Swine ‘Flu Guidance

Here you will find all the documents issued this July 2009 relating to Swine Flu Prevention from Ely Diocese and also the Archbishops’ Pastoral Letter issued July 24th 2009. Towards the bottom of the page you will find some reflections by Rev Ally Barrett, Vicar of Buckden, on the implications of communion in one kind.

I hope you will find it helpful should swine ‘flu prevention be something which is  exercising your thoughts at the present time.

July 1st Guidelines issued by the Diocese of Ely

For Pastoral and Liturgical Continuity in a Pandemic

Diocesan Guidelines v.5 (1.7.09)

The key principle is that, though we cannot now prevent the onset of H1N1, we can still slow its advance and mitigate its effects.  The more we slow its advance the more chance there is of the virus attenuating and less chance there is of it mutating into something more serious.  The Chief Medical Officer has warned clearly against ‘the seriously flawed thinking’ that the virus should be allowed to spread unabated, since we know insufficient about the risk profile.

1.         Stay as cool, calm and collected as you can in dealing with congregational concerns.   The safest line is the official one:  ‘The outbreaks in Cambridgeshire are fortunately mild at present, and we can do much to ensure that they remain so if we adopt a responsible attitude and follow government advice.’

2.         Encourage people –

• to follow the Government guidelines to use tissues and ‘catch it, kill it, bin it’;
• to be scrupulous in washing their hands  (download a poster and put it in church);
• to maintain social distance (the evidence is that the bug won’t transmit air-borne over distances of more than a metre);
• to stay at home and contact NHS Direct or their GP if suspect they are developing symptoms (several of – fever, cough or shortness of breath, general malaise, headaches, chills, aching muscles, sore throat, runny nose or repeated sneezing, lose of appetite), remembering the incubation period is typically 2-4 days, during which people are infectious.  The number of NHS Direct is 0845 4647. Be warned, though, that there may be a significant delay in dealing with enquiries.   Other numbers may be advised by the Health Authority in due course.   There is a flu information line on 0800 1513 513.
• to be wary of the plethora of advice emerging, and especially that offered by unauthorised websites.  A safe source of information is the Department of Health site at http://www.dh.gov.uk/en/Publichealth/Flu/PandemicFlu/DH_065006

3.         Be conscious of the ways the virus spreads –

• air-borne by coughing and sneezing;
• by direct contact with an infected individual such as shaking or holding hands;
• by touching one’s own mouth, eyes or nose if the virus is on one’s hands;
• by contact with contaminated door handles, light switches , etc.

This will guide precautionary action.  The virus is currently thought to survive 24 hours on steel/hard surfaces, 2 hours or so on soft furnishings and about 15 minutes on clothing, but this is not finally confirmed.

4.         There is no need as yet to suspend church services, social events or pastoral visits to hospitals and care homes unless instructed to by Government or Health Authority or advised by the Diocese, but take care to observe the provisions of (2) above.  It would be helpful now, ecumenically where possible, for congregations to think seriously about how they can best support their communities through an epidemic, especially the more vulnerable members, (the Flu Buddy initiative suggests how this might be done), and for chapters and deaneries to consider how cover might be managed in the event that an early peak of infection coincides with holiday absences.   Inform people of the visiting guidelines (passim but especially (2) above) so they don’t themselves become carriers.   If a centre were established near you for the distribution of anti-virals, would you be prepared to help at it?   If local hospitals need to extend their chaplaincy services, would you be prepared to help?   The Diocese may be asking for your assistance.

5.         There is no need for surgical masks (which are anyway largely ineffective) or gloves at present if hygiene precautions are followed and social distance observed.

6.         In the event of widespread illness, ensure that service books, lectern Bibles, corporals and purificators and other linen, oils etc. do not become contaminated in case you transmit infection.  If anointing the sick, consider pouring oil onto cotton wool for each infected person and then dispose of it.   In church, consider using disposable service sheets rather than hymn/service books, and bin them afterwards.

