Social Distancing, Public Health, and the Bible

Leprosy lesion on chest

Social distancing is an important public health measure to slow or stop the spread of many diseases. God’s instructions to the Hebrews in the Bible were primarily for holiness, but also had important health benefits.

By Mark D. Harris

I was at the auto parts store last week buying brake pads to replace the old ones in my daughter’s Prius. An elderly woman walked in, donning a mask and gloves, and carefully staying at least six feet away from others. When a clerk approached her and when other customers walked by, she retreated. I walked the long way down a separate aisle to get around her, trying to provide the space that she needed. Given her increased level of risk, and the fact that she didn’t seem grumpy, I appreciated her caution.

Social distancing, putting space between people who may infect each other with a disease, is the major way that individuals and governments throughout the world are trying to deal with the COVID-19 pandemic. It has worked many times in history, such as in the Spanish Flu pandemic of 1918, a far deadlier disaster than the current plague. The nation, and indeed much of the world, has been staying at home, or at least away from others, for over six weeks. Public health experts have used many other interventions for infection control as well. This article will discuss social distancing and other public health actions against infectious disease.

Social distancing for a respiratory illness such as the pneumonic plague, influenza, or COVID-19, involves wearing masks, staying six feet away from others, and isolating oneself at home. It also involves handwashing and avoiding bodily excretions like sputum. Prevention of non-respiratory diseases (like hepatitis or ebola) involves contact precautions such as masks, handwashing, and avoiding bodily excretions like sputum, blood, stool, and pus. This article will combine both.

The Old Testament

In the late Bronze Age (1400-1200 BC), around the time of the Law of Moses, people knew little about infectious diseases. No one understood bacteria, much less viruses, nor did they have a grasp of the human immune system, physiology, or most of medical science. They did know, however, that God commanded certain practices to ensure the holiness of the Hebrew people. What they did not know was that these practices would have the side effect of improving their health. God’s blessings would come primarily through ordinary means, and obeying God’s law was in their best interest (Deuteronomy 7:12-16). One of those practices was social distancing.

Leviticus 13 and 14 discuss how to handle people with “tsara`ath”, translated “leprosy” by the KJV and most modern translations. The modern disease of leprosy, also known as Hanson’s Disease, is caused by mycobacterium leprae, and the earliest convincing reference comes from India around 600 BC. The oldest skeletal remains of a patient with leprosy date from 2000 BC, also in India.[1] Leprosy was probably not present in the ancient Middle East until about 300 BC, with sources suggesting that Alexander’s Macedonians brought it back from India.[2] The biblical term “tsara`ath” probably encompassed a host of skin diseases including fungal infections (tinea), bacterial infections, vitiligo, multiple dermatitis conditions, and psoriasis. Moses (Exodus 4:6) and Miriam (Numbers 12:10-15) both had leprosy, but God healed them. David cursed Joab’s house with leprosy (2 Samuel 3:28-29). Four leprous men living outside of Samaria found the camp of the besieging Arameans deserted (2 Kings 7:3-14).

Naaman’s “leprosy” may have been scabies, and Elisha practiced social distancing by not going to meet him (2 Kings 5:1-10). Naaman was furious at what he perceived as a slight to his honor, and the fact that Elisha did not do what Naaman expected. Though he did not want to bathe in the dirty Jordan, Naaman may have been cured by the unique characteristics of that river. The Jordan River’s fast flow would wash away some of the mites in the fast water and its high sulfur content would kill the mites that remained on him (2 Kings 5:11-14).[3] While Naaman bathed, a servant probably washed his clothes, and between baths Naaman probably rested nude in the hot sun. Scabies can only live in clothes for up to 72 hours, so the mites would have been dead when he returned home. A diagnosis of scabies would be consistent with the fact that Elisha’s servant Gehazi contracted the disease when he took (and presumably wore) Naaman’s clothes (2 Kings 5:20-27). If this explanation is true, it is no less a miracle and no less an act of God. God is the only source of healing (Exodus 15:26, Psalms 103:3).

A man with a skin condition would present to the priest.[4] After several days of repeated exams, and while staying away from the community, if the condition continued to worsen and developed certain characteristics, the priest would diagnose chronic leprosy and declare the patient “unclean.” The patient was required to move outside the camp and live alone or with other lepers, as long as he was infected (13:45-46). It could be all his days, as it was for King Uzziah of Judah (2 Kings 15:5, 2 Chronicles 26).

