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Is It Safe To Fast During The Coronavirus Pandemic?

An Afghan youth carries bread for Iftar, the meal for breaking the fast during the Muslim holy month of Ramadan on the outskirts of Jalalabad.
An Afghan youth carries bread for Iftar, the meal for breaking the fast during the Muslim holy month of Ramadan on the outskirts of Jalalabad.

During the holy month of Ramadan, observant Muslims abstain from eating and drinking from sunrise to sunset.

The month is marked by social and religious gatherings where families and friends meet to break their daily fast. Many of the world’s 1.8 billion Muslims also attend mosques more frequently and congregate for longer prayers.

But the coronavirus crisis this year has changed everything.

The pandemic -- which has infected some 2.75 million people and killed more than 192,000 globally as of April 24 -- has increased fears that fasting could pose a health risk by weakening people's immunity and making them more susceptible to contracting the deadly virus. The frequent gatherings of family and friends during Ramadan has also sparked worries of more infections.

RFE/RL spoke to two experts to examine these issues.

Is fasting advisable during the pandemic?

"If you are healthy and have previously fasted during Ramadan without issues, there is no evidence to suggest you cannot fast this time round either, should you wish to," said Dr. Salman Waqar, an academic clinical fellow at the University of Oxford.

Dr. Salman Waqar
Dr. Salman Waqar

Waqar is a member of the British Islamic Medical Association, which published guidelines for fasting during the coronavirus outbreak.

"In the majority of cases, people who are in good health and have previously fasted safely should be able to do so during the pandemic," said Dr. Shafi Malik, a transplant nephrologist at the University Hospitals Coventry & Warwickshire in Britain.

Malik warned that those with a chronic illness or fever should consult a doctor and end their fast, if advised to do so.

According to Islamic beliefs, children, the elderly, the sick, and those who are traveling are exempt from fasting during Ramadan, one of the five pillars of Islam. The fast is intended to bring the faithful closer to God and to remind them of the suffering of less fortunate people.

Fasting, faith, charity, prayer, and the Hajj pilgrimage form the basis of how practicing Muslims live their lives.

Can fasting weaken immunity and the ability to fight the coronavirus?

The word Ramadan comes from the Arabic "Al-Ramad," which means intense heat and the dryness that follows. It is symbolic of the hardship experienced by those fasting and the burning off of sins.

Fasting is a grueling undertaking, leading many to question if it compromises a person's immunity and makes someone more susceptible to the coronavirus.

"There is insufficient evidence to suggest fasting would weaken people's immunity," Malik said. "Studies have been mainly retrospective and observational in nature that are open to bias, therefore at present there is no conclusive evidence that immunity is weakened by fasting."

Waqar said the main issue to be aware of when fasting during the coronavirus pandemic was dehydration. He said those with fever or prolonged illness should"“break the fast and seek prompt medical attention" because people with coronavirus "can become very sick quickly and adequate hydration here is vitally important."

Some Islamic scholars claim fasting actually strengthens immunity. Is this true?

Egypt's Al-Azhar University, considered the top theological authority for Sunni Muslims, issued a statement on April 18 reminding Muslims that they had to fast, with no special exceptions because of the pandemic.

"Not fasting during Ramadan due to coronavirus is not permissible, and fasting is a duty and a must for Muslims," Al-Azhar said.

Shi'ite religious leaders issued similar statements.

Ayatollah Bashir Hussein al-Najafi, a top Shi'ite cleric in Iraq, issued a fatwa on April 15 saying that fasting strengthens the immune system and could actually prevent Muslims from contracting the coronavirus.

But Malik said that "there is no conclusive evidence to suggest fasting strengthens immunity."

Waqar said medical research on Ramadan was an emerging field and based on observation rather than trials, making it difficult to ascertain if fasting improved or compromised immunity.

"We do know that, for instance, in some people weight and blood pressure can improve in Ramadan, but if often returns to [the] baseline shortly after," he said. "It is also worth noting that intermittent fasting outside Ramadan has also become popular as a dietary choice."

Can Ramadan traditions increase the chance of contracting the coronavirus?

For many, Ramadan involves breaking the fast in big groups. It also entails attending mosques more often to pray.

The coronavirus is transmitted by close contact between people, as the virus is "spread through respiratory droplets and contact with contaminated surfaces," according to the World Health Organization.

To lessen the public health effects, many countries have enforced strict social-distancing measures. Many Muslim-majority countries and those with sizeable Islamic communities that are fearful of a surge in infections have restricted Ramadan religious services and communal feasts.

"While Ramadan is traditionally a very social time, this year it must be different," Waqar said. "Social distancing is vital in this pandemic. If anyone does not follow the government advice of social distancing, they will be contributing to a further rise in coronavirus cases."

Dr. Shafi Malik
Dr. Shafi Malik

Many governments have made efforts to get this message out to Muslim households. Meanwhile, various Muslim organizations have launched awareness campaigns on social media, including the #RamadanAtHome campaign.

Malik said social-distancing measures enforced by governments and health authorities are essential in limiting and containing the spread of the coronavirus. "People fasting during Ramadan must abide by local rules and follow social-distancing guidelines," he said.

What measures can Muslims take during Ramadan to stay safe?

"People must stay at home," Waqar said. "This includes family and friends who may feel like coming over to share a meal or spend time with you -- this cannot happen. Mosques are closed and prayers are being performed at home."

Otherwise, he said, people who fast should take the usual precautions: ensuring that during nonfasting hours they are well hydrated, that meals are balanced and healthy, and seeking prompt medical attention if they become ill, including from issues that are not related to the coronavirus.

"Ramadan has been shown to improve the mental health of some individuals, although in the context of a pandemic this may be different, and people should try and capture the spirit of Ramadan in other ways such as with virtual iftars," he said, referring to the breaking of the fast after sundown.

"Those who are asymptomatic and healthy should be able to observe fasting like in previous years," Malik said. "Those who feel unwell or have coronavirus symptoms are at high risk of reduced fluid intake and subsequent dehydration and should consider abstaining or break their fast in addition to seeking help."

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    Frud Bezhan

    Frud Bezhan is the editor for Afghanistan, Iran, and Pakistan in the Central Newsroom at RFE/RL. Previously, he was a correspondent and reported from Afghanistan, Kosovo, and Turkey. Prior to joining RFE/RL in 2011, he worked as a freelance journalist in Afghanistan and contributed to several Australian newspapers, including The Age and The Sydney Morning Herald.