03/23/2020

WATCH: Dr. Shelly Senders on Safely Celebrating Passover

Tags: Federation, Family, Holidays, Passover, Children, Live

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This year is NOT like all other years. Dr. Shelly Senders of Senders Pediatrics spoke to Jewish Clevelanders on March 22 on this hour-long webinar about strategies to keep yourself and your loved ones safe from the coronavirus during this year's Passover celebration.

Watch the video now:

Below is a transcript of his remarks. You can download the full transcript here.

Q: At what age should someone NOT attend a family seder?

A: Because the mortality rate rises significantly above 65, people over 65 and certainly over 70 should NOT attend a family seder this year.

Q: What are some alternatives to attending a Seder in person?

A: Virtually via ZOOM, FaceTime and other electronic means.

Q: What about medically fragile individuals or members of the orthodox community where ZOOM is unlikely or unable to be an option?

A: If you can do a seder by yourself, then do it by yourself. If you are unable, then have just 1-2 healthy people there to help you. Multi-family sedarim should not take place this year.

Q: How do we stay sane during this time of physical distancing? Over the past few weeks, since the rise in COVID-19 cases in the US, it has been reported that 57% of adults have experienced irritability.

A: Get enough sleep! It is absolutely critical that people get as much sleep as they can.

• Adults: at least 7 hours/night
• Children aged 10: 10 hours/night
• Children aged 12: 9 hours/night
• Children aged 14-15: 8 hours/night

With children out of school, there is no excuse for kids not to be getting enough sleep.

A: Exercise! Even with the governor’s stay-at-home rule, you can get outside. Fresh air helps clear the cobwebs and causes the body to secrete the chemicals that reduce anxiety and depression.

A: Eat! Make sure you eat healthy foods.

• Eat breakfast.
• Get protein, especially early in the day. It helps provide long lasting nutrition to the brain.
• Reduce carbs since they give short term boosts of energy but no long lasting benefits.

A: Start a Happiness Journal
• Evidence shows that writing down 3 things that make you happy each day or have gratitude for each day, will make you happier one week, one month, three months later, and up to six months later. But you have to write it down.
• Get in the habit of doing this each day. Parents who do this with their children are often amazed at how connecting the activity can be, even with tough teenagers.

A: Volunteer
• Teenagers who engage in one volunteer activity each week are found to have 30% lower anxiety levels.
• Even though we can’t volunteer in person, we can do all sorts of volunteer activities online such as engaging with the elderly.
• FaceTime or Skype with up to 5 older adults each day. Being able to see faces and make eye contact helps develop connections that are lost due to isolation. With so many of us sheltering in place, connecting with our friends in a similar fashion is also very powerful.

A: Hug Your Children!
• Arthur Brooks, the renowned social scientist recommends that every two hours you should hug your child for 45 seconds. With teenagers with whom this may not be possible, find a way to just lightly touch them around mealtimes.
• Hugging and touching the people who are in your house (not outsiders) releases the chemical, oxytocin, which is the “cuddle hormone” and provides for more connectivity and reduced alienation.

A: Use Technology
• Schedule virtual play dates for your children. 
• Have virtual dinners with your friends. 
• Virtual dinners are particularly helpful for teenagers who have lost “hang out time” with their friends.

A: Chalk Message
• Go to a friend’s house and leave a chalk message on their sidewalk.

A: Write and Send Letters
• This worked wonderfully back in the day. There is nothing more special than getting a card or a letter in the mail. Stamps still work!

A: Keep in Touch
• Make a list of five people you want to keep in touch with each day.

Questions from the online audience

Q: We’ve brought home a newborn who has not had her shots. We’re keeping distance and not allowing visitors. Is there anything else we should be doing?

A: There’s not a lot of data, but newborns seem to be very protected against the virus that causes COVID-19. Especially in breast-fed babies there have been very few, if any cases, even in China. Breastfeeding is one of the best things you can do. But avoid having other people including family members around.

Q: Once a person has had COVID-19 can the same person recover and get it again?

A: We don’t know for sure. It seems unlikely in the same season but many experts believe that COVID may become like influenza with outbreaks each year. There will be a test available soon that will detect antibodies that confer immunity.

