*Editorial* **Looking at the Impact of COVID-19 on Religious Practice and the Impact of Religious Practice on COVID-19**

**Joel Zimbelman 1,\* and Andrew Flescher 2,3,4**


## **1. Religion and Health Care Policies in the Era of the Pandemic**

As this collection of essays on the manner in which religion and public health policy have impacted one another in the COVID-19 era goes to press, both the United States' Centers for Disease Control (CDC) and the United Nations' World Health Organization (WHO) have recently declared the end to the pandemic (CDC 2023b; UN 2023b; Williams 2023; Siddiqui et al. 2022). The easing of various legal and policy restrictions, disappearance of financial support initiatives, and dismantling of some infrastructures for the delivery and dissemination of tests, vaccines, and medications, as well as altered case reporting protocols, are significantly changing or ending in many countries. Still, COVID-19 cases, deaths, and costs continue to be a crushing burden in many global communities (Johns Hopkins Coronavirus Resource Center 2023; *Our World in Data* 2023; Harvard Global Health Institute 2023; Dartmouth College 2023; American Public Media 2023; UN 2023a; *New York Times* 2023; *Washington Post* 2023; *Towards Science Data* 2023; European Union 2023).

One of the great underreported stories of the global coronavirus tragedy was the way in which this public health crisis was, on the one hand, uniquely experienced by specific religious and culturally distinct communities, and, on the other, how the responses of these communities either contributed to or exacerbated the public health challenges and muted successes in battling the pandemic. Even a cursory review of most documented timelines of the pandemic reveals the extent to which religion was not initially considered an important variable in appreciating how various publics perceived and reacted to COVID-19 (CDC 2023a; WHO 2023; Kantis et al. 2023). In 2020, the scholarly voices and media addressing these issues were few and far between, but wider interest and sustained coverage and analysis appeared shortly thereafter and has been increasing since early 2021 (Levin 2020; Hartford Institute for Religion Research 2021; Levin et al. 2022; Levin and Bradshaw 2022; Majumdar 2022; Witt-Swanson et al. 2023). A number of university-supported and statesponsored centers and institutes (some with religious affiliations) have established research agendas for conversations that address the intersectionality of religion and COVID-19 (Georgetown University 2023a, 2023b; Hartford Institute for Religion Research 2023; Pew Research Center 2023).

Each of the ten essays which appear here explores these concerns in a sustained and representative way. Together, they provide the first significant attempt to examine comparatively a sizeable complement of scholars willing to address both the experiences of particular religious communities and to interrogate those experiences from the perspective of the comparative and multi-disciplinary academic study of religion. The essays originate from disparate global regions and distinct religious communities, and include additional insights from the related fields of comparative religious ethics, public health, literature, sociology, history, and anthropology. We believe it is an important resource that will invite

**Citation:** Zimbelman, Joel, and Andrew Flescher. 2023. Looking at the Impact of COVID-19 on Religious Practice and the Impact of Religious Practice on COVID-19. *Religions* 14: 933. https://doi.org/10.3390/ rel14070933

Received: 2 June 2023 Accepted: 7 July 2023 Published: 19 July 2023

**Copyright:** © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

a larger and developing discussion of the experience most communities have been through since the end of 2019 coping with a pandemic which shook the stability and collective mental health of whole societies worldwide. Some of these essays emphasize the partisan and self-referential motivations of individuals in their faiths and communities, but they also bear witness to the common humanity, vulnerability, and aspirations for life and sense of purpose that bind us together. It is such shared experiences that makes challenges like the COVID-19 pandemic an opportunity for putting into collective practice the basic norms of justice, compassion, and human flourishing felt across particular communities.

There are two foundational claims that the selected essays within this collection reflect. The first is that attention should be given to the relationship that exists de facto between religious beliefs and practices and the lived experiences of those suffering the mental and physical health consequences of the COVID-19 pandemic. These connections fly under the radar and are often easy to miss, but our contention is that the modern human experience of COVID-19 cannot be fully appreciated without attention to these connections.

A second claim is that insights from the humanities and social sciences are indispensable to the project of analyzing and interpreting the full range of lived human experiences spiritual and psychological, social and communal, and political—that communities confront with challenges like COVID-19. There were missed opportunities in the first three years of the pandemic to fully appreciate the insights, challenges, and resources that religious communities would present as this catastrophe unfolded (Pankowski and Wytrychiewicz-Pankowska 2023). That failure diminished our appreciation of the complex ways that public health functions and of its dependence for success on broad community and culturally inflected collaboration (Volet et al. 2022).

