A Video post on the Measles Outbreak

I made a video. You have not seen a video this ammueture since 1997. I wanted to try video instead of writing, because I thought it might be more enjoyable. So I spent an hour ranting into my Samsung Galaxy camera and then cut out all the times I got up to pet the dog, etc.

The video is on the measles outbreak, and all major theological, philosophical, economical, medical and other tangentially related issues to the measles or to things tangentially related to the measles. I tried to address many questions about the measles outbreak in a Q&A format. It was a panel with just me.

Here is the text, which I ended up writing anyway.

 

ABOUT THE MEASLES OUTBREAK

Is it safe to tour the Hasidic community during the outbreak?

I am no doctor, so I’ll tell you what my doctor told me: “Make sure you’re immune and you’re good”. If you were vaccinated, you are probably okay, but you might want to get a blood test to check if you are immune. They call it “titers”, with a hard I, like tiger, tights, like aie yaiy yaiy (per dictionary.com) So get that – the tay-ters. I got mine and have evidence of immunity to measles, mumps and rubella and I feel good about that.

If you have a baby who isn’t vaccinated, then talk to the pediatrician. A couple of people with babies changed plans because of the measles, and I get it. I’ll totally work with you if that’s your situation.

So the outbreak is scary. What’s going on?

Looks like a recurrence in several countries around the world, from where it spreads. It reached the New York Hasidic community via Israel from Ukraine, where there were more cases than any other country. From February 2018 to March 2019 they had 72,408 cases; in 2016 the WHO reported only 42% of kids were vaccinated.

I read about Hasidic anti-vaxxers. Is Hasidism anti-vaccine?

No.

The Williamsburg Hasidic community is pro-vaccines. There are always individual opinions and dissenters, as anywhere. They are an asterisk. I will talk about them later. But they are the exceptions, not the rules. You can say Americans embrace individual freedoms, and you can say Hasidim embrace vaccines. In both instances it doesn’t hold true for every single dingle person, but it is a correct generalization.

But Hasidim are anti-science and anti-modernity?

Nah. You can’t generalize like that. Maybe we can say Hasidim are against Enlightenment values and philosophies. But they are very much a modern phenomenon, shaped in the womb of modernity.

When it comes to many medicines, Hasidim are very eager to embrace the latest technologies – even if these technologies were developed by understanding evolution. Read about Hasidim doing in vitro fertilization in this really fascinating article in the Washington Post. The Hasidic charity organizations for the sick, Bikur Cholim, were in the news because Hasidic volunteers pushed for extending life which seemed to clash with NYU’s counseling for, say, patients on a ventilator who are only alive because of machines. From Jewish Breaking News; “They say that the NYU health system’s approach to end-of-life care has changed and conflicts with the Orthodox Jewish approach to issues surrounding ending life support and administering palliative care — and the hospital doesn’t want observers witnessing decisions that to Orthodox eyes may fall short of extending life by any means available.” Or check out Dor Yeshorim, an organization that performs genetic testing before marriage and according to their website, “successfully eliminates the agonizing occurrence of fatal and debilitating genetic diseases in Jewish families worldwide through its premarital genetic screening program.” It is as if Hasidim have almost no religious comments on many life-saving sciences, because once it is life-saving, it is usually “kosher” by definition. Think of the expression pekuach nefesh docheh shabbes, which means that to save a soul, the shabbes can be desecrated.

 

But Hasidim are anti-science in other way; they reject life-saving changes to circumcision practices or education. Isn’t this vaccine issue the same?

Dear New York Times: not the same. Ugh, the Times loves lump one Hasidic issue in with another. An annoying op-ed by some suspiciously unknown and supposedly Hasidic person, Moshe Friedman (who is he/she really?), brings up these two frequently cited parallels:

1. Metzitzah b’peh (the part of ritual circumcision that exposes the newborn to potential transmission of herpes.)

“When Mayor Michael Bloomberg’s administration in 2012 introduced rules that required parental consent before an infant could have a form of ritual circumcision believed to be linked to the spread of herpes, some rabbis denounced those efforts as a blood libel or “the evil plans of the New York City health department.”
Some rabbis derided the health department’s scientific expertise, and one respected rabbi went as far as to question the health department’s statistics. “

2. Education (the Hasidic community’s minimal secular curriculum for boys)

“In more recent years, when the Department of Education pushed for an increase in secular studies in the city’s yeshivas, some of our leaders once again instigated their community to oppose these much-needed reforms.”

