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Sarah Khalil

Ramadan, fasting and Covid-19: Your medical questions answered

Umrah pilgrimage to Mecca this Ramadan is likely to be cancelled [AFP]

Date of publication: 22 April, 2020

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Dr Milad Hilli speaks to The New Arab to answer some of the most commonly asked questions about the effects of fasting during Ramadan amid the coronavirus pandemic.
Muslims around the world are awaiting the sighting of the new moon this week to mark the beginning of the holy month of Ramadan and the start of one of Islam's most important religious rituals.

With the coronavirus pandemic now spreading across the globe, most mosques have already announced their doors will be closed for the duration of the month, and the Umrah pilgrimage to Mecca in Ramadan – which in previous years saw millions of Muslims flock to the holy city – is now likely to be cancelled.

At the same time, many Muslims themselves are grappling with a host of health-related questions on how to embark on the one-month series of daily fasts under the shadow of this new and devastating infectious disease.

With Ramadan being both a physical and spiritual journey, and a communal ritual that often involves gatherings and socialisation, The New Arab speaks to UK-based General practitioner Dr. Milad Hilli with some of the commonly asked questions about fasting, socialising and maintaining good health under the threat of Covid-19.

Many are worried that fasting will make them more likely to get infected with the coronavirus. Does fasting have an impact on the immune system?

There is no evidence that people who fast are at increased risk of coronavirus. On the contrary, some studies suggest fasting can boost your immune system in the short term. However, it is important to point out that these studies are limited, and we need more research on this topic.

If a person is generally healthy and able to stay at home, would fasting make them more vulnerable to contracting Covid-19?

There is no association between fasting and contracting Covid-19. Fasting will not put you at increased risk of catching the virus, if you comply with the advice from public health. This advice applies to all, whether you are fasting or not. To prevent the spread of this virus stay at home, wash your hands for 20 seconds, avoid touching your face with unwashed hands, use a hand sanitiser if water is not available and cough/sneeze into a tissue and throw the tissue in the bin.

What advice do you have for people working in public and on the frontlines while fasting during Ramadan?

My advice about reducing the risk of contracting the virus would be the same for all workers whether you are fasting or not. If you have to go to work maintain a two-metre distance between you and others. If you are unwell stay at home. 

For those who are fasting and working, it is important to have adequate hydration and the right food in Suhoor and Futoor to maintain energy levels throughout the day.

What coronavirus-related symptoms should people look out for before deciding to fast?

The symptoms of coronavirus vary from person to person, as does the severity of these symptoms. The two common symptoms are: a new persistent cough and a high temperature (37.8 degrees and above – or if you feel hot to touch on your chest or back). If you have either of these symptoms you should not leave your home and follow the governments guidance on self-isolation. 

With regards to fasting, as per Islamic rulings if you are unwell you should not be fasting – if in doubt about your individual case seek the advice of your doctor. This applies to people with symptoms of the coronavirus, who are in discomfort or have a fever, as they will need to be drinking water regularly throughout the day and they may need paracetamol.

Keeping well-hydrated and eating food that boosts immunity are often suggested as important in the fight against Covid-19. How can people fasting keep well-hydrated and boost their immunity? 

It is so important to drink plenty of fluids during both Suhoor and Futoor, and to eat the right food in regular size portions (remember have a meal not a feast!).

Suhoor should contain slowly digesting food which provides enough energy throughout the day. This includes complex carbohydrates and fibre-rich food.

Complex carbohydrates are found in grains and seeds, wheat, oats, beans, lentils, whole meal flour and basmati rice. Fibre is found in cereals, whole wheat, grains and seeds, vegetables such as green beans and almost all fruit.

Muslims are grappling with a host of health-related questions about fasting under the shadow of the coronavirus pandemic

Iftar could include dates and fruit juices as they provide a burst of energy. Keep rich food to a minimum. Try to avoid deep fried and fried food, instead try shallow frying, baking of grilling. 

Some may not have access to fresh foods during lockdown, what cupboard staples would you recommend as a healthy alternative?

If you cannot get hold of fresh food, such as vegetables frozen options are a great alternative, as are canned vegetables, e.g. peas and sweetcorn. As mentioned before, grains, oats and cereals are all great staples for this holy month. 

For many who are now social distancing, the stress of lockdown and the feeling of loneliness are particularly devastating. With the social element Ramadan key to so many people's lives, do you have any advice on how to deal with loneliness and how to help mental health during this month? 

Loneliness is a big problem which people are facing during these challenging times. The responsibility falls upon us all as a community to reach out to friends, family and neighbours, one phonecall a day can really make a difference. Those with access to computers and smart phones can video call each other as a more interactive way of staying in touch. It is also a good way to carry out some of the religious rituals like reading the holy Quran and recite Duas together while socially distancing.

Staying active by carrying out light exercise such as yoga or walking is also very important during this month, not only for your physical health but also for your mental health.

My advice to anyone struggling with their mental health is to reach out, there is a lot of support out there, from your family or friends, family doctor or mental health charities, such as MIND.

It is clear that inviting people home for the meal to break the fast goes against the general rule of social distancing. However, people have wondered if they have been self-isolating for a while, and friends and family have also been self-isolating, can they get together for Iftar? 

As per current government guidance we are still in lockdown and everyone must stick to the social distancing rules which strictly prohibits gatherings of any sort regardless whether you have self-isolated or not. 

Preparing food for friends and family and sending it to their homes for Iftar used to be quite common. Are there any particular risks or precautions if people continue to do so?

At present there is insufficient evidence that this virus can be spread through food, and the risk of contracting it from packages including food containers is low. It is important to wash your hand before and after food preparation and especially after handling meat of all forms. If you want to deliver food to family and friends, it is advisable to do so by leaving the food outside their door and maintaining the 2m distance. 

For a number of working people, ordering food from restaurants or take outs is a lifeline. Are there any further risks or precautions they need to take? 

As above, there is insufficient evidence of contracting the virus through takeaways. However, it is important you wash your hands after handling packages and before you eat. 

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