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Second wave like a tsunami

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OP-EDS

We have emerged from the eye of the storm to confront a second wave that is significantly worse than we anticipated. It feels like a tsunami.

Once again, SARS CoV2 has proven to be unpredictable, and has mutated to a new strain which is more contagious, involves a higher number of people, and is less discriminating. We have easily slid back into our roles in a well-remembered dance.

Once again, we are working long hours and spending a lot of time on our feet. Stress levels are very high again, and there is a constant feeling of anxiety as one waits for the next crisis.

Last time, the patients were older, and it was easier to be more philosophical in accepting their deaths. In a complete deviation from pattern, this wave of COVID-19 has affected younger people to a much greater extent. They are often younger than us, and we all know a lot of people who have COVID-19.

As with the first wave, there are more men in hospital than women, with 60% of the patients being male and 40% female. This time, however, all population groups seem to be represented.

When looking at intensive-care units (ICUs), which are a critical resource under huge pressure, it’s startlingly obvious that not only have we had to accommodate more patients in ICU, but that they are significantly younger and much sicker this time. Fifty percent of the ICU cohort are under the age of 60, and 80% are on more than usual oxygen therapy.

Our ICU is full, and we are using all our ventilators for one form of ventilatory support or another. It is a surreal experience to look around and see the vast majority of our patients with masks of various shapes and sizes strapped tightly to their faces in an attempt to keep their blood oxygen levels adequate. It’s difficult to communicate, and all one sees are the eyes looking at you with fear, anxiety, distress, and sometimes calm acceptance.

The mood is sombre, and there’s little humour this time around. Patients with comorbidities still raise a red flag in that they are more likely to have severe COVID-19 with a higher mortality rate, but this time around, there are significant numbers of young, fit, healthy individuals with no comorbidities who are desperately ill. The staff are more fearful because of this. After all, you can’t allay your anxiety by listing the patient’s comorbidities which have resulted in severe COVID-19 if there are none.

Another unique feature is the number of young individuals presenting with severe cardiac disease that has proven to be rapidly fatal. There are also a few confirmed cases of reinfection now, some far more severe than the initial episode of COVID-19.

In addition, we are called for far more acute deteriorations in clinical condition, and seem to be running to many more resuscitations than we ever dreamt we would be. Often, patients have young families, and a desperate desire to live for their children.

There is definitely a higher number of patients who require mechanical ventilation and as such, there is enormous pressure on ICU beds. We are contacted on a daily basis by hospitals looking for ICU beds for young patients with severe COVID-19 pneumonia.

It’s not only the beds that are under pressure, but the units are often understaffed as the healthcare workers contract COVID-19 themselves or simply burn out.

This past weekend, I was told of a physician who contracted COVID-19 and landed up on a ventilator in his own unit and was cared for by his friend and colleague. This is all very hard to deal with.

The fact that many of the patients in hospital are well into the pulmonary phase with significant inflammatory changes in their lungs means that it’s a juggling act, with ICU beds being filled as soon as they are emptied and patients yo-yoing between ICU and the wards, and back to ICU.

There are times when ambulances wait patiently to offload their patients while space is made in emergency, or they are diverted to another hospital.

We are aware of private hospitals which have actually run out of oxygen for a time period. We are aware of hospitals in which they have started using anaesthetic machines to ventilate patients in their theatres.

We have seen photos from a hospital in Gauteng which has set up tents in its parking lot to treat patients with COVID-19.

Resources are limited, and a strict criteria for ICU admission will have to be implemented, a task we are dreading.

In the meantime, as we deal with this unprecedented surge in numbers, elective surgery has been cancelled and, other than COVID-19 cases, we are admitting emergencies only. People are scared to come to hospital and as such, are waiting until they can’t wait anymore, being admitted in extreme conditions.

Our physical discomfort is worse with long hours in personal protective equipment in the summer heat with no air conditioning in the wards. Our fingers are cracking open again, and the emotional toll is huge.

This past weekend, we witnessed the compassion with which our staff cared for a patient with Down’s Syndrome and how happy they were when it seemed that she would survive. We have taken wives to say goodbye to their husbands who are dying of COVID-19. We had to tell five patients that their parent/spouse had died of COVID-19 while they were lying in a hospital bed. I also had to call a lady who was isolating at home with COVID-19 to inform her that her husband had passed away on their 56th wedding anniversary. We also celebrated two birthdays here.

