All the actors wore clear face masks. That way, the audience could better see the actors’ expressions, which is “a pretty big deal in live theater,” said Jess Heuermann, who played Sister Mary Wilhelm in the show.

Theater companies and musical ensembles looking to resume live performances are coming up with creative ways to make sure the show goes on safely, particularly in states that ban venues from imposing vaccine or mask requirements.

In states without such bans, productions can require proof of vaccines for cast, crew, administrative staffers and audience members to protect against transmission of the virus that causes covid-19. That’s what all 41 Broadway theaters in New York City have done.

Other performers and venues are taking additional measures. The Chicago Symphony, for example, is for now limiting performances to 90 minutes or less, with no intermission. A Rock Hall, Maryland, venue left the first row of seats empty, in addition to requiring masks and proof of vaccination, for a recent musical performance.

But raising the curtain has been more of a struggle in states like Montana, Florida and Texas, where the politicization of public health measures has found its way inside theaters.

Florida and Montana ban state and local governments from requiring masks, but private businesses and entities are allowed to do so. Montana prohibits both private employers and government entities from “discrimination based on vaccine status.” Florida Gov. Ron DeSantis from requiring customers to show proof that they’d been vaccinated against covid. In October, Texas Gov. Greg Abbott from issuing covid vaccine mandates.

Nine states — Arizona, Arkansas, Georgia, Indiana, New Hampshire, North Dakota, Oklahoma, Tennessee and Utah — also have varied restrictions on requiring proof of vaccines.

Some big-name performers are canceling shows over vaccine or mask bans. Singer Michael Bublé, for example, canceled a September show in Austin because the University of Texas arena said it could not impose a vaccine requirement for audience members. University officials said they were confident in their health and safety protocols.

Country singer Travis Tritt took the opposite stance. He canceled a series of shows at venues with mask and vaccine mandates or “pushing testing protocols on my fans.”

Local troupes and performers who had been on a pandemic hiatus don’t have that luxury. They must work with — or around — their state’s rules if they want to work at all.

A survey by the advocacy group Americans for the Arts found 99% of nonprofit arts groups canceled events during the pandemic, amounting to 557 million lost ticketed admissions as of July.

Though some losses have been offset by federal aid, most arts groups and performers are reporting significant financial losses.

In Montana, the Missoula Community Theatre has reduced capacity and eliminated assigned seating, allowing patrons to be spaced apart while still sitting next to their “bubble” of friends and family for performances. Some people who had lowered their masks after taking their seats raised them up again after an announcement just before the performance began that it was required.

“People came to the theater tonight because they know the theater is trying to keep everyone safe,” said Paula Jones, a retired nurse in attendance.

But some theater operators seem anxious about scaring away potential patrons with such rules. For instance, the recently renovated Alberta Bair Theater in Billings, Montana, whose normal capacity is 1,376, recommends patrons wear masks but does not require it.

In Florida, nine theaters in Sarasota, along with others in Miami and Tampa, joined to create a uniform set of requirements for theatergoers meant to get around that state’s ban on vaccine mandates. Audience members must show proof of vaccination or proof of a negative covid test conducted less than 72 hours before any performance.

Some people have complained about the policy to the Florida Department of Health, which can impose a $5,000 daily fine for violators of the state’s vaccine passport ban. Department officials have not acted on those complaints, but one small Sarasota theater canceled a scheduled November show, saying it feared the owners of the small operation couldn’t afford any fines.

Theater owners are also finding that a small percentage of people will resist their mask mandates, even after multiple reminders. If they try to impose a covid safety measure that isn’t barred by state law, individuals opposed to the rules will ignore it.

“It’s like playing whack-a-mole,” said Rebecca Hopkins, managing director of the Florida Studio Theatre in Sarasota. “As soon as you walk away from some people, they pull their masks down. We’ve had to tell people that ‘We’ve asked you three times politely that we require masks and if you can’t comply, you’ll have to go.’”

