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Take suicidal comments seriously and get help – experts

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Three people committed suicide in the Johannesburg Jewish community in November, and four others since January, leaving families and friends questioning how to spot the signs and help anyone thinking of taking their own life.

This is especially important as the pandemic drags on and the festive season arrives – a time when many are more emotionally vulnerable.

For Sarah*, the loss of her friend to suicide, “was the greatest shock of my life. She was gorgeous, extrovert, smart, successful, financially secure, and well-loved. Lockdown isolation put a nail in her coffin. We believe that if COVID-19 hadn’t happened, she would still be with us. I had to identify her at the mortuary. No-one should ever have to do that. It has been traumatic.

“I don’t think that people considering suicide – and presumably they are among us – have any idea of the impact of their actions,” she says. “They do it believing that the world would be better off without them. They are so wrong. It leaves everyone reeling,” says Sarah.

“We are all obsessing about the signs we missed. It’s hard to hear a person ‘deeply’ at the moment when they say they feel anxious or depressed, because we all feel that way. It doesn’t stand out. How do you know when you need to worry? When do you need to intervene? I don’t have the answers.”

According to Chevrah Kadisha Funeral Director Philip Kalmanowitz, there have been five suicides in the Johannesburg Jewish community since lockdown began, and one unnatural death that may or may not have been a suicide. “No person who is a victim of suicide is treated differently to anyone else in death. We see it as an illness. They are buried in the same way and the same place as others,” he says.

“With COVID-19 being so prolonged and so much financial strain, people don’t see an end in sight, which could lead to depression or thoughts of suicide,” says Johannesburg clinical psychologist Leanne Stillerman Zabow. “The risk over the holiday period is that there aren’t as many distractions; it’s a time of taking stock, and may be a reminder of everything we feel we may be lacking in life, which can bring up depressive feelings.”

“Suicide feels so counter-intuitive,” she says, “because in many ways, people strive for life. So, this idea of taking one’s own life – how one predicts that – is jarring. Often a person who commits suicide has so much going on internally that’s hidden from others. There’s often a sense of pain and anger turned against the self, rather than being expressed outwards.

“It can also be ‘masked’. Someone can be a very high achiever, but have an enormous internal sense of worthlessness. Often someone will act out as a ‘cry for help’, especially teens. It could be subtle, so we really need to take heed. People have a fantasy that there is relief in suicide, and it can lure or tempt them, but the truth is, you’re not going to get another chance to resolve things. People may think ‘my family will be better off without me’, but in reality, suicide causes massive waves of trauma.”

Johannesburg psychiatrist Dr Shana Saffer says, “The person almost has a drumbeat in their head saying ‘you are of no value, your family will be better off without you, you don’t belong, get it over with’. The problem is others don’t regard that person in the same way – we may see a funny, talented, delightful person, and we would be shocked to know what their inner ‘voice’ is repetitively saying.”

She refers to suicide expert Dr Lisa Firestone, who says that people who talk about suicide often do go on to kill themselves. “We should take their communication seriously. They may allude to ‘not being around anymore’, yet when someone shows concern, they may quickly deny that they are in distress.

“This back-and-forth behaviour speaks to ambivalence in suicidal people; a part of them wants to die, but the other part wants to live up until the last moment. So it’s worthwhile for us to make an effort because many people are just waiting to be helped.”

Warning signs include having trouble sleeping, isolation, withdrawal from friends, family or social activities, loss of interest in hobbies, work, school, and in one’s personal appearance, giving away possessions, making out a will, having experienced a recent personal loss, taking unnecessary risks, and talking about suicide.

“Another risk is when we have admitted a patient to hospital for severe depression, around the time of discharge, the person may finally have the energy and planning ability to carry out a long-contemplated attempt. A person who had been very low but suddenly has a brighter mood could indicate a decision to carry out a suicide plan,” says Saffer.

Johannesburg clinical psychologist Yael O’Reilly says she sees two kinds of “suicidality” in her practice. “The one is a sense of life being so hard that ‘I wish I wasn’t around anymore’, but there’s no intent to actually hurt themselves. It isn’t so much about suicide as this person needing help to manage everyday life. If supportive elements are put in place, that person isn’t necessarily at risk for suicide.

“The other element is when they are actually suicidal, and it’s not just their representation of how hopeless, depressed, or lonely they feel. The questions we want to ask [to differentiate] are ‘do you have a plan’ or ‘is there intent to hurt yourself?’

