By Rabbi Yair Hoffman

 

By Rabbi Yair Hoffman

The following ruling was issued by the chief rabbi of Israel, Rav Yitzchok Yosef, shlita, in regard to Yom Kippur and davening and fasting. It is a guide for shuls and individuals. Rav Yosef, shlita, enjoys a reputation similar to that of his father, Rav Ovadiah Yosef, zt’l, and his sefarim are recognized throughout the world as masterpieces of halacha. These rulings were shown to leading poskim in America, who stand behind them as well.

Rav Yosef’s ruling was issued on Wednesday, 5 Tishrei 5781. He writes as follows:

Firstly, I wish to make it clear:

  • Each person must keep a distance of a few meters from each other.
  • All the windows in the synagogue must be opened.
  • Everyone must wear a mask or a scarf that will cover the nose and the mouth.

Our Torah is the Torah of life, and commands us with the words “V’nishmartem me’od l’nafshoseichem — and you shall be very careful with your lives,” and the Torah also said, “v’chai ba’hem — and you shall live by them.” Our sages in the Talmud in Yuma 85b darshened, “To live by them and not die by them.” Therefore, pikuach nefesh sets aside the entire Torah. A sick person who is dangerously ill eats on Yom Kippur. We violate the Shabbos [for such a person], even on a doubt in this regard. It is as the Rambam has written (Hilchos Shabbos 2:3): “And it is forbidden to delay in the desecration of Shabbos for a sick person who is in danger, as it states ‘that a person does live by them’ and not die by them.”

The Ba’alei Tosfos have already written (Bava Kamma 23a), “A person should be more careful to not harm others than to not harm himself,” and certainly in the general prohibition against harming his friend, there is also the duty to prevent a situation that could infect his friend with the disease, chas v’shalom.

The great gaon, Rabbi Akiva Eiger, zt’l, had circulated a ruling at a time when the cholera epidemic was raging in Europe, and wrote there: “I have already warned many times, warning after warning, that they must conduct themselves in said manner … as they arranged, and that the doctors had decided … and no one should violate their words.”

The Law of Prayer

  • Each man or woman should daven in close proximity to their home [RYH: This does not apply in the U.S. for now], until the period of Divine wrath is over and we receive mercy from Heaven.
  • One may perform a hataras nedarim through the telephone or other technological method. A sick person who cannot hear a hataras nedarim should rely on the hataras nedarim that he or she did the previous year [Rav Shmuel Fuerst, shlita, remarked that one should just do so later rather than rely on the previous year’s hataras nedarim.]
  • It is proper to refrain from toiveling in a mikveh on erev Yom Kippur unless it is absolutely certain that it is one’s own private mikveh. Immersion in a mikveh [before Yom Kippur] is an important minhag, but it is not a full-fledged obligation [see Rosh, end of Yuma]. In a situation where there is a possibility of spreading illness one must forgo the immersion — even for a person whose practice it is to immerse every day.
  • Large synagogues should not hold the tefillos with a large group that is crowded; rather, they should split up the congregation in a manner consistent with the requirements of the health department. They should erect a thick nylon curtain to divide the room, and open up all the windows even if there is an air conditioner in the shul.
  • One must also be concerned for overcrowding when the minyanim take place outside.
  • When there is not sufficient room for a large congregation, the women should daven at home, and minimize, this year, attending shul.
  • An elderly person or someone susceptible to disease or illness should daven in minyanim that take place in an open area. [RYH: If it is particularly cold outside, such as in the U.S. at times, they should daven at home.]
  • So as to not stay for a long time with the congregation, one should shorten the tunes and the number of piyutim recited. They should also skip some of the inspirational speeches and divrei Mussar that were normally said in other years.

Fasting on Yom Kippur

  • A person who is in isolation due to his or her being exposed to a verified patient, but has no symptoms at all, must fast as usual. Likewise, one who was sick with the virus and healed, even if he or she is slightly weak, must fast as usual.
  • A person who is in isolation and has muscle aches and a bit of a cough should begin fasting, and be self-aware that if he or she feels excessive weakness and headaches, he or she should drink b’shiurim [minimal amounts not to exceed a half a mouthful at one time]. If one is over the age of 45 or possesses background illnesses and is coughing or has muscle aches, one may add the basic minimum of eating [not to exceed a k’zayis] as well.
  • A person who is in isolation and has a strong and significant cough or difficulty breathing should not start fasting at all, but immediately in the morning will drink water b’shiurim [minimal amounts not to exceed a half a cheekful at one time]. If he or she is over the age of 45 or with background illnesses, then he or she must add the basic minimum of eating [not to exceed a k’zayis] as well.
  • Anyone who is infected with the virus and only demonstrates symptoms of loss of smell and taste must fast as usual.
  • A person who is infected with the virus and has a fever, significant weakness, cough, or joint pain, and must be bedridden, or has difficulty breathing, in there is a fear that the illness will develop further and he or she will become endangered, as has happened in many cases, that person is exempt from fasting but must drink and eat minimally as explained in Yalkut Yosef. This is especially if he is over the age of 45 or has a prior illness.
  • Anyone infected with the virus and after three days the fever has already subsided and the person feels almost like any other person aside from a general feeling of weakness must fast as usual. It has nothing to do with whether or not he or she regained the sense of smell and the sense of taste. This has no significance in regard to fasting. The only thing that determines the halacha is the fever, the cough, being bedridden, or difficulty breathing. If, as the fast progresses, he or she feels considerably worse, then he or she may eat with shiurim, the minimal amounts.

