Swine Flu and Eucharist

Christian Worship in the face of Pandemic

This is not intended to be a comprehensive or definitive treatment of the “swine ‘flu” pandemic, and does not represent the official position of any church body. It is simply an attempt to make available, in accessible a form as possible, the essential information, on the basis of which decisions affecting our worship and community life may need to made at some point in the future. This includes the medical and public health advice which has been issued to faith communities, as well as the theological and liturgical principles governing our worship.

We are all aware, mostly through the media rather than through personal experience, of a virulent strain of influenza spreading in our society. There has also been considerable media attention to the implications of this pandemic for Christian worship. If this is going to affect our corporate life, then we need to be well informed about it, to ensure that our response is appropriate and proportionate, and that concerns about public health and the integrity of our worship are balanced.

Our principal source of medical information is the Ministry of Health, with the Government Medical Adviser collaborating with the Department of Communities and Local Government, giving particular attention to the implications of the pandemic for faith communities.[1] The Scottish Government has also published its more general advice on the public health issues.[2] While we need to consider this seriously, we also recognise the political necessity for governments not to appear complacent. The prevalence of the infection is not uniform, and not all parts of the country are equally affected. Church authorities are therefore not wishing to be precipitate in implementing emergency measures which would affect very deeply our worship and corporate life.

There is inevitably considerable disagreement among the medical and other professionals responsible for addressing this situation. There are precedents, but previous influenza epidemics were several decades ago, and epidemiology and clinical medicine have developed considerably over the years, public health has improved in significant ways, and preventative measures as well as treatments are more widely available. The continuing prevalence, and in some places, spread of HIV-Aids is a rather different social phenomenon, but there have nonetheless been significant developments in clinical medicine and epidemiology on this account. In all cases, it is important for us to recognise, the infection needs to be present, though not necessarily with manifested symptoms, before contagion can result.

So far as the strain of influenza currently threatening public health is concerned, it is clear that both direct and indirect contact can lead to contagion. People knowing themselves to have been exposed to the virus should therefore quarantine themselves for a period of five days. It is with undiagnosed occurrences of the infection that we need to be concerned, and to which we need to respond proactively.

As in all social contexts, contagion is most likely through unarrested coughing and sneezing. The normal social conventions apply, and, while particular care must be taken, no special measures are needed for public worship.

Contagion is possible also through food, which raises concerns about direct and indirect contact, through the hands and through vessels in which food and drink are contained. This concerns our worship very directly, and therefore requires careful and well-informed consideration.

It is highly unlikely that the Government will proscribe public worship in general, or the celebration of the Eucharist in particular. But questions have been raised about some customs relating to the Eucharist, and the cleanliness of the vessels used, and of the hands of the ministers administering Communion.

There may be Christians who genuinely believe that they are protected from contagion by the sanctity of the Eucharistic elements. While their piety is to be respected, it has never been orthodox Christian doctrine to attribute magical or quasi-magical qualities to the consecrated elements. The Church therefore cannot be complacent about the risks of infection, or the consequences of being perceived as providing an environment conducive to the spread of a virus with potentially fatal consequences. We need to be aware also that, whereas twenty years’ ago it was understood that the alcoholic content in Communion wine, and the metal of the chalice, were hostile to transmission of HIV, this is not believed by current medical opinion to be the case with other viruses, including that causing the particular strain of influenza now spreading.

Our Sacristan, Servers, and Eucharistic Assistants will of course take all due measures to ensure that the sacred vessels are cleaned after each celebration of the Eucharist, and are stored in sanitary conditions when not in use. Purificators and lavabo towels will be washed thoroughly after every use, as in always the practice. Ministers will of course also ensure that their hands are clean before touching vessels or cloths, as well as wafers, used in the celebration of the Eucharist. This is no more than we have always been trained to do, and we will continue to observe normal practice, as well as adopting any further measures which may be deemed necessary in the future.

There are two particular customs relating to the Eucharist which we need to consider with care. These are the Greeting of Peace, and Communion from the common Chalice.

The Greeting of Peace is a very varied, and in some respects a subsidiary, part of the Liturgy. Many of us will remember rites, such as that of the English Book of Common Prayer, in which it is excluded altogether. The Scottish Liturgy (1970), which we use regularly, uses the words associated with the Peace, but makes no provision for communicants to exchange greetings with each other in the context of the liturgy. Most, if not all, contemporary Anglican liturgies include the Peace, and envisage that worshippers should exchange greetings, according to local custom. The handshake is the most widespread custom in the western Church, clearly borrowing from prevailing cultural conventions, and practice may accordingly vary in other parts of the world. However accustomed we have become to the handshake, therefore, it is by no means essential to the Greeting of Peace. The physical contact involved in the handshake, when the hands are shortly to be used to receive food, i.e. the Communion wafer, does pose a limited risk of contagion. It would be possible for the Peace to be conveyed verbally, or by other gestures which do not involve physical contact, and such a practice may have to be considered.

It would be technically possible, even if time-consuming and practically difficult, for communicants to disinfect their hands after the Peace. There are various products available, some of which are probably more effective than others. But it is very easy for cleaning products themselves to become agents of contagion if they are not administered correctly, and if they generate waste matter which could harbour infections. We would also need to consider both the disruption to our worship this would entail, and the denial of precisely what the Peace is intended to convey, which such actions could be perceived to express.

