Throughout history, Judaism has had a halachic (informed religious law) response to various pandemics with commentary surprisingly relevant to our current COVID-19 pandemic. The Jewish people have excelled in making meaning out of seemingly senseless loss and finding ways in which to move forward. It is noteworthy in looking back at previous plagues and pandemics that issues such as how to conduct oneself so as to remain healthy by maintaining social segregation, shuttering synagogues, and self-quarantine procedures, as well as issues regarding death and dying, have all been addressed in detail and are considered meaningful until today. Looking back at just one example of a plague in Israel - the plague of 1786: like COVID-19, it too began in the early spring, running approximately seven weeks from the holiday of Purim, until just after Passover, with quarantine and social distancing featuring prominently. During the Passover Seder of April, 2020 when quarantine forced people to celebrate alone, in the absence of close family and loved ones, reciting the traditional question, “Why is this night different from all other nights?”, the irony of the retelling of the biblical Passover narrative of the ten plagues was sadly not lost on anyone.
This recent plague, the COVID-19 global pandemic, began in Israel in late February, and like the plague of 1786, began to turn around in early May, with the number of deaths and new cases declining greatly. As of mid-May, at the time this is being written, restrictions and closures have lessened, though everyone is required to wear a mask in public, be physically distanced two meters apart and pay close attention to hand hygiene. People are just beginning to return to school and stores, which have remained closed since early on, and the numbers of infections are being closely watched to ensure that they remain low. Work, when possible, until now has been “from home”, restaurants are not yet opened, and synagogues which were generally closed entirely have recently allowed first up to 10, then 19, and now 50 people to pray together, outside and socially distanced. Israel has fared much better than other parts of the world and this is believed to be in part due to early and extremely strict physical isolation efforts. That said, there is a tentativeness in the air for many, given the novelty of the virus and the uncertainty of its behavior. The weather has warmed up, and with a heat wave driving temperatures into the 90’s Fahrenheit and above, people vacillate between concern with respect to crowds as restrictions get lifted and a deep hope that the virus will be driven out permanently by summer temperatures.
While some people now anxiously await and attempt to prepare for a possible second wave of COVID-19, which is expected by the fall or winter, in time to possibly coincide with the Jewish New Year, all would acknowledge that their assumptive world has been turned totally upside down. This has in turn affected every aspect of life and death within the Jewish community. With its multiple challenges, on so many different levels, the pandemic has forced the Jewish world to recognize, reorganize and reexamine synagogue attendance, as well as many other losses – both big and small - along the painful continuum of illness, death, and bereavement. These concerns have been multifaceted and the resultant implications enormous for traditional Jewish practice. This paper sets out to discuss some of these changes from a Jewish, and often Israeli, perspective.
Most people did not expect to deal at once with the sudden onset of a pandemic, the lack of normalcy, economic hardship, instability, complete uncertainty with respect to physical, emotional and financial health, both in the present, as well as in anticipation of further loss. In addition to both the individual and collective grief that people have experienced, these issues have been so overwhelming that they have created ongoing anxiety, fear, and sadness for just about everyone. Nonetheless, there have been many positives and the resilience within the Jewish community, given all the upheaval, has been quite remarkable.
While there has been tremendous illness and loss with COVID-19, proportionally the Jewish community worldwide (for example in the US, UK, France and the Netherlands) has been especially hard hit. This can be attributed in part to the nature of traditional religious practice especially among the Orthodox and Ultra-Orthodox communities, who came together in large groups at least three times a day, seven days a week, for communal public prayer. In addition, multiple life cycle ritual ceremonies such as circumcision (brit milah), bar and bat mitzvah celebrations, weddings, and funerals have frequently involved hundreds to even thousands of attendees who by the very nature of the event and the tremendous warmth within the community, pray and dance in close proximity and physical contact with one another. Furthermore, in the case of this pandemic, the height of contagion occurred between the Jewish festivals of Purim and Passover, a time that typically involves even larger festive gatherings than usual. Sadly, by the time information about the infectiousness of the virus, suggested isolation procedures and hygiene techniques was disseminated in many religious Jewish communities throughout the world, who typically may have little access to such information, it was too little and too late. By the time COVID-19 was declared pandemic, large clusters of people, including several members within individual families were already seriously affected.
