The first results of the COVID study on thousands of Orthodox Jews

The paper has been peer reviewed, meaning that its findings have been reviewed and accepted through a rigorous process. Today, its authors – four Orthodox Jewish doctors who conducted a study of thousands of blood samples from Orthodox Jews who contracted COVID-19 in five states – say their article has lessons as officials of public health is guiding Americans through the next phase of the pandemic.

“There should be specific recommendations for each religious and ethnic community,” said Dr Israel Zyskind, pediatrician in Brooklyn and one of the authors. “They should be culturally sensitive, which we haven’t seen with the pandemic, especially early on.”

Dr Avi Rosenberg, a renal pathologist at Johns Hopkins University and another author of the article, said for Purim in particular, “The advice came a week too late.

The document is the first publication to come out of a research project launched by three Orthodox Jewish doctors who decided at the start of the pandemic to turn a tragic turn of events – the widespread spread of the coronavirus in Orthodox communities around Purim – into an opportunity to learn more about the virus through research. As part of their project, which they called a “multi-institutional study analyzing anti-CoV-2 antibodies” – or the MITZVA cohort – they collected thousands of blood samples which would then be used in 10 research laboratories. for virology studies related to COVID. in addition to their own article published on Wednesday.

For the initiators of the MITZVA cohort, the results are an embodiment of the good deed they hoped to take last spring and a correction to some of the negative criticism some Orthodox communities have received for violating public health guidelines.

“The point of all this effort was to do a ‘kiddush Hashem’, to show that we care about our neighbors,” Zyskind said, using the term for the sanctification of God’s name. “And we went out by the thousands to do this.”

The most important finding from their article, according to the authors, is to understand how the Purim calendar and the lack of public health advice at that time allowed the disease to spread widely in Orthodox communities. The study found that the onset of symptoms in the five states studied occurred within a week of each other, suggesting that the interdependence of Orthodox communities between states should be taken into account when considering response to a pandemic.

Published just weeks before Passover, the paper’s argument for public health advice tailored to religious communities is still relevant today. With millions of Americans already vaccinated, many families are hoping to come together this year for the Passover Seders after a year of Jewish holidays spent in isolation. But with most of the country still not vaccinated, the risks of premature reunification are significant for those who are not vaccinated.

“Passover is about to come and we have been in this business for a year now that we should let it go,” Rosenberg said. “Knowing how we celebrate… the suggestion would be that the numbers are still quite high and, unless you are vaccinated or recently recovering, continue to temper the celebrations in family units.”

The article also suggests that infection rates in Orthodox communities in the early stages of the pandemic were higher than in surrounding communities, which the authors attribute to the highly social nature of the Orthodox community. But while many members of some Orthodox communities have come to believe that their communities had achieved herd immunity in late spring and early summer, many returning to normal lives while experiencing few new infections. , study data shows this is unlikely.

In New Jersey, the community with the highest percentage of positive antibody tests among study samples, 32.5% of the samples tested positive for antibodies.

“No value in the document comes close to collective immunity,” Rosenberg said.

In fact, the study also helped correct misconceptions some people had about their immune status last spring.

“We learned during this process that a lot of people reported symptoms but did not have serological evidence of COVID,” Rosenberg said, meaning people who thought they had COVID and were few likely to contract it again had not actually had COVID. The study also found antibodies in people who had not shown any symptoms, indicating asymptomatic cases.

The study first came together at the start of the pandemic when Rosenberg reconnected with Zyskind, his former classmate at Brooklyn College. The two were answering similar questions from members of their community about COVID and policies for synagogues and schools. They quickly began to think about the possibility of researching COVID within the Orthodox community and contacted Dr. Jonathan Silverberg, a dermatologist and epidemiologist at George Washington University, also a classmate.

They sought approval from the Institutional Review Committee to conduct a study and collected blood samples over a two-week period in May. With the help of community organizations such as Lakewood Bikur Cholim in New Jersey, which provides food and other services to inpatients and others with medical issues, they were able to collect samples. blood of 6,665 people in Orthodox communities in five states.

When Silverberg, Rosenberg, and Zyskind first considered a research project, they hoped to conduct a prevalence study, which would indicate what percentage of a community had been infected with COVID. But the sample size needed for a prevalence study turned out to be too large, so the trio revamped their approach.

They decided that each trial participant would complete a detailed questionnaire about the onset of their symptoms (the questionnaire provided the English calendar dates for Purim and Passover as benchmarks), the severity of the symptoms, and their duration. Then they would take two vials of blood from each participant, one from each participant to be used for antibody testing and for the paper.

The remaining vials, along with about 2,000 saliva samples taken from the same participants, would be sent to 10 research labs for a range of virological studies related to COVID.

The three doctors say they are delighted to finally publish the results of their research almost a year after the start. And with around eight studies currently underway using these samples, more papers are expected in the coming months on topics such as the differences between T cell immunity and antibody immunity and the detection of antibodies in the cell. saliva.

“There are now five more manuscripts in development with data from this cohort that is truly groundbreaking,” said Silverberg. “It is an honor to the Orthodox community and their efforts to come forward and help put it all together.”