The New York Times - USA (2020-10-17)

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THE NEW YORK TIMES, SATURDAY, OCTOBER 17, 2020 Y A


Tracking an OutbreakThe Stricken


JERUSALEM — When the eld-
erly father of an ultra-Orthodox
radio personality in Israel con-
tracted the coronavirus recently,
his family dreaded the prospect of
his entering an isolated hospital
ward and possibly never coming
out.
So the broadcaster made a
round of calls that turned up an al-
ternative.
A small charity was offering an
under-the-radar service treating
mostly ultra-Orthodox and older
Covid-19 patients in their homes,
even in severe cases where health
experts say it could endanger
lives. Drawing on the services of a
few doctors — and dozens of vol-
unteers, most without medical
training — it was operating out of
a basement in Mea Shearim, a Je-
rusalem stronghold of the most
extreme anti-Zionist Jewish sects
that shun cooperation with the
state.
Hundreds had already turned
to the charity for care out of a
sense that remaining with family
— and avoiding public hospitals —
outweighed the risks. But the
project was also tinged with a gen-
eral distrust of government
among the ultra-Orthodox com-
munity, which appears to be in-
creasingly going it alone in han-
dling the pandemic and many
other aspects of daily life.
Since the home-care initiative
was reported by Israel’s N12 news
service this week, health officials
and experts have responded with
a mix of condemnation and curi-
osity. One leading epidemiologist
was among those who said the ap-
proach could help ease the burden
on hospitals.
The debate comes as Israel is
under its second national lock-
down after daily infection and
death rates soared to among the
highest in the world, and ultra-Or-
thodox areas top the virus hot
spots. Health officials say that
about 50 percent of those aged
over 65 and under 18 who are in-
fected in Israel are from the ultra-
Orthodox community, though it
makes up no more than 13 percent
of the country’s nine million citi-
zens.
And the actual infection num-
bers may be even higher: The
charity does not report coronavi-
rus cases to the authorities, which
may be skewing the national virus
data on which policymakers base
their decisions.
Dr. Sharon Elrai-Price, a senior
Health Ministry official, de-
nounced the operation as a “dan-
gerous” departure and said the
ministry was looking into the le-
gality of some aspects of it.
Dr. Ran Balicer, an Israeli health
care official who advises the gov-
ernment on the pandemic, called
the charity “a gamble.” A corona-
virus patient’s condition can de-
teriorate rapidly, he said, adding it
was “hard to predict a moment of
no return for people who might
have survived had they reached
the hospital in time.”
But Dr. Gabriel Barbash, a lead-
ing Israeli professor of epidemiol-
ogy, is among those who view the
charity’s approach as a possible
way to ease the load on hospitals
and worthy of further study. Other


advocates insist that even in se-
vere cases, a calm home envi-
ronment can aid recovery.
Yitzhak Markovitz, a member
of a small Hasidic sect, started the
at-home care service about six
months ago through his charity,
Hasdei Amram. He said his pa-
tients generally avoided taking
government Covid-19 tests to
evade official attention and pres-
sure to go to hospitals, adding that
those factors are also why he does
not report cases to the authorities.
The charity offers a limited
range of treatments compared
with a hospital, providing only
oxygen support, medication and
close monitoring by a doctor. Its
services are not exclusively for
the ultra-Orthodox, though most
patients do come from that com-
munity.
The hardest part, Mr. Markovitz
said, is recruiting doctors because
they fear being investigated
should anything go wrong.
The ultra-Orthodox community
has long kept itself apart in an ef-
fort to shield members from out-
side influences. But their ways
have riled many other Israelis.
Its school system operates in-
dependently of the Education
Ministry. Many ultra-Orthodox
men study the Torah full-time in-
stead of working in paid jobs, and
they receive government stipends
to remain in seminaries while be-
ing largely exempted from man-
datory military service. Many

from the community live in almost
exclusively ultra-Orthodox cities
and West Bank settlements.
And now, their independent ap-
proach to dealing with the pan-
demic is exacerbating the coun-
try’s religious-secular divide.
Gilad Malach, who directs the
ultra-Orthodox program at the Is-
rael Democracy Institute, an inde-
pendent think tank, said the sec-
ond wave of the country’s corona-
virus outbreak, which began this