Due to the rapid spread of this novel coronavirus, crisis management in Israel involved quick and extensive isolation and social distancing for all patients and their families, both with and without a COVID-19 diagnosis. This occurred later and to a lesser degree, for most countries worldwide. Concomitantly, with border closures, greatly reduced airline schedules and subsequent flights being cancelled all together, patients were painfully separated from their loved ones, both near and far, and left on their own and alone, at the worst imaginable time, and ultimately at the end stage of their lives. Visiting and comforting the sick (bikur cholim), an important commandment (mitzvah) became impossible. This happened all within a very short timeline. In addition, sudden, unexpected deterioration of patients with multiple organ failure resulted in much confusion for all and not infrequently death without family members or a Rabbi being physically present or emotionally available to help with deathbed confessional (Vidui) or other prayers, or with end of life discussion as patients advanced quickly toward death. This further exacerbated the distress to the patients, their families and the medical personnel involved.
Knowing how the presence of family has always been very critical to patient care, Israeli hospitals have been on the forefront in addressing these concerns. As such, they have been one of the first countries to respond to the psychosocial impact of hospitalization without family being present. Hospital teams introduced personal protective equipment (PPE) with photos of the faces of the medical staff visibly pasted on the front of their uniforms for patients to see, the use of audio-visual technology or phone conversation whenever possible to enable bedside communication between the patient and his family, and most importantly, allowing a loved one, properly gowned and protected to be in the ICU near the time of death. There is no doubt that these small acts of kindness at such a critical time will be viewed as helpful for all involved in the healing process.
One of the most beautiful aspects of Judaism’s approach to death is its focus on ritual. These rituals lovingly embrace the mourner and help him move forward step by step, from the time of death, transitioning through the funeral, to the Shiva (7 days), shloshim (30 days), and year of mourning in a way which gently guides the mourner at a pace that parallels and promotes psychological healing. With COVOD-19, this has been painfully altered and has shaken the Jewish community.
Declaration of death, subsequent care of the deceased, and physical preparation of the remains for burial, hold a spiritual and very important and meaningful place in Jewish ritual, both in the hospital and at the funeral home. This ritual purification ceremony (tahara), has been altered as a result of needing to deal with possible infection. The Chevra Kadisha (Jewish Burial Society), to avoid the possibility of contagion to those involved, has been asked to do minimal, and at times no, ritual preparation, in what under normal circumstances is considered a very important opportunity to show honor and respect, in this essential rite of passage for moving on to the afterlife. Now, the Chevra Kadisha having had additional training to deal with this situation, must don their PPE, take additional precautionary measures, and work much longer hours given the increase in numbers of deaths occurring daily. Furthermore, while Jewish ritual practice usually includes watching (shemira) over the body from the time of death until burial, and identification by a family member prior to burial, in this time and with the possibility of contagion, these too have often had to be abandoned with the deceased being left alone, and the family left with uncertainties.
With Jewish burial, the time between death and interment is kept as brief as possible with the deceased often buried within 24 hours of death. Now, with so many deaths, there may be multiple funerals a day, resulting in expedited burials or inevitable delays, given the tremendous amount of paperwork and manpower involved. Furthermore, should one wish to have their loved one buried in Israel, which is not uncommon, respective countries need to coordinate this process. Restrictions on international air travel with reduced access and unavailability, and increased costs of flights, along with more stringent requirements if the deceased had COVID, has greatly complicated interment in Israel. At times, this has necessitated temporary burial outside of Israel, with reburial at a later time, requiring repeated emotionally painful rending of garments and observing another full day of Shiva (see below).
Funerals too have changed dramatically in this age of COVID-19. Once a large event, of many hundreds and more, in March funerals were restricted to 10 people, the minimum requirement for a minyan (religious quorum of 10 men), spaced at least 2 meters apart and wearing masks. When accounting for members of the PPE-clad burial society and immediate family, this often did not allow for others to be present. In mid-May, in Israel, this number was raised to 50 attendees which still felt highly restrictive given that in some cases it is not unusual to have thousands in attendance. While its typically customary for those present to fill in much of the grave with soil, this too has often had to be abandoned to keep mourners safe from physical contact from sharing the shovels and to minimize time spent at the cemetery. Some people outside of Israel have reported lack of availability of shovels, the need to fill graves with their hands, and or not even being allowed outside of their car during the burial process itself. For those in attendance, and wearing masks, in attempting to limit exposure to others, the actual burial ceremony itself is often abbreviated, with little or no opportunity to eulogize the deceased, and with little time to say goodbye in person in any meaningful way. Given that Jewish burial places great emphasis on honoring the deceased by helping escort them to their final resting place, this is seen as a tremendous loss and very painful for both the mourners and those who want to be with them at this time.