7.         Obtain an anti-bacterial wash/spray/wipes for yourself for use in the sacristy.   Thoroughly cleanse all communion vessels.  Consider using disposable tissues rather than linens for corporals and purificators.   Wipe down obvious common surfaces with an anti-bacterial wash/spray after services (communion rail, door handles, tops of pews, etc.)   A reliable and inexpensive source for alcohol hand rub is St John Ambulance Supplies, who offer their own brand sanitiser.   Their phone number is 0207 278 7888. The website is http://www.stjohnsupplies.co.uk/ A useful information sheet on this is available at http://www.cec.health.nsw.gov.au/pdf/AlcoholHandRub061013.pdf

8.         The issue of the common cup is often a sensitive one.   It has to be a matter for local discretion at the moment (1 July). Given the virus may well linger on metal surfaces, and that wiping with the purificator will be ineffective, several options suggest themselves:

• communion in one kind only, the president alone drinking from the cup, the wafer given directly into the communicant’s hand (not on the tongue in case the mouth is touched);
• communion by wafer sprinkled with wine (as practised in some sick communions);
• a general invitation to intinct – but it is crucial people’s fingers do not touch the wine as this will spread infection.   (Nb. In the event of widespread infection, intinction is not a sensible option.)

Of these, the safest and most reassuring at present is the first, but the need to balance caution with avoidance of panic is a difficult line.   It may be helpful to use the Scriptural imperative about taking responsibility for the neighbour.   Please refer to Appendix A for further information.

9.         Consider asking people to avoid personal contact at the Peace (the social distance principle).

10.        Consider provision now of pastoral support for the sick housebound – a leaflet of prayers and readings, copies of sermons, service tapes, devotional reading, etc.

Michael Goater

Bishop’s Adviser for Emergency Planning

01223 843654

michael@mickthevic.org.uk

mickthevic@live.com

Appendix A

ADMINISTRATION OF HOLY COMMUNION DURING A FLU PANDEMIC

The Bread

Government advice envisages that during a flu pandemic the distribution of the consecrated bread at Holy Communion will continue, but specifies that communion should not be given on the tongue. Care ought to be taken to ensure that the fingers of the person distributing the sacrament do not come into contact with the communicants’ hands. High standards of hand hygiene should be adopted. (Soap and water is an effective means of cleaning hands, and handrubs can be used as an alternative.)

The Cup

In 1987 the then Archbishops of Canterbury and York issued guidance on the use of the chalice at Holy Communion. This indicated, on medical advice, that fears that sharing of the common cup might be a possible means of infection with HIV were groundless, and that the risk of other types of infection being transmitted via the chalice were extremely small and could be reduced even further by the application of normal rules of hygiene.

Scientific advice confirms that the guidance given in 1987 continues to be generally correct. However, it indicates that neither the alcoholic content of wine nor the antiseptic qualities of noble metals will provide any protection against a pandemic flu virus. Government advice is that in the event of pandemic flu affecting centres of population, administration of the common cup ought to be suspended. Studies have suggested that in the context of pandemic flu the practice of intinction may involve a greater risk than the common cup.

The administration of Holy Communion in the Church of England is principally governed by section 8 of the Sacrament Act 1547, which provides that ‘…  the … most blessed Sacrament be hereafter commonly delivered and ministered unto the people … under both the kinds, that is to say of bread and wine, except necessity otherwise require … ’  It is thought that the permission for administration of the sacrament in one kind only in cases of necessity was included because communicants were unwilling to drink from a common cup in times of plague.

In the event of pandemic flu affecting centres of population, the Bishop may advise clergy that Communion should be administered in one kind only (the priest alone receiving in both kinds) until the danger has passed.  Should it become necessary to do so, the Archbishops will issue such advice in respect of Holy Communion in the Church of England as a whole.

Where such advice has not been issued, communicants may nevertheless choose to receive Communion in one kind only. Clergy should emphasize that while Communion in both kinds is the norm in the Church of England, in faithfulness to Christ’s institution, when it is received only in one kind the fullness of the Sacrament is received none the less.

Notes

1.  The Legal Advisory Commission has advised that ‘The practice of intinction may be regarded as lawful where a communicant or the congregation as a whole is fearful of contracting or communicating a contagious disease through drinking from the cup.’ (Legal Opinions Concerning the Church of England [8th edition: 2007], pp. 345-348). However, if the consecrated wine is administered to communicants they cannot be required to receive it by intinction. The use of individual communion cups is not lawful in the Church of England and would, in any event, also involve hygiene risks in the context of pandemic flu.