In Utah, the 360 singers in the Tabernacle Choir at Temple Square in Salt Lake City are vaccinated, along with the orchestra and anybody else who enters the rehearsal and performance space. A handful of singers declined vaccinations and were put on leave, according to choir president Michael Leavitt, the former Republican governor of Utah and President George W. Bush’s Health and Human Services secretary.

Additionally, every choir member is tested for covid before each rehearsal and performance. Performers are instructed to stay home if experiencing possible covid symptoms, including sniffles. The choir did, however, drop a mask mandate for singers during rehearsals after complaints that voices were being muffled. Mask-wearing is still required when the choir is not singing.

Orchestra members have the option to take off their masks while performing if they feel a mask inhibits their performance.

Most important, Leavitt said, the choir, which still hasn’t scheduled its first performance before an audience, is prepared to pull back rehearsals and performances if things go wrong. It hasn’t set rules for audiences when performances begin. Some state lawmakers have proposed blocking vaccine mandates.

“I have used the analogy of walking into a newly frozen lake. Take one step at a time. Listen for cracking and if we don’t hear any, we’ll move forward. If we do, we’ll scamper back to shore,” Leavitt said.

Since covid, performance groups are relying increasingly on members with medical backgrounds to advise them how to perform safely. That person for the Atlanta Symphony Orchestra is Dr. Susan Ray, a hospital epidemiologist and a soprano with the orchestra’s chorus.

Orchestra members now wear masks for both rehearsals and concerts. The choir is masked for rehearsals and plans to be masked for its first concert with the symphony, in December. The newly appointed conductor, Nathalie Stutzmann, does not wear a mask so she can better communicate with orchestra members, but is tested daily for covid.

Ray is confident the orchestra is taking all the right steps to protect the choir audience, including a requirement that audience members show proof of vaccination or a negative covid test. “But I’m still nervous,” Ray said. “We have a lot of chorus members with gray hair, and not everyone is nice and thin.”

People 65 and older are among those more likely to experience serious medical issues from covid, and obesity increases the risk.

Researchers from the University of Colorado-Boulder and the University of Maryland that while masks reduce the flow of droplets for both singers and instrumentalists, the quality of the filtering material and fit are key components of effectiveness.

They also found that the longer that musicians play and sing together, the greater the risk. They recommend breaks after rehearsing or performing for 30 minutes indoors and 60 minutes outdoors. And they also suggest leaving several feet of distance between musical instrument players and singers to reduce “aerosol flow.”

“I want to acknowledge the courage of the music directors and the teachers to go ahead and follow our suggestions in the face of all of this adversity, fear and worry,” said Shelly Miller, co-author of the study and a professor of mechanical and environmental engineering at Colorado-Boulder.

that more than 15 minutes of exposure in an enclosed space with poor ventilation in which an infectious person is shouting, singing or exercising can increase the risk of transmitting the virus.

Some college students hoping to prepare for future employment in the arts worried that canceled classes and performances due to covid might limit their future opportunities.

Lauren Bergen, 22, a senior theater student at Wagner College in Staten Island, New York, was so worried that she took the 2020-21 academic year off because of “so much potential for things to go wrong.”

Now, she’s back acting in Wagner College theater productions, and the school is following the same safety protocols required for Broadway shows.

Bergen’s first fall semester show was “Small Mouth Sounds,” a play chosen, in part, because it required actors to be “mostly silent,” according to Felicia Ruff, a Wagner College theater professor.

“We’ve very strategic in selecting shows that can be done safely,” Ruff said.

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On one hand, the pandemic caused major health setbacks for non-covid patients who were forced to, or chose to, avoid tests and treatments for various illnesses. On the other hand, in cases in which no harm was done by delays or cancellations, medical experts can now reevaluate whether those procedures are truly necessary.

Numerous studies have shown that overtreatment causes unnecessary suffering and billions of dollars in unnecessary health care costs.

