The Covid-19 Fertility Crisis: A Short Story

News item: The coronavirus was found in the sperm of some 13% of screened male Covid-19 patients. In the end, no population was spared, but the fertility crisis hit the haredim the hardest. At the height of Israel's second wave, no one yet knew about COVID-19's effect on sperm count. Yes, scientists had discovered how the novel coronavirus attached itself to ACE2 receptors, which are found in cells all over the body. But it wasn't until back in October 2020 that the first reports appeared indicating that because the testicles also have ACE2 receptors, they too were getting hit by the virus. Still, the true extent of the problem didn't show up for a few years, long after the vaccine from the Israel Institute for Biological Research finally transformed COVID-19 into a seasonal, mostly benign virus by mid-2022. At first it was thought to be a result of lingering depression. We had gone through a pandemic of an unprecedented scale, leadership had gone wanting, civil liberties were no longer a given. Who would want to bring more kids into such a world? But that wasn't the attitude in ultra-Orthodox communities. The mitzvah of pru urvu – to be fruitful and multiply – is so important that the very thought that individuals might choose to slow down or delay having children in response to a shared global tragedy was preposterous. But eventually it became clear that babies weren't being conceived in their pre-pandemic numbers. Young couples would try for months, even years, to get pregnant, to no avail. It wasn't everyone, of course, but it was still a high enough percentage that it became the only thing people in the haredi world could talk about. “Gitti and Yaakov still don't have any kids. Do you think... ?” “They finally went to the doctor. It turns out it's him, not her.” “What if it runs in the family? Will we still be able to arrange a good match for our children?” Dr. Dan Aderka of Sheba Medical Center in Israel was the first to identify that there was a 50% decrease in the volume, concentration and motility of sperm in patients with moderate disease, even 30 days post-diagnosis. That's because the coronavirus binds to the ACE2 receptors on the surface of the Sertoli and Leydig cells in the testes, destroying the cells and causing infertility, Aderka told The Jerusalem Post's Maayan Hoffman. The Sertoli cells support sperm maturation. The Leydig cells produce testosterone. It was not known initially if this infertility would be temporary or long-lasting, even resulting in permanent sterility. Aderka called for follow-up exams to see if the damage “stands the test of time.” By the mid-2020s, however, it was clear that it did. And it hit the haredim harder than the general population because of many of their leaders' unwillingness at the virus's worst point to adhere to health guidelines. MASS PRAYER services, a refusal to mask up or socially distance, continuing tisches with the rebbe became endemic, as was the controversial decision in some sectors to court infection in an aim for a kind of “herd immunity,” at least among younger yeshiva students. The haredi leadership has “a strategy for dealing with the plague,” wrote Haaretz's Anshel Pfeffer. “Change nothing. It may cost more lives in the short-term, but once this is finally over, they will have preserved their institutions and communal framework.” If yeshivas and synagogues were closed, however, haredi power brokers' grip on their followers could be irretrievably weakened, the thinking went. After all, in April 2020, during Israel's first lockdown, thousands of pupils left their yeshivot and sought out leisure activities; and haredi cities reported a sharp rise in the number of homes connecting to the Internet despite rabbinical prohibitions. That was before the fertility crisis drove home exactly what was at stake – not widespread death as a result of corona, but long-term, chronic and unexpected health consequences. “If you're ultra-Orthodox, you might start asking how you can trust leadership,” Prof. Yedidia Stern of the Israel Democracy Institute told The Jerusalem Post when the pandemic was still considered “just” a killer virus. “Once the pure belief in their leaders is shaken, no one can anticipate what might be the ramifications of this change in the ultra-Orthodox world.” Looking back, it was nothing less than an earthquake. As fertility rates dropped, a crisis of faith spread across haredi society. Increasing numbers of ultra-Orthodox men and women deluged the Israeli employment service, searching for work and retraining. Enrollment in high school matriculation courses filled up. Newly trained haredi programmers joined the tech force. The tax coffers overflowed. The fertility crisis had its most dramatic effect in politics, where many of the newly unrooted chose to counter their formerly fierce allegiance to the religious parties and voted for the Center-Left. Yair Lapid, whose Yesh Atid Party had remained in the opposition even through the fallow years of prime minister Naftali Bennett, finally found the support he needed and was elected leader of the country by a clear majority. His first act was to pardon former prime minister Benjamin Netanyahu, who was still in the courts appealing his conviction from 2024. Lapid's move shocked the now fading right wing and helped to heal a broken nation. By the time the pandemic of 2030 arrived, Israel was well-prepared, with a robust democracy and a firm fidelity to facts that the fertility crisis had driven home. This time, everyone wore their masks. The writer's book, Totaled: The Billion-Dollar Crash of the Startup that Took on Big Auto, Big Oil and the World, is available on Amazon and other online booksellers. brianblum.com

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