemiologist, nor have any medical
training, but, as a (now retired) mathematician, I am familiar with the
stochastic models used by epidemiologists which is why I made the comment:

>> The way it is spreading is precisely what one might expect given that,
>> initially, there were no immune persons.

> With those disclaimers in mind:
> 
> 1.  Martin's comparison is of apples and oranges. He is using the wrong
> denominator.

I would dispute Orrin's claims. There is no reason to suppose that the
coronavirus spreads any differently from anything else.

> AFIK, one is either sick with common influenza or one is not. If you have the
> flu, you have a diagnosed case of it.

Not everyone who is infected by the influenza virus becomes ill - and
obviously those people who show no symptoms are not recorded as having been
infected - but they can still pass it on. It is only because symptom-free
people are being tested for the coronavirus that we are aware of their
status.

> The mortality rate for the flu based on diagnosed cases is about 0.5%.  The
> mortality rate for COVID based on diagnosed cases exceeds 3%.

This is a case of comparing apples and oranges - for flu we only have people
who are sick but with COVID we have also those who have come into contact
with an infected person, but have themselves shown no symptoms, who have
nonetheless been tested for infection.

> Also, nearly everybody who dies of the flu is pretty sick to begin with and
> likely would have died of something else. COVID-19 is striking down healthy
> people.

As I wrote above, we are aware of COVID-19 infecting healthy people but NOT
necessarily striking them down.

> And, given the lack of natural immunity in the population, a large number of
> people getting the disease means a lot of dead bodies.

Again predominantly from those who had underlying health issues to begin
with and were likely to have died of something else anyway in the not too
distant future.
 
> 2.  Herd immunity is all well and good.  That is the theory that Boris
> Johnson, the leader of Martins home country, is pursuing in  as I understand
> it  declining to attempt to slow the spread of the disease. No other country,
> AFIK, is following this approach.  Aside from the cost of lives to get there
> in the best of circumstances, critics have pointed out that if the
> calculations of Johnsons epidemiologists are wrong, there will be a lot more
> dead bodies because the hospitals will be overwhelmed and the medical
> professionals themselves will be out sick, unable to treat patients.

I have just read a report on their public presentation and their predictions
of the spread of COVID-19 based on the available data and epidemiological
models which, more or less, agrees with what I wrote. They may be wrong but
that is unlikely on the evidence available.

> One might ask this group whether a society subject to the 7 Noahide laws is
> even permitted to follow this approach.

That is a separate discussion and would depend on the parameters of 'murder'
under the Noahide law. It is certainly different from that of Torah miSinai
as is evident with the way a ben Noach is treated in respect of foeticide.
 
> 3.  I Googled coronavirus together with mass hysteria.  The combination is a
> quote from President Trump, the self-proclaimed expert on the coronavirus (and
> everything else).

I was not aware that President Trump had made the comment but, even if Orrin
likes to ridicule him as a "self-proclaimed expert on the coronavirus (and
everything else)", that does not mean he might not be correct this time.
Personally, I think the approach of the UK government is much more sensible
than the draconian measures taken by that of Israel which may, I suspect, be
partially motivated by political considerations arising from the stalemate
in the recent elections.

The outgoing president of the Israeli Medical Association, Professor Leonid
Eidelman said 

<https://www.timesofisrael.com/liveblog_entry/outgoing-medical-chief-warns-a
gainst-coronavirus-panic-exaggerated-decisions/>

"Tens of thousands of people are not going to die in Israel, ... Some of the
decisions that Israel has been taking are exaggerated, ... There is a
pandemic, including in Israel but we will pay a heavy price for the stress
on people in isolation and the strain on the medical service. The panic over
the coronavirus is more damaging than the actual coronavirus."

Others may disagree - we will have to wait and see how things develop in the
various countries taking differing approaches, and trust HKBH to do whatever
He considers the best for all of us.

Martin Stern

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From: Martin Stern <md.stern@...>
Date: Sun, Mar 15,2020 at 07:01 AM
Subject: Corona outbreak

Isaac Balbin wrote (MJ 64#55):

> Martin Stern wrote (MJ 64#54):
> 
>> In response to David Ziants (MJ 64#53):
>> 
>> In my opinion, the reaction to the current corona virus epidemic verges on
>> mass hysteria. The way it is spreading is precisely what one might expect
>> given that, initially, there were no immune persons.