Comforting the bereaved, a hallmark of Jewish practice, has more recently been replaced by “virtual” processes with mourning and grief moving online. With funeral attendance often prohibited, or access restricted due to concerns about the health and welfare of attendees, global lockdowns, closed airspace and more, many funerals are now taking place on Zoom, with only the very immediate family present, if at all, in the cemetery. For family that were unable to travel, or who had no other option, this at least offers some comfort and enables them to “be there” from a distance. Thus, in 2020 with the global pandemic, the concept of a Zoom or livestreamed virtual funeral has often been the only way to have mourners bid a final farewell to their loved ones. It may feel difficult enough not to be involved in the funeral process, but looking on from a distance from their living room, inevitably can feel more removed, painful, and quite surreal. The lack of rending a garment at the time, in the actual physical presence of a body, and witnessing the sights and sounds of a burial firsthand, cannot help but impact the acknowledgement and acceptance of the loss, making it that much more complex and difficult to fully comprehend.
While before the funeral, the focus has been primarily on the deceased, now the emphasis moves to one of comforting the mourner. Under normal circumstances, each family member would be comforted and very much taken care of by those already in attendance at the funeral as they return from the cemetery to sit together in the home of the deceased. They would be served a ritual meal of consolation upon arrival, and for a seven-day period known as Shiva, sit together day and night to be comforted by friends, family, and other members of the community. With COVID-19, mourners feel very lonely and isolated as none of this can take place. In a time when they desperately need the comforting embrace of others, to share treasured memories, they are left to fend for themselves and sit alone to eat, mourn, pray and more. Families now not able to comfort each other physically with their presence are left to grieve, each alone in their own home and in their own way without the stories, photos, and visits by others. In a typical Shiva house, there are children of all ages, adults, family and friends, those who knew the deceased well, and those who didn’t-- but know the mourner and come to give comfort and hear about the special person who has died. Many visitors too would have brought full meals or comforting snacks as they know the mourner has all he can do to get up each morning. The mourners are not thinking of their basic needs and the community lovingly provides this gentle form of embrace. There would be many stories exchanged as the mourners and others present spoke of what happened and gave visitors insight into the life of their loved one. There would be tears and there would be laughter, all of which in an exhausting week help the mourner begin to heal and gain closure at such a difficult time.
Now bereft during this pandemic, most mourners have little opportunity to experience any of this, with visitation being limited or suspended altogether. Instead they are left to derive comfort on their own, through a telephone visit, a Zoom virtual Shiva with single or multiple mourners, and perhaps a memorial tribute later. While for some a virtual Shiva session may be somewhat helpful and better than nothing, for many it is perceived as intrusive and unsatisfying. There are frequently difficulties hearing, sound delays, issues with poor band width, people speaking too loudly or too much, and often multiple people speaking simultaneously, and mourners are forced to relay the same difficult stories surrounding the loss repeatedly. In a Shiva house, there is a more natural flow with visitors coming and going and often staying for a brief period. In a Zoom Shiva, people often do not know what to say, when to say it, when to stay quiet, and when to leave. Seeing only the face and possibly shoulders, eye contact is far more difficult to achieve, and other nonverbal cues and posture are hard to assess. While in a natural conversation, face to face, it is normal to look away, gaze averting in a Zoom call may be interpreted as a sign of disinterest. It is not easy to direct conversation to the mourner and achieve the feeling of being physically present. The mourner too may feel forced to be “on”, needing to elicit conversation and maintain an exhausting focus with those that “zoom” in at random times. As difficult as face-to-face Shiva is, video Shiva may feel both empty and draining simultaneously. Sadly, with few other choices, this has had to become the norm.