We are familiar with the vagaries of this disease, and write the treatment charts by rote, monitoring individuals intensively. We make therapeutic adjustments according to various clinical and blood parameters, desperate to prevent severe pneumonia or the cytokine storm.

We feel enormous relief if it looks as if the inflammatory process is reversing. And yet, in spite of all the knowledge gained over the past few months, there are patients who you know cannot pull through. At those times, kindness and compassion are all we can offer.

The stories are familiar. A minority of our patients (often the elderly) contracted COVID-19 through no fault of their own. But the vast majority know exactly where they picked it up – a dinner party, a function, on holiday, at a picnic, in a friend’s home, etc. The equation is simple to me: socialising without respecting the COVID-19 rules of social engagement = COVID-19 (for yourself or some unlucky individual that you come into contact with).

If you’re lucky, you get away lightly, and if you’re unlucky, you become critically ill (with the attendant risk of dying) or you develop long COVID-19 or one of the unusual late complications.

It’s going to get a lot worse, and we are going to run out of hospital beds, medication, and potentially oxygen. There’s no magic cure, and the vaccine is on the horizon. It behoves everyone to be respectful of COVID-19 and behave responsibly, respecting the sanctity of life.

  • Dr Carron Zinman is a pulmonologist at the Linksfield Clinic.

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OP-EDS

SA media’s anti-Israel bias verges on incitement

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Nuance, context, fact checking, and, above all, reflecting both sides of the story when the issues are sharply contested, are the sine qua non of professional journalism.

This is particularly true when it comes to reporting on any conflict, whether involving individuals, communities, or entire countries. Conversely, uncritically reflecting the narrative of one side while minimising – if not disregarding altogether – the version of the other side isn’t journalism. Rather, it’s dishonest propaganda masquerading as such.

Over the past week, the distress of the Jewish community over the renewed violence in the Middle East has been compounded by the local media’s palpable failure to adhere to the most basic standards of journalistic rigour in terms of reporting what has been happening.

With few exceptions, mainstream news outlets have unquestioningly regurgitated the exaggerated, emotive, and frequently inflammatory claims of the hardline anti-Israel lobby while routinely omitting the Israeli perspective.

From print and online media through to radio and TV channels, a distorted picture of brutal, rampaging Israeli oppressors victimising helpless, blameless Palestinian victims has been served up again and again, without introducing even a small measure of balance to temper that false picture.

It’s obvious that the Israeli-Palestinian conflict invariably elicits strongly-held opinions on all sides. Even the salient facts of the situation are sometimes disputed, which is often true of most conflict situations.

Journalists who wish to convey an accurate picture of this fraught subject must be especially rigorous in order to maintain proper standards of truth and objectivity. That entails careful fact checking, reflecting competing narratives, avoiding exaggeration or sensationalism and, in general, making a reasonable effort to present opposing points of view fairly.

This isn’t to say that professional journalism necessarily entails never having an opinion of one’s own. As is all but inevitable, news reporting will often to some extent be slanted towards a particular point of view, especially when it comes to issues where the salient facts are hotly disputed.

This is certainly true about the conflict between Israel and her neighbours. To expect the media to be completely neutral on that question and just report “the facts” may be unrealistic. However, the manner in which the recent violence on the Israeli-Palestinian front has been reported in the local media is something else entirely.

What we are witnessing instead is the journalistic equivalent of unquestioning group think, an unseemly rush on the part of editors, reporters, and opinionistas of every stripe to convey a single, rigid ideological orthodoxy.

This kind of “four legs good, two legs bad” approach is of course standard fair in authoritarian regimes. The question we are confronted with is why it has come to dominate the way in which Israel is being portrayed even in democratic countries, and perhaps most glaringly in South Africa, where antipathy towards Israel is deeply rooted in the ideology of the ruling party.

As has come to typify reporting on “clashes” (an often-used word by reporters) between Israelis and Palestinians, it’s invariably the response of the first rather than the provocation of the second that dominates the headlines.

In reports, we are seeing, as we saw in previous confrontations, how Israeli counter-strikes against terrorist positions in Gaza and their impact on the population have eclipsed any understanding of the unprovoked barrage of lethal rocket fire against Israeli cities. So there is no understanding of what necessitated such retaliation in the first place. Cause and effect have simply been reversed.

The ostensible cause of the current unrest goes back to the controversy about ownership of certain properties in the neighbourhood of Shimon HaTzadik/Sheikh Jarrah. The media’s unreflecting take has been simply to rehash the standard propaganda canard of rapacious Jewish settlers attempting to drive Palestinians out of their homes in “occupied East Jerusalem”.