2.  In accordance with this provision of the Sacrament Act 1547, Note 6 to the Distribution of Holy Communion at Home or in Hospital provides that ‘Communion should normally be received in both kinds separately, but where necessary may be received in one kind, whether of bread or, where the communicant cannot receive solid food, wine’ (Common Worship: Pastoral Services, p. 79).

Pastoral Letter from the Ely Bishops July 17th 2009

To:   The Clergy of the Diocese

Dear colleagues,

Swine Flu Outbreak

The numbers of those affected by the outbreak of H1N1 ‘swine flu’ are rising in our diocese. We would like to assure you of our prayers for both you and your parishioners at this difficult time. Should you be affected yourself, do take the time away from your duties that you need, both to speed your recovery and help prevent the spread of the infection. It would be sensible to let your Rural Dean and local colleagues and churchwardens know too.

Diocesan guidance on response to the outbreak (version 5 dated 1.7.09) is being circulated in this month’s diocesan mailing and is being posted electronically on both the diocesan website and Bishop David’s ‘blog’. We are grateful to the Revd Michael Goater for his work on this. It contains much common sense advice about hygiene and precautions. Do read it.

The receiving of Holy Communion, and especially the common cup, is likely to be a concern. The guidelines explain the options you have. Please note that they point out that legally communion may be given in one kind where necessity requires. At the moment this would be a local decision. If the outbreak escalates, further diocesan or national guidelines may be issued.

Yours in Christ,

Bishop Anthony and Bishop David.

ARCHBISHOPS’ LETTER JULY 22nd 2009

The Feast of St Mary Magdalene

22^nd July 2009

Dear Colleague,

It now seems right to offer guidance at a national level about how the Church of England’s worship might best take into account the interests of public health during the current phase of the swine flu pandemic.

The Department of Health have recently advised us that “in a pandemic it makes good sense to take precautions to limit the spread of disease by not sharing common vessels for food and drink”.  In the light of this advice, we recommend those presiding at Holy Communion suspend the administration of the chalice during this wave of pandemic flu. [1][1] For those who still wish to offer in both kinds, we recommend the practice whereby the presiding minister, whose hands should have been washed with the appropriate alcohol based rub before handling the elements and the vessels, personally intincts all wafers before placing them in the hands of communicants. This is a practice widely observed in Anglican churches throughout Africa. Communicants receiving in this way need to be confident that the clergy and all assistant ministers follow the relevant guidance on hygiene.

The Bishop of Ripon & Leeds circulated substantial guidance, including a summary of the government’s advice[2][2], with his letter of 23 June[3][3].  Many of you have already issued local guidance based upon its content.  We regard it as important that those presiding at Holy Communion are aware of this advice[4][4] and of that contained in this letter.  They should offer guidance to the congregation about appropriate precautions in receiving communion and exchanging the peace.

We shall keep this advice under review and will ensure that the detailed guidance provided on the Church of England website[5][5] is kept up-to-date.  In the meantime, wish to express our gratitude to you and those who share your ministry for the pastoral care and service offered at this time of national concern.

+Rowan Cantuar:                                +Sentamu Ebor:

Bishop Anthony’s letter July 24^th 2009

In the light of the recommendations issued this morning (23 July 2009) by the Archbishops of Canterbury and York that there should be a suspension of the sharing of the chalice at communion, The Bishop of Ely has offered the following guidance to the Diocese in the interests of public health during the current phase of the H1N1 flu pandemic.

Michael Goater

Bishop’s Adviser for Emergency Planning

“As our diocesan guidelines advise, the responsible course of action which we have adopted in the Diocese is to take all reasonable precautions to limit the spread of the H1N1 virus.  Because the progress of the infection in our diocese has been uneven, the nature of these precautions has properly been, and to an extent should remain, a matter of local discretion, having due regard to the advice of the central authorities.

“However, in deciding their local response to what is undoubtedly now a more rapid and widespread advance of the virus in our region, I am advising parishes today that they should weigh most seriously the Archbishops’ strong recommendation that from this Sunday (26 July 2009) those presiding at Holy Communion should suspend the administration of the chalice during this wave of the pandemic, having regard to the duty of care we owe to the neighbour in our congregations and communities.