Leviticus 15 provides rules on how to handle various body fluids such as blood, semen, sputum, or pus. A menstruating woman would be unclean for seven days and would have to purify herself with water at the end. Someone who touched her would be unclean until evening, but a man who had sex with her would be unclean for seven days as well. Anything she touched during this period would be unclean, whether bed, clothes, chairs, or pots. Customs of uncleanness around menses are common in cultures throughout the world and predate the Mosaic Law. Rachel’s menstrual uncleanness is probably why Laban did not search under where she was sitting for his household idols (Genesis 31:30-35).

A person with an emission, whether pus, semen, sputum, or blood, would be unclean until evening, as would anyone who touched such an emission. The remedy was washing oneself and one’s clothes in water. Wood objects could be rinsed but pottery had to be broken. Running water was preferred. Childbirth made the mother unclean; seven days for a son and fourteen days for a daughter. She would continue her purification, forbidden to touch consecrated items or enter the sanctuary for 33 days for a son and 66 days for a daughter (Leviticus 12). Afterwards the woman was required to visit a priest who would make atonement for her uncleanness, not that she had done anything wrong, but that uncleanness separated a person from the Holy God.

Ancient Hebrews also became unclean if they touched the dead body of a human or animal (Leviticus 5:2, Numbers 19:11). Since most people at the time died of disease, and it was difficult to know what they died of or if it was contagious, this was a prudent safeguard. Human excrement was to be buried outside the camp (Deuteronomy 23:12-14). Soldiers were required to cleanse and purify themselves and their captives after war. Plunder had to be purified by fire or by water (Numbers 31:19-24). Captive women had to purify themselves for thirty days, including shaving their heads, trimming their nails, and destroying their old clothes, before intercourse was allowed and they could be fully brought into the Hebrew community (Deuteronomy 21:10-14).

New Testament

The Old Testament law was still in effect for first century Jews, and many early Christians followed the rules therein. Christ’s work eliminated the requirement to follow the hygienic laws in the Torah (Acts 15), and many Christians did not follow them. We should have followed many of them, though not all, as the annals of life from the Middle Ages to the nineteenth century describe diseases and plagues that would have been entirely preventable with good hygiene and social distancing.

Jesus did not practice social distancing, superseding these parts of the Law of Moses. He touched a leper (Mark 1:41), allowed a woman with a chronic vaginal bleed to touch Him (Matthew 9:20), touched the bier of a widow’s son (Luke 7:14), and took the hand of the dead daughter of Jairus (Matthew 9:25). Jesus visited the home of “Simon the Leper,” who had probably died and had bequeathed his house, located in Bethany, to Lazarus, Martha, and Mary (Mark 14:3).

Biblical social distancing laws and other public health measures were balanced against economic, military, and other needs in ancient Israel. In the Parable of the Good Samaritan, the Levite and the priest were justified in avoiding the wounded man, who they probably thought was dead, since they would have become ceremonially unclean by touching him. They also could have become infected it he had had a blood borne disease. The Samaritan would become unclean and possibly infected as well, but he saw the greater need and met it (Luke 10:30-37). Jesus’ lesson was not that the priest and Levite were sanctimonious hypocrites denying care to a wounded man, but that they did not understand their responsibility under the Law to meet a greater need than just staying ceremonially clean. He made the same point in the stories of picking grain on the Sabbath (Mark 2:23-28), healing a woman (Luke 13:10-17), and healing a man with dropsy (Luke 14:1-6).

Conclusion

Social distancing is an important public health measure to slow or stop the spread of disease. In conjunction with other prevention and treatment methods, it has been used successfully for millennia to mitigate the effects of infectious diseases. However, it has always been balanced against economic realities and other needs. America and the world are right to practice social distancing, and to practice all of public health. We must at the same time allow normal economic processes to continue and to care for the other needs of our communities. This Biblical model will serve us well.

References

[1] Gwen Robbins, V. Mushrif Tripathy, V. N. Misra, R. K. Mohanty, V. S. Shinde, Kelsey M. Gray, Malcolm D. Schug, Ancient Skeletal Evidence for Leprosy in India (2000 B.C.), PLOS One, May 27, 2009, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0005669.

[2] Bernard Palmer, Medicine and the Bible, Christian Medical Fellowship, (UK, Paternoster Press, 1986), 111.

[3] The Jordan River is 686 feet below sea level and falls 726 ft in 65 miles to the Dead Sea at 1412 feet below sea level. It is one of the fastest flowing rivers of its size in the world.

[4] As in most premodern cultures, the roles of religious leader and healer were combined in one person, the priest, in ancient Israel.

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