Scientists say stress levels, healthy habits, and community support could be key to beating the virus.
SALT LAKE CITY — In April, a Virginia pastor died from the coronavirus after telling his congregation to ignore physical distancing rules. Even after the story made national news, some religious leaders continued to defy public health orders and hold services, including a Louisiana pastor who told his church members, “God gave you an immune system to kill that virus.”
The next month, the Centers for Disease Control and Prevention warned the virus can spread easily at large religious gatherings, citing a case where two people with COVID-19 infected 35 others in March at church events in Arkansas.
Stories like these show the potential danger of holding large meetings while the coronavirus continues to claim U.S. lives and could cast religious leaders who insist on public worship in a negative light. But Harold G. Koenig, professor of psychiatry and director of the Center for Spirituality, Theology and Health at Duke University Medical Center, has some positive news for people of faith. He argues that religiousness may actually reduce a person’s risk of contracting and dying from COVID-19.
According to Koenig, people who participate in organized religion or have their own spiritual practices are less likely to engage in unhealthy behaviors like smoking and drinking and more likely to have good habits like eating well and exercising. Not only can religious and spiritual involvement impact people’s physical health via their lifestyle choices, but it can also have a significant effect on their emotional well-being, said Koenig. All these factors combined can give a person’s immune system a leg-up in fighting off viruses of any kind, he said.
“There’s no question religion has an impact on both susceptibility to viral infections and recovery from it once you’re infected,” said Koenig, who was raised Catholic and now practices in a Protestant church. “This just makes sense when you think about it.”
However, Nicole Fisher, president of Health & Human Rights Strategies, a health care and human rights-focused advising firm in Washington, D.C., warns that religion and spirituality are not protective measures against COVID-19 on their own.
“Viruses don’t have any respect for religion, race, gender, politics or anything else. They look for a suitable host, and that can be anyone not taking proper precautions,” said Fisher, who is spiritual but does not associate with a particular religion.
Still, there are clear links between beliefs, emotions and the body, Fisher said.
“Prayer alone cannot cure you,” Fisher said. “But, with medical attention appropriate for how bad your illness is, prayer, meditation and faith can certainly bring a person peace of mind — which can undoubtedly improve mental and emotional health, which is oftentimes linked to physical health.”
More than a hundred studies have found that religious people are less likely to smoke, a habit which has a large impact on coronavirus outcomes.
According to Stanton Glantz, a professor of medicine and director of the University of California, San Francisco’s Center for Tobacco Control Research and Education, research shows smoking nearly doubles a person’s risk of COVID-19 disease progression, which could involve the need for critical care or death.
Glantz explained that the respiratory system has a very strong natural immune function, starting with microscopic hairs called cilia in the nose that trap viruses, bacteria and toxins. Deeper inside the lungs, cells called macrophages “gobble up” those things that can harm the body.
“Smoking disables a lot of that immune function and makes you more susceptible to getting infected. Then if you get infected, the infections are worse,” said Glantz, who added that vaping has a lot of the same effects as smoking.
According to Koenig, most research involving religion and health looks at Christianity, which promotes healthy behaviors by teaching that the body is a temple. But there are a number of studies that also examine Islam, Judaism, Buddhism and Hinduism, which all espouse similar beliefs about the sanctity of the body. Vegetarianism and yoga practices associated with Hinduism and mindfulness and breathing practices associated with Buddhism can also have direct health benefits, Koenig said.
A 2017 study by researchers from the Emory Rollins School of Public Health categorized subjects as Protestant, Catholic, Jewish, other religion or no religion. The study demonstrated a link between regular attendance at religious services with improved health and lowered mortality. They found that people who attended services frequently had a 40% lower hazard of mortality compared with those who never attended. Even those who attended services less frequently had a greater protection against mortality than those who didn’t attend at all, but there were no differences by religious affiliation.
Stress increases susceptibility to viral infections, said Koenig, but individual spiritual practices and the support networks that come with organized religion can promote emotional well-being.
“A big part of going to church is the social support in the community that one receives,” said Carolyn Aldwin, director of the Center for Healthy Aging Research at Oregon State University. “Social integration has a big effect on health outcomes.”
Aldwin was raised Catholic and now attends an Episcopal church. To protect against the coronavirus, religious communities can support people who are older or immunocompromised by calling and checking in on them, or providing services like grocery shopping so they can avoid going out, Aldwin said.
The benefits of emotional self-regulation are also significant, said Aldwin, who has studied the effects of religion and spirituality on people with congestive heart failure.
“When you have something like congestive heart failure, which is very hard to regulate and difficult to live with, being calmer and happier, and maybe feeling supported may allow you to experience less distress and even live longer,” Aldwin said.
According to Koenig, positive emotions have the opposite effect on the immune system that negative emotions and stress have.
“If you have meaning and purpose, if you have joy and satisfaction with life, if you experience a sense of peace, all of that has a positive impact on the immune system in the exact opposite way seen with chronic stress, anxiety and depression,” Koenig said.
Lakkireddy’s COVID prayer study is set up as a double-blind randomized control trial, where coronavirus patients who voluntarily enroll on the website will be assigned into either a control group, or a group that will be prayed for by various volunteer religious groups representing the Christian, Muslim, Hindu, Jewish and Buddhist traditions. Lakkireddy and his colleagues plan to measure whether this remote intercessory prayer affects coronavirus outcomes like mortality, number of days in the ICU and days on a ventilator.
Lakkireddy was born into Hinduism and went to a Catholic school, but doesn’t consider himself to belong to one religion in particular. He said the study required hardly any funding from the institute because he and others have all volunteered their time.
“I was always intrigued by this idea of a supernatural divine power that can impact what we do as human beings on this earth,” said Lakkireddy. “As scientific and critical as I want to be in my thinking, the question about this divine force interested me.”
But Aldwin is skeptical that any one aspect of spirituality, like prayer will prove to have a large impact on health with the coronavirus.
“People who are sincerely religious have multiple things going for them, it’s the community which provides support, almost like a social safety net. There’s the better health behaviors, the calmness and acceptance in the face of adversity,” said Aldwin. “It’s the whole package.”
Gathering to worship
While some religious practices and belief systems may be correlated with healthy behaviors, the benefits could be instantly negated if people of faith are gathering to worship in large groups without the proper precautions, like social distancing and wearing masks. Multiple coronavirus outbreaks have been traced to religious groups, like Orthodox Jewish communities in New York or the Shincheonji religion in South Korea.
“Religiousness, spirituality or faith, as in all facets of life and current health challenges, can be part of the problem or part of the solution,” said Jeff Levin, University Professor of epidemiology and population health and director of the program on religion and population health at Baylor University. “Where there are messages coming from the pulpit, or coming from religious leaders, telling people to ignore public health messages, I just think it’s incredibly foolish.”
With coronavirus fatalities decreasing by the week across the country, U.S. churches are beginning to open back up. But most are trying to discourage the hugging and hand-shaking that typically accompanies fellowshipping. Some are implementing rules regarding how close people can sit in the pews, or eliminating the tradition of singing hymns because exhaling air with increased force can spread the virus farther.
Levin, who is Jewish, said he thinks these precautions are reasonable and wise.
“Churches and pastors and religious organizations shouldn’t be a source of anxiety for people, or discouragement, they should be supporting people and letting people know we will get through this, just a little longer,” said Levin. “We don’t want to undo the good that we’ve done. There is still so much we don’t know about the virus, and we are still learning that things could go south at any moment. It’s not time for a victory lap at all.”