3. Vaccines: .

“We see this same approach now among some of our leaders toward vaccines. Some rabbis are contributing to the spread of disinformation, repeating unfounded claims about the health risks of the M.M.R. vaccine.”

So Friedman concludes:

“Whether out of shortsightedness or strategic malice, some of our religious leaders have directly fostered an atmosphere where thorough research is sneered at, the scientific method is doubted and the motivations of professionals are assumed to be nefarious and steeped in anti-religious animus.”

I don’t even know how to write a straight sentence without grinding my jaw down. Such sloppy simplifications. We can see from other examples that Hasidim clearly are not “doubting the scientific method” or assuming that the motivations of professionals are nefarious. Because surely that adds up with the Hasid who is going to top doctors for a transplant. “I’ll go to the top doctor. The top nefarious doctor!” Thought nobody.

By the way this author also incorrectly identified the leader of the largest sect in Williamsburg. He clearly has no expertise or insight. He seems to get all his information about Hasidim from the New York Times. Even if he is Hasidic, and of the sect in question, he does not add any information that an outsider wouldn’t have – so what’s the point?

But vaccines are not kosher…?

Again the New York Times: “some view vaccines as a violation of kosher restrictions and a danger to children’s health.”

And is a kosher phone edible? And are kosher cameras properly slaughtered? And are kosher pigs properly vaccinated? These are questions that should keep you up at night.

But then why aren’t they cooperating with the city?

They are. 21,284 doses of the MMR vaccine have been administered to people who are under 19 years old in Williamsburg and Borough Park since October, per the New York City Health website.

Seven yeshivas were closed, but they were also reopened.

Maybe not so well-organized. Maybe not willing to get into big wars with parents. But not not cooperating.

When the Hasidic community decides not to cooperate, like with the New York Sate education standards, there are mass protests in huge stadiums and outcries on the front page of their newspapers and the streetposts fill with posters warning people about the impending danger from the outside. They court politicians and the rabbi meets with the bigwigs and promises votes. It’s a ruckus. With the measles outbreak, there is nothing in the newspaper. Most of the anger is directed at anti-vaxxers, not people from the outside.

Then why is the outbreak so bad?

Let’s look at BAD in perspective. Let’s say there were 360 cases – an estimate. That’s out of a population of about 100,000. That’s .36% of the population. Measles will infect almost any unvaccinated person it comes in contact with. A rate of less than a half percent shows a huge, huge success rate on the part of the vaccine.

But there are many more outbreaks among Hasidim. Doesn’t that prove they have more anti-vaxxers?

More measles cases does not mean more anti-vaxxers.
Hasidim are a more vulnerable population than the rest of society for two main reasons:

1) They have a younger population, which means there are more babies. Let me put it to you in numbers. I’ll use the census data from Kiryas Joel, a Satmar village north of New York City, because we don’t have any census data for Williamsburg Hasidim — their data is mixed with that of other Williamsburg residents. Kiryas Joel is more insular but in all important ways like Williamsburg, and there the median age is 13! Thirteen! This means that half the population is thirteen or under. Compare that to the median age in New York as a whole: 38.2. So the simple math is that Hasidim have far more very young children. Herd immunity depends on a high percent of the population being immune. If 95% of a population is immune, the virus won’t spread. But what happens if 90% of the population are under age one? It’s more likely the measles will spread.

2) The extremely close proximity of Hasidic kids. Let me illustrate how close Hasidic kids come to each other. If a Hasidic kid is not vaccinated and is infected, he will be around an average of eight children in his family, he will go to school on a bus with twenty (six days a week), he will be in a classroom with thirty, at family celebrations with fifty, in the synagogue with hundreds. The opportunity to pass contagions is enormous.