The first issue that crowded out religious voices and the analytic and cautionary message of these disciplines was the declaration of an "emergency" and the positioning of the main players on the chess board for what was to come. As the pandemic broke in the first days of 2020, it was the concerns of politicians which seemed to surface first and which monopolized media coverage, though a broad consensus on policy responses appears to have held for several months across disparate politically defined communities in the US and elsewhere (Covid Crisis Group 2023; Wallace-Wells 2023). At the same time, the WHO, CDC, the US Food and Drug Administration (FDA), the US Department of Health & Human Services (HHS), and the National Institute of Allergy and Infectious Diseases (NIAID), along with other national health agencies and state public health departments sought to orchestrate a narrow and crisis-informed public health response, slowing or stopping the spread of this unknown virus through continuing research and initiatives at various levels. While lip service was paid to the importance of pacing policy development in ways that would be acceptable to various parties and communities which might have a likelihood of achieving broad compliance, a technical public health focus tended to dominate initial policy efforts. Vaccine research and design, production, and phased drug trials moved to center stage in the first five months as a long-term response and as "our best hope" to addressing the acute crisis. Press conferences, evening news reports, and data management and dissemination coalesced around these same priorities, with less attention initially given to psycho-social concerns, distinct issues experienced locally by various communities, socio-economic challenges, and the demands of distributive justice.

The second development that crowded out religious and community-based concerns was the speed and tenacity with which the conflict between public health imperatives and civil rights claims solidified as a polarized either/or proposition. A plethora of constituencies, largely driven by political or religious identities, took sides in that debate in short order. Forty years ago, it was HIV/AIDS, not COVID-19, that was the first major public health crisis to emerge in the era of modern civil rights. However, the velocity of spread of the COVID-19 pandemic particularly its initially elevated R0 (pronounced "R-naught"), as well as the fact that everyone, and not just a handful of narrow populations, was assaulted by indeterminate rates of morbidity and mortality arguably made the experience of COVID-19 more tangible, frightening, and pervasively disorienting to

a broader population of individuals (Eisenberg 2020). No one had the luxury of being spared in the second great pandemic of the contemporary era, as they had been in the first. Complicating matters was the final design and production of families of likely successful vaccines commencing very early in the process. Within a year of our discovery of the SARS-CoV-2 virus, debates about how to pay for and mobilize production of the vaccines which would counter it; who to prioritize for vaccination; how to assure just and efficacious distribution of vaccines; and how to address vaccine-refusal prevalent in several quarters of the globe all quickly surfaced among the major concerns of many of the players just identified. Meanwhile, rarely at this stage of policy formation, which included bickering among agencies and government entities, did one hear of substantive consultation with local faith or ethnic communities. Largely absent as well were community-led discussions and debates (as opposed to insular sectarian pronouncements) that might have informed vaccination priorities in those settings.

These developments meant that little public attention was paid to the fact that all human beings live in and have their identities and moral visions largely shaped by the religious and social communities of which they are a part. The trenchant research and observations of scholars such as Robert Wuthnow and Nancy Ammerman have helped us to appreciate the unassailable power that religious identity has on worldview as well as on the mundane, everyday practices of human life (Wuthnow 2022; Ammerman 2021; Wuthnow 2010). In other words, the discussions, debates, sermons, teachings, rituals, and evolving practices of thousands of these different religious communities inevitably informed billions of people's attitudes, dispositions, and responses to the pandemic in ways that were subtle yet profoundly significant. This lack of engagement meant that many developing and essential viewpoints informing policy were lost on the policymakers. Sometimes these religious attitudes diverged from the secular public health narratives and prescriptions (Martens and Rutjens 2022; Bartkowski et al. 2023). However, additional analysis reveals that the preponderance of religious communities and their leadership embraced positions that in significant ways dovetailed with, and even reinforced, evolving and "best-practice" public health policies (Idler et al. 2022; Nortey 2022). Indeed, studies seeking to determine the factors informing variations in morbidity and mortality across communities in the first year of the pandemic noted that religious belief was not a statistically significant factor in accounting for such differences (Chang et al. 2022). The failure to focus adequate attention on the religious beliefs and practices of various communities meant that public health professionals, the general public, and the mainstream media were blind to important insights into specific motivations and behaviors of their constituencies. They missed nurturing partnerships with particular communities for successful public education (Majumdar 2022). They failed to ameliorate suspicion and anxiety about both the pandemic itself and the efficacy of vaccination (and testing, masking, distancing, quarantine, and treatment) (Sisti et al. 2023). And so, over a period of two to three years, they tended to solidify policies that at times reinforced, but could also be antagonistic toward, the realities on the ground.

