Over the past few days, the media has focused a lot of attention on every new diagnosis of
COVID-19 in the United States. The virus has likely been circulating in the United States for
several weeks already, and we are only testing – and therefore hearing about – the most severe cases. This is because the vast majority of cases are mild or even asymptomatic and do not require medical treatment, especially in young healthy people.

Because we have only been testing only severely ill patients, it is likely that the actual mortality rate of COVID-19 is lower than has been publicized so far. To date, the data suggests that the rates of severe illness in young, healthy, people – especially in young children – is very low.

If you are otherwise healthy and have only mild symptoms (fever, cough, runny nose, body aches, but no trouble breathing and no trouble staying hydrated), it is best NOT to go the emergency room or urgent care center just to be tested for COVID-19. Going to these places will risk exposing others to COVID-19 if you have it, and exposing you to COVID-19 from other patients if you do not have it.

For mild illness, it is recommended to take supportive measures at home (i.e. drink plenty of fluids, take over the counter fever and pain medicine as needed and rest), and call your
physician for advice.

If you have more moderate or severe symptoms, you are urged to call your
physician first, as he/she will direct you to the most appropriate care setting (i.e. clinic, urgent care or emergency department) and will tell you how to get tested for COVID-19 if indicated. Your doctor will also call the care or testing site ahead of time so that the appropriate facilities and equipment can be ready when you arrive.

As always, if you are feeling severely ill or having difficulty breathing, you should seek
emergency care right away. If you call 911 or Hatzolah, let the dispatcher know if you have been exposed or have risk factors for COVID-19, so the medical team sent to you
can take the necessary precautions to treat you safely and prevent further spread of the illness.

Most importantly, if you are feeling sick – do NOT go to school or to work. Do not needlessly expose others to illness. Please follow the recommendations of your physician and local health departments regarding the need to self-isolate or quarantine and when it is safe for you to return to your regular activities.

While most young, healthy people only have mild illness from COVID-19, the rate of severe
illness is substantially higher in the elderly, immunocompromised, and in those with chronic
illness. Therefore, these individuals should avoid large crowds or gatherings and minimize close physical contact with others for the time being.

In regards to the upcoming Shabbat Zachor and Purim holiday – many shuls are offering
alternative ways to hear Zachor and Megillat Esther (i.e. live streaming, private readings, etc) for those who are unable to attend services due to illness, quarantine, or the need for social distancing. Please contact your shul leadership for more information.

The risk to pregnant women from COVID-19 is not yet known, as the number of cases has been too low to enable confident estimates. Therefore, if you are pregnant, it may be best to err on the side of caution.

It is currently recommended that people who have been exposed to patients with COVID-19 or have traveled to areas with high rates of COVID-19, self-isolate and self-monitor at home for 14 days, even if they do not have symptoms. As long as the initial person remains asymptomatic, other members of the household do not have to be quarantined.

If a member of the household does develop symptoms (fever, cough, shortness of breath), then everyone in the home should initiate quarantine until the symptomatic person is evaluated by a doctor or healthcare professional.

While the decisions about quarantines, school closures, and travel restrictions are complicated – and sometimes confusing – the goal is to balance key aspects of health and public safety. We need to take prudent measures to curb the spread of serious illness, while avoiding mass hysteria and panic.

It is important to remember that this too shall pass. While COVID-19 is a new strain of
coronavirus, other coronaviruses have been circulating for centuries, and are one of the main causes of the common cold. While we do not know for certain how COVID-19 will behave, other coronaviruses generally do not spread in the spring and summer. Many doctors and scientists are hopeful that this will be the case for COVID-19 as well.

It is possible the virus will return in the fall, and efforts are ongoing to
create effective medications and vaccines before that happens. We should continue to support these efforts.

Through our good deeds and prayers over this Purim holiday, may we merit that Hashem will bring us good news, protection and salvation for our nation and all nations.

Sincerely,

Maureen Nemetski MD PhD (Pediatric Emergency Medicine)
& Alisa Minkin MD (Pediatrics)
Co-Chairs, JOWMA preventative health committee.

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