The legal background to this case is complex, with roots going back nearly 150 years to the era of Ottoman rule and preceding the emergence of the modern-day Zionist movement itself. Yet, in the age of electronic communication, that information was readily available to anyone wishing to portray the situation as accurately as possible.

Suffice to say that little or no effort has been made in that direction. Equally mendacious is the way in which the violent altercations between police and protestors on the Temple Mount have been portrayed as a case of jack-booting Israeli stormtroopers brutalising blameless and peaceful Palestinian worshippers. Given the profound sensitivities surrounding religious freedom, and particularly when relating to this profoundly fraught and contested part of the world, this arguably crosses the line from mere anti-Israel bias to outright incitement, not just against the Jewish state but, inevitably, against Jewish people everywhere. It is, to say the least, irresponsible.

One small silver lining that we can take from this fog of misinformation that the media has been so complicit in propagating is that we are fortunately no longer reliant on mainstream media outlets for our information.

There exist today a plethora of online resources enabling anyone genuinely interested in learning about these issues to fill in the gaps that our inveterately biased media have helped to create.

Our challenge today must be first to educate ourselves, and from there hopefully go on to educate those who in spite of the ceaseless indoctrination that confronts them at every turn are still open to listening, engaging, and making properly informed choices about what to believe.

  • Rowan Polovin is the national chairperson of the South African Zionist Federation.

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OP-EDS

The law of the land is the law

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When it came to the tragic events at Mount Meron over Lag B’Omer, the writing was on the wall, say many who have written and spoken about it in Israel over the past few days.

It followed disastrous political policy in past years (preceding Bibi Netanyahu’s coalition governments, but gaining momentum under him), which has enabled the Haredi community in Israel to develop a model of exterritorial behaviour – behaviour which assume that the rules don’t apply to them. This reality isn’t dictated by their special needs as a community, but by their politicians as a show of strength.

The only thing that’s legitimate to say to the families of the victims, those who lost their lives, and those who were injured in the compound around the grave of Rabbi Shimon Bar Yochai, is that we send our heartfelt condolences and want to find ways to help them in any way possible.

Their pain is immeasurable, and the impact of this awful, tragic event on their lives will accompany them into the future. We need to care for the widows, the orphans, and we will. That’s who we are, and I’m proud of this fact.

And it’s exactly because we care for the widow and the orphan that our response to what happened cannot end with condolences.

We have a responsibility to all of those who live with us as citizens, residents, or visitors to our country, to ensure their well-being and safety. It’s to that end that we created an extraordinary vaccination campaign during this time of pandemic. Our national health system (kupot cholim) ensured that vaccines were available to all, irrespective of whether they acknowledged the legitimacy of the Jewish state or not. It’s to that end that the Israel Defense Forces defends all those who live in this country whether they live in Bnei Brak, Um Al Fahm, or Tel Aviv. Viruses and missiles are blind to ethnicity, faith commitments, and political ideologies.

Similarly, when it comes to taking responsibility for the public domain, for health and safety, for building ordinances, for roads, for large-scale public events like sports events, religious gatherings, rock concerts, it’s the state and its agents who must not only take responsibility, but also face responsibility for all of these spaces and situations, irrespective of which populations are involved.

There is no difference between what needs to be done on the Temple Mount during Ramadan, the Arad Music Festival, the Kotel during the priestly benediction, in Tel Aviv during the large Gay Pride Parade, at Meron on Lag B’Omer, and in Rabin Square during mass demonstrations of any political group.

So why was this allowed to happen? We have lived with a model of separate communities who very rarely interact with each other in meaningful ways for a very long time. Jews and Arabs, secular and religious, modern Orthodox, and Haredi. All living most of the time in our separate tribes and only occasionally – usually in times of trauma – coming together as am echad (one people).

The voices coming out of what happened in Meron are diverse. There is the voice which says, “This is the will of G-d.” There is the voice which says (very quietly most of the time), “The Haredi community had this coming to them. Just look how they ignored the rules during Corona.” There are political voices which are already manipulating the situation as they desperately try to form a new collation to rule in coming years (this is the crocodile-tears voice).

To this I wish to add my voice with a very clear Talmudic concept, “Dina d’malkhuta dina.” This powerful statement, which appears four times in the Babylonian Talmud, means quite simply, “The law of the land is the law.” I choose to use a phrase from within the codex of Jewish law for the obvious reason that this tragedy was a tragedy which had an almost exclusive impact on the Haredi community.