But never before, said researcher Allison Oakes, has there been such a large database to compare patients who received a particular test or treatment with those who did not.

Oakes was a principal author of an October in Health Affairs by the Research Consortium for Health Care Value Assessment. The paper noted that covid provided an important new measurement — examining outcomes for patients who received treatment before hospitals canceled care because of covid and those who had their care canceled.

Areas ripe for study, said Oakes: colonoscopies done on patients older than age 85; hemoglobin blood work for Type 2 diabetes patients; semi-elective surgeries, such as knee arthroscopy for articular cartilage surgery; and yearly dental X-rays. All were done less often because of covid, she said.

“There are two sides of the pie: low-value care and care that people get in trouble if they don’t get,” said Oakes, who expects researchers to take advantage of all the data provided from covid on “both types of care.”

One recent looked at Veterans Affairs patients who had elective surgeries canceled because of covid. The study found they were no more likely to visit hospital emergency departments than patients who had undergone those surgeries in 2018.

of Brigham and Women’s Hospital and Harvard Medical School said much testing and care was cut back by patients’ fears of contracting covid in a medical setting and because medical facilities and staffers were fighting just to keep up with covid cases.

“There are some procedures, tests, and exams that cannot be delayed in any situation,” Lyu said in an email. For example, she pointed to the screening, surveillance and treatment of cancer patients.

However, she said other tests and treatments can be delayed or canceled without negative effects. Lyu oversaw a of 2,000 physicians, with half the doctors saying the percentage of unnecessary medical care was higher than 20.6% and half saying it was lower.

Unnecessary treatment or overtreatment can result from several factors, the doctors in Lyu’s survey said. Concerns about malpractice lead doctors to test even for unlikely problems to avoid missing something, they said. Sometimes health providers have difficulty assessing patients’ prior medical records. Then there is the incentive for the health industry to boost revenue, sometimes to help pay for expensive testing equipment, the doctors said.

Leaps in technology are a major factor.

, a radiologist at Johns Hopkins Medicine in Baltimore, said a CT scan that provided 30 or 40 images when she began practicing in the 1990s now provides thousands of high-resolution images.

“We now see things that we would have never seen before, like a lesion that may never become a problem,” Wruble said.

Wruble said some patients still opt for aggressive medical treatment for things like that questionable lesion.

“Patients … often resist advice to ‘watch and wait’ and will demand surgery even when the operation itself comes with potentially dire consequences,” Wruble said. The consequences are not only higher costs but potentially years of physical discomfort and pain, along with diminished physical abilities, she said.

, dean and professor at the William F. Connell School of Nursing at Boston College, said covid provides not only opportunities to study unnecessary medical care, but also opportunities to examine areas of insufficient care. She cites a lack of mental health resources for covid patients suffering through difficult treatment and even facing death without friends or family.

“When we are thinking of new ways to treat, we all need to think about our fascination with surgery and invasive procedures and start thinking more holistically about health,” Gennaro said.

Covid’s upending of scheduled non-covid care hit hard in March and April last year, when the pandemic first began to overwhelm hospitals. Cancer surgery scheduled in April for Krista Petruzziello, for example, was postponed due to the focus on covid care.

Instead of surgery, the 49-year-old real estate agent from Lowell, Massachusetts, received hormonal treatment usually reserved for breast cancer patients with larger tumors.

“It was concerning for sure,” said Petruzziello. “Who knew a year ago how long it would be until surgery would be available for patients like me?”

It was only about six or seven weeks later when she had successful surgery to remove a tumor shrunken by the hormonal treatment. A recent follow-up scan found her clear of cancer, she said.

“Maybe there will be cases where the tumor disappears altogether [from hormonal treatment], allowing the surgery to be canceled,” Petruzziello said. “Wouldn’t that be a good thing?”

, an oncologist at Dana-Farber Cancer Institute in Boston who treated Petruzziello, said breast cancer surgery will remain a key component of treatment for the foreseeable future. But he said hormone treatment “before surgery” can shrink the tumor and “hopefully make for less extensive surgery.”

