Courage in the Crisis

CMDA and COVID-19

Care for the Frontline Healthcare Worker as the Coronavirus Progresses

Are you worried about spreading the disease to your family? Are you ramping up to fight the virus or being placed on standby because much of your work is elective or “noncritical?” Are you fearful for the future, whether your health, your finances or your job?

If you’re asking yourself these questions and more, remember that you are not alone! CMDA is here for you for such a time as this. As a ministry for Christians in healthcare, we stand ready to pray for you, to assist you in any way we can and to offer resources to help you sustain the onslaught of extra work.

We are going to be here with you every step of the way, so check back often for the latest information and resources to help you as you fight against COVID-19.

CMDA update on COVID-19 Vaccines as of November 16, 2020:

Operation Warp Speed  (OWS) currently has eight vaccines within its portfolio:

  • Moderna's mRNA vaccine
  • Pfizer's mRNA vaccine
  • AstraZeneca's adenovirus vector vaccine
  • Janssen's adenovirus vector vaccine
  • Novavax's recombinant subunit vaccine
  • Sanofi's recombinant subunit vaccine
  • Inovio's DNA vaccine
  • Merck's recombinant vesicular virus vaccine

The vaccines from Moderna, Pfizer, AstraZeneca and Janssen (a subsidiary of Johnson & Johnson) are the only vaccines to have entered Phase 3 trials at this point. AstraZeneca and Janssen both paused their Phase 3 trials recently when severe side effects occurred in three different individuals. However, both companies resumed their Phase 3 testing on October 23 after confirming that none of the side effects were related to a vaccine. The Novavax, Sanofi and Inovio vaccines are currently in Phase 1/2 trials, while the Merck vaccine is still in preclinical testing.

 

Ethical Concerns

Unfortunately, research performed by The Charlotte Lozier Institute has confirmed that six of the OWS vaccines have used one of two different fetal cell lines derived from two separate decades-old abortions to assist in the development of these new vaccines. It is still unknown whether the two remaining companies, Sanofi and Merck, have used a fetal cell line because they have not published any information regarding their vaccines' development.

The two fetal cell lines are:

  1. HEK-293: A kidney cell line derived from a fetus aborted in 1973. Used by:
    1. Moderna
    2. Pfizer
    3. AstraZeneca
    4. Novavax
    5. Inovio
  1. C6: A cell line owned by Janssen developed from a fetus aborted in 1985. Used by:
    1. Janssen

 

It is important to note that fetal cell lines can be used in three different stages of vaccine development: design, confirmation and ongoing production. Many ethicists, including those at the Charlotte Lozier Institute, believe that using a fetal cell line for ongoing vaccine production is more ethically problematic than using a fetal cell line for design or confirmation. The design and confirmation steps use a limited number of fetal cells while the production stage is continuous.

 

Below is a chart that designates the known involvement of fetal cell lines in all eight vaccines:

 

If, as a CMDA member, you would like to advocate for the development of a COVID-19 vaccine that is free from any ethical concerns, you may do so at our Freedom2Care Action Center. It should take you less than 30 seconds.

 

Part of the mission of Christian Medical & Dental Associations (CMDA) is to glorify God by caring for all people and advancing Biblical principles of healthcare within the Church and throughout the world. With that in mind, CMDA has enlisted several expert members to provide guidance to church leaders as they wrestle with the problem of re-opening their services within the ongoing COVID-19 pandemic.

Statement of the Problem

Religious involvement correlates with the following health benefits through various pathways:

  1. Decreased overall mortality
  2. Improved outcomes with chronic conditions such as diabetes
  3. Increased ability to cope with stress
  4. Decreased depression, suicide, and anxiety
  5. Some evidence of decreased blood pressure
  6. This has been shown to be especially true for vulnerable sub-groups in the African American community

However, attendance at religious services has been labeled “high risk” for SARS-CoV-2/COVID-19 exposure due to “enclosed space, prolonged close contact, potential clustering of people, high-touch surfaces, singing, and projection of voice”. Thus, many congregations in the United States have gone through a period of not gathering in person because of state restrictions.  As the pandemic continues, churches have been placed in the unfortunate position of having to weigh the risks of reopening with the benefits of gathering in person amid conflicting interstate and intrastate guidelines.

