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Op-Ed: Coordinated City Attack Against Ancient Jewish Tradition

by Rabbi Levi Heber

New York City has once again launched a coordinated attack on the age-old practice of metzitzah b’peh (“mbp”)

First, the Department of Health and Mental Hygiene (“DOH”) issued a Health Alert touting a new case of Herpes Simplex Virus Type 1 (“HSV-1,” commonly known as cold sores) after a bris with mbp.  (HSV-1 is extremely prevalent and usually harmless in adults, but can be dangerous to newborns.)  Then the administration issued a series of statements to the media claiming that the Jewish community reneged on an agreement it made with the administration by not encouraging parents to come forward with the identities of mohelim associated with children infected with the virus.

Talk about fake news.

On the Health Alert at least, we’ve been here before.  Over 10 years ago, the DOH began issuing Health Alerts about mbp, repeating them over and over again.  In 2014 alone, measuring by sheer number of health alerts, mbp was a more serious health issue to the DOH than drugs and meningococcal disease, equal to West Nile virus and measles, and right behind ebola.

And every time, the alert said more or less the same thing:  factors consistent with transmission by mbp (timing and location of lesions, laboratory-confirmed HSV-1) indicated that mbp was the cause.  Of course, factors consistent with one mode of transmission (mbp) could be consistent with many others as well (such as handling by caregivers, a mode of transmission known in the medical literature).  But that was not to deter the DOH’s agenda, which they freely admitted as eliminating mbp.

As then, so now:  the latest alert says these factors “are consistent with transmission” by mbp.  And then it elevates consistency to actual cause, saying this is another case of “an entirely preventable cause of infection.”

We haven’t seen these Health Alerts for a couple of years.  Why?  One reason is because this theory of consistent factors showing causation by mbp is now known to be false.

In Rockland County, scientific testing was introduced 4 years ago to investigate cases of HSV-1 after mbp, using state-of-the-art DNA-sequencing to match the virus in the baby to the adult source.  In each case where the investigations had conclusive results, the mohel was definitively found not to be the source of the virus, notwithstanding the presence of all of the similar factors NYC says prove causation (timing and location of lesions, laboratory-confirmed HSV-1).

Although the DOH’s Health Alert is simply wrong scientifically, one might think it is a benign mistake.  As a matter of public health policy, however, it is dangerous.  By focusing exclusively on the mohel, it misses other potential sources of infection.  Indeed, the results in Rockland County led the Health Department there to seek the real source of infection in those cases, something that NYC’s DOH myopic focus would certainly have missed.

This Health Alert is insidious in another ways as well.  It seeks to induce fear about mbp, claiming there were as many as 24 laboratory-confirmed cases of HSV infection reported to the DOH since 2000 following Jewish circumcision (out of the hundreds of HSV cases in NYC).  It doesn’t say which of the cases were not HSV-1 (such as HSV-2, which is totally unrelated to mbp) or how many of these Jewish circumcisions did not involve mbp (such as one caught on video showing the mohel using a tube).

One thing the DOH has said is that it estimates approximately 3,500 mbp circumcisions annually in NYC.  Over the same 17-year timeframe as the so-called 24 cases, that’s about 59,500 mbp circumcisions, meaning that these HSV-1 cases occur from all sources in less than one-half of 1/10th of 1 percent of all mbp circumcisions.  And that’s the high end of the estimate.  On the other hand, since Rockland County instituted DNA-based mbp investigations, 100% of conclusive investigations proved that the mohel was clearly not the source of the virus.

The Health Alert might have been dismissed, but it was accompanied by an onslaught in the media which also reported that the City said it did not know the identity of 4 mohelim in the last 6 cases over the past 3 years.  Somehow this showed that the community, by not identifying the mohelim, reneged on an agreement reached with the City in February of 2015 that was made in exchange for the City rescinding the anti-mbp regulation passed by the previous Bloomberg administration.

Now we’re in the realm of alternative facts.

True, there was an agreement reached between representatives of the community and City Hall that provided the community would cooperate in DNA-testing, as was done in Rockland County, with respect to future cases of neonatal HSV-1 infection after mbp circumcisions in NYC. But the DOH soon thereafter refused to commit to the agreement’s terms, so the agreement fell apart almost immediately and DNA-testing in NYC was never done.  Several attempts were made to revive the agreement before the Board of Health met in September to rescind the mbp regulation, but to no avail.  City officials were well aware that the rescission of the regulation occurred while the agreement was set aside, due solely to the DOH’s rejection of its terms.

