This qualitative explorative study sought to contribute to addressing the lack of evidence on experiences of local communities in coping with COVID-19 and related outbreak control measures, using the example of Orthodox Jewish communities in Antwerp.
We showed that government-issued COVID-19 control measures clearly had an impact on the distinctive communal life of religious minority communities in Belgium. Although it is difficult to isolate religious and cultural factors influencing people’s adherence with official pandemic control measures from broader socio-economic factors, our study reveals specific challenges faced by Orthodox Jewish communities. These challenges were mainly related to organizing religious life in a remote way, and the practice of ‘physical distancing’ in socially strongly connected communities. Our results also provide insights into how these particular communities coped with these challenges by being able to rapidly mobilize community resources which were partially pre-established before the pandemic hit, revealing their resilience.
The potential vulnerability of Orthodox Jewish communities to COVID-19 has been highlighted in several reports [13, 29, 30]. Especially the tightly-knit and strongly connected communities of Haredi Jews were believed to have been disproportionately affected by the pandemic in large urban areas of, for instance, New York and Israel [11, 13]. While we lack official epidemiological data on the impact of COVID-19 on the Antwerp Jewish communities, many respondents in our research did not feel that their communities had been disproportionately affected by the pandemic. These perceptions were also in accordance with several media reports stating that, in contrast with previous predictions, the Antwerp Jewish communities seemed to have rather successfully mitigated the potentially devastating impact of a first wave of infections [31]. The impact of COVID-19 on the physical health of Antwerp Orthodox Jews did not emerge as a prominent theme in our data. However, many respondents referred to the indirect effects of the pandemic on the social and religious lives of community members. Since Orthodox Jewish communities can be described in terms of a collective communal, familial, and socially connected culture that values interaction with other community members, public health measures rooted in the concept of ‘physical distancing’ might indeed be experienced as particularly stressful to their members [32].
Interviewees also provided us with some noteworthy elements that might constitute successful community responses against COVID-19. Firstly, respondents appealed to a feeling of internal solidarity which they felt added to the resilience of Jewish communities in coping with the current pandemic. This feeling was expressed in terms of being able to count on a broad social network providing them with material and mental support. While the close social connections within the Orthodox Jewish communities were previously identified as a potential risk factor for acquiring COVID-19, our study seems to suggest a possible protective effect. This confirms the findings from a recent study done among American Orthodox Jews showing that despite a high level of exposure to COVID-19, levels of stress and negative impact of the epidemic were generally low [30]. Besides an association with the positive effects of religious coping, the authors also referred to the possible benefits of a family- and community-centric culture that Orthodox Jews maintain. The combination of a strong sense of identity, an ethos of mutual help, and the feeling of belonging, have previously been described as buffers in reaching and maintaining good mental health in Orthodox Jewish communities [33]. Similar mechanisms might have been at play in the communities included in our study.
Consistent with previous research, our data show that even in the early phases of responding to a novel infectious disease outbreak, the rapid mobilization of community resources proved to be paramount to facilitate top-down-issued ‘one-size-fits-all’ control measures [34]. The tailoring of such measures to the needs of socio-culturally diverse sub-groups within communities, including addressing language barriers, is a particular expertise that local experts bring to the table. In addition, historically rooted issues of mistrust towards the government were found to have complicated the initial coverage and uptake of control measures in Orthodox Jewish communities. Nevertheless, our research also shows that in the context of an infectious disease outbreak such as COVID-19, this mistrust can be overcome by the involvement of appropriate and trustworthy mediators who bridge the trust and information gap between communities and (local) authorities. We identified community leaders who maintain various connections both within and outside the communities, such as Jewish family physicians and the CMT, as particularly important to act as a bridge between these two worlds. Their engagement contributes to an effective and community-adapted outbreak response by merging scientific knowledge and expertise from outside the community with ‘insider’ knowledge of local sensitivities. Especially the importance of engaging religious leaders in this process has already been clearly established in the literature on previous disease outbreaks [35]. For instance, experiences of the 2013–2016 Ebola outbreak in West Africa highlighted the need for engaging with local and religious leaders and trusted peers to create an environment of trust within the growing climate of suspicion and fear towards governments’ and international NGOs’ motives in the outbreak response [36]. Respondents in our research articulated an equally important role for Rabbis in facilitating the uptake of the government’s COVID-19 control measures. Rabbis did not only mitigate feelings of mistrust towards the government, they also made sure measures were articulated in a culturally appropriate way that had the potential to induce true behavior change. Notably, in some Orthodox Jewish cultures, the adoption of behavior that crosses traditional social or cultural boundaries might not be obtained without the blessing or advice of the Rabbis [19]. This was also reflected in the narratives presented here, stating that all communications sent out by community organizations on COVID-19 should be endorsed by the Rabbinate to increase their uptake.