But Kiryas Joel had much fewer incidents of the outbreak.

This is super interesting and it proves a number of things. That Kiryas Joel is more organized. They collaborated with the Hudson Valley health department for a pro-vaccinate publication months ago. It is also much more authoritarian. People who don’t follow conventions are often so marginalized, they have to enjoy suffering to stay there. Most would move to Monsey or Brooklyn.

It also tells you that the outbreak wasn’t a result of some conspiratorial friendship between DiBlasio and the Hasidim. Or that Hasidim don’t want to vaccinate. Because if any of this was true, Kiryas Joel would be at the forefront and the virus would go viral (ha ha, hilarious).

So tell me about the anti-vaxxers. Spill on these juicy nuts.

Anti-vaxxers in the Hasidic community are mostly women who consider themselves enlightened about health and refuse to just follow the masses in these conspiracies they see all around them. They see themselves as smarter and more informed than the rest and refuse to “put all these chemicals” into their perfectly healthy baby’s body. They are a tiny subset of unwieldy rebels within the community. They are the same women who have home births and go to this crackpot and that witchdoctor for all sorts of jewelry-swinging cures. You know the type. People who are very busy with themselves and their special vitamins and juicing and many mishigasen.

But this Hasidic woman told reporters that she doesn’t vaccinate because it’s her “religious freedom”?

Religious freedom is an American concept. Just because one woman cries religious freedom doesn’t mean this is actually a religious issue for her. If she says you should give her a hundred dollars for her religious freedom will you also take her at face value? She is borrowing from the American vocabulary and is using it to her advantage. She learns that if she doesn’t want to vaccinate, she needs to request an exemption for religious reasons. It’s not rocket science. This same woman wouldn’t claim religious freedom to the community.
Let me give you an example: If a Hasidic lady wants to wear, ehhh, say skirts to the floor instead of mid-calf, and to the floor is not really a-okay, she won’t argue with her finger-wagging neighbor that this her religious freedom. She will try to make arguments to its religious validity – like “this is modest”. Religious freedom doesn’t fly here. What freedom? This is the Hasidic community, Lol. Concerns for freedom don’t course through its veins.

But… what about religious exemptions for vaccines?

What about? Were religious exemptions written into law for the Hasidic community? I’m sure not. Let’s dig up why it’s there – I’m curious. Again, we need numbers and details. How many religious exemptions are there and how many medical exemptions? 

Because as per the principal of KJ UTA, a lot of people will be so secretive about health problems that they will claim religious exemption in order to hide the fact that they need a medical exemption. So I don’t even know — how many religious exemptions there are on the books, and how many net exemptions are actually voluntary.

In fact, take a look at this conversation on the religious women’s forum imamother, from 2016(!):

Woman OP: “For my own reasons, I’m an declining the varicella vaccine. I do NOT want my children to have it. I know in public schools, you can claim a religious exemption, and they will be fine with the lack of vaccination. What do you do for a frum school? It’s not like I can fake a religious reason when there isn’t one.Has anyone gotten an exemption for a vaccine from their school?”

Internet Person: “The school doesn’t really care, so if you want to use a religious reason you can (mitzva to take care of the body, and you feel that giving vaccines violates that mitzva.) “

See how it goes? What comes first the religious reason or the vaccine hesitancy? Obviously not the religious reason.

But these Hasidic women wouldn’t believe such nonsense if they got a regular education.

Ehh… How do we me measure this even? Count the number of fringe folks in Silicon Valley? Look – these Hasidic women are incredibly versed in their mishigas. They are not coming to it out of innocence.

Every society will have its conspiracy theorists, its individualists who believe they are the smartest thing to happen to mankind, its walking illustrations of the Dunning Kruger effect. I’ve come to see that some people are just beyond reason. They can’t see past the end of their noses, their logic fails to account for big picture or to keep risk in perspective, they believe they understand everything and everyone else is being led like blind sheep. They form identities based on their being misfits and outsiders and relish their uniqueness. There are such people. They are just human. No?

So what do we do about these anti-vaxxers?