Unfortunately, in this day of COVID-19, mourners by necessity are inevitably more removed and deprived of the outpouring of comfort, so integral to the healing process for not just the mourner, but for the entire community. In being alone, sadly they are often truly physically alone, with other family members also left on their own elsewhere, to each mourn separately in their own homes. With no community interfacing with the mourner, who is there to mark the rituals, make the meal, cover the mirrors, dote on, and protect the mourner? If the door is not left ajar (as it normally would be), and no one walks in, who notices the absence of leather shoes, the unkempt beard, the shirt torn just prior to the funeral, and the desolation? Who is there to honor the deceased and elevate him through the sharing of stories and help validate this loss, made all the more painful due to the circumstances? If no one is there, did it really happen? Does the situation feel so unreal that one is rocked by a sense of disorientation and disbelief? If too, the death occurred during the height of contagion and around the time of the Passover holiday, the Shiva period may have been eclipsed by the start of the holiday or delayed and only begun after the holiday ended, feeling very long; both of which make the Shiva even more difficult. Any death which takes place around a holiday seems more difficult to bear in the future, with the holiday feeling forever marred. Furthermore, with so many funerals taking place within such a short period of time in the community, finding the emotional space to grieve each person’s loss has been almost impossible.
In the early stages of COVID-19, (early to mid-March, 2020) when there were still Shiva visits, hand sanitizer was often a prominent feature in a room, people often awkwardly made excuses or refrained from getting close or hugging, felt uncomfortable if they did engage in physical contact and both mourner and visitors were uneasy and anxious to the point where a harmless sneeze drew much unwanted attention. Now in Israel, which is ahead of most places with respect to loosening restrictions, as warm weather has started to return, Shiva visits are beginning to take place with limited numbers of attendees and outside in back yards, physically distanced and with face masks. For those who know the mourner well, talking on a video chat, one on one, while difficult to arrange, may feel more personal than a Zoom call and yet still more “safe”.
The goal in each situation is to attempt to connect mourner and those providing consolation in whatever way will allow technology to enable the mourner to benefit. Some have attempted to honor and memorialize their loved one through creating shared photo albums, montages, a time capsule for children or putting on social media a book of thoughts where family and friends can enter their own memories and stories for a delayed memorial service. All will hopefully offer a creative space in which to grieve and heal. One recognizes that in these times, now more than ever, one week of Shiva is often not enough.
The required ten man, three times a day prayer minyan, also has been disrupted and more difficult to arrange. In a typical Shiva, people naturally visit around the time of prayers so that they can help constitute a minyan. With no visitation, some were able to participate in a Zoom minyan, while others had to abandon the idea of a minyan and the opportunity to say the mourner’s prayer (Kaddish) together. For those fortunate enough to live in an enclave of several Jewish families, the concept of a balcony minyan, has provided tremendous meaning for many participants and has enabled friends and neighbors to acknowledge the prayers of a mourner, with a simple Amen. As the weather has become warmer, and the restrictions have been lifted somewhat, people have attempted to help the mourner have a minyan by being present at the mourner’s home, with a mask, and in the open air.
At the end of Shiva, and again when the tombstone is unveiled, which may occur from one to 12 months after death, some have the custom to go to the cemetery, which for all of the above reasons may or may not be an option or may happen only with a few attendees present. During the entire first month after burial (shloshim) there are still many signs of ritual mourning that are typically observed as the mourner transitions back into society. Most notable in addition to three times a day synagogue attendance for prayers which include the mourner’s kaddish (said throughout the first year), is the unshaven beard and lack of attending social gatherings. Given that previously synagogue attendance was not possible, and things have only just begun to open up, it is quite possible that a mourner will not have received recognition for being a mourner. Since the current period of time, coincides with a time in the Jewish calendar known as Sfirat H’Omer when the Orthodox world observes certain practices emulating the mourning period such as refraining from shaving, it is possible that outside of the synagogue a mourner may not be identifiable. Hopefully if the mourner’s daily search for a minyan has been successful, and on the four times a year when as part of holiday synagogue attendance there are special memorial prayers (Yizkor), and on the anniversary of the death each year (Yaretzeit), the individual losses will be more formally recognized as we move back into synagogues and prayer in some way begins to resemble what was once more familiar and comfortable. Until then, we will be forced to create new rituals, with people close and from afar acknowledging that they care through phone calls, video chats and email messages, sending a meal, and simply being there in whatever way it is still possible to let someone know that they are being thought about and genuinely cared for, all of which can and will make a difference, especially at this time.