However, our study also reveals that we still lack understanding of how to reach sustainable involvement of communities and their leaders in decision-making spaces of local governance structures. Such community participation might lead to better ways to capitalize on existing community expertise and resources during health emergencies to foster community-adapted approaches. Future research should therefore continue to focus on documenting best practices of effective community engagement that go beyond passive consultation and actively include community representation in all steps of the outbreak response cycle. A recently conducted evidence synthesis concluded that such knowledge gaps remain especially evident in high-income countries [35]. Yet, the potential benefits of a community-based approach are well-known and reiterated by this current research study. For instance, communicating in ways that are understandable, relatable, and tailored to people’s competencies to interpret them, was pointed out by community members themselves as essential elements of effective risk communication in their community. It is, however, important to note that communities that are not as strongly socially organized and connected as Orthodox Jewish communities, might not be able to come up with innovative systems to streamline such communication efforts themselves. Moreover, heterogeneity within religious groups further complicates effective communication within these communities and risks overlooking the needs of the most vulnerable community members. Describing the highly heterogeneous Jewish communities as a homogeneous ‘risk group’, risks overstating the importance of certain beliefs or practices which may be particular only to a specific group of community members within ‘the Jewish community’. Therefore, there remains a need to build partnerships that engage in a continuous dialogue with different community representatives and integrate a variety of local experiences into a constantly adapted and diversified response. Particular attention in this regard should be paid to engaging with minority populations, as their voices and needs are particularly at risk of otherwise being marginalized [37].
The findings of this study also point towards the risk of stigmatization that comes with the framing of public reporting on specific population groups. The possible negative consequences of such reports on the attitudes towards minority populations might bring to surface persistent and discriminating stereotypes [38]. Monitoring done by the Tel Aviv University showed an increase of 18% of anti-Semitic incidents since the start of the outbreak, and a study done among a non-probability sample of over 2,500 adults in the UK showed that almost 20% of participants believed to some degree in conspiracy theories around COVID-19 involving Jews [39–41]. One of the reasons why this stigmatization towards Jewish people in particular is surfacing during this pandemic, might be found in the (re)production of processes of ‘Othering’ [42]. By attributing undesirable or socially discredited behavior to an unknown or – in relation to prejudices and stereotypes – a historically familiar ‘other’, a false sense of assurance or safety might be maintained among the dominant group [43]. Yet during times of social crisis (i.e. in this case a pandemic), these processes can lead to discrimination and blame. To avert this and to mitigate the negative effects of stigmatization, there is a clear need for inclusive communication towards a broader audience.
Study limitations
There are several limitations to this study. Firstly, in order to perform a relatively rapid assessment to inform the outbreak response, we failed to explore more in-depth some complex issues related to the social and cultural factors behind specific narratives (e.g. reasons of mistrust towards the government). Secondly, there are limitations in terms of the sampling. We relied on a mix of purposive and convenience sampling, and the final sample may therefore not adequately reflect the heterogeneity of Orthodox Jewish communities residing in Antwerp. However, our aim was not to be representative of these entire communities, rather we sought to learn from the insights of respondents with different profiles and backgrounds, approaching interviewees as experts of their own experiences with the communities. Despite several efforts, we failed to include Orthodox Jewish women, which has led to a gender bias in our reporting. Reasons for this might be related to cultural sensitivities of having a male researcher, ‘outsider’ to the community, inviting Orthodox Jewish women for a private conversation. In addition, gender separation is generally more common in Orthodox Jewish communities to be in accordance with the Halacha, and clear gender roles might result in less participation of Orthodox Jewish women in community leadership positions [44]. Thirdly, there are limitations to the digital methods used for online data collection. This excluded the participation of people who do not have a sufficient level of digital literacy, or do not wish to use electronic devices for other reasons. Lastly, the researcher being perceived as an ‘outsider’ to the communities might have yielded sometimes socially desirable or otherwise unreliable answers. Yet, by triangulating the information obtained through different sources, we aimed to overcome some of these challenges.