> His advice is sensible in the sense of VeNishmartem Es Nafshosechem [look
> after yourself] however the word Meod appears, which suggests a Torah command
> to look after your self *extra* well. How does one parameterise this, let
> alone accuse some of hysteria for taking this more seriously that the norm?

This is difficult problem but there must come a point where 'being
especially careful" morphs into OCD behaviour.

Also Carl Singer wrote (MJ 64#55):

> Martin Stern wrote (MJ 64#54):
 
>> I read today that the World Health Organisation have stated that about 80% of
>> patients experience only mild symptoms and recover completely within a week
>> or so. The quoted mortality rate is 3%, but is probably much less since many
>> people who were infected had no significant illness and so were not recorded
>> as having been infected. I suspect it is, in reality, less than 1%, much the
>> same as ordinary influenza.

> Briefly, People are NOT statistics.  "ONLY 1%" etc.  is meaningless to that 1%
> and their kin, and to the broader population who have real or imagined risk.
> Similarly, comparing statistics among various outbreaks neglects the
> characteristics of each disease.

I agree but the crucial point is what I wrote immediately after the above

>> Almost all those who have died had underlying medical conditions - again like
>> influenza - so, while everyone should take reasonable precautions, there is
>> no need to panic.

While each disease will have slightly different characteristics, I very much
doubt if they make much difference to those who unfortunately succumb - they
probably would not have survived significantly longer whatever the
circumstances. 

In response to both, while every moment of prolonged life [chayei sha'ah] is
of infinite value, governments have to act in the best interests of the
whole population.

I think the panic is caused by the general population confusing the risk of
infection with the risk of serious illness. Apart from those with underlying
health issues the latter is fairly low - they obviously need to take extra
precautions but that does not mean that the whole of society needs to be shut down. 

I think we are overreacting much as we do to peanut allergy where the
responsibility is shifted from those who are allergic to the general population
so, for example, eating peanut butter sandwiches gets banned in case someone
with an allergy might be in the vicinity. IMHO all that is needed is to post
warnings to the latter that there may be peanuts in the vicinity - if they
ignore them and suffer that is their fault. 

Coronavirus is nothing like bubonic plague with a 70% mortality but the way
people are reacting makes one think it is.


Martin Stern

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From: Chaim Casper <info@...>
Date: Sun, Mar 15,2020 at 05:01 PM
Subject: Drinking during Davening

Martin Stern asks (MJ 64#54) if anyone "has ... come across this questionable
practice [of drinking coffee, tea or water during davening] or have any opinion
on it? In addition, would the opposition to it be less at minchah or ma'ariv?"

I am responding to Martin's kol koreh [public enquiry] if anyone has seen
this practice in action. I have neither seen nor heard any halakhic response as
to whether it is or is not permissible.

I first came across this "practice" a number of years ago at a synagogue I used
to frequent. A gentleman (a fellow musmakh from my yeshiva) would always show up
with a thermos of coffee and drink from it during shaharit every day of the
week. I was aghast at it, but the rabbi did not want to make waves and so
nothing was done about it (certainly publicly though I do not know if anything
was said to him privately).
    
The synagogue I now daven at every Shabbat originally offered small bottles of
water. And sure enough, most mitpallelim (daveners) would take a bottle and
drink during the tefilot. That is until one day, the rabbi put out a note
alongside the bottles asking people to maintain the sanctity of the sanctuary
and drink the water in the lobby. Most of the drinkers accepted the
psak/tzivui/bakashah [ruling/command/request] and stopped bringing the bottles
into the davening and consuming them there. There are still some who continue to
drink during the davening (because we are an am kshei oref [a stiff necked people?].
    
I do not recall ever seeing it during minhah and maariv. But there is a mass
exodus of guys leaving the sanctuary after minhah while the rabbi is speaking
and teaching. Some of these guys socialize and some may be drinking water or
some other soft beverage.
   
B'virkhat Torah,
Chaim Casper
North Miami Beach, FL


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From: Joel Rich <JRich@...>
Date: Wed, Mar 18,2020 at 04:01 AM
Subject: Hand shake

I listened to a shiur where the maggid shiur said that R'X used to advise job
interviewees to use the dead fish handshake, then later advised the iron man
handshake until he was told that each of those would not get you a job. Now he
advises a firm, quick business-like handshake. 

May I vent - I heard R'X say these things over the years and always wondered who
he had asked about the real world. How many job opportunities were lost?? etc.??
 How much of a responsibility does a poseik have to determine "reality"?
(Another example - toveiling electronics)

KT
Joel Rich



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End of Volume 64 Issue 56