Covid, he said, forced health care providers to “think outside the box.”

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El , presidente del Departamento de Cardiología de la Clínica Billings de Montana, estaba confundido durante los primeros días de la pandemia. ¿Por qué la caída repentina de pacientes con ataques cardíacos? ¿Y por qué los que llegaban lo hacían después de horas de sentir los primeros dolores en el pecho?

Dos pacientes, que sufrieron un daño cardíaco mayor por retrasar la atención, ofrecieron las típicas respuestas. Uno dijo que tenía miedo de contraer covid si iba al hospital. El otro fue a la sala de emergencias por la mañana, pero se fue sin recibir atención porque había mucha gente. Regresó esa misma noche, cuando pensó que habría menos pacientes y menos riesgo de contraer covid.

“Para un paciente que está teniendo un ataque cardíaco, la primera hora se conoce como la hora dorada”, dijo Rah. Después de ese tiempo, aumenta la probabilidad de muerte o una reducción de por vida en las actividades y la salud, explicó.

El , vicepresidente ejecutivo y director clínico de SCL Health de Colorado y Montana, dijo que “está despierto a la noche” por retrasos en importantes pruebas médicas. “La gente pospone los exámenes de rutina de los senos y habrá algunos cánceres ocultos que no se identificarán, lo que podría retrasar la intervención”, explicó.

A Valin también le preocupa que los pacientes no busquen un tratamiento oportuno cuando padecen síntomas de apendicitis como dolor abdominal, fiebre y náuseas. Un apéndice reventado generalmente implica más riesgo y una semana de hospitalización, en lugar de un tratamiento de un día para quienes reciben atención inmediata, agregó.

La doctora Fola May, gastroenteróloga que también es directora de calidad e investigadora de equidad en salud en UCLA Health, se preocupa por las consecuencias de una caída del 80% al 90% en las colonoscopías realizadas por los médicos del sistema de salud durante los primeros meses de covid.

“De repente, estábamos minimizando las medidas de salud que suelen ser de alta prioridad, como tratar de prevenir enfermedades como el cáncer, por controlar la pandemia”, dijo May.

Además de exacerbar los problemas de salud existentes, la pandemia de covid también ha causado una serie de nuevos problemas médicos en los pacientes. La población estadounidense saldrá de la pandemia con los dientes desgastados por rechinar, problemas de espalda por encorvarse sobre escritorios improvisados en casa, y crisis de salud mental por una combinación de aislamiento y estar demasiado cerca de la familia.

La doctora , dentista de Chevy Chase, Maryland, dijo que los pacientes no discuten cuando les dice que han estado rechinando o apretando los dientes y que podrían requerir un tratamiento de conducto, un implante dental o un protector nocturno.

“Son personas atrapadas en casa todo el día, sintiéndose solas y con un poco de depresión. Todo inducido por el mundo en el que vivimos y todos los cambios en nuestras vidas”, expresó Markogiannakis.

Una de la American Dental Association halló que más del 70% de los dentistas miembros informaron un aumento en los pacientes que rechinaban o apretaban los dientes desde covid. Más del 60% reportó un aumento en otras afecciones relacionadas con el estrés, como dientes astillados y agrietados.

El doctor Gerard Mosby, pediatra de Detroit, Michigan, dijo que sus pacientes están sufriendo más estrés, depresión y aumento de peso que antes de la pandemia. Están confinados en sus casas y muchos viven en hogares multigeneracionales temporales, o han experimentado la enfermedad o muerte por covid entre miembros de sus familias.

“Dado que su posibilidad de salir es limitada, no pueden desahogarse con amigos u otros familiares. Además, la mayoría no tendrá acceso a servicios de salud mental para recibir consejería sobre el duelo”, dijo Mosby.