Make their likeness into a piñata and hit it to shreds? Shame them until their lightbulbs go on. Yeah? No. We create laws to deal with the balance between their right to believe whatever and the risk that such rights might bring to others.

The Amish also had a large outbreak in 2014. Is this like — the same cause?

I’m not any more informed about the Amish than you!

I’d caution you against extrapolating conclusions about one insular community based on information about another. Just because there are similarities doesn’t mean that they’re the same in all ways. As they will say on my epitaph: nuance, baby.

Has the media accurately portrayed the outbreak?

No. The coverage made me really angry. A bad kind of anger, the isolating, unhappy kind. Not the one where we feel really good and smart and self-righteous after ranting. I’m exhausted of my anger.

It was a coverage bad for its omissions.

It was as if the reporters simply filed the CDC press release as their stories. No context, no additional information, just whatever the CDC had as its numbers. I can look at the CDC website myself. I need the media to frame the numbers. But since they didn’t, we only learned two things:

• The number of confirmed measles cases. (Now at 764 for the US in 2019)
• That “The majority of people who got measles were unvaccinated.”

Journalists have been hammering on the “unvaccinated” part. But here’s the rub: they are using unvaccinated interchangeably with anti-vaxxers. Just because folks are unvaccinated doesn’t mean they are an anti-vaxxer. Think of all the people unvaccinated in a pediatric oncology ward. Or all the infants in the maternity ward. All of them are at risk and are unvaccinated! The CDC told us that lots of people who got measles were unvaccinated – but the media went straight from there to blaming anti-vaxxers. An article a day in the Times about how anti-vaxxers are all to blame, because they are unvaccinated.

Again, Williamsburg will have a greater number of unvaccinated minors. There is no greater proof of this than by looking at what the CDC did: they ordered that we vaccinate Hasidic babies at 6 months instead of a year. If the regular vaccine schedule alone worked, and the only problem was anti-vaxxers, than all we’d do would be make the anti-vaxxers vaccinate.

In fact, I asked around about specific cases and this is what some people knew of: a newborn baby who got the measles and ran a high fever for a few days (terrifying!), a sickly two year old who wasn’t able to be vaccinated and caught it, a seven month old who had already had one MMR, an adult who didn’t think they could get it. Etc. Many unvaccinated, but not anti-vaccine.

What bothered me was that we never got figures or perspective, so everyone was left with the impression that Hasidim have as a group at a large rate passed on vaccines. But the media never gave us numbers. They never provided more information. This kind of omission created hate and misinformation. Zero sympathy from the public, all blame. I find this scary.

Why do you think the media has been covering this so poorly?

Because Hasidic anti-vaxxers … are you kidding me? A double-whammy of the permitted punching bag. Both anti-vaxxers and Hasidim are fodder for outrage culture. The stubborn single anti-vaxxer lady is red meat for the mob. The public loves to pick themselves up a little bit by collectively bashing those on the list of permitted hates. This must bring in lots of clicks for the newspaper.

Who is to call out the media for malpractice? Unlike, say, Jewish issues related to Israel, Hasidim don’t do PR campaigns to push back against the reporting. If the media doesn’t self-correct, what’s to improve this?
My ranting, that’s what. Of course.

So the coverage made things look bad. Why is it really a problem?

I think reporting should be fair and complete. On principal. Even if for no other reason that we don’t try to wing it with coverage if we can get away with it.
Don’t you want your news to be accurate?
Also – you are really kind of proving to Hasidim that they are right: the media is just out to hurt them.
Also – this is creating hate. A lot of unfair hate against Jews. Really.
Also – and most importantly – healthy coverage when inaccurate fails the public. By hyper-focusing on anti-vaxxers, the media missed an important part:

Some people need to be revaccinated. 200 cases of measles were of people who were vaccinated. This is the kind of information that the public health journalism is supposed to uncover and disseminate. They didn’t, because the media was too busy salting and delivering red meat. Here is a video created by a Jewish community in which one individual came down with the measles:

Update: CNN ran a story that illustrates how a humane story can look like. Watch here.

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