“In the first category, they’ll say no, definitely not, I can’t do that to my family, or it’s against my values, or I can’t imagine leaving my child etcetera. But if you ask the second category of person, they will often cry, and say ‘yes I have thought about how I would do it’.” If someone falls into this category then “it’s considered a medical emergency, and that person needs to be admitted to hospital for suicide observation”, says O’Reilly.

The biggest way to help someone in these moments is by offering emotional support. “I can’t stress this enough. The more supported a person feels, the less likely they are to go through with it,” she says. “Support comes in so many different forms – psychotherapy, medication, a support system, or organisations. This is really what can pull a person through, especially in critical moments. If there are interventions, the person has a really good chance of coming out of that depressive episode and suicidal ideation.

“While there have been massive strides in the realm of mental health and the availability of resources, there is still a stigma,” says O’Reilly. “It’s so important to realise that mental illness doesn’t discriminate. In this day and age, it should be second nature to know where and how we can access help. There needs to be an ongoing narrative, and everyone should know the warning signs. We still have a long way to go in normalising and acknowledging that this exists, particularly in our more insulated community.”

*Not her real name

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Wedding leads to a number of COVID-19 cases

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Buffets of canapés and dessert, the sharing of snacks and dips, and horah dancing – allegedly without masks – were just some features of a Jewish wedding held at the height of the second wave in Cape Town, from which a number of community members contracted COVID-19. And while this was one wedding or social gathering that broke the law and flouted restrictions, there have been others.

The daughter of a Johannesburg rabbi and the son of a prominent Johannesburg Jewish family got married in early January 2021. Our source says that under the chuppah, “a man made a speech where he bragged about how his shul was circumventing COVID-19 laws by having people ‘enter secretly through the back’. The general feeling was that his community was more concerned about flouting health precautions in order to conduct Jewish ceremonies than protecting the community from the virus,” the source says.

He says there were about 60 guests, and at first, things seemed safe. “I wasn’t worried as I was sure that there would be a strict protocol that would keep everyone safe.

“On arrival, the staff sprayed hand sanitiser, a registry was filled out, and everyone was wearing masks.” Then things began to shift. “From what I saw, once the bridal party had their makeup on, they didn’t wear their masks. I wasn’t too worried, as there was still social distancing in place. But in the room where the groom was signing the ketuba, there were snacks and dips which everyone was sharing. I thought this was a bit irresponsible.”

He says that at the chuppah, the guests were seated far from each other to create social distancing, but “by the time the horah dancing started, the whiskey was flowing and by now, hardly anyone was social distancing or wearing masks. What also really worried me was the fact that the caterer served the canapés and dessert as a buffet, where guests shared sushi soy dips, finger-food dips, a self-service ice cream machine, and other foods that were obvious virus-spreaders.”

The venue’s owners insist, however, that “no alcohol was served by the venue in any part of the venue. Neither the staff, nor the independent wedding planner, nor the caterer saw any alcohol consumed.” They say staff enforced mask-wearing, and that only family participated in the dancing.

According to the source, “A few days later, I felt very run down and had an extremely sore throat and sinuses. I tested positive for COVID-19. As a healthy person, I have had no serious complications, luckily, but I still had a rough time. After I got sick, I heard from a secondary source that a lot of people at the wedding had caught COVID-19, including the bride and groom.” Another source says that at least two guests have since been in hospital with COVID-19.

“What I saw at this wedding was a general attitude of laxness when it comes to something so serious,” says the source. “The wedding could have been pulled off safely if they had considered a few obvious fixes: simply postpone the wedding until after the second wave; hold the horah dancing outside or cancel it entirely; and the caterer should have had better COVID-19 protocols such as separate dip containers for each person and plates of food rather than buffets.”

The caterer told the SA Jewish Report that she felt pressured into catering the wedding, but “it should never have taken place”. At first she thought she would drop off the food, but was then told to do “normal” catering in the style that the couple wanted. She emphasised that the main meal was plated. She was also asked to cater for the Shabbat dinner and the sheva brochas, but refused. As far as she knows, both those events went ahead. She says a number of rabbis attended the wedding.

Another source recalls being told that it would be a small wedding of 40 people. “The venue was excellent about sanitising, taking temperatures, and registering – it even gave everyone their own pen to write their details. Everything was legally permitted, but I think the lesson our community needs to learn is that at some stage, guests dropped their guard. Being careful 90% of the time isn’t necessarily enough.”