Q: Should immediate family members be quarantining from each other?

A: The current CDC recommendations are for individuals with COVID-19 to be isolated for seven days, or three days after they are feeling better, whichever is longer. Everyone else in the house should be quarantining for 14 days to see if symptoms develop.

Q: Please define immediate family, does that include grandparents?

A: If grandparents are part of your life and there on a regular basis, then yes, they are immediate family.

Q: Is there a maximum number of people that should be at a Seder?

A: You should limit your Seder to your immediate family and not invite friends or guests. If you have a large immediate family (2 parents and 8 kids) that is fine. But please do not invite other families or relatives.

Q: Two-family units and grandparents who have all been self-quarantined since Purim. Can they still celebrate together?

A: This is an exception, as you have been doing some very strong distancing. But the rule remains to limit to six people as much as possible.

Q: My parents are in their 50s and in good health, we see them regularly. Can we continue to have a Seder together?

A: Another exception, because the people we are trying to protect are over 65.

Q: Can two-three people over 80 have a Seder together?

A: The challenge is the context. If they’re healthy and living together in a similar context, then yes. But the more people over 80 that are together, the more likely they are to get into trouble.

Q: What is the best way to have a safe Seder?

A: You can use plastic or silverware. Use a dishwasher with hot water to wash your dishes.

Q: Is it ok to play tennis outside for exercise?

A: Fortunately, this is a game where the players are 6 feet apart and it is played outdoors. Please don’t use the locker room. Exercise is important!

Q: Can you test negative and later on test positive?

A: Yes. You can test negative today and positive tomorrow. That is why the antibody test is the most critical test – many people may already be immune, but we don’t know that.

Q: Should older people be concerned about getting mail from the mailbox for fear of getting the virus?

A: No. There are studies that say the virus can live on cardboard and paper, but that was in a laboratory. In regular use, the likelihood of something remaining alive on paper is close to zero. Both the CDC and the WHO have written statements supporting the position that COVID is not spread with mailed letters.

Q: Should we be concerned about eating food (matzah) handled by others?

A: No. If they can be at your Seder, they should be fine to handle matzah.

Q: Kids coming back from Israel, should they quarantine for two weeks?

A: Yes. And we should move away from playdates now too.

Q: Do you recommend people not get pregnant during this time?

A: No, no! We Jews are a very optimistic people and children are our lifeblood. During some of our darkest times, during the Egyptian slavery, during the Crusades and even during the Holocaust, we continued to have children. While there is an increased incidence of spontaneous miscarriage in early pregnancy, studies of later pregnancies show that there is almost no likelihood of transmission to an unborn child. There has been no Coronavirus detected in breast milk or amniotic fluid. Please speak with your OB for any further questions.

Q: My son is coming home from Yeshiva and is on immunosuppressants. His rabbi is feeling unwell and is getting tested, but we don’t know the results. What’s your recommendation?

A: There are many studies being done about the efficacy of hydroxychloroquine and azithromycin, and only now are they testing these drugs in human subjects. There is no evidence so far that immunosuppressants actually increase the chance of contracting COVID-19.

Q: Would you recommend that 86-year-olds walk around the block?

A: Yes, please go outside! If you live in the house together, take a walk together. If you live in a building with an elevator, be careful not to get into an elevator with other people.

Q: Should we take extra care at the Seder by leaving extra seats between people or wearing gloves?

A: No. The only extra seat should be for Elijah. If the people at your Seder are well enough to be with you, then you do not need extra precautions. If you are worried enough about leaving an empty seat by a person, you shouldn’t be having them over.

Q: How long do you think this strict isolation will last?

A: Deep breath. If the curve we’re looking at is real, that curve is likely not to reach its bottom until the end of July. Some people believe it will be five months. We need to take it one month at a time.

Q: Why are playgrounds closed if the virus can’t live on surfaces outside?

A: Because we don’t want people playing together. You won’t get the virus from a teeter totter, but you could get it from the person you’re sitting with. You could go to a backyard playground, but don’t sit together.

Q: The governor of Ohio issued a stay at home order, limiting gatherings to 10 or fewer. Does this conflict with what you said about Seders?