Nancy Karim, consejera profesional licenciada y terapeuta de arte de Bridgeport, Connecticut, dijo que, además de luchar contra el aislamiento, sus pacientes están estresados ​​por el contrario al vivir demasiado cerca de personas sin el beneficio de poder descansar del trabajo o la escuela.

Mientras tanto, Matthew Jones, optometrista que ejerce en Blytheville y Osceola, Arkansas, informa que también han empeorado las afecciones oculares, por ejemplo algunos pacientes dejaron de usar gotas para el glaucoma durante covid. También ve mucha más fatiga visual “porque la gente pasa mucho tiempo frente a la pantalla de una computadora” y recomienda a sus pacientes anteojos que filtren la luz azul.

La necesidad de sesiones de fisioterapia también están aumentando.

“Los pacientes que han pasado al trabajo remoto normalmente trabajan con configuraciones ergonómicas deficientes y están mucho tiempo sentados”, dijo Kaylee Smith, fundadora y presidenta de Smith Physical Therapy and Performance Studio en San Diego, California.

“Veo más dolor y lesiones relacionadas con una mala postura (como dolor de cuello, lumbalgia) y un aumento significativo de pacientes que llegan con caderas tensas por pasar más tiempo sentados”, dijo Smith en un correo electrónico.

Algunos consultorios informan que están llegando al número de pacientes pre covid, pero otros aún enfrentan resistencia.

“Aunque hemos visto una mejora en las últimas seis semanas, todavía no es significativa”, dijo Neville Gupta, de Gupta Gastro en Brooklyn y Far Rockaway, Nueva York. “Nuestros pacientes siguen evitando recibir la atención que necesitan, sin importar las precauciones de seguridad que se hayan adoptado”.

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Dr. , chair of the cardiology department at Montana’s Billings Clinic, was confused in the early days of the covid pandemic. Why the sudden drop in heart attack patients at the Billings Clinic? And why did some who did come arrive hours after first feeling chest pains?

Two patients, both of whom suffered greater heart damage by delaying care, provided what came to be typical answers. One said he was afraid of contracting covid by going to the hospital. The other patient went to the emergency room in the morning, left after finding it too crowded, and then returned that night when he figured there would be fewer patients — and a lower risk of catching covid.

“For a heart attack patient, the first hour is known as the golden hour,” Rah said. After that, the likelihood of death or a lifelong reduction in activities and health increases, he said.

, executive vice president and chief clinical officer at SCL Health of Colorado and Montana, said he is “kept awake at night” by delays in important medical tests. “People put off routine breast examinations, and there are going to be some cancers hiding that are not going to be identified, potentially delaying intervention,” he said.

Valin is also concerned that patients aren’t seeking timely treatment when suffering appendicitis symptoms like abdominal pain, fever and nausea. A burst appendix generally involves more risk and a week’s hospitalization, instead of one day of treatment for those who get care quickly, he said.

Dr. Fola May, a gastroenterologist who is also quality director and a health equity researcher at UCLA Health, worries about the consequences of an 80% to 90% drop in colonoscopies performed by the health system’s doctors during the first months of covid.

“All of a sudden we were downplaying health measures that are usually high-priority, such as trying to prevent diseases like cancer, to manage the pandemic,” May said.

Along with exacerbating existing health problems, the covid pandemic has also caused a host of new medical issues in patients. The American population will be coming out of the pandemic with teeth worn down from grinding, back problems from slouching at makeshift home-work stations and mental health problems from a combination of isolation and being too close to family.

, a dentist in Chevy Chase, Maryland, said patients don’t argue when she tells them they have been grinding or clenching their teeth and might require a root canal procedure, dental implant or night guard.

“These are people stuck at home all day and feeling lonely and feeling a little depression. It is induced by the world we live in and all the changes in our lives,” said Markogiannakis.

A recent American Dental Association survey that more than 70% of member dentists reported an increase in patients grinding or clenching their teeth since covid. More than 60% reported an increase in other stress-related conditions, such as chipped and cracked teeth.

