From the Rector: Coronavirus Update

3/11/2020

Dear Friends,

As I mentioned yesterday, things are evolving quickly regarding COVID-19, and we are doing our best to be sure and timely in response.

That said, we have decided to cancel a number of activities, which is a great disappointment, but is widely felt to be a prudent move. The ECW Annual Luncheon, the Men's Retreat, and Rise Against Hunger are cancelled. In addition, Wednesday lunches and flower delivery to the sick are being suspended. The Youth Group dinners will not be cooked by volunteers, but Abby will be ordering pizzas and the like. There will be more to come, I am sure.

Importantly, in accordance with a directive from our bishops, the congregation will receive Holy Eucharist under one kind only until further notice. This means the bread only, not the wine. This practice, historically called "communion under one kind," is most ancient and acceptable theologically. 

We will also suspend home delivery of Holy Communion at this time, and we will not be passing around the plate during the offertory. (So please make a pledge!) And finally, please pass the peace by saying resolutely "Peace be with you!" and perhaps waving a peace sign or doing an elbow bump.

It is indeed a sad day that we are at this point nonetheless, and I feel no small degree of loss at this change of our liturgical custom. However, I take deeper comfort in knowing that Christ is whole in either bread or wine, and that even for those who take no communion at all, Christ is made fully known in the communal memorial of his death and resurrection. What's more, we are all in it together. As members of Christ's body we are one

The Lord is Good, and we are all in this together.

In Christ,

Greg+

+ ++

3/10/2020
Dear Friends,

Just a week ago we learned of the first case of Covid-19 in Wake County. Several more cases in the Triangle have since been discovered. On Sunday, the nation learned that an Episcopal priest in Georgetown, D.C. had been diagnosed. It turns out that the Rev. Tim Cole and I were both at the same Episcopal Church leadership conference in Louisville in February before he became symptomatic. I do not know him, but I know who he is and I did see him a few times at a distance. The CDC and the leaders of that conference (which had hundreds of attendees) have been in close conversation about the case, and we have been assured we need not be concerned. In the more than two weeks since the conference ended, I have not experienced any symptoms and neither have my numerous colleagues who attended the very large gathering.

But we are being vigilant regarding these unfolding matters. Toward that end, I am in frequent conversations with the Rev. Dr. Vince Kopp, M.D., who is closely monitoring the latest information and news regarding Covid-19. We expect that as it draws closer to our community we will have to think about it more and more. Vince and I will be assembling a group of health care professionals to serve as a medical advisory committee for the parish, so we may look at the medical issues and concerns of different groups. We will be looking at what changes might need to be made to our practices in terms of meetings, pastoral visits to homes and hospitals, and so forth. As this is an evolving story, we will be looking at it in real time.

For now, I have assured the staff that they are encouraged to stay home if they have any symptoms of flu, cold, or whatever, and of course the same goes for all our members. We are looking at what events and programs might need to be rescheduled. On a general note, at worship, please remember that shaking hands is not required at the peace! An elbow bump or peace sign will do! Just be sure to say, “Peace be with you.” As well, receiving wine is not theologically necessary to partake in communion. If you wish to only receive the host, then you are on solid Christian footing to do so. Many churches have begun to ban intinction (dipping) because that has been shown to be more problematic than drinking from the common cup. However, at present, we are not changing our practices. 

As of this week, we are merely looking toward what may come to pass. We are particularly mindful of those groups more vulnerable — the aged and those with compromised immunity, for instance. As well, we know that we must continue to wash our hands, be careful, and pray without ceasing for those around us.

In Christ,

Greg

3/4/2020

Dear Friends,

Yesterday afternoon we learned that the first case of coronavirus has been identified in Wake County. The infected person was exposed while visiting a nursing home in Seattle with confirmed cases of the virus.  

We are very fortunate to have the Rev. Dr. Vince Kopp, M.D., as a priest associate on our clergy team now. He is very well versed in health issues as one might imagine as a teaching professor of pediatric anesthesiology at UNC Medical School for decades. I have asked him to write a longer piece which is below.

We do not plan to make any changes to our liturgical practices. However, Dr. Kopp will explain the research on disease transmission through religious practices, like taking communion and passing the peace, and he has some recommendations. 

In a nutshell, study after study shows that people dipping their host into the small chalice have a somewhat HIGHER rate of transmission than people drinking from a common cup. This goes entirely against what most people think. But the science backs it up. Why? Because a huge percentage of those who intinct put their fingers all the way in the cup. That all being said, receiving communion is not in fact a particularly risky action as far as the transmission of disease (despite deeply felt and commonly held ideas about how things work.) Passing the peace by shaking hands is far more so. 

Nonetheless, people can refrain from the wine altogether and should know that receiving only the host counts as full communion. It always has since ancient times. Moreover, if people want to be super careful, they should not shake hands with folk, but perhaps make the peace sign.