“Where parishes wish to continue to offer communion in both kinds, my advice is that from this Sunday (26 July 2009), the presiding minister – and s/he alone – should personally intinct all wafers before placing them in the hand of communicants, a practice which is widely observed in Anglican churches in Africa.   I would strongly advise against placing the intincted wafer in the communicant’s mouth, since this risks the spread of infection.

“As the diocesan guidelines remind us, our communicants need to be confident that the clergy and all assistant ministers have followed the guidance on hygiene in this, and, particularly, that ministers’ hands should have been washed with an appropriate alcohol-based rub before handling the elements and the vessels.

“The diocesan guidelines also invite parishes to consider their practice when exchanging the peace.   Again in the light of the Archbishops’ recommendations, I would urge now that very serious thought be given to the principle of social distancing in minimising the spread of infection by avoiding direct personal contact at the peace and at the church door.

“I shall keep this advice under constant review and ask that you check regularly the guidelines on the diocesan website, which will be updated when required and as quickly as possible to take account of the changing situation.

“Thank you to all of you whose ministry in these confused and troubled times is bringing the love and healing power of Christ to the people of our Diocese.”

The Rt Revd. Anthony Russell

Bishop of Ely

“Real Presence”- Revd Ally Barret

Friday, 31 July 2009

Swine Flu and the Real Presence in the Eucharist

So, sharing the common cup at communion is no longer an option, and the congregations in my churches will be receiving only the bread for the foreseeable future – and that might be for a while. I wanted to share why, for me, receiving communion ‘in one kind’ is still just as valid as receiving both the bread and wine.
Now, I am someone who very much believes in the Real Presence of Christ in the Eucharist. But my understanding is that the reality of Christ’s presence is spiritual, not physical (the physical bread and the wine in the sacrament are not there because God needs them in order to be present with us, but because we find that they help us ‘notice’ that he is there). It is not that the spiritual reality of Christ’s presence is somehow piggy-backing on the physical reality of bread and wine, but rather that the physical reality of bread and wine help to make visible and tangible the prior spiritual reality of the presence of Christ.
Think about the resurrection appearances of Jesus, when he walked through solid walls and locked doors. Was that because Jesus was somehow insubstantial, like a ghost, compared to the solid physical wall? Or was it rather that Jesus was so real, so substantial, that the solid wall was insubstantial in comparison? The spiritual world is not less real than the physical world, it is more real.
When we receive communion, we are eating bread, but through faith we are receiving so much more than that – the very real (more real than anythning else) spiritual presence of Christ in our lives. If there were no bread in the world, and the wine had all run dry, Christ would still be just as real, and just as present with us.
Not sure if that will help anyone with the current situation of not being able to receive communion wine, but it did help me.
No doubt someone will tell me if it’s totally heretical!

Revd Ally Barrett

Vicar of  Buckden with The Offords.

http://allybarrett.blogspot.com/

1. “No doubt someone will tell me if it’s totally heretical!”
   Well…according to a correspondent in today’s Sunday Telegraph:
   “We should take note of the words of Aelfric, the 10th-century Wessex monk and teacher: ‘If we consider the Holy Eucharist in a bodily sense, then we see … it is corruptible bread and corruptible wine, and by the power of the divine word it is truly Christ’s body and his blood; not, however, bodily, but spiritually.’

   Sadly, the treatise on which this homily was based was later condemned and ordered to be destroyed by the Roman church!”

   Pxvbscm

   Martina Fuseli

   Comment by Martina Fuseli | November 15, 2009 <!– @ 11:09 pm –> | Edit | Reply

   • Thanks for your comments Martina – I find it so hard to put into words quite what I believe about the moment of blessing of bread and wine – and it is so sad that interpretation of communion has divided Christians so bitterly over the years. I imagine RC’s wouldnt have liked Aelfric’s interpretation very much….are you finding there is controversy over whether we should withold the chalice with the swine ‘flu pandemic where you are?
     Take Care
     paxtonvic

     Comment by paxtonvic | November 17, 2009 <!– @ 4:51 pm –> | Edit | Reply

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