The Orthodox Church and scientific knowledge typically parallel each other. In the event that a reconciliation appears unreachable between the Church and science, it signals that it is time to reconsider past traditions in light of current scientific evidence. Science cannot in any way dictate Orthodox theology, but rather provides a contribution to the theological aspects of the Church and to society in general.
The Coronavirus disease 2019 (Covid-19) pandemic has revealed a multitude of vulnerabilities at many levels of society. For example, despite thousands of scientific reports published since the first appearance of severe acute respiratory syndrome (SARS) coronavirus in 2003, many individuals and communities were still taken by surprise by the “sudden” emergence of the current pandemic. Since we will have other epidemic outbreaks in the future, unfortunately, it is important to consider the scientific evidence.
With regard to the Orthodox Church, there are considerations involving traditional practices including