A: No, it actually fits with what I have been saying. The situation is constantly changing. But to be clear, I recommend no more than six people unless you have many children. If you don’t, you need to have a Seder by yourself.

Q: Is there risk in eating carry-out food from people who may be infected?

A: It is not a risk. Data shows that we do not get COVID 19 infections from swallowing food. The only precaution is to remove prepared and delivered food from its packaging, throw the packaging away, wash your hands and eat the food. It is important, as a community, to support all of our food institutions.

Q: I’ve been delivering groceries to my mom in her mid-80s several times each week and have been touching the items. My kids are home from New York and have not been quarantined. Should we have Seder together?

A: No. Touching the items is not a concern, because you’re healthy. But you should not be having Seder together with your mom in her mid-80s. The kids need to be quarantined.

Q: What about a vaccine?

A: It’s got to be a good vaccine and it’s got to be a safe vaccine. It may take 12-18 months. The worst thing we can do is to rush a vaccine, have people have side effects and then make people fear the vaccine.

Q: Is cleaning help ok?

A: Maybe…It depends on who is doing your cleaning and if your household is currently healthy. Please make sure that you know where your help has been. If he/she has been in risky areas, you should consider postponing the cleaning for a few weeks. Remember the goal is to protect the elderly and those with chronic issues at high risk. So if your cleaning help is over 65, has a chronic disease, or family member with a chronic disease then please consider paying them for their time this month and encourage them to stay home. If your own family is sick then make sure you and your family stay in isolation and do not have anyone into your home. It is a great opportunity for children to step up to the plate and take on more household responsibilities.

Q: Does Vitamin C help to prevent COVID-19?

A: There is no data that Vitamin C protects against COVID-19. There is data that too much Vitamin C is not good for you. Some data shows that small amounts of zinc for seven days may be helpful (Cold-Eze). Please do not take zinc supplements in large amounts for more than 7 days as it can reduce copper levels in your body. There is no evidence about Echinacea helping.

Q: Should I pack up and deliver food for people who would have attended my Seder?

A: Please, please do that! Your food is fine.

Q: Should my brother and his girlfriend from Boston go to Long Island to share a Seder with my parents? They are in their 63 and healthy.

A: Please don’t do it. It’s not worth the risk.

Q: How long should people from New York quarantine?

A: Currently, the recommendation is 14 days just like the rest of us.

Q: If 70 shouldn’t attend, how about 60-70?

A: No good answer. The data shows that the curve goes up at 65, but really goes up at 70.

Q: Without a vaccine unlikely by next season, do you expect this to happen again next year?

A: The data from Washington State indicates that once you get to a critical mass of people, things start slowing down and some immunity will develop. If it turns out that COVID 19 becomes an annual disease just like flu, we hope that eventually there will be an annual vaccine that will protect most of us from ongoing infections.

At the end of the session, Dr. Senders quoted from Rabbi Lord Jonathan Sacks on the difference between a crowd and a community.

A crowd, is where “individuals lose their individuality. A kind of collective mentality takes over, and people find themselves doing what they would never consider doing on their own...Sometimes this expresses itself in violence, at other times in impulsive economic behavior giving rise to unsustainable booms and subsequent crashes. Crowds lack the inhibitions and restraints that form our inner controls as individuals.”

A community, by contrast, is a group of individuals who unite together not in a frenzied act of fear, or with a destructive lack of control, but because they are similarly focused on one goal, one purpose. We see that type of community in last week’s Torah portion when the Jewish people came together to contribute all that they can to construct the Tabernacle. Says Rabbi Sacks, “Communities build; they do not destroy. They bring out the best in us, not the worst. They speak not to our baser emotions such as fear but to higher aspirations like building a symbolic home for the Divine Presence in their midst.”

One of the most amazing things about our Federation is its expertise in building community. Hopefully, this event and events like it will allow us all to move Mayavdut L’chayrut, from being in servitude to the coronavirus – a sort of house and space arrest – to the freedom to do whatever we need and want once this pandemic is beyond us.

For more resources on how Federation is addressing Coronavirus concerns, click here.

Learn More: Federation, Family, Holidays, Passover, Children, Live

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