summer, was “a microcosm of the
whole story of the Haredim” in Is-
rael, referring to the ultra-Ortho-
dox.
“They cannot be a state within a
state,” he said. “If 50 percent of the
sick are Haredim, it affects the
whole country.”
“There is a huge amount of an-
ger and criticism over their be-
havior among the general popula-
tion,” he added. “So we are both
linked to one another but more
alienated from each other.”
Many Israelis blame the com-
munity for the country’s second
full lockdown after ultra-Ortho-

dox politicians used their political
clout to thwart plans for more lim-
ited local lockdowns that would
have targeted their towns. And
while some ultra-Orthodox rabbis
have urged compliance with gov-
ernment regulations against large
gatherings, others have flouted
them, relying more on the power
of prayer.
Having large families crammed
into typically small apartments
has contributed to the high infec-
tion rates within the community.
The independent Haredi school
system has remained at least
partly open while state schools
have been closed.
And as in Brooklyn, inter-com-
munal tensions have been fueled
by scenes of large weddings, fu-
nerals and religious gatherings in
ultra-Orthodox communities. Po-
lice enforcement has been erratic
and has led to clashes.
Still, national infection rates in
Israel have fallen under the lock-
down restrictions, some of which
are expected to be eased on Sun-
day.
Although Mr. Markovitz’s serv-
ice began with treating cases in
Mea Shearim, it soon spread to
other ultra-Orthodox neighbor-
hoods in Jerusalem and other cit-
ies. Supporters claim amazing re-
covery rates, far exceeding the
national ones for older people.
Mr. Markovitz said that only
about 20 of his 2,000 cases had
ended up in the hospital and that

only a fraction of those 20 ulti-
mately died.
“What we see from this whole
experience,” he said, “is that when
a person is in good mood and spir-
its, that’s when the situation im-
proves.”
But critics say the project’s data
is unreliable.
Mr. Markovitz said he had be-
gun keeping a register of patients
only over the last month and that
he currently had about 500 receiv-
ing care. He and a volunteer said
that up to 170 of them had blood
oxygen levels below the point at
which health experts would ad-
vise hospitalization.
Families pay 1,000 shekels ( just
under $300) for a private visit
from a doctor who takes blood
samples and sends them to a pri-
vate lab for testing. The price in-
cludes follow-up monitoring by
the doctor, mostly remotely.
Volunteers, who are mostly
seminary students, wear protec-
tive clothing to deliver drugs and
donated equipment, including de-
vices for measuring blood oxygen
levels and oxygen generators.
Young family members who are
prepared to risk infection help
care for the patient.
Patients who require intubation
are transferred to Israel’s hospi-
tals, which are currently treating
about 800 virus cases.
A few other organizations in Is-
rael offer some at-home health
care services for coronavirus pa-

tients. Yad Sarah, Israel’s largest
volunteer organization for health
and home care services, has been
providing oxygen devices. The
public health system offers some
degree of home care for mild
cases. And a private clinic associ-
ated with a major Tel Aviv hospital
offers high-end home treatment
for wealthy virus patients at a
hefty cost, according to Israeli me-
dia reports.
For Avi Mimran, a popular
presenter on the ultra-Orthodox
Kol Hai radio station, what mat-
tered was saving his father.
Yitzhak Mimran, 85, was running
a fever and tested positive for the
virus a few weeks ago.
Within an hour of calling Mr.
Markovitz’s charity, Mr. Mimran
said, a doctor was at his father’s
door. The fever and some breath-
ing problems persisted for about a
week. The doctor stayed in touch
twice a day, and three grand-
daughters tended to him.
Because he had been tested,
health officials also called to check
on him. Within a couple of weeks,
he seemed to be feeling better.
“In the hospital corona ward,
people are isolated, alone and
without family,” Mr. Mimran said.
“They are completely cut off and
that’s what kills.”
Mr. Markovitz insisted that his
efforts were not driven by ideol-
ogy or anti-Zionist sentiment.
“We are only about saving
lives,” he said.

RELIGIOUS CHARITY


Ill With Covid-19, Some Ultra-Orthodox in Israel Choose Home Care


By ISABEL KERSHNER

A volunteer with Hasdei Amram, a small religious charity, leaving after making a home visit to a coronavirus patient in Jerusalem on Thursday.

DAN BALILTY FOR THE NEW YORK TIMES

An independent


approach to dealing


with the pandemic.