Web-based data resources and various well-regarded publications have estimated the numbers of excess deaths that occurred during the pandemic as one statistically significant proxy for its virulence and toll (Woolf et al. 2020; *Economist* 2021, 2023; COVID-19 Excess Mortality Collaborators 2022; Stoto and Wynia 2020). Certainly, better public policy and more focused and targeted vaccine access could have significantly reduced those numbers. However, our most basic contention is that the pain of the pandemic in its first three years, its morbidity and mortality rates but other dimensions as well, was exacerbated by the disconnect between the public health, national political, and broad media discourse on the one hand, and the rich reflections and insights of various religious communities that span the globe, on the other.

It is not too late to engage both the pandemic perspectives and biases of religious communities as a way to ameliorate our current situation. Unlike the pestilence gripping Camus' Oran, it is unlikely that our virus will just exit the city and dissolve into the sea, or that the populations most impacted by COVID-19 will hit a magical "herd immunity" status that confers significant protection against infection. Best current estimates reflect that someone still dies from COVID-19 every four minutes, even after the infection has claimed over 20 million lives globally (Cortez 2023). Health precautions and testing, vaccines and boosters, medications, and altered social arrangements will be with us for years to come. In such a situation, we will have to better account for how religious people and communities engage and think about health care crises; how radically divergent their ideas can be; how they still retain or have abandoned respect for public health and political institutions; how best to engage the most eloquent and compelling voices from within these communities to further discussion and debate; and how the discipline of the academic study of religion, and cognate fields, can help to frame our analysis. These will each be important tasks to take on in the coming years. In the same way that emerging moral dilemmas in a health care context reinvigorated the disciplines of religious studies and philosophy fifty years ago, COVID-19 may provide scholars in various fields, including potentially all of the humanities and social sciences, an opportunity to be part of larger and more vigorous policy conversations.

The challenge we face can be framed in more practical terms. A crucial component of claiming to deal successfully with a challenge like COVID-19 must be the establishment of effective health care policy. Even now, policy making in this context continues to be somewhat inchoate, inconsistent, weak on benchmarking, and short of sufficiently effective outcomes. We anticipate that a series of detailed monographs and comprehensive reports in the coming years will be used to conduct an analytic and exhaustive post-mortem on our global response to the pandemic. It will acknowledge some of our imaginative decisions and at the same time excoriate us for our blind spots, mixed allegiances, and selfishness. Most importantly, it will situate this acute health care crisis in the context of larger and growing concerns of global sustainability and interdependence (Ebi et al. 2020). Along with a few other works starting to appear (Covid Crisis Group 2023; Blumcczynski and Wilson 2023), our collection of essays will hopefully arm us with resources and deeper understandings of our human capacity to fight the next battle better on behalf of its victims—a population that ironically is so often left out of these debates.

#### **2. Our Contributing Authors**

One of the things which becomes immediately clear in looking at this collection of essays in their entirety is the extent to which they balance one another. The reader will encounter just as many examples of religion and the appeal to the resources within religious communities serving to alleviate the major health stresses and burdens precipitated by the pandemic as ones in which the influence of religion has stood as an impediment to achieving desired health outcomes. In the majority of cases, this balance is reflected within the essay itself. Indeed, it was not lost on our authors that religion turns out more often than not to be a double-edged sword, both an extra demand in encountering, and a surprising remedy in service of managing, the global pandemic challenge. We believe that both the breadth and diversity of the religious traditions reflected here as well as the various ways, politically speaking, that these traditions have been interpreted by their authors establishes this collection as a distinctive and compelling voice in emerging critical analyses and conversations. These essays serve as welcome occasions to appreciate how ubiquitous crises like the COVID-19 pandemic and other healthcare challenges should be appreciated and interpreted when the perspectives of various religious traditions and the transdisciplinary scholarly tools developed in the humanities and social sciences are embraced. In this world, it is rarely up to governmental entities alone, at their worst perceived as external Leviathans, to choose what people care about the most. It is our hope that in this respect these essays confront the reader as a welcome reality check.

Julia Brown interrogates the role that religion has played in communal identity-making during the pandemic in the United States, an identity-making, she argues, which in some cases has stymied public health efforts to stop, or at least significantly slow, the spread of COVID-19. Drawing from Gabriel Garcia Marquez's *Love in the Time of Cholera* as a historical case study, Brown uses Garcia Marquez's depiction of religion's identity-making power during the cholera pandemic depicted in his novel as a comparison by which to understand the reported experiences of white evangelical Christians in America. Among other things, Brown asks us to evaluate whether religion itself is inimical to public health objectives, or whether such a claim is perhaps too simplified.