Yet another source who only attended the chuppah says, “The bottom line is that assurances were made that this wedding would be done in a safe way. I’m not entirely sure those assurances were kept.”

Professor Efraim Kramer, the head of the division of emergency medicine at the University of the Witwatersrand who has worked tirelessly to ensure the safety of the community during the pandemic, didn’t mince his words. “Those members of our community who continue to ignore and deny the reality of death and destruction caused by the COVID-19 pandemic are playing a critical game of Russian roulette with their lives and the lives of others.

“They are breaking the law of South Africa, and Jewish law, and therefore acting simply like criminals, nothing less, bringing shame and disgrace on the Jewish community as a whole. It’s a pity we don’t excommunicate anymore.”

“If these facts are true, then it’s a great disappointment,” says legal expert Professor Michael Katz, a member of the board of directors of the Solidarity Fund. “It may have breached the law, and it’s a danger to human life and health.”

Tzvi Brivik, the chairperson of the Cape South African Jewish Board of Deputies (SAJBD), says, “We are very disappointed to learn that a wedding took place under these circumstances. Super-spreader events such as what this could potentially have become are precisely why the second wave of the pandemic has been so devastating to our community and South Africa as a whole.

“Any event which takes place now must meet level-three regulations – there is no compromise. Each infection and loss to the pandemic is a loss to our community and South Africa. Our principal aim is the preservation of life, and we will do what we can to forward that aim.”

Stuart Diamond, the executive director of the Cape SAJBD, echoed these sentiments. “By following the rules, you’re not only protecting yourself, you’re protecting our community. And by doing that, you’re saving lives and ensuring our communal resources aren’t stretched financially and in terms of manpower.”

“We are a five star, tourism-graded venue, set on four acres of grounds with only a small venue on the grounds,” say the venue owners. “There is ample space outside. We allocated six tables inside in a room certified for 150 people. Although they are 12-seater tables, we allowed only six people to be seated at each. The room has frameless, sliding stacking doors on two sides of the venue and four large opening doors on the smallest side. All doors were open. Families sat together at these tables in their own bubbles.

“All serving staff wore gloves, masks, and some wore additional face shields. There was ample sanitiser at several points. The bar has a Perspex shield across it. The wedding ceremony was in the open air, at least 200m from the venue, and the chairs were placed at the correct social distance. We have heard that someone who was at the wedding tested positive the following day. This person must have been contagious at the wedding and could have spread it, but was in no way caused by the venue.”

One of the owners says she was against the wedding going ahead, and has since closed her venues for the next two months. She emphasised that they had no control over the food, and everyone left by 19:30 because of the curfew. “We have won many tourism awards many years in a row, so we are rigorous about the implementation of safety protocols,” she says.

  • The SA Jewish Report reached out to both families who hosted the wedding, but they chose not to comment. The newspaper chose not to use the names of the parties involved in order for them not to be targeted.

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Vaccine refusal isn’t personal, it affects others

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While people around the world line up for vaccination against COVID-19, only 53% of South Africans plan to get vaccinated when it becomes available to them. This is according to a recent Ipsos pollconducted in partnership with the World Economic Forum.

Vaccine hesitancy within and without the community poses a real threat to being able to stem the coronavirus pandemic.

“This would indeed be a major headache for planners if the aim is to reach 67% of the adult population in order to achieve herd immunity,” Professor Barry Schoub, the chairperson of the Ministerial Advisory Committee on COVID-19 vaccines told the SA Jewish Report this week.

The reality is that we need 40 million adult South Africans to be vaccinated so that herd immunity can kick in and put an end to the cycle of pain and suffering. However, uncertainty, fear, and dread surround immunisation against COVID-19 in spite of a considerable amount of research that reinforces the effectiveness and safety of the vaccines.

“There is no doubt in my mind that I would take the vaccine. Not tomorrow. Today,” said Johannesburg doctor Anton Meyberg, who is working at the coalface of the illness.

“The sooner the better. It’s considered pikuach nefesh [preservation of human life] at the highest levels to get vaccinated to protect ourselves and our fellow man,” he said this week amidst growing vaccine hesitancy.

While the country scrambles to secure enough doses to obtain herd immunity – a situation in which most of a population is immune to an infectious disease, giving indirect protection to those who aren’t immune – the question is whether all this effort and money amounts to nought when scores of people are reluctant to get the vaccine.