It’s therefore the duty of the Israel political and administrative leadership to go to this community in a language it understands and make it clear that they are acting on their behalf; make it clear that, as this community is an integral part of Israel by virtue of them living here, and irrespective of the attitudes they may or may not have about the secular nature of many of the laws of the state, they deserve to be cared for by the state. One of the ways the state cares for its citizens is by enacting laws and ordinances which ensure the safety of all of those who live within its boundaries.

Politicians who don’t act in this way, whether from the left or the right, secular or religious, are acting in a criminal way, are endangering the people of this country, and have to be removed from office. Only then will our people here (and remember “our people” includes, in my definition, everyone who lives here) be safe and be able to pray, dance, cheer, and march in large numbers.

  • Julian Resnick grew up in Somerset West and made aliyah with Habonim Dror to Israel in 1976. He lives on Kibbutz Tzora with his little tribe of wife, two of his three children, and his five grandchildren. He guides and teaches in Israel and around the world, wherever there is a Jewish story.

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OP-EDS

What will it take for me to go back to shul?

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(JTA) When I was very young, what motivated me to go to shul on Shabbat morning was the fire station two houses away from the synagogue.

My dad was the rabbi of the only congregation in Annapolis, Maryland, and shul attendance was a family affair. If I behaved during services, my big brother would take me to the fire station afterward, and sometimes the firemen let me sit at the wheel of the hook-and-ladder truck. That made my week.

In recent days, I’ve been thinking a lot about my various experiences with shul attendance over the years. The sad truth is that though I’m fortunate enough to have received my second COVID-19 vaccine more than a month ago, I haven’t been back to shul and I’m not sure why.

It’s ironic because these past few years, I’ve really enjoyed shul – the services, the rabbis, the people, the singing. In my early years, not so much.

As kids, learning to read Hebrew and becoming familiar with the prayers, the goal at services was to be the fastest.

When I was about 10, I attended a family wedding in New York and stood in awe as I took in the sight of what seemed like hundreds of men in black hats and dark suits swaying fervently as they recited the afternoon mincha prayer. I zipped through the silent Amidah and was waiting for the service to continue. A few minutes went by and then a few more minutes until it seemed everyone had finished.

I asked my brother what the holdup was, and he pointed to a very short older man, eyes closed, still in fervent prayer.

“That’s Rav Aharon Kotler, the head of one of the biggest yeshivas in the world,” he told me.

“What’s taking him so long?” I asked. “Can’t he read Hebrew?”

As I got older, I learned about the importance of kavanah, or intention, putting one’s heart and mind into the words we were saying as we prayed. But during my teenage years, prayer was associated more with obligation than choice.

Over the years as an adult, with shul attendance no longer coercive, I have been blessed to have belonged to three synagogues (in the three states where we lived) that were true houses of prayer. And in each of the shuls, what I have enjoyed most in the service is when our joined voices blend in song, stirring a kind of transcendent feeling of collective prayer and community.

Then came COVID-19, and we had no choice but to stay home. I missed the rhythm of walking to and from shul on Friday evening and Shabbat morning, feeling part of the spirit of the kehillah (congregation), and often lingering after services to catch up with friends.

But I became accustomed to staying home, and that had its own pleasant pattern: sleeping later, praying at home, spending more time with my wife and, when the weather allowed, meeting friends – six feet (1.8m) apart – on a bench outside.

I know I’m not alone in my ambivalence about going back to shul now. Going back would be good for the congregation, and probably for us, even though the prospect of COVID-19-limited attendance, singing, and socialising is less than appealing.

Are we just lazy or fearful of becoming sick? Or have we become dependent on the safety and security of keeping close to home?

What would get me back to shul? No, it’s not the prospect of visiting a nearby fire station after services. It’s the chance to ignite a spark of faith and commitment, and time to take the next step back on the long path toward normalcy.

So there I was, on Saturday, back in synagogue. Sitting alone, at least six feet away from others, and wearing a mask, felt isolating at first, like praying alone in a room in spite of others around me. But gradually, the mood lifted and the familiar comfort of the prayers – and the warm (if muted) greetings from fellow congregants – made me feel at home again. I could get used to this.

  • Gary Rosenblatt was editor and publisher of ‘The Jewish Week’ from 1993 to 2019. Follow him at garyrosenblatt.substack.com.

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