Donald Heinz, likewise, takes up the directed responses of conservative religious expression which has often appeared in the form of right-wing political activism and individualism in the face of government regulation during health crises, straining, despite the temptation in his treatment to herald the virtues of compassionate legislation usually associated with leftist religious expression, to adopt the perspective of some of the biggest critics of public health efforts throughout the pandemic. Thus, he manages to do justice to the perspective of both the ideological right and left within a religious context and provide a useful overview of the American political landscape of the last three years, contributing a much-needed analysis rooted in sociological methods that inform a discussion about how COVID-19 has impacted religion and religious expression, and vice versa.

Andrew Lustig, in keeping with the caution not to be too quick to embrace convenient either/or constructions often imposed on secular versus sectarian responses to public health crises, addresses the Catholic perspective on health and health care that has crucially informed the language of both duties and rights of caretakers and sufferers during the COVID-19 era. Working from the body of knowledge comprising "Catholic Social Teaching" (CST), Lustig interprets the obligation of "good stewardship" to entail both individual health needs, which includes being sufficiently health-literate and informed, as well the flourishing of others. Among other insights, Lustig argues that if Catholic rights language is meaningful at all, then the implications of the Catholic case for expanding public health are decisively reformist and impactful on global health policy in their own right.

Efstathios Kessareas, assessing the Greek Orthodox tradition, takes a close look at the controversy surrounding the distribution of Holy Communion that surfaced during the COVID-19 pandemic, arguing that there is more than one way to assess the compatibility of taking the Eucharist with mitigation measures issued in response to the spread of SARS-CoV-2. He maintains that not only is the Church's Holy Communion controversy reflective of a familiar tension between religious and secular voices in the Greek Orthodoxy concerning what should have the most influence over daily ritual and practice during periods of societal upheaval, but also that religious norms are baked into the modern secular socio-political order itself.

Andrew Flescher addresses the applicability of religious exemptions to public health policies such as vaccine mandates, acknowledging the legitimacy of the category of such exemptions while arguing for the absence of any coherent basis for their invocation in resisting mandated workplace COVID-19 vaccines on traditionally accepted grounds of "sincerely held beliefs". Flescher argues that in the name of the principle of autonomy, or "medical freedom", those seeking exemptions to state issued health requirements in effect seek a "blank check" whereby they hope to become the sole determiners of the authority of their personal beliefs within the state. Flescher looks at recent Supreme Court cases in which this issue is currently being adjudicated, noting a recent trend whereby the system of checks and balances which had governed where the public good is supposed to give way to individual liberties (and vice versa) can no longer to be taken for granted. He observes that a consequence of how the authority of personally held beliefs is now being interpreted is that contested political position becomes deliberately disguised as a protected religious value, an outcome neither in the interests of those who care about public health outcomes, nor in the interests of religious leaders who care about promoting public health.

Aaron Quinn, like Flescher, is focused on what makes faith-based exemption requests for health-protective mandates like vaccines legitimate, but in Quinn's case the analysis is confined to the epistemic grounds for religious authorization to begin with from which the moral authority of their invocation presumably follows. Quinn argues that not all kinds of beliefs are supported by equally legitimate justifications, and furthermore, that one indication that a belief can be epistemically sustained is its demonstrable appeal to cross-cultural consensus about agreed-on facts about the world, facts which, he argues, rest in shared human experiences affirmed by empirically verifiable evidence or reliable testimony. Quinn maintains that due to the private character of religious belief, not inherently universalizable, appeals to it will not be convincing, particularly when a population's health is at stake. Positions that stake out rights to opt out of mandates based on such appeals, consequently, are at some level arbitrary.

Mahan Mirza, probing causes for vaccine resistance among Nigerian Muslims, discerns two general categories of reasons for non-compliance: theologically based reasons and worldly ones pertaining to a lack of trust in public institutions. He then goes on to demonstrate, systematically, that the latter, not the former, is the likely dominant explanation for the seeming reluctance among some to succumb, within a Muslim setting, to scientific authority. Theologically, Islam has as many resources to recommend scientific advance as it does to cast doubts upon it, but these resources are likely to be overlooked without concurrently establishing grounds for having faith in representatives of the state. Mirza recommends engagement with religious norms, rather than their dismissal, as the most encouraging way forward with regard to efforts to address vaccine resistance among local actors, especially in communities in which religious authority is likely to influence health and health care policy.

