Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

COVID-19: Study of Orthodox Community Suggests Transmission of SARS-CoV-2 Occurred Far Earlier Than Previously Recognized

MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Jonathan Silverberg, MD, PHD, MPH
Associate Professor
Director of Clinical Research
Director of Patch Testing
George Washington University School of Medicine and Health Sciences
Washington, DC

MedicalResearch.com: What is the background for this study?

Response: The COVID pandemic hit the Orthodox Jewish community in the United States particularly hard, especially in the early days when much was unknown. At that time of great loss, Jewish communities around the United States rallied to help the millions of other people impacted by the pandemic.

A partnership was established of local community organizations across 5 states with premier academic universities across the United States and Canada. Over a 10 day period in May 2020, more than 6500 people came out to participate in the The Multi-Institutional Study Analyzing anti-CoV-2 Antibodies (MITZVA) cohort. Participants completed surveys and donated blood in order to become potential convalescent plasma donors and help learn more about the science of COVID.

MedicalResearch.com: What are the main findings?

Response: A near simultaneous surge in COVID-19 symptoms and concomitant seroprevalence occurred in a large percentage of geographically distinct yet culturally-bound religious communities, in this particular instance among Orthodox Jews. This surge corresponded to social events surrounding the festival of Purim, prior to widespread recognition of epidemic mitigation strategies. This finding has potential ramifications for other communicable diseases as well owing to close-knit nature and cultural bonding of these communities.

Interestingly, multiple SARS-CoV-2 cases were identified with much earlier than anticipated dates of symptom onset, including December 2019 and early January 2020. These cases appear to have preceded the first reported case of SARS-CoV-2 in the US on January 20, 2020. These results suggest that community transmission of SARS-CoV-2 occurred far earlier than previously recognized.

MedicalResearch.com: What should readers take away from your report?

Response: Given the interconnection of this sociocultural community across multiple US cities and states, local restrictions at a city or state level may not be able to address the interconnection of culturally bound communities across the US. On the other hand, one-size fits all national guidelines do not address individual risk factors for spread of communicable diseases within these communities. A partnership is required of public health officials with community leadership and clergy to achieve optimal and culturally-sensitive guidance that will effectively and respectfully mitigate risk of disease transmission.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: The MITZVA cohort has led to remarkably successful academic collaborations with many ongoing cutting edge research studies.


Zyskind I, Rosenberg AZ, Zimmerman J, et al. SARS-CoV-2 Seroprevalence and Symptom Onset in Culturally Linked Orthodox Jewish Communities Across Multiple Regions in the United States. JAMA Netw Open. 2021;4(3):e212816. doi:10.1001/jamanetworkopen.2021.2816 

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Last Updated on March 11, 2021 by Marie Benz MD FAAD