, a Detroit pediatrician, finds his young patients are suffering more stress, depression and weight gain than before the pandemic. They are confined in their homes, and many are living in multigenerational homes or foster homes or have experienced covid illnesses or death among family members.

“Since their ability to get out is limited, they can’t vent to friends or other family members. Also, most will not have access to mental health for grief counseling,” Mosby said.

, a Bridgeport, Connecticut, licensed professional counselor and art therapist, said that, in addition to struggling with isolation, her patients are conversely stressed by living too closely with people without the benefit of breaks on work and school days.

Meanwhile, optometrist Matthew Jones, who practices in Blytheville and Osceola, Arkansas, reports worsening eye conditions for patients, some of whom stopped taking drops during covid for conditions like glaucoma. He’s also seeing much more eyestrain “because people are spending so much time in front of a computer screen” and recommends eyeglasses that filter out blue light to his patients.

Physical therapy needs are also on the rise.

“Patients that have transitioned to remote work are typically working with poor ergonomic set-ups and spending a lot more time sitting,” said Kaylee Smith, founder and president of Smith Physical Therapy and Performance Studio in San Diego.

“I am seeing more pain and injuries related to poor posture (i.e., neck pain, low back pain, etc.) and a significant increase in patients coming in with tight hips related to increased sitting time,” Smith said in an email.

Some providers report they are finally nearing pre-covid patient levels, but others still face covid resistance.

“Although we have seen an improvement over the past six weeks, it’s still not much,” said Neville Gupta of Gupta Gastro in Brooklyn and Far Rockaway, New York. “Our patients are still avoiding getting the care they need, no matter the safety precautions in place.”

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Garayoa, de 68 años, servía en la iglesia católica Little Flower de El Paso, y fue uno de los tres sacerdotes que vivía en la casa local de la Orden Católica de los Agustinos Recoletos que contrajo la enfermedad. Garayoa murió dos días antes del Día de Acción de Gracias.

Era consciente de los peligros de covid, pero no podía rechazar a un feligrés que buscaba consuelo y oraciones cuando esa persona o un ser querido luchaba contra la enfermedad, según contó la peluquera jubilada María Luisa Placencia, una de sus feligresas.

“Siempre que veía a alguien sufriendo o preocupado por un hijo o un padre, rezaba con ellos y mostraba compasión”, dijo Placencia.

La muerte de Garayoa subraya los riesgos personales que corren los líderes espirituales que confortan a los enfermos y a sus familias, dan la extremaunción o dirigen los funerales de las personas que han muerto de covid. Muchos de ellos también se enfrentan al reto de liderar a congregaciones divididas sobre la gravedad de la pandemia.

Atender a los enfermos o a los moribundos es una de las principales funciones de los líderes espirituales de todas las religiones. , teóloga en la Universidad de Duke, dijo que covid crea un sentimiento de obligación aún mayor para el clero, porque muchos pacientes están aislados de los miembros de la familia.

Las personas terminales suelen querer interactuar con Dios o arreglar las cosas, señaló Dunlap, y un miembro del clero “puede ayudar a facilitar eso”.

Esta labor espiritual es la clave del trabajo de los capellanes de los hospitales, pero puede exponerlos a la propagación de virus en el aire o, a veces, a través del tacto.

Jayne Barnes, capellán de la Clínica Billings de Montana, dijo que trata de evitar el contacto físico con los pacientes de coronavirus, pero puede ser difícil resistirse a un breve contacto, que a menudo es la mejor forma de transmitir compasión.

“Es casi un momento incómodo cuando ves a un paciente angustiado, y sabes que no debes cogerle la mano o darle un abrazo”, apuntó Barnes. “Pero eso no significa que no podamos estar ahí para ellos. Son personas que no pueden recibir visitas, y tienen muchas cosas que decir. A veces están enfadados con Dios, y me lo hacen saber. Estoy allí para escuchar”.