Johannesburg pulmonologist Carron Zinman told the SA Jewish Report she felt as if COVID-19 was winning the war. “Sadly, people haven’t modified their behaviour enough to control this deadly disease, and no one wants to stay locked away for the foreseeable future. Vaccination is our only hope of halting COVID-19 in its tracks.”

She said that by the time the vaccine is accessible in South Africa, it will have proven its safety and efficacy. “It makes no sense whatsoever for anyone to refuse something that could save your [or a loved one’s] life.”

Experts insist that nothing has more effectively contributed to the health of humankind than the provision of clean water and administration of vaccines.

The enormous pressure on vaccine manufacturers to produce an effective and safe vaccine as soon as possible is widely documented in the light of a devastating pandemic which has claimed more than two million lives.

In less than a year, manufacturers have been able to produce about 10 different vaccines which are in widespread use throughout the world. This contrasts with the 10 to 20 years it took to produce the vaccines of yesteryear, Schoub said.

“Public opinion on COVID-19 vaccines has ranged from the eager ‘why the delay?’ to the hesitant ‘I’m unsure about that vaccine’, to the militant ‘anti-vaxers’ with their science-fiction conspiracies,” he said.

In tackling the “vaccine refusal problem”, it’s important to distinguish vaccine hesitancy from anti-vaxers, he said.

The breakneck speed at which vaccines have been developed and put into use, as well as the uniqueness of the platforms which have been used to construct these vaccines – some completely new to humans – “has raised legitimate concerns in the minds of many anxious citizens”, said Schoub.

Much of the vaccine hesitancy centres on a fear of side effects, especially unknown, long-term side effects. There is also uncertainty about whether the vaccine will be successful against mutations of the virus, and lack of understanding about the differences between the various vaccines.

Anti-vaxers, Schoub said, “are a different breed”.

“Fortunately, they are a relatively small minority in this country, but they are, at the same time, a rather vocal minority, who exploit social media to spread wild and wonderful tales.”

Some of these tales include that COVID-19 is the result of 5G radiation and COVID-19 vaccines contain embedded microchips from Microsoft’s Bill Gates; or that the vaccine can alter our DNA.

“These folk will obstinately cling to these tales and refuse to listen to reason, preferring the comfort of conspiracies,” said Schoub.

It also doesn’t help when people in prominent positions voice their fears based on unscientific, unproven misinformation.

Chief Justice Mogoeng Mogoeng sparked outrage last month with some of his bizarre comments about the “devil vaccine”, and a handful of public servants have also voiced seemingly illogical concerns.

Realising the importance and urgency of herd immunity, certain politicians including Julius Malema and Blade Nzimande have recently encouraged people to listen to science and get the jab.

Schoub said vaccine-hesitant people “do have very legitimate and understandable concerns” about the new COVID-19 vaccines.

“Sometimes their opinions are coloured by anti-vaxer stories; sometimes it’s misinformation; but usually it’s [as a result of] a lack of correct, scientifically validated information. Often, hesitancy is merely reluctance to be a guinea pig,” he said.

“Often, just seeing their friends, neighbours, or relatives being vaccinated, and being reassured that they are hale and hearty after the vaccination while boasting of now being immune to infection is enough to dissolve their hesitancy,” he said.

Careful and non-condescending messaging is important, he said. “For example, the fact that the mRNA vaccine contains absolutely no DNA and cannot alter one’s DNA, and is, furthermore, very rapidly disposed of in the body after its work of stimulating immunity is done.”

Experts agree that it’s important to educate the public about the rigour with which vaccines are monitored for safety and efficacy, from the clinical-trial stage through to international and national licensure, all of which needs to be publicised.

An often-heard objection to the COVID-19 vaccine is the mantra of human or individual rights. “I will choose what’s done to my body”, people say. The choice, however, said Schoub, isn’t between getting vaccinated or not getting vaccinated. The choice is between the perceived risk of getting vaccinated against the real risk of getting the disease.

“There’s no neutral position. Moreover, with infectious diseases, the choice to refuse a vaccine isn’t a choice for the individual alone, it’s also a choice affecting others.”

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Acceptance as back-to-school goes back online

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Jewish schools are resuming online teaching, and while the situation is causing some frustration, parents have expressed support for the schools’ caution.