The State University of New
York at Oneonta on Thursday an-
nounced the abrupt resignation of
its president only weeks after it
experienced the most severe co-
ronavirus outbreak of any public
university in the state.
The departure of the president,
Barbara Jean Morris, is one of the
most high-profile over the corona-
virus crisis, which has thrown
many colleges and universities
across the country into turmoil as
they try to maintain some sem-
blance of campus life during the
outbreak.
Last month, more than 700 stu-
dents at Oneonta tested positive
for the virus, causing the shut-
down of in-person classes. The
outbreak forced state officials to
send a virus control crew to the
university to keep the spread from
reaching the rest of the city, which
is in upstate New York.
On social media, posts about
students being taken out of dorm
rooms in the middle of the night by
men in hazmat suits were widely
circulated. Photos of students par-
tying in quarantine dorms went
viral, drawing the ire of parents,
staff members and town resi-
dents.
The fallout from the crisis led to
a state review, a change of corona-
virus protocols throughout the
SUNY system and now the resig-
nation of Dr. Morris, who did not
offer any public comment on
Thursday.
Officials said the university
would soon begin the search for a
new president. Dennis Craig, who


recently served as interim presi-
dent at SUNY Purchase, was
named as a temporary replace-
ment.
The mayor of Oneonta, Gary
Herzig, said: “I think that we all
recognize that this was a time
where change was needed. It’s a
time for a new start.”
In an interview, Mr. Herzig add-
ed: “There had been some loss of
trust here amongst both the col-
lege community and the city com-
munity. Trust is everything.
Sometimes you need to make
changes in order to rebuild trust.”
Although the university did not
directly tie Dr. Morris’s resigna-
tion to its handling of the out-
break, state and local officials at a
news conference on Thursday an-
nouncing the change praised the
efforts of Mr. Craig, who guided a

successful reopening plan at
SUNY Purchase, which is in West-
chester County, just north of New
York City.
SUNY Purchase has reported
just seven cases at its campus of
more than 4,000 students.
“SUNY Purchase has one of the
best plans out of the SUNY sys-
tem,” the system chancellor, Jim
Malatras, said at the news confer-
ence. “They brought back about
25 percent of their students and
they have had regular testing and
a very low positivity rate. Presi-
dent Craig led the way on that.”
Mr. Malatras said Dr. Morris in-
formed them last week of her deci-
sion to resign.
When asked if Dr. Morris’s res-
ignation was related to her han-
dling of the virus outbreak, Mr.
Malatras skirted the question,
saying she resigned of “her own
volition.”
“I think everyone in the com-
munity would agree that there
were problems collectively, but
now we want to move forward,” he
said.
The outbreak at Oneonta began
modestly with only two cases on
Aug. 25, but then spread quickly.
Initially, the university tied the
cases to a series of parties near
campus, which led to five suspen-
sions. Within days, 29 more pos-
itive cases were found. By Aug. 30,
the university announced that 105
students — or about 3 percent of
the people who were on campus or
using campus facilities by then —
had tested positive.
By now, more than 700 students

had tested positive.
Oneonta, a school of about 6,
students, has had almost more
than double the number of virus
cases that any other school in the
SUNY system had.
Parents, students and resident
assistants were critical of the uni-
versity’s reopening plan. Students
were not required to provide a
negative test before classes began
or once they arrived on campus.
The university said the decision
not to test asymptomatic students
was based on guidelines of the
Centers for Disease Control and
Prevention. Students who had
traveled from a “hot state” or out
of the country were asked to quar-
antine from seven to 14 days, the
university had said.
It is unknown if SUNY Oneonta
will reopen its campus for in-per-
son classes for the spring semes-
ter. Rori Matthews, 20, a SUNY
Oneonta student, said she
doubted it would.
Ms. Matthews, who is immuno-
compromised and has asthma,
said she was stressed by the rising
number of cases and annoyed by
how Dr. Morris handled the out-
break.
She said she was surprised by
the news because Dr. Morris pre-
viously said during a virtual town
hall event that she would not re-
sign because of the outbreak.
Now, her resignation has just
become another part of a whirl-
wind year.
“It was the next step in the long
road that’s 2020 at SUNY Oneon-
ta,” Ms. Matthews said.

NEW YORK


College’s Leader Resigns After 700 Student Infections


By AMANDA ROSA

The State University of New
York at Oneonta shut down in-
person classes in September.

CINDY SCHULTZ FOR THE NEW YORK TIMES

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