It is true that the new cases in our community continue to be overall relatively rare and sporadic, however, it remains critically important for everyone to not be prematurely lax, and to continue to socially distance and wear a mask when outdoors. Similarly, we continue to urge those at increased risk of severe illness to continue to isolate as much as possible.
Prematurely being lax in these matters may G-d forbid result in an increase in cases, and this is something we cannot afford. We are not through with this yet, although we anxiously await a time when this saga will be behind us.
Social support update
The hotline has thus far field over 4,500 calls and the errand helpline has performed hundreds and hundreds of errands for those in need. At the same time, the need for these services in the community appear to be declining, which mirrors the trajectory of the illness in our community. As a result, we will be transitioning away from the live hotline model.
Beginning after Shabbos, if anyone has a covid related question, please feel free to call the hotline number, 212-901-2000, and leave a message; someone will call you back. Alternatively, please email your question to the email address as email@example.com, with “hotline” in the subject line, and someone will respond to your email.
With respect to errands, the errand support helpline will continue to function, however given that many food stores in Crown Heights deliver, the primary focus of the errand helpline will be for those home and in urgent need of medication or the like. For such a request, please email firstname.lastname@example.org, with “errand” in the subject line, or you may call the hotline and leave a message.
We continue to monitor the course of this illness throughout our community, and it is our fervent hope that we will continue to see only rare and sporadic cases, and a decline in the need for these social support services. Again, if anyone has been newly ill recently, please make a note of that here: Hatzalah/TGS COVID Survey
Antibody testing updates
Many questions on the hotline have been related to antibody testing, and we’d like to address this issue in more depth:
When a person is infected by a virus, the virus can cause them to become ill. While the body is fighting that illness, the immune system begins to develop “antibodies”, which are molecules in the blood that can recognize that virus that caused the illness. If the body is attacked by that same virus in the future, these antibodies are already in place and are prepared to quickly fight off the virus before it causes the illness. Therefore, because the body can fight off the virus before they become ill, they are considered “immune” to the virus.
With the current COVID-19 pandemic, we are hoping that this same model will hold true. We are hoping if one is sick with COVID, that their body will develop antibodies against the coronavirus (SARS-CoV-2) causing the COVID disease, thereby rendering them immune.
The problem is that we don’t know if this is true yet. Specifically: We don’t know for sure whether the body is indeed developing antibodies to the coronavirus. In addition, even if the body develops antibodies, there may be different strains of the coronavirus and we don’t know for sure whether the antibodies will protect someone against the coronavirus in the future if the strain is slightly different.
We hope that in general, the body will develop antibodies, and we hope that for the most part these antibodies will lead to immunity, but we don’t know for sure yet.
As a result of the above, testing for antibodies for the purpose of “proving” immunity is not something we know enough about just yet, although we are hopeful that we will know more about this soon and that this may indeed be the case for most people. There is however another purpose to testing for antibodies: There is hope that blood containing antibodies might be helpful if transfused into a patient sick with COVID. It is for this second purpose that many hospital centers (including Mt. Sinai) are testing for antibodies.
This brings us to the second issue, which is that of reliable testing. Every medical test has a certain amount of “false negatives” and “false positives”, and of course the attempt is to make those numbers as low as possible. If a private company rolls out antibody tests without appropriate oversight, we don’t really know their rates of false negatives and false positives. (Obviously, we wouldn’t just take their word for it, as they are nogeiah b’davar.) If we can’t trust their negatives to be truly negatives, and we can’t trust their positives to be truly positives, then the test becomes not only useless, but it becomes dangerous, as it can lead people to conclusions that are false.
Of course, even for a “reliable” test, such as those being performed by Mt. Sinai and others, there is still the fundamental issue discussed above: Although we are hopeful that the presence of antibodies might mean that someone is immune, we don’t know this for sure just yet and can’t make social decisions on the basis of them just yet.
(This discussion is distinct from the question of whether someone who has been sick is still contagious. While some patients still have pieces of the virus present weeks after their illness (“viral RNA” swab test, which is different from the antibody test), we don’t yet know to what extent this means the patient is still contagious.)
Therefore, the following recommendations and pointers:
We urge people not to get tested for antibodies using tests that have not been confirmed as reliable. We are in the process of trying to determine which are the reputable tests, and this is a rapidly changing landscape. We will inform the community when we have widespread reliable testing in place.
For those who have used a reliable test and have tested positive for antibodies:
As discussed above at length, although we are hopeful that this may mean that one is immune, we don’t know this for sure yet and therefore no conclusions should be drawn. In particular, people should not be lax with respect to social distancing, until such time as we have more information.
We still do not have a reliable way of knowing at what point someone is no longer contagious, and this is irrespective of antibody status. Yes, we assume that the further out one is from the illness, the less likely they are to be contagious, but we don’t have an exact answer to this question yet.
We would like to thank the dedicated volunteers of the Gedaliah Society for their continued work, and the heroes of Hatzalah for continuing to care for us on the front lines. Wishing everyone well.
– The Gedaliah Society, in conjunction with Dr. Rosen.