(Translated by Rabbi Yair Hoffman for 5tjt.com)
The following ruling was issued by the Chief Rabbi of Israel, Rav Yitzchok Yosef, shlita in regard to Yom Kippur and davening and fasting. It is a guide for shuls and individuals. It was translated by Rabbi Yair Hoffman. Rabbi Yoseph shlita, enjoys a reputation similar to that of his father Rav Ovadiah Yosef zt”l, and his seforim are recognized throughout the world as masterpieces of halacha. These rulings were shown to many leading Poskim in America, who stand behind them as well. The ruling is followed by guidelines for the amounts and the timing written by Rabbi Hoffman that were carefully reviewed by Rav Yisroel Belsky zt”l.
Rav Yosef’s ruling was issued on Wednesday, 5 Tishrei 5781. He writes as follows:
Firstly, I wish to make it clear:
- Each person must keep a distance of a few meters from each other.
- All the windows in the synagogue must be opened
- Everyone must wear a mask, or a scarf that will cover the nose and the mouth.
Our Torah is the Torah of life, and commands us with the words “VeNishmartem me’od lenafshosaichem – and you shall be very careful with your lives,” and the Torah also said, “vechai bahem – and you shall live by them.” Our sages in the Talmud in Yuma 85b darshened – To live by them and not die by them. Therefore, Pikuach Nefesh sets aside the entire Torah. A sick person who is dangerously ill eats on Yom Kippur. We violate the Shabbos [for such a person], even on a doubt in this regard. It is as the Rambam has written (Hilchos Shabbos 2:3): “And it is forbidden to delay in the desecration of Shabbos for a sick person who is in danger as it states “that a person does and he shall by them” and not die by them.
The Baalei Tosfos have already written (Bava Kamma 23a) “A person should be more careful to not harm others than to not harm himself”, and certainly in the general prohibition against harming his friend, there is also the duty to prevent a situation that could infect his friend with the disease, chas v’shalom.
The great Gaon, Rabbi Akiva Eiger zt”l had circulated a ruling at a time when the Cholera epidemic was raging in Europe and wrote there: ‘I have already warned many times, warning after warning, that they must conduct themselves in said manner … as they arranged, and that the doctors had decided … and no one should violate their words.”
THE LAWS OF PRAYER
- Each man or woman should daven in close proximity to their home [RYH: This does not apply in the USA for now], until the period of Divine wrath is over and we receive mercy from Heaven.
- One may perform a hataras nedarim through the telephone or other technological method [RYH: The American Poskim did not agree with this ruling – neither through the telephone nor through technology]. A sick person who cannot hear a hataras nedarim should rely on the hataras nedarim that he or she did the previous year [Rav Shmuel Fuerst shlita remarked that one should just do so later rather than rely on the previous year’s hataras Nedarim]
- It is proper to refrain from tovelling in a Mikveh on Erev Yom Kippur unless it is absolutely certain that it is one’s own private Mikvah. Immersion in a Mikvah [before Yom Kippur] is an important minhag, but it is not a full-fledged obligation [see Rosh end of Yumah]. In a situation where there is a possibility of spreading illness one must forego the immersion – even for a person whose practice it is to immerse every day.
- Large synagogues should NOT hold the Tefilos with a large group that is crowded, rather they should split up the congregation in a manner consistent with the requirements of Health Department. They should erect a thick nylon curtain to divide the room, and open up all the windows even if there is an air conditioner in the shul.
- One must also be concerned for overcrowding when the minyanim take place outside.
- When there is not sufficient room for a large congregation – the women should daven at home, and minimize, this year, from attending shul.
- An elderly person or someone susceptible to disease or illnessshould daven in minyanim that take place in an open area [RYH: If it is particularly cold outside such as in the USA at times – they should daven at home].
- So as to not stay for a long time with the congregation, one should shorten the tunes and the number of piyyutim recited. They should also skip some of the inspirational speeches and divrei Mussar that is normally said in other years.
FASTING ON YOM KIPPUR
- A person who is in isolation due to his or her being exposed to a verified patient, but has no symptoms at all, must fast as usual. Likewise, who was sick with the virus, and healed, even if he or she is slightly weak must fast as usual.
- A person who is in isolation and has muscle aches and a bit of a cough, should begin fasting, and be self-aware if he or she feels excessive weakness and headaches, he or she should drink b’shiurim [minimal amounts not to exceed a half a mouthful at one time as discussed below]. If he or she is over the age of 45, or possesses background illnesses, and coughs, or has muscle aches, one may add the basic minimum of eating [not to exceed an olive amount as discussed below] as well.