We pray to the Creator of the world that He send a complete recovery to all those who are ill, and that He stop this pandemic and this destruction from upon us and all of Israel and on all of the world. Let us hear good tidings, salvations, and consolations. Let us be written and signed in the Book of Life and of Peace. May our prayers be graciously answered with a complete redemption, quickly. Amen.

Feeding a Dangerously Ill Person

Guidelines approved by Rav Yisroel Belsky, zt’l, and written by Rabbi Yair Hoffman

The Torah does not want us to endanger ourselves by being overly stringent in matters of fasting. If it is determined that a patient must not fast, then it is a mitzvah to eat. A serious punishment is exacted upon people who refuse to eat when it is medically mandated (see M.B. 618:5).

Experience tells us that when people get very ill or very old, they often do not think logically when it comes to their own health. It is often excruciatingly painful for old and sick people to eat even though they must. As a consequence, they will often use their lifelong strict adherence to halacha as an excuse not to eat even when instructed to do so.

How should family members deal with this? They should patiently and lovingly say that their mitzvah now is to eat, just like there is a mitzvah to eat on erev Yom Kippur. Often the best manner to approach it is to divert their attention with other matters or questions when one feeds them. Sometimes switching the feeder, or laying guilt trips can work, too. [This is all referring to situations when there is no feeding tube or parenteral nutrition port.]

There are other situations where a generally healthy person may have recently just taken ill, too. It is therefore important to be familiar with the definitions and parameters found below.

Chatzi Shiur: “The Below The Threshold” Prohibition

There are actually two different prohibitions that are violated when a regular person eats on Yom Kippur. The lesser-known prohibition is called “below-the-threshold prohibition” or the “chatzi shiur prohibition.” Although this prohibition is a Torah one, it does not invoke the serious punishment of kareis. It is also set aside whenever there is anyone who is dangerously ill.

What about the regular “above-the-food-threshold” prohibition? May a dangerously ill person violate this regular prohibition if he can be eating “below the threshold?” Although this issue is actually a debate, the consensus of opinion is that if it is completely feasible from a medical perspective, such a person should just eat and drink “below the threshold.”

The parameters involve both time and food amounts. The “food amounts” are volume measures, not weight measures. Food and drink are very different.

Food measurement is a constant. Two-thirds of a medium egg (see S.A. O.C. 618:7) — understood as one fluid ounce. If it is determined that the patient should be fasting on Yom Kippur, then, if feasible, the maximum quantity of food that may be eaten at one eating session is one fluid ounce, or 30 milliliters (CCs). It is a good idea to prepare these amounts in schnapps cups in advance. Proteins are more filling than starches.

Amount for liquids varies. This depends upon the person’s individual cheek volume. It is not a mouthful, but rather a cheekful — one side of the mouth. For the average person, one can figure 35 milliliters. For a small person, it could be 30 milliliters.

Pagum Water. All this refers to regular water. However, a few years before his passing (before Yom Kippur of 5769), Rav Elyashiv, zt’l, ruled that a person could actually use a different option — consuming water that has a pagum (unnatural) taste that is not normally consumed because of its negative taste. The rationale for this ruling (based upon a Rema) is that such drinking does not constitute a normal form of drinking and is thus only forbidden by rabbinic ruling. The rabbis never made such enactments for people who are dangerously ill.

Antibiotics. Some people have some life-threatening illnesses that require the consumption of a potent antibiotic. These antibiotics must be consumed with a significant amount of water. The pagum water suggestion of Rav Elyashiv, zt’l, would be the most appropriate approach to this dilemma.

What should be the recipe for such water? It should be distasteful enough that a normal person would not be drinking the water, yet not so distasteful as to cause the drinker to get sick or to violate the prohibition of bal teshaktzu, doing something disgusting.

One should always check with one’s doctor, but this author has experimented with various concoctions to create the pagum water. [Do not take the pagum water if your doctor does not advise it for you.] The recipe that best fits the bill, in this author’s opinion, is a room-temperature 16.9-oz. bottle of water, mixed with a half-teaspoon of granulated onion powder and three shakes of salt. [The onion powder should first be dissolved in a small amount of hot water before Yom Kippur if possible. This will keep it as pagum but will help reduce possible stomach unrest later.] If there is a negative reaction to the pagum water, one can always go back to the “below the threshold” method. Experiments conducted by this author have revealed that the colder the water, the more onion powder and salt one can tolerate.

Time Amounts. What is considered an eating or drinking session? Ideally, one should try to space them every nine minutes. The view of Rav Chaim Na-eh for food is eight minutes (see Shiurei Torah 3:15). Rav Moshe Feinstein, zt’l, writes (Igros Moshe O.C. IV #41) that, b’dieved, in a case of need, they should have a gap of four minutes between them. In regard to liquids, one should aim for a nine-minute gap, but if not a four minute gap. If this is not possible, then, for liquids, one should try to fulfill the view of the Chasam Sofer (Responsa Volume VI #23) of a gap of at least two minutes. The timing is based on the concept of the eating of a pras, four eggs. The Mishneh Berurah (618:20) writes that the shiur for this is nine minutes. These are the main views.

Conclusions

As discussed earlier, it is this author’s opinion that the material under discussion should be more widespread and made more available to others. Whenever there is a doubt as to whether one is dangerously ill and there is no doctor or knowledgeable rabbi present or available, one should feed the patient. We should all know the one-ounce food figure and then a nine-minute-gap formula (and the four-minute gap if this is not possible). It may also be worthwhile to have pre-filled one-ounce food containers available for emergency situations.

May Hashem, the Healer of all illness, grant us all a year of health, parnassah, and nachas.

Rabbi Hoffman may be reached at yairhoffman2@gmail.com.

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