Thus, the purpose of these guidelines is to provide evidence-based recommendations for Christian communities who wish to reopen safely. Though evidence-based, these guidelines are not intended to replace government ordinances or health regulations and should be considered in light of local guidance which accounts for the community prevalence of SARS-CoV-2/COVID-19 and available resources. 

Summary of Recommendations[1]:

Critical Question 1: How many people can safely gather in a given area for worship services?

Recommendation: The number of people that could gather safely for worship should be determined by the type of space (enclosed or open-air), size of meeting area, and safety measures enacted.  Such gatherings should avoid having a large number of participants, unmasked, in closer proximity than 6 feet between households for a prolonged period of time in an enclosed space without hand sanitizer or hygiene measures.

 

Critical Question 2: Is it safe to practice the sacrament of communion?

Recommendation: Communion can be safely done using single-serving, pre-packaged communion.

 

Critical Question 3: Is it safe to practice the sacrament of baptism?

Recommendation: Baptism may be safely done with clean water.  For serial baptisms in the same baptistry, the baptismal should be heated above 23oC and treated with chlorine to decrease the risk of transmission of SARS-CoV-2/COVID-19.  We recommend that the person performing the baptism wear a mask, practice hand hygiene prior to the baptism, and defer to someone else if he/she has any symptoms compatible with SARS-CoV-2/COVID-19 infection. 

 

Critical Question 4: Is it safe to have a choir performance/practice?

Recommendation: Choir practices or performances that have a large number of participants, unmasked, in close proximity to one another for a prolonged period of time in an enclosed space with shared food, commonly touched items, and non-socially distanced interactions before and after will increase the risk of transmitting SARS-CoV-2/COVID-19 infection if one of the participants is infected.  Therefore, choir rehearsals and performances should avoid these factors to decrease the risk of spreading SARS-CoV-2/COVID-19 infection.

Critical Question 5: When can congregational singing be done safely?

Recommendation: Alternatives to congregational singing likely have the least risk for SARS-CoV-2/COVID-19 transmission. With the uncertainty regarding congregational singing, we recommend thoughtful consideration of alternatives.  If congregational singing must be done due to specific faith convictions or practices, we recommend the following to decrease risk of SARS-CoV-2/COVID-19 transmission:

  • Singing outdoors rather than in an enclosed space when possible,
  • Maintaining a minimum distance of 6 feet between congregants, and
  • Wearing masks while singing, and
  • Singing in a quiet, subdued voice.

 

Critical Question 6: Is it safe to have wind, percussion, and/or string instrumental accompaniment in worship?

Recommendation: The use of instrumental accompaniment in worship does not appear to increase the risk of spreading SARS-CoV-2/COVID-19 infection when appropriate distancing and hygiene measures can be followed.

 

Critical Question 7: What general measures should be considered for all worship gatherings?

Recommendation: Social distance (minimum of 6 feet between households) at all times including during entry and exit, wearing of masks, availability of hand sanitizer, and frequent hand washing should be done. Consideration should be given to vulnerable populations in the congregation as defined by the CDC. We recommend that masks be worn continuously unless you become short of breath, and then they may be removed for a brief 30 second interval. If you experience continued shortness of breath with a mask, it would be best for you to get up and go outside.

Further guidance regarding children will be provided in the near future.

Guideline Committee

Timothy Jang, MD, Professor of Clinical Emergency Medicine, David Geffen School of Medicine at UCLA, Associate Editor, Academic Emergency Medicine

Kristen Ojo, MHS CPH, Co-leader, Side by Side Twin Cities Chapter, A Ministry of CMDA for Medical Wives

Ifelayo Ojo, MBBS, MPH, Assistant Professor of Pediatrics, University of Minnesota Medical School, Pediatrician, Hennepin Healthcare

Amenah A. Agunwamba, ScD, MPH, Assistant Professor of Health Services Research, Mayo Clinic, Department of Health Sciences Research

Jeffrey Barrows, DO, MA, Senior VP Bioethics and Public Policy, Christian Medical and Dental Associations

Secondary Reviewers

David Kim, MD, MBA, Chief Executive Officer, Beacon Christian Community Health Center, Staten Island, NY

Janet Kim, MD, MPH, FAAP, MA, Chief Medical Officer, Beacon Christian Community Health Center, Staten Island, NY

[1] For the evidence and strength of each recommendation, please see the attached addendum which includes a description of the literature search, assessment of the data, and further discussion.