From playschool to matric, most students in the community began the school year this week. Following the government’s announcement that the opening of public schools has been postponed to 15 February, Gauteng Education MEC Panyaza Lesufi appealed to private schools to do the same to avoid putting strain on the province’s struggling health system.

Consequently, Jewish schools such as King David, Yeshiva College, Maharsha, Hirsch Lyons, and Herzlia have opted to continue with online lessons following an initial two-day orientation held on campuses early this week.

“We brought the kids onto campus on different days for orientation, and then will be moving online for three days,” says Rabbi Shimon Pinski, the principal of Maharsha Boys Primary. “We will assess the situation towards the end of the week after the government gazette has been finalised.

“We’ve seen the positivity of kids studying at school in spite of all difficulties. We are vigorously keeping all protocols laid out by government, and following the recommendations of Professor Barry Schoub and Dr Michael Setzer. We hope that our postponement will end soon, and we can get our kids back to school depending on numbers, regulations, and doctors’ advice.”

“Our nursery school will be open on campus from this week, with all protocols in place, but Grades 1 to 12 have gone online after an initial orientation,” says Rabbi Steven Krawitz, the academic principal at Hirsch Lyons. “We’re waiting for the government to clarify the way forward for private schools.”

Andries van Renssen, the executive director at Herzlia, says parents’ reactions to the way in which the school has reopened have been mixed, though they are generally much more favourable towards in-person teaching.

“During orientation, it was clear how excited the children were to be back and how eager they were to start the learning process,” he says. “Teachers and management are making a real effort to create the safest possible learning environment.”

These efforts are clearly being recognised by parents across the schools, in spite of the frustration the situation is causing.

“Infection numbers are very high at the moment, and schools are using good systems to cope with the pandemic,” says Adina Roth, whose seven and 11-year-old children attend King David Victory Park (KDVP). “I trust King David, and I feel it’s wise to wait for a while until things are a little bit safer.

“The school hasn’t tried to sugar coat anything, and it has made its commitment to in-person teaching clear, which I find reassuring. Expectations have to shift in a pandemic, and we can’t carry on as normal when people are dying.”

Nonetheless, Roth firmly believes that online teaching is no substitute for the classroom experience.

“It’s not just about receiving knowledge but the interactions which come with learning,” she says. “It’s challenging on a personal level when you need to help the younger ones with their classes and work at the same time, but there’s a bigger picture here. We need to deal with the situation and support the school.”

Lara Jersky, whose son began Grade 1 at King David Ariel this week, says that she felt nervous at the thought of him going back to school in person.

“The orientation was good, but I feel more secure that my son will be at home from school for now,” she says. “Yes, it means some stress for me in terms of work and looking after him, but we’ll have to see how it goes. In-person school is an added stress, so I’m happy with the way things are for now.

“Of course, human interaction is gold for kids, and it’s what we want, but schools are definitely doing the right thing.”

According to mom Bianca Rubenstein, Yeshiva College is the only school which hasn’t reopened its nursery school for in-person teaching, causing some strain.

“I’m still dealing with the post-traumatic stress disorder from online classes last year,” she laughs. “I have four kids, the eldest is in Grade 3, and it was a nightmare to run from room to room to see that they were all online.

“My youngest son was to go back to nursery school until Sunday, when we got an email to say things had changed. It wasn’t easy to accept. I was happy for him to go. I could then focus on the other kids online.

“I’m annoyed that he won’t be going back, but I trust Yeshiva’s protocols. You can’t complain or blame in this situation You need to see it for what it is.”

Shelley Meskin says that the changes haven’t been easy for all kids to accept. Her children, eight and 11 years old, attend KDVP.

“My 11-year-old is in mourning,” she laughs. “Last year’s online schooling was incredibly difficult for her. She works off the energy of the other kids and the teacher, so it wasn’t the ideal system for her.

“It’s sad that they can’t be at school, but it’s difficult to decide the right thing to do in this situation. We don’t know whether we should stop our lives or carry on. We want to see our kids back at school because we are growing a generation that won’t know how to deal with things in person after staring at a screen all day.”

Nonetheless, she stresses that parents need to make safety a priority. “People need to listen and do what’s safe,” she says. “Our community hasn’t been so good at that. If we don’t listen, we’ll suffer the repercussions. Whether you agree with the decision or not, you need to follow the rules. If we do that, we’ll get our kids back to school before long.”

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