- A person who is in isolation and has a strong and significant cough, or difficulty breathing, should not start fasting at all, but immediately in the morning will drink water b’shiurim [minimal amounts not to exceed a half a mouthful at one time as discussed below]. And if he or she is over the age of 45 or with background illnesses, then he or she must add the basic minimum of eating [not to exceed an olive amount as discussed below] as well.
- Anyone who is infected with the virus, and only demosntrates symptoms of loss of smell and taste, must fast as usual.
- A person who is infected with the virus, and has a fever, significant weakness, cough, or joint pain, and must be bed-ridden, or has difficulty breathing, in this there is a fear that the illness will develop further and he or she will become endangered, as has happened in many cases – that person is exempt from fasting, but must drink and eat minimally as explained in “Yalkot Yosef.” This is especially if over the age of 45 or has prior illness.
- Anyone infected with the virus and after three days, the fever has already subsided and the person feels almost like any other person aside from their general feeling of weakness – must fast as usual. And it has nothing to do with whether he or she regained the sense of smell and the sense of taste or not. This has no significance in regard to fasting. The only thing that determines the halacha is the fever, the cough, being bed-ridden, or someone who suffers from difficulty breathing. But if, as the fast progresses he or she will feel considerably worse, then he or she may eat with shiurim – the minimal amounts.
And we pray to the Creator of the world that He send a complete recovery to all those who are ill, and that he stop this pandemic and this destruction from upon us and all of Israel and on all of the world. Let us hear good tidings, salvations and consolations. Let us be written and signed in the Book of Life and of Peace. May our prayers be graciously answered with a complete redemption quickly, Amain.
Up until here is the ruling from Rav Yitzchok Yosef.
Guidelines approved by Rav Yisroel Belsky zt”l and written by Rabbi Yair Hoffman
PARAMETERS OF FEEDING A DANGEROUSLY ILL PERSON
It is important to know that the Torah does not want us to endanger ourselves by being overly stringent in matters of fasting. If it is determined that a patient must not fast – then it is a Mitzvah, in fact, to eat. Indeed, there is a very serious punishment that is exacted upon people who refuse to eat when it is medically mandated (See MB 618:5).
Experience, however, tells us that when people get very ill or very old, they often do not think logically when it comes to their own health.
It is often excruciatingly painful for old and sick people to eat – even though they must.
As a consequence, they will often use their lifelong strict adherence to halacha as an excuse not to eat even when instructed to do so.
How should family members deal with this?
They should patiently and lovingly say that their Mitzvah now is to eat, just like there is a Mitzvah to eat on Erev Yom Kippur. Often the best manner to approach it is to divert their attention with other matters or questions when one feeds them. Sometimes switching the feeder, or laying guilt trips can work too. [This is all referring to situations when there is no feeding tube or parental-nutrition-port.]
Of course there are other situations where a generally healthy person may have recently just taken ill too. It is therefore important to be familiar with the definitions and parameters found below.
CHATZI SHIUR – “THE BELOW THE THRESHOLD” PROHIBITION
There are actually two different prohibitions that are violated when a regular person eats on Yom Kippur. The less commonly known prohibition is called “below the threshold prohibition” or the “Chatzi shiur prohibition.” Although this prohibition is a Torah one, it does not invoke the serious punishment of Karais. It is also set aside whenever there is anyone who is dangerously ill.
But what about the regular “above-the-food-threshold” prohibition? May a dangerously ill person violate this regular prohibition if he can be eating “below the threshold?” Although this issue is actually a debate , the consensus of opinion is that if it is completely feasible from a medical perspective, such a person should just eat and drink “below the threshold.”
PARAMETERS OF “BELOW THE THRESHOLD”
What are the parameters of “below the threshold?” The parameters involve both time and food amounts. The “food amounts” are volume measures – not weight measures. And guess what? Food and drink are different – very different.
The food measurement is a constant –two thirds of a medium egg (see SA OC 618:7) – understood as one fluid ounce. The liquid measure varies according to each person. If it is determined that the patient should be fasting on Yom Kippur, then if feasible, the maximum quantity of food that may be eaten at one eating session is one fluid ounce – or 30 milliliters (ccs). It is a good idea to prepare these amounts in schnapps cups in advance. Proteins are of course more filling than starches.
The amount for liquids varies – depending upon the person’s individual cheek volume . Remember, it is not a mouthful, but rather a cheekful – one side of the mouth. For the average person one can figure 35 milliliters. For a small person it could be 30 milliliters.
