To all members of our Lakewood kehillah, 25 Nissan 5780/April 19, 2020,

COVID-19, the disease caused by the novel coronavirus, has led to disruption of life and to terrible illness and death in our community. The most vulnerable group of patients are those over 60, but some young adults have been severely affected as well. There have been close to 50 deaths from our community and we still have tens of patients on ventilators in the intensive care units at area hospitals.

As much as we want to come out of these restrictions of social distancing, we have to be aware that the virus is still spreading and causing new infections. If we let down our guard we may, chas ve’shalom, see an increase in new cases and deaths.

We believe that we are NOT at a point where social distancing can be relaxed yet AT ALL. There is no safe way to gather together (due to aerosolized respiratory droplets). It is not safe to share items between households. Visiting different households, even among family members, cannot occur yet.

Each of us can have an impact on the LIFE of our immediate families, our grandparents, our neighbors. We must remain vigilant to avoid real sakanas nefashos!

Our response to this pandemic needs to be responsible. Our lives and the lives of our loved ones are at stake. Please note:

• COVID-19 is often spread by asymptomatic carriers, i.e., people who have NO symptoms but spread respiratory droplets full of virus to others via regular social contact (speaking within close proximity of one another, touching each other).
• Unlike many other infectious diseases, spreading the virus may occur several days before people develop symptoms of illness, i.e., someone who first develops symptoms on Thursday may have been spreading virus to many people on the previous Monday, Tuesday and Wednesday.
• COVID-19 is much more contagious than we ever expected; 2.3 million people have already been documented to have this disease, but the numbers are probably much higher.
• COVID-19 remains on surfaces of items for up to 4 days (cardboard for 24 hours, wood and cloth for 2 days, metal and plastic for 3 days, and glass and paper money for 4 days).
• The bottoms of shoes can pick up virus and bring it into homes; this is especially important where children play on the floor.
• Although social distancing has been recommended as “6 feet apart,” recent data confirms that respiratory droplets with the virus travel 13 feet. The virus can even stay aerosolized in the air for up to 3 hours.
• A mask should be worn over your nose and mouth when you are grocery shopping; this will protect you, as well as protect others from your respiratory droplets.
• People who have had COVID-19 may be contagious for weeks, even after resolution of all symptoms and may not be immune. Hopefully, further studies and FDA approved, validated antibody testing will shed more light on this subject in the near future.
• Hydoxychloroquine has not emerged as the “cure” drug that some hoped it to be, but more data is needed to determine its appropriate use.
• Remdesivir, IL-6 inhibitors, and convalescent plasma are hopeful treatments that are being studied and may save lives, but we need to learn more about these treatments.

We are constantly learning more about this deadly virus and the data from yesterday may be irrelevant today. Every day brings new knowledge and we hope that the future will bring better treatments and mechanisms that can allow a return to a more normal life, BE”H.

Daniel Roth, MD Howard Lebowitz, MD Reuven Shanik, MD

Jonathan Cohen, MD Allen Lempel, MD Dovid Friedman, MD

Dovid Ogun , MD Daniel Lapidus, MD Micah May, MD

Shalom Aharon Fenster, MD Yaacov Zamel, MD Neal Gittleman, MD

Mordechai Tarlow, MD Baruch Kassover, MD Lawrence Shoner, MD

Yisrael Kadosh, MD Jeffrey Kaminetzky, MD Hillel Peltz, DO

Rabbi Sruli Fried, MSW on behalf of CHAI Lifeline Binyomin Greenberg, MD

Dr. Shimshi Zimmerman, Medical Director of Hatzolah of Central Jersey