In the meantime, please remember the following:

WASH

  • Wash hands

  • Avoid touching your face or surfaces

  • Sneeze and cough covering

  • Home rest when ill

To help ensure the health and well-being of everyone in our church community, we remind you to please stay at home if you have any flu-like symptoms. 

Please stay tuned for more information,

In Christ,

Greg

+ + + 

What Should We Know and Do About the Coronavirus? 

The Rev. Dr. Vince Kopp, M.D. 

On March 3. Wake County recorded North Carolina’s first case of COVID-19. At this time, while we pray for all patients, health care workers, and communities affected the presence of COVID-19, here and around the world, I have been asked by our rector the Rev. Greg Jones to address concerns related specifically to corporate worship and liturgical practices at St. Michael’s during times of community illness.

According to the US Center for Disease Control (CDC), the novel human coronavirus causing the global spread of COVID-19 is named SARS-CoV-2. The prefix “corona” refers to projections on the virus’ outer surface.

Religious Practices and Infection Risk
Large gatherings of people, including in worship, heighten the risk of any infectious disease transmission, COVID-19 included. Facts relevant to liturgical practices relate to the risk of any infection transmission are presented below:

● Church attendance when ill (with or without fever) exposes others to potential infection

● Sacred vessels, bread, and wine are handled with health and holiness in mind

● Low-touch (a fist or elbow bump) or no-touch (a Peace sign) methods for Passing the Peace work

● Holy Communion presents low risk for infection transmission:

o The medical literature recognizes common cup use as low risk; intinction, less so

▪ Sarkies JWR: Infection and the common cup. Can Med Assoc. J. 1957; 76 (4):327

▪ Gill ON: The hazard of infection from the shared communion cup. J Infect. 1988; 16(1):3-23

▪ Pellerin J, Edmond MB: Infections associated with religious rituals. Int J Infect Dis. 2013; 17:e945-e948
o Metal vs. ceramic vessels, turning the cup, and proper purificator use can reduce transmission risk

o Reception of bread or wine alone are sufficient for Holy Communion

● Cough or sneeze only into disposable tissue and pocket used tissue after use

● Avoid touching nose, mouth, and eyes as all are reservoirs for sub-clinical (undetected) infection; making the Sign of the Cross presents less risk of disease transmission

● Use of 60% alcohol-content personal hand sanitizer is advised when hand washing not possible

● Immunocompromised persons are at highest risk of getting sick (We can come to you!)

Other Considerations 
Beyond liturgical practices other considerations deserve attention: special cases, personal health practices, and global preventative health measures.

Special Cases 
● Physical fragility presents a considerable mortality risk from COVI-19 at any age

● Children without significant health conditions (cancer, cystic fibrosis, asthma, cardiac anomalies, and/or renal and hepatic disease, or diabetes) may be at less risk from COVID-19 than to seasonal influenza

● Travel to and from affected areas increases the risk of community acquired disease (no known specific contact)

Personal Health Practices
● Pray for strength, health and acceptance when faced with illness

● Follow generally accepted and all mandated infection containment practices

● Fear spreads faster than infection while anxiety increases stress which can increase disease susceptibility, so keep calm and carry on

● Overwork, poor diet, excessive alcohol use, and lack of exercise can further decrease resistance to all infectious diseases, so use moderation and good judgment

● Reach out to clergy and lay ministers as needed

General Considerations 
● Exposure does not equal infection but should be assessed

● Illness signs and symptoms may vary from inapparent to full-blown

● Seasonal allergies may mimic any mild viral illness without a fever

● Handwashing remains the best defense against all infectious disease transmission

o Soap is best but hand sanitizer is better than nothing

o Proper hand washing technique involves a minimum of 20 seconds of soap use on all hand surfaces including between fingers

▪ Saying “The Lord’s Prayer” while hand washing gives adequate time

▪ Singing “Happy Birthday” twice while washing approximates 20 seconds

▪ Children should be taught proper handwashing technique early on

Resources
COVID-19 specific resources are available and are continually being updated: ● https://www.who.int/emergencies/diseases/novel-coronavirus-2019

● https://www.cdc.gov/coronavirus/2019-ncov/index.html 

● https://epi.dph.ncdhhs.gov/cd/coronavirus/providers.html 

● https://www.episdionc.org/blog/episcopal-relief-development-and-diocese-of-nc-offer-guidance-in-responding-to-coronavirus-concern/

Conclusion
In times of illness and crisis it is easy to forget we share in all of God’s creation (coronaviruses included), depend on God’s grace, and are called to love God and to love one another as we love ourselves, always. This means caring for each other above all. Here St. Paul’s words from Romans 8 speak to us: “…nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.”