Tim Davies, Kenneth Matengu, and Judith Hall tackle the multi-dimensional phenomenon of vaccine refusal in sub-Saharan Africa, a problem they demonstrate became exacerbated during the pandemic when Western actors, some with the best intentions and pushing for a "science-based" approach to health policy formation, neglected to adopt an inclusive approach to involving native religious establishments in health protective efforts. Davies, Matengu, and Hall argue that Western and other aid agencies seeking to promote vaccination programs need to act less like their colonizing predecessors, and more collaboratively, in order to develop a dialogue with powerful local agencies otherwise resistant to implementing often complex initiatives which utilize several stakeholders and partners. To this end, the authors encourage more attention to and emulation of the ancient African philosophical tradition of "Ubuntu", which recommends interdependence and mutual trust as opposed to top-down directive as a way of achieving practical health goals.

Radhika Patel and Daniel Veidlinger probe the efficacy of the postures, breathing control techniques, and meditative states of Hat.ha Yoga in promoting overall mental and physical health, asking whether this form of yoga could be effective in reducing serious illness during the COVID-19 pandemic. While exploring the considerable advantages of Hatha Yoga, they also take on a series of health-related counterclaims that ask whether its communal practice has the potential to create conditions that facilitate disease transmission due to heavy breathing in small, enclosed spaces. Thus, they seek comprehensively to work through an interesting tension within the religious practice that is their subject, weighing the health benefits of Hatha Yoga against concerns of engaging in it in the context of a health emergency known to be worsened by dense congregations of individuals in small spaces. Veidlinger and Patel conclude by introducing ways to resolve this tension, offering concrete recommendations for facilitating yoga practice in future pandemics.

Finally, Ellen Zhang looks at some of the unheralded advantages of the collectivist ethos intrinsic to the Confucian tradition for fighting a pandemic like COVID-19. To this end, she considers the normative justification for state intervention with respect to public health policies in the face of the health challenges precipitated by COVID-19 through the lens of Confucian paternalism. She distinguishes "Confucian exemplary paternalism" from the more criticized notions of paternalism understood in the West that are often used in contemporary political philosophy. Zhang argues that the former, "soft", notion of paternalism, and related paternalistic healthcare policies, are not only morally permissible, but also arguably preferable to, policies of thoroughgoing libertarianism in the face of a pandemic that threatens whole populations. Zhang's work, in essence, serves as a microcosm of the essays in this volume: Through an analysis of the collectivist norm of

an eastern tradition in comparison with prized notions of individualism often featured in the West, she provides a balanced account of where it might make sense in any society for individual liberties, under dire health circumstances, to give way to a state regulation for the larger good.

Over the last three years, mistakes—which cost lives—were made when authorities promoting science and sound health care policy sought to have their advice heeded in local settings without making the extra effort to translate their often opaque public health message into language that would have been understood and appreciated by their target populations. Into the fourth year of the pandemic, most of the analysis on COVID-19 is expressed in the categories and assumptions of secular agents and, by extension, at the expense of a serious consideration of religious voices and responses. The claim of many of the contributors to these ten essays is that the scope and vision of such exclusively secular assumptions need to be expanded, first, in order to honor a commitment to openness and inclusiveness, and, second, by such inclusion, in order to expand the resources available for coordinating and implementing more effective public health policy (Erduran et al. 2019).

This volume is in part an effort to reflect on the lessons learned from some of these missed opportunities, which, if heeded, might have led to better health outcomes for many communities. In keeping with this ambition, each of the ten essays included here reflects a particular narrative account of an interplay between a local community and the global world order in the context of an unprecedented health crisis from which almost no one on the planet was spared. Each seeks to arrive at practical solutions as we continue to grapple with the issues raised by the COVID-19 pandemic. Each seeks concretely to recommend a set of best practices which might constitute good guidance for the next healthcare crisis that we will inevitably face. We do not believe that we will be able to leverage the knowledge and wisdom we have gained in this fight without a renewed appreciation of the ways that religious voices and scholarly insights can be more respectfully engaged and more fully integrated into well-coordinated public responses. Listening, critiquing, and debating with intellectual and faith communities not traditionally at the table will offer a better opportunity to attain greater success in facing the inevitable global challenges ahead.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


Covid Crisis Group. 2023. *Lessons from the Covid War: An Investigative Report*. New York: PublicAffairs.

COVID-19 Excess Mortality Collaborators. 2022. Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020–2021. *The Lancet* 399: 1513–36. [CrossRef]

Dartmouth College. 2023. Dartmouth Atlas Project. Available online: https://www.dartmouthatlas.org (accessed on 15 May 2023).


*Washington Post*. 2023. Coronavirus. Available online: https://www.washingtonpost.com/coronavirus/ (accessed on 15 May 2023).


Wuthnow, Robert. 2022. *Religion's Power: What Makes It Work*. Oxford: Oxford University Press.

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