All this refers to regular water. However, a few years before his passing (before Yom Kippur of 5769), Rav Elyashiv zatzal ruled that a person could actually use a different option – consuming water that has a Pagum (unnatural) taste that is not normally consumed because of its negative taste. The rationale for this ruling (based upon a Ramah) is that such drinking does not constitute a normal form of drinking and is thus only forbidden by Rabbinic ruling. The Rabbis, however, never made such enactments for people that are dangerously ill. More on this will follow in the next section.
There are some people who have some life-threatening illnesses that require the consumption of a very potent anti-biotic. These anti-biotics must be consumed with a significant amount of water. Because of this, the Pagum water suggestion of Rav Elyashiv zt”l would be the most appropriate approach to this dilemma.
But, what should be the recipe for such water? It should be distasteful enough that a normal person would not be drinking the water, yet not so distasteful as to cause the drinker to get sick or to violate the prohibition of bal teshaktzu – doing something disgusting.
One should always check with one’s doctor, but this author has experimented with various concoctions to create the Pagum-water. [Do not take the Pagum water if your doctor does not advise it for you.] The recipe that best fits the bill, in this author’s opinion, is a room temperature 16.9 ounce bottle of water, mixed with a half teaspoon of granulated onion powder and three shakes of salt. [The onion powder should first be dissolved in a small amount of hot water before Yom Kippur if possible. This will keep it as Pogum but will help reduce possible stomach unrest later.] If there is a negative reaction to the Pagum water, one can always go back to the “below the threshold” method.
Experiments conducted by this author have revealed the following revelation: The colder the water, the more onion powder and salt one can tolerate.
What is considered an eating or drinking session? Ideally, one should try to space them every nine minutes. The view of Rav Chaim Na-eh for food is 8 minutes (See Shiurei Torah 3:15). Rav Moshe Feinstein zt”l writes (Igros Moshe OC IV #41) that b’dieved – in a case of need, they should have a gap of 4 minutes between them. In regard to liquids one should shoot for a nine minute gap, but if not a four minute gap. If this is not possible, then, for liquids, one should try to fulfill the view of the Chasam Sofer (Responsa Volume VI #23) of a gap of at least two minutes. The timing is based on the concept of the eating of a Pras – four eggs. The Mishna Brurah writes 618:20 that the shiur for this is nine minutes. These are the main views.
As discussed earlier, it is this author’s opinion that the material under discussion should be more widespread and made more available to others. Whenever there is a doubt as to whether one is dangerously ill and there is no doctor or knowledgeable Rabbi that is present or available, one should , of course, feed the patient. We should all know the one ounce food figure and then a nine minute gap formula and the four minute gap if this is not possible. It may also be worthwhile to have pre-filled one ounce food containers available for emergency situations too.
May Hashem, the Healer of all illness, grant us all a year of health, parnasah and nachas from our families and ourselves.
The author may be reached at [email protected]
What follows is the original Hebrew of Rav Yitzchok Yosef’s ruling:
ראשית הנני להבהיר כי יש להקפיד על שמירת מרחק של כמה מטרים בין האחד לרעהו, לפתוח את כל החלונות בביהכ”נ, ולחבוש מסכה, או צעיף שיכסה את החוטם והפה.
תורתנו היא תורת חיים, ומצוה אותנו ונשמרתם מאד לנפשותיכם, ועוד אמרה התורה, וחי בהם, ודרשו חכמים בגמ’ יומא פה: ולא שימות בהם. ולכן פיקוח נפש דוחה את כל התורה כולה, חולה שיש בו סכנה אוכל ביום הכפורים, מחללים שבת על חולה שיש בו אפילו ספק סכנה. וכמו שכתב הרמב”ם (פרק ב מהלכות שבת הלכה ג) בזה הלשון: “ואסור להתמהמה בחילול שבת לחולה שיש בו סכנה, שנאמר ‘אשר יעשה אותם האדם וחי בהם ולא שימות בהם’.
וכבר כתבו התוס’ (ב”ק כג.) “יותר יש לאדם ליזהר עצמו שלא יזיק אחרים משלא יוזק”, ובודאי שבכלל האיסור להזיק את חבירו, גם החובה למנוע מצב העלול להדביק את חבירו במחלה ח”ו.