The DOH, not the community, broke the agreement.  And the regulation was rescinded after the agreement was broken, not before.

Yesterday, representatives of the community expressed to Mayor de Blasio that they remain committed to the agreement and all of its terms, including a ban of a mohel who is DNA-matched to an infected infant, if only the DOH would do so as well.

This doesn’t mean the community should be complacent about HSV-1, which can be life-threatening for newborns, although with early diagnosis and treatment the prognosis is greatly improved.  Because of this, community representatives in conjunction with infectious disease experts, the Rockland County Department of Health, mohelim and Rabbinic advisors put together a comprehensive pamphlet of best practices, entitled Infection Control Guidelines for a Bris, detailing how to minimize the risk of infection.  This pamphlet, first printed and distributed in 2015, contains separate sections for mohelim, parents and other caregivers, and convalescent homes, and is endorsed by the Rabbinical Board of Vaad Mishmeres Habris.

9 Comments

  • 1. BH wrote:

    For Rabbi Levi Heber for clearly explaining what is really happening.

    There was a time in my life that I too thought that we may be a ‘backward’ community, and that the ‘Scientific’ world has it correct. But over the years I have seen more and more how there is a hate out there (by certain people) to the Torah way and to Frum Yidden, which blinds them from seeing the ‘scientific’ and ‘truth’ in situations.

    I have come to see more and more how Chazal were correct in their assessments on life, and I thank G- d every day for this.

    and although there are some who don’t like us…we must continue to love them as our Rabbeim taught us.

    Reply
    • 2. Milhouse wrote:

      Unfortunately in this case the hatred is not coming from outside the Torah community but from inside. There is one person who is called a rov beyisroel, and whose personal mesorah is from those poskim who allow metzitzoh to be done through a straw. That is very well; there are indeed great poskim who hold that way, and since this is how his rebbeim taught him he has the right to follow them. But that’s not enough for this individual; for years he been engaged in a jihad against those who pasken otherwise, with the objective of using the armed force of the government to make everyone follow his psak.

      Nor is this the first time he has sought to use government force to impose his psak on those who pasken differently. 40 years ago he testified in court to force a Jew to trim his beard, telling the judge under oath that the psak of the Tzemach Tzedek is irrelevant and should be ignored. Halocho says a person has the right to say “kim li” like the Tzemach Tzedek even though he’s in the minority, but this person went to court to deny that.

      He’s also the same person who more than 50 years ago led the whole frum world around by the nose, convincing everyone to rely on his so-called scientific knowledge to overturn centuries of unanimous mesorah, and incidentally sparking a machlokes with the Conservative movement, who ironically didn’t accept his chiddush and stuck with the mesorah.

  • 3. Moishe pipek wrote:

    There is no need to blame the health dept.If you have scientific prove that they are wrong show it to them or to other scientist If there is a problem the poskim should get together with the doctors and try solve it.

    Reply
    • 4. Milhouse wrote:

      The Health Dept is entirely to blame. First, they are the ones who broke the agreement, and are now telling everyone we broke it. Second, even if their numbers were right (which they’re not) the risk from mbp would be acceptable, in fact lower than many risks that we assume routinely.

      They insist that the risk must be reduced to zero, which is a standard not applied to any other risk. Essentially they are saying that milah has no value and no benefit, and therefore even the slightest risk is unacceptable. That is an attitude that can only be explained by a hostility to religion, which is why the appeals court ordered that Bloomberg’s regulation be evaluated under strict scrutiny.

  • 6. Thanks for the clear article wrote:

    Thanks for really spelling out clearly what is going on and the nasty motives and clear disdain our lovely politicians have for us “backwards” folk. I thought they work for us. Can’t stand that they have this attitude that they in fact own us and know what is best for us. This is a clear affront to our freedom.

    Reply
  • 8. Milhouse wrote:

    Let’s not forget that the reason the Board of Health rescinded the regulation was not because of the agreement, which they had already rejected, but because they were afraid they would lose in court, and they didn’t want the embarrassment of an official court decision effectively branding them antisemites. Rather than risk that they backed down. Evidently the risk to the poor little children was not as important to them as their own reputation, but they still think it should be more important than the Torah.

    Reply
  • 9. TY Rabbi Heber wrote:

    TY Rabbi Levi for much clarity here, well written and you can tell he understands the issues and I happened to know he has been in the forefront of this for a long time .

    Aside form that he is a nice guy with “nesias chein” as well and the son of my Rosh Yeshiva.

    MBA

    Reply

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