Coronavirus Update #39: Presumed Reinfections, New Cases

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We are continuing to closely watch the situation here in Crown Heights and in our “extensions” upstate (where an additional element of risk is that there is a relatively high number of people from other communities, including hotspot states).

The number of new cases (known to us) in Crown Heights and our upstate extensions have been gradually increasing; please see the graph below (dates have been shifted minimally to protect anonymity).

What is worrisome (beyond the objective acceleration of cases) is that the recent infections include the following details:

• Two cases of presumed reinfection. This involves people who were ill with Covid several months ago, and completely recovered. Both had antibodies but upon recent retesting had “lost” their antibodies, and now, after  being exposed to Covid, these people became sick again and tested positive. These 2 new cases are so clear in their course as to take reinfection from a probable phenomenon to a reality (albeit difficult to prove as we don’t have initial viral samples to compare). At this time the symptoms appear relatively mild compared with the initial illness.  How widespread will this phenomenon  become? How severe will reinfection be? Will these reinfected individuals themselves be infectious? These pressing questions are all without answers at this time. We as a community unfortunately were the first to suffer wide community spread and are ahead of other neighborhoods on the timeline. As such we are a living laboratory with very little precedent to go on, but the above must ring some alarm bells.
• A recent case here in Crown Heights that was acquired via community spread – that is, he had travelled nowhere, did not have obvious contact with people from hot-spot states, was not at crowded simchas (all of our known risk factors implicated in recent cases), and yet got quite ill with first time COVID. The implication here is that there is infectious virus present in the community at this time.
• At least one or two infections are in people who have never previously been ill, but who have previously been extensively exposed  while helping take care of others in their family at home who had been ill. This is worrisome because we had hoped that such a high degree of exposure in the home would mean that their body “saw the virus” in some unmeasurable way, and would recognise it again with an immunological response, but this is now called into question.

Both the general increasing number of cases, as well as the somewhat disturbing features of these cases as outlined above, are very troublesome.  Have we been enjoying some sort of honeymoon period with no or few cases, that is now coming to an end? Or, hopefully, are these all isolated incidents, and as a community if we can take appropriate action we will remain without a resurgence?

The following are what we would consider the minimum preventive actions as we increase our level of caution.

• Resumption of careful mask use in social settings, along with distancing wherever possible. The elderly and vulnerable should avoid 770, and any other crowded situation, where social distancing is not practiced.
• Avoid crowded simchas, particularly those where visitors from hotspot states and countries are present.
• Children are returning from sleepaway camps where many small uneventful outbreaks seem to have occurred. There remains the possibility that they may be returning with the virus and they should be kept away from vulnerable elderly until sure that they are well. In cases of doubt, get them tested.
• Anyone who does not feel well should stay home, not go to shul, work or other gatherings, and should get tested immediately.

This caution is heightened by the fact that in the coming weeks we expect an influx of students into Crown Heights; we have done our very best to ensure that this happens in as safe a way as possible, and have provided guidelines to schools and yeshivas. However no system is perfect and we must add as many layers of protection to ourselves as a community as we can.

To the students and schools, we continue to urge compliance with the recommendations as broadly outlined in the previous update, and as disseminated in more detail to those in positions of leadership. Out of town students quarantining locally is not something we recommend, for various logistical and practical considerations. It must be addressed that the above disturbing trends in new infections raises the question of whether there indeed can be any way to safely incorporate out of town students into Crown Heights, irrespective of their prior history etc. For the time being our protocols to the schools remain in place, although we are closely watching the situation and will make changes as the need arises, to ensure the safety of the community.

To the visitors who feel compelled to come for Tishrei, we strongly advise that only those with confirmed prior infections come to Crown Heights, and we have been in touch with the various Rabbonim and Hanhalos (both here and in Eretz Yisroel) to ensure as broad a compliance as possible.

To our dear local community: Even with the best of policies and guidelines, it is impossible to seal all the holes in the system. The chances of succeeding  in protection of the community will depend on the community itself taking a stand, and making sure that guidelines are being followed. It behooves us to act with a heightened sense of caution; we hope and pray for the best but at the same time we must take appropriate precautions, as outlined above.

We are learning more quite literally every day, and are in touch with medical professionals in situations similar to ours, as well as various experts in the field. Although we are many months into this, there remains a lot that is still being discovered, with profound implications for public policy.

We will continue to update the community as more becomes known, both locally about our community and about the virus overall. We hope and pray that we only have good news to share.

Kesiva vechasima tova!

• The Gedaliah Society, in conjunction with Dr. Rosen