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Shul Corona Safety Guidelines

02/03/2021
This past Shabbos, after speaking to several members of the shul, I was prompted to make a public announcement at the end of davening. There seemed to be great confusion of how to proceed once vaccinated (Both shots.) Some people thought that once they have been vaccinated they no longer need to wear masks, or be concerned with social distancing. This would be a grave error. Both Pfizer and Moderna only tracked people who developed symptoms after vaccination. They have no idea how many vaccinated people became infected but without symptoms.  The vaccine is injected deep into the muscles and stimulates an immune response to produce antibodies. Some of those antibodies reach the nose, but it is unknown in what quantity or if they are entirely protective against an active form of the virus residing in the mucus membranes of the naso-pharynx. It is highly possible that although patients who received both vaccines against the coronavirus are 95-98% protected they can nevertheless harbor the virus in their nasopharynx which will not affect them, but it could be spread to those that are vulnerable.  Unlike the measles vaccine where once you are vaccinated you cannot spread the disease to others Corona just keeps giving, but not the gifts we are pining for. The obvious implication of this fact is that one must continue to wear masks, wash hands often and maintain social distance.
Irrespective of being vaccinated or not, It is my opinion that until there is herd immunity or everyone is vaccinated, masks should be worn particularly where groups of people congregate such in Houses of Worship. Simply put, those speaking, lecturing in the synagogue or being called up for an Aliyah, irrespective of plastic barriers, the mask should not come off.
A separate issue has been brought up regarding Cross ventilation.  There is a lot of infectious disease history related to fresh air from the outdoors. This has been particularly effective with Tuberculosis and Infectious Disease experts believe the same is true of the Corona Virus. Anything that would increase the air exchanges above the standard in an office space (4) to 10-12 would be ideal. One can achieve this with recirculating the air. Ideally to really be effective one would need an HEPA filter in place such as is present in most hospitals currently .While this maneuver may chill some bones, I believe it is well worth it to have cross ventilation as opposed to stagnant air. Covid -19 is a deadly disease, obviously and fortunately not for everyone that contracts it, but for me it has been a personal sobering experience having witnessed over 1000 deaths at NYU. Every bit counts, even if to some degree the benefits derived are anecdotal.
What to do if an individual has already had Covid-19 and is now exposed to another individual in an infectious state. First of all, while rare, individuals can get Covid a second time. Moreover, at present, we do not know what level of antibody present is protective and for what period of time.  The ID experts at NYU think that those individuals, who have had Covid within 90 days, do not need to be quarantined. If > than 90 days, then the routine quarantine guidelines are applicable.  This may, however, be moot as the New York State Board of Health does not specifically address this issue, and mandates quarantine nevertheless.
In short, we are trying to navigate the vicissitudes of this disease, often without a compass, and certainly in uncharted waters. The best we can do is err on the side of caution, and hopefully avoid the consequences of this potentially lethal virus. 
  
H. Leon Pachter M.D. F.A.C.S
The George David Stewart Professor and Chair Emeritus
Department of Surgery
NYU School of Medicine

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