Sin embargo, hay veces, dijo Barnes, que la desesperación es tan profunda que no puede evitar “ponerte un guante y tomar la mano de un paciente”.

A Barnes le diagnosticaron covid cerca del Día de Acción de Gracias. Se ha recuperado y tiene una “mejor comprensión” de lo que los pacientes están soportando.

Tratar con tanto sufrimiento afecta incluso a los médicos y enfermeras más curtidos, comentó. El personal de la Clínica Billings quedó devastado cuando un médico muy querido murió de covid, y se unió en apoyo a una enfermera que estuvo gravemente enferma, pero se recuperó.

“No sólo cuidamos de los pacientes, también estamos ahí para el personal, y creo que hemos sido un activo importante”, dijo refiriéndose a los capellanes del hospital.

En Abington, Pennsylvania, el pastor Marshall Mitchell, de la Iglesia Bautista de Salem, explicó que parte de su deber espiritual es persuadir a su congregación y a la comunidad afroamericana, en general, de que tomen precauciones para evitar la enfermedad.

Por eso Mitchell permitió que los fotógrafos captaran el momento en que, en diciembre, recibió su primera dosis de la vacuna.

“Como pastor de una de las mayores iglesias de la región de Philadelphia, me corresponde demostrar los poderes tanto de la ciencia como de la fe”, dijo.

Mitchell aseguró que podría utilizar su credibilidad para convencer a otros afroamericanos, que se han visto desproporcionadamente afectados por covid, de que una vacuna puede salvar vidas. Muchos son .

La politización de las precauciones para evitar contagiarse el coronavirus, como las máscaras y el distanciamiento social, ha puesto a muchos pastores en una posición difícil.

Mitchell dijo que no tiene paciencia con las personas que se niegan a usar máscaras.

“Los mantengo muy lejos de mí”, añadió.

Jeff Wheeler, pastor principal de la Iglesia Central de Sioux Falls, en Dakota del Sur, dijo que su iglesia anima a llevar máscaras y que la mayoría de los feligreses lo hacen. Sin embargo, la tensión subyacente se refleja en su mensaje a los miembros en el sitio web de la iglesia:

“A medida que avanzamos, simplemente les pedimos que eviten avergonzar, juzgar o hacer comentarios críticos a quienes llevan o no llevan máscaras”.

El jeque Tarik Ata, que dirige la Fundación Islámica del Condado de Orange, en California, explica que el Corán pide a los musulmanes que tomen medidas para cuidar de su salud y que los congregantes cumplen, en gran medida, las directrices de covid.

“Por lo tanto, nuestros miembros no tienen ningún problema con el mandato de llevar máscara”, dijo.

Covid ha golpeado duramente a la población musulmana del condado de Orange, indicó Ata. La religión se ha convertido en una importante fuente de consuelo para los miembros que han perdido sus trabajos o se han enfermado.

“Nuestra fe dice que, por muy difícil que sea la situación, siempre tenemos acceso a Dios y así el futuro será mejor”, dijo Ata.

Adam Morris, rabino del Templo Micah de Denver, Colorado, contó que se reúne con enfermos de covid a través de internet. En los servicios funerarios, le preocupa que con la máscara puesta las personas no aprecien la preocupación y la compasión que siente por su situación.

Oficia los funerales junto a la tumba para un pequeño número de dolientes, pero exige que todos los participantes lleven máscara.

Musulmanes y judíos practicantes creen que es importante enterrar a las personas rápidamente después de su muerte, dijo Morris.

“Algunas tradiciones y rituales deben seguir adelante”, concluyó Morris, “con o sin covid”.

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Garayoa, 68, who served at El Paso’s Little Flower Catholic Church, was one of three priests living in the local home of the Roman Catholic Order of the Augustinian Recollects who contracted the disease. Garayoa died two days before Thanksgiving.

Garayoa was aware of the dangers of covid, but he could not refuse a congregant who sought comfort and prayers when that person or a loved one fought the disease, according to retired hairstylist Maria Luisa Placencia, one of the priest’s parishioners.