The position of the Greeting of Peace in the Eucharist is variable. The predominant custom is for this to take place before the Offertory. There are precedents for this at least as ancient as the second Christian century.[3] The Scottish Liturgy (1982) provides, alternatively, for the Peace to be shared at the start of the service, which is the custom at St Aidan’s. This is a less ancient observance, but one which reflects the need for the community to be formed anew as the Body of Christ before it can celebrate the Eucharist. In both positions, the Peace precedes the Communion, and physical contact could therefore pose some risk of contagion. The Peace could also form part of the conclusion of the Eucharist, after the Communion, as a sign of our going out into the world as the Body of Christ. A theological and liturgical case could be made for this, and there are some ancient precedents.[4] There is no provision for this in the Scottish Liturgy, but the Bishop has intimated that there would be no impropriety in innovating here. If we were to adopt this custom, we would avoid direct physical contact without abandoning the Greeting of Peace. This is another option we may have to consider.[5]

Communion from the common cup is a very much more sensitive issue. As most of us will be aware, Communion in one kind, i.e. the distribution of consecrated wafers, with the Priest alone consuming the wine, is normative in the Roman Catholic Church. This has been the custom since the mediaeval period, and it is thought that it was in response to the Black Death, and in fear of contagion through the chalice, that the cup was withdrawn from the laity. Centuries later, this was to be one of many issues of contention at the Reformation. For many of the reformers, this practice was a violation of our Lord’s command at the Last Supper, to “Do this in remembrance of me”. While the response of the mediaeval Church to the Black Death could suggest an historical precedent for introducing Communion in one kind now, it also illustrates how the contingencies of one moment, if they become established custom, can subsequently become the occasion for strife and schism. A further consideration to be weighed is that, with drinking from a common cup so contrary to prevailing secular culture, it might be difficult to restore the Chalice to the laity should it be withdrawn for any length of time. The last influenza epidemic in the United Kingdom persisted for well over a year. The implications of such liturgical change for our corporate life, not only in individual congregations but throughout the Anglican Communion and ecumenically, could be considerable. If we do take the step of administering the Sacrament in one kind only, it will need to be clearly understood that this is an emergency provision, and it must not on any account become established custom.

Communion in one kind is not the only alternative to sharing the common cup. Many of us will have experienced Communion from individual cups in the Church of Scotland and in other Protestant denominations. There may well be pressure to consider its introduction in Anglican and Episcopal churches. The capital costs of investment in the necessary vessels, the supply of which is presumably quite limited, at short notice would certainly militate against introducing such a system in our church. Such a change would also fundamentally change our experience of the Eucharist. It would therefore need to be considered very carefully, and not in reaction to what we hope will be a transient danger to public health.

In Anglicanism, an increasingly common alternative to drinking from the Chalice has been intinction of the consecrated wafer in the wine. How this is done varies considerably. In some parts of the Anglican Communion it has been normative for some years for the Priest, Deacon, or authorised lay minister to instinct the wafer in the Chalice, and then to place it on the tongue of the communicant. In the Orthodox churches communicants are not permitted to touch the Eucharistic elements with their hands, and until recent decades this was the practice in the Roman Catholic Church also. But, for many Anglicans, receiving the Sacrament in our hands is important, and reminds us of the very physicality of our Lord’s incarnation, and also that our hands and our whole bodies, and what we do with them, are consecrated to God. Another form of intinction, already adopted by some members of our congregation, is for the communicant not to consume the wafer until he or she has dipped it in the Chalice. Both these methods of intinction are now being actively discouraged by the Government in its advice to faith communities, as the contacts involved are deemed to pose a risk of contagion. In the former case, the fingers of the minister could become contaminated through the saliva of an infected communicant, and transmitted to the wafers in the Ciborium or directly into the mouth of another communicant. In the latter case, the fingers of a communicant, which have been in contact with the virus, could transmit it to the Chalice, from where it could be contracted by another communicant. The Archbishops of Canterbury and York, whose jurisdiction of course includes only the Church of England, have accordingly advised that, where intinction is practised, the minister dip the wafer in the Chalice and then place it in the hand of the communicant. A moist wafer may be more likely than a dry one to contract any virus present on the communicant’s hand, so it may be doubted whether this would in fact be a safe or sanitary solution to the problem.

It is a widespread custom, though not currently in use in this Charge, for wafers for Communion taken to sick or housebound members of the congregation to be intincted, after consecration, and allowed to dry before they are taken to homes or hospital wards for distribution. In this particular context, intinction avoids the risk of spilling or leaking consecrated wine while conveying it to the communicant, as well as the use of Chalice and purificator which could potentially convey infections. A further advantage is that, if communicants are taking prescribed medication, questions to do with compatibility of alcohol with these drugs do not arise. It would be possible for wafers to be intincted for distribution in public worship. However, this would be a time-consuming undertaking, and the wafers would probably need to be intincted before the service, so that they can dry before the Communion.

Perhaps the most important point to be made is that no infection can spread in a community unless it is already present. However, should the particular influenza virus be manifested in one or more of our members, with the risk of exposure of others to inflection, we would need to consider the options. The purpose of this document is to provide as much background information as may be helpful should that situation arise. But it does not represent, or purport to represent, a definitive or official position of any organ of the Church.

[1] www.communities.gov.uk/publications/communities/influenzapandemic.

[2] http://www.scotland.gov.uk/Topics/Health/health/AvianInfluenza/mexicanswiuneflu.

[3] Justin Martyr [Rome], I Apology 65.

[4] Tertullian [late second, early third century, Carthage, North Africa], On Prayer 18; Origen [late second, early third century, Alexandria, Egypt, mid third century, Caesarea Maritima, Palestine], Commentary on St Paul’s Epistle to the Ramans 10.33; possibly Augustine [late III, early IV cent. Hippo], Sermons 227.

[5] Further discussion, Paul Bradshaw, Eucharistic Origins (London: SPCK, 2004); L. Edward Phillips, The Ritual Kiss in Early Christian Worship (Cambridge: Grove, 1996).