April 6, 2020
Rav Dr. Aaron Glatt, asked that we share this important note sent to the Young Israel of Woodmere. Please share it with your kehillah:
With
the upcoming Yom Tov rapidly approaching, Rabbi Billet asked me to put
together some general guidelines for what to do if, rachmana leztlon,
people get sick or are diagnosed with confirmed or suspected COVID-19
over Yom Tov.
We
obviously are not intending to provide specific advice which only your
physician should do. Indeed, if someone does get sick before Yom Tov
starts,
they should link up with their physician, urgent care center or a tele-health physician and decide several things:
1)
Do you require prescription medications, and if so when should you
start them? Not all COVID-19 patients require treatment, and treatments
do have side effects. However, if treatment with oral agents is
necessary, it might be better to start therapy earlier rather than
later. Obtain the prescription and fill it before Yom Tov if
appropriate, but it is absolutely allowed (even required) to fill it on
Yom Tov or Shabbos, if indicated.
2)
Find out what is the optimal way for you to get follow-up care should
you need to do so on Yom Tov or Shabbos. Find out who and when to call
before Yom Tov. If your condition deteriorates even mildly, one should
not hesitate to call your provider sooner rather than later to be
re-evaluated on Shabbos or Yom Tov.
3)
If your condition worsens to the point where you are short of breath or
have significant changes in breathing, mental status (e.g. lethargy,
delirium or unresponsiveness), or chest pain, call hatzalah or 911
without hesitation.
BH,
most patients with COVID-19 do not actually require hospitalization.
The trick is to identify as soon as possible those patients who
unfortunately are
progressing (worsening) and require more intensive care (medications, oxygen and / or going to the hospital).
One
of the best guides to COVID-19 illness worsening is a change in
breathing. More rapid breathing at rest, shortness of breath on even
mild exertion and / or not being able to fully “catch your breath” after
movement are strong indicators that you need to be evaluated again by
your provider asap.
For
those that have the capability, checking oxygen saturation with a pulse
oximeter (the little piece of equipment that is wrapped around a finger
and gives a number) is an excellent way to follow and assess breathing
status.”Normal” values will differ for everyone, but healthy people will
“saturate” between 96% and 99%, whereas people with respiratory
problems will have lower numbers (in the 92-96% range). As long as the
number are stable for you, and not dropping, that is a good sign. If,
however, the numbers are dropping, and certainly if they fall below
90-92%, one must get re-evaluated. I stress, if your condition worsens
to the point where you are short of breath or have any other significant
changes in breathing, mental state, or chest pain, call Hatzalah or 911
without hesitation.
All
of this is REQUIRED on Shabbos or Yom Tov because of “safeik sakanas
nefashos” (possibility of risk to life). Even the possibility of loss of
life overrides all Shabbos prohibitions. No one should have any
halachic indecision in calling a provider for help if they are worried.
Indeed, one is required to err on the side of being overly cautious. A
person is called a “chosid shoteh” – a “righteous fool” – if one does
not take risk to life seriously. Our Rabbis tell us it is better to
desecrate one Shabbos and live to observe many more than to not
desecrate the Shabbos and possibly die.
Our
practicing extreme social distancing has already begun to have a
significant impact on COVID-19 cases. We MUST not lose our resolve or
let down our guard even as the numbers hopefully improve over Pesach. If
we are to prevent further loss of life, we must do everything we can to
prevent any new cases of illness.
May we all have a safe, healthy chag kasher ve’sameach.
Aaron E. Glatt