“He could not see someone suffering or worried about a child or a parent and not want to pray with them and show compassion,” Placencia said.

Garayoa’s death underscores the personal risks taken by spiritual leaders who comfort the sick and their families, give last rites or conduct funerals for people who have died of covid. Many also face challenges in leading congregations that are divided over the seriousness of the pandemic.

Ministering to the ill or dying is a major role of spiritual leaders in all religions. , a divinity professor at Duke University, said covid creates an even greater feeling of obligation for clergy, because many patients are isolated from family members, she said.

People near death often want to interact with God or make things right, Dunlap said, and a clergy member “can help facilitate that.”

Such spiritual work is key to the work of hospital chaplains, but it can expose them to virus being spread in the air or sometimes through touch. Jayne Barnes, a chaplain at the Billings Clinic in Montana, said she tries to avoid physical contact with covid patients, but it can be difficult to resist a brief touch, which is often the best way to convey compassion.

“It’s almost an awkward moment when you see a patient in distress, but you know you shouldn’t hold their hand or give them a hug,” Barnes said. “But that doesn’t mean that we can’t be there for them. These are people who cannot have visitors, and they have a lot they want to say. Sometimes they are angry with God, and they let me know about that. I’m there to listen.”

Still, there are times, Barnes said, that the despair is so profound she cannot help but “put on a glove and hold a patient’s hand.”

Barnes was diagnosed with covid near Thanksgiving. She has recovered and has a “better understanding” of what patients are enduring.

Dealing with so much suffering affects even the most hardened doctors and nurses, she said. Billings Clinic staffers were devastated when a beloved physician died of covid, and rallied behind a popular nurse who was seriously ill but recovered.

“We’re not only taking care of the patients; we are also there for the staff, and I think we have been an important asset,’’ she said of the hospital’s chaplains.

In Abington, Pennsylvania, Pastor Marshall Mitchell of Salem Baptist Church said he believes part of his spiritual duty is to persuade his congregation and the broader African American community to take precautions to avoid covid. That is why Mitchell allowed photographers to capture the moment in December when he received his first dose of a vaccine.

“As pastor of one of the largest churches in the Philadelphia region, it is incumbent on me to demonstrate the powers of both science and faith,” he said.

Mitchell said he might have credibility in convincing other African Americans, who have been disproportionately affected by covid, that a vaccine can save lives. Many are .

The politicization of covid precautions such as masks and social distancing has put many pastors in a difficult position.

Mitchell said he has no patience for people who refuse to wear masks.

“I keep them the hell away from me,” he said.

Jeff Wheeler, lead pastor of Central Church in Sioux Falls, South Dakota, said that his church encourages mask-wearing and that most congregants comply. However, the underlying tension is reflected in his message to members on the church’s website:

“As we move forward, we simply ask you to avoid shaming, judging or making critical comments to those wearing or not wearing masks,” it reads.

Sheikh Tarik Ata, who leads the Orange County Islamic Foundation in California, said that the Quran calls for Muslims to take actions to ensure their health and that congregants largely comply with covid guidelines

“So, our members don’t have a problem with mask mandates,” he said.

Covid has hit the Orange County Muslim population hard, Ata said. Religion has become an important source of comfort for members who have lost their jobs and struggled with illness or finding child care.

“Our faith says that no matter how difficult the situation, we always have access to God and the future will be better,” Ata said.

Adam Morris, the rabbi at Temple Micah in Denver, said he has turned to online video to meet with congregants sick with the coronavirus. When meeting with his congregation members in person, such as during graveside services, he worries that with his mask on people might miss seeing the concern and compassion he feels for their plight.

He conducts in-person graveside funerals for a small number of mourners but requires all participants to wear masks.

Observant Muslims and Jews believe it is important to bury the dead quickly after death, Morris said.

“Some traditions and rituals must go forward,” Morris said, “covid or not.”

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