הגאון רבי עקיבא איגר זצ״ל פירסם קריאה בתקופה בה השתוללה הכולי-רע באירופה וכתב שם: “כבר הזהרתי פעמים הרבה אזהרה אחר אזהרה שיהיו הנהגתם… כפי אשר סידרו, ואשר שפטו הרופאים… ולא יעברו על דבריהם”.
▪ כל איש ואשה יתפללו בסמוך לביתם, עד אשר יעבור זעם וירחמו מן השמים.
▪ אפשר להצטרף ל”התרת נדרים” דרך טלפון ושאר אמצעים טכנלוגיים. וחולה שאינו יכול לשמוע התרת נדרים, יסמוך על מה שעשה התרת נדרים בשנה שעברה.
▪ נכון להמנע מטבילה במקוה בערב יוהכ”פ, אא”כ מקוה פרטי לחלוטין. הטבילה במקוה היא מנהג חשוב, אך אינה חיוב גמור מעיקר הדין [ע’ רא”ש סוף יומא], ובמקום ספק הידבקות יש לוותר על הטבילה גם למי שרגיל לטבול בכל יום.
▪ בתי כנסת גדולים לא יקיימו תפילות עם ציבור גדול ובצפיפות, אלא יחלקו את הצבור באופן שיעמוד בדרישות משרד הבריאות. יעשו וילון ניילון עבה, לחלק את המקום. ויפתחו את כל החלונות גם כשיש מזגן בביהכ”נ.
▪ יש לדאוג להצללה במניינים המתקיימים בחוץ.
▪ כאשר אין מספיק מקום לציבור גדול, הנשים תתפללנה בביתם, ובשנה זו ימעיטו מלהגיע לבתי הכנסת.
▪ אדם מבוגר או בעל מחלות רקע, עדיף שיתפלל במניינים המתקיימים בשטח פתוח.
▪ בכדי לא לשהות הרבה זמן עם ציבור יש לקצר במנגינות ובפיוטים, וידלגו על אמירת דברי התעוררות ומוסר כפי מה שרגילים בכל שנה.
▪ הנמצא בבידוד עקב כך שנחשף לחולה מאומת, אך אין לו תסמינים כלל, יצום כרגיל. וכן מי שהיה חולה בנגיף, והבריא, אף שהוא קצת חלש יצום כרגיל.
▪ הנמצא בבידוד ויש לו כאבי שרירים וקצת שיעול, יתחיל לצום, ויהיה עירני לעצמו, אם מרגיש חולשה יתירה וכאבי ראש, ישתה ביום ליטר מים לשיעורין כפי הדין. ואם הוא מעל לגיל 45, או שיש לו מחלות רקע, ומשתעל, או שיש לו כאבים בשרירים, יוסיף גם אכילה לשיעורין.
▪ הנמצא בבידוד ויש לו שיעול חזק ומשמעותי, או קשיי נשימה, לא יתחיל לצום כלל, אלא מיד בבוקר ישתה מים לשיעורין. ואם הוא מעל גיל 45 או עם מחלות רקע, אזי גם יאכל לשיעורין.
▪ מי שנדבק בנגיף, ויש לו רק תסמינים של איבוד ריח וטעם, יצום כרגיל.
▪ מי שנדבק בנגיף, ויש לו חום, חולשה משמעותית, שיעול, או כאבי פרקים, ונפל למשכב, או שיש לו קשיי נשימה, בזה יש חשש שמא יכבד עליו חוליו ויבוא לידי סכנה, כפי שקרה במקרים רבים, ולכן הוא פטור מלהתענות, אבל ישתה ויאכל לשיעורין, כפי המבואר ב”ילקוט יוסף”. בפרט אם הוא מעל גיל 45 או בעל מחלות רקע.
▪ מי שנדבק בנגיף ולאחר שלשה ימים כבר עבר החום ומרגיש כמעט כאחד האדם מלבד חולשה, יתענה כרגיל. ואין לזה קשר אם חזר לו חוש הריח וחוש הטעם או לא, שאין זה משנה לענין הצום, וכל מה שקובע זה החום, שיעול, ומה שנפל למשכב, או שסובל מקשיי נשימה. אך אם ירגיש גרוע ביותר במהלך הצום יאכל פחות מכשיעור.
בתפלה לבורא עולם שישלח רפואה שלימה לכל החולים, ויעצור המגפה והמשחית מעלינו ומעל כל ישראל, ומעל כל יושבי תבל, ונשמע בשורות טובות ישועות ונחמות, ונכתב ונחתם בספר החיים והשלום, ויקבל תפלותינו ברצון בגאולה השלימה בקרוב, אמן