This has been a time where almost everything feels fragile and nothing feels at all normal. Given this lack of stability and great uncertainty with respect to just about everything, one would anticipate increased anxiety which makes it much more difficult to grieve and move forward. Nonetheless, the Jewish community is very resilient and is carefully looking towards the future in order to adopt strategies that lower risk should there be a second wave. The physical presence of others is fundamental in Jewish beliefs, as are established mourning rituals which provide a sense of comfort, security and routine. While physical and social distance are the antithesis of the character of Judaism, in the interim the goal has been to learn how to stay emotionally and socially connected and close to each other, while staying physically apart and separated. Being comforted by the community and feeling their support without touch and at a distance will necessarily be an important part of the healing process. This will require at the very least changing conceptions and terminology from that of “social distancing” to that of “physical separation”. This will involve working on being socially and emotionally very present and connected, while still protecting everyone from the risk of contagion. When one cannot visit either the sick or bereaved, it will be very important to access other forms of communication and means of connectedness. One will also have to assess when and how it is helpful or traumatic for families and patients to visit virtually in the ICU, as well as continue to create alternatives for being present virtually at either a funeral or Shiva. While offering to walk with them at a distance, it must be done safely and with the emotional and physical well-being of all in mind.
All of these issues are particularly relevant for children who will bear the precious legacy of the community’s actions. As such, they must be thought out in great detail. The impact of loss on children of all ages must be seriously explored. The essence of Jewish education entails constantly encouraging our children to ask questions. What questions might they ask at the Passover Seder if we were to be with them today and what answers would we offer? How do we make sense of it all to them when nothing makes sense? What values have taken on greater appreciation and new meaning and what have each of us, including our children, learned from this?
As we now attempt to return to routine when nothing seems at all routine and many are still dealing with past losses as well as current ones, the Jewish world has painfully been reminded once again just how fragile life can be. Through the ordeal of the past several months, the opportunity for post-traumatic growth has led to tremendous acts of kindness. Now in moving forward, opening synagogues and creating both meaningful prayer and dialogue in a manner that is protective for all, is a key concern as so many people are craving the comfort of familiarity and social connectedness. No one is at all sure as to when we will be able to return to such Jewish rituals as visiting the sick, funerals and Shiva in a way that expresses our love of our traditions to the degree that we would like. Given the uncertainty from one day to the next, many wonder not only when or how they will be able to travel to visit their loved one’s grave but when they will even be able to see their own living family members. These challenges are part of the painful “new normal” that we all must adjust to if we are to truly heal and grow.
While grief is very much experienced by each person in his or her own way, and there is no one “right” way in which to grieve, this pandemic has brought new challenges that will be especially difficult for the bereaved. It’s only natural that when our loved ones are ill or dying that we be there for them in every way, be there to honor them and say our good byes, and be with those who will help us in our grieving process. Electronic communication is not a substitute for face-to-face communication but at present may be the only way possible in this time of physical isolation. If so, it behooves each and everyone of us to work to be very present during this difficult time and to help the bereaved to heal.
Given the sudden, traumatic, and unexpected events over the past 2 ½ months, in addition to the isolation, uncertainty, lack of familiar rituals, inability to say goodbye, and lack of closure in so many areas, one would expect mourning to be more intense and exhausting, with losses felt very deeply in all spheres of life, and the grieving period to be more prolonged and complicated than one would expect. It is essential that those who work with the Jewish community try and anticipate some of these issues that may evolve so that they may better help those in need.
Attempting to make sense when everything feels so senseless may entail a greater search for meaning and purpose. How for instance does one derive God’s comfort and that of others in such an anxious and sad world? Conversations with a Rabbi, other spiritual leaders and counselors may become more important as a multitude of feelings get addressed and one looks to honor their loved ones and feel greater connection. As we reach out and ask, “what do you think might be helpful for you at this time” we might be surprised to discover that the answer is not at all what we might expect. Finally in these abnormal times, it is important as a community to validate that it is truly okay to not be okay.
Dr. Batya L. Ludman, Psy.D., FT is a licensed clinical psychologist and thanatologist in private practice, in Ra’anana, Israel. She has been a psychology columnist for The Jerusalem Post since 2000, a member of the advisory boards of Get Help Israel and CoronaCareIsrael and the author of Life’s Journey: Exploring Relationships — Resolving Conflicts. She can be reached at ludman@netvision.net.il and www.drbatyaludman.com