DOWNLOAD FULL GUIDE

DOWNLOAD SPANISH VERSION

CMDA's Recommendation on Mass Gatherings:

Romans 13: 1, 2 gives clear guidance in times like these. “1Every person is to be in subjection to the governing authorities. For there is no authority except from God, and those which exist are established by God. 2Therefore whoever resists authority has opposed the ordinance of God; and they who have opposed will receive condemnation upon themselves. Christian Medical & Dental Associations endorses the efforts of state and federal government authorities to mitigate the spread of the coronavirus by limiting large gatherings. We believe that churches that ignore those instructions are placing their congregants at increased exposure and risk of SARS-Co-V-2 (Covid-19) infection and therefore we cannot condone such decisions or actions by churches.

RESOURCES & TOOLS

Articles and Personal Stories...

A Plea to Our Churches

By Jeffrey Barrows DO, MA (Bioethics) | November 19, 2020

Ethical Science at Warp Speed

By David Prentice, PhD | November 16, 2020

The Polarizing Pandemic

By Autumn Dawn Galbreath, MD, MBA | May 21, 2020

Lessons from the Epicenter

By Christian Medical & Dental Associations® | May 21, 2020

Thinking of Ultimate Things

By Amy Givler, MD | May 28, 2020

Responding to Anti-Christian Animus Revealed in the Pandemic

By Jonathan Imbody | June 4, 2020

Heroes, Wistfulness, Roles and Faithfulness

By Robert E. Cranston, MD, MA (Ethics) | June 11, 2020

Living with Uncertainty

By Tracy Liang | June 23, 2020

What if Christians Led the Way Out of This? – Redefining our Freedom According to the Cross

By Christian Medical & Dental Associations® | July 22, 2020

A Vaccine Trial is Not a Trial: What Participating Looks Like

By Amy Givler, MD | September 24, 2020

Overcoming the Bombardment of COVID-19

By Doug Lindberg, MD | October 22, 2020

Share Your Prayer Requests

By Christian Medical & Dental Associations® | March 26, 2020

Faith in Times of Uncertainty

By Sam Molind, DMD | May 19, 2020

A Touch of Compassion

By Jennifer Wade, DDS | May 5, 2020

In the Midst of Uncertainty

By Krystal Mattox, DDS | March 30, 2020

A Healthy Fear

By Al Weir, MD | April 7, 2020

A Guide in the Middle of COVID-19

By Autumn Dawn Galbreath, MD, MBA | March 19, 2020

Anxious? Me, Too. How To Lean On God When Feelings Don’t Cooperate

By Amy Givler, MD | March 26, 2020

CPR in the Times of COVID-19

By Christine C. Toevs, MD | April 7, 2020

Immunizing Conscience

By David Prentice, PhD | May 18, 2020

Coronavirus Response Reveals Character of Governments

By Jonathan Imbody | April 2, 2020

Keep FDA Safety Requirements and Nix Telemedicine Abortions

By Jonathan Imbody | April 30, 2020

COVID-19 Ramblings and Reflections

By Robert E. Cranston, MD, MA (Ethics) | April 9, 2020

Finding Precedent, Perspective and Our Place in the “Unprecedented”

By Christian Medical & Dental Associations® | May 14, 2020

Prayer for 2020 Montgomery County National Day of Prayer Breakfast – May 7, 2020

By Nicole D. Hayes | May 7, 2020

PRIVATE PRAYER REQUEST FORM

  • Private Prayer from your CMDA Famiy

    Share your prayer requests privately with CMDA staff. These requests will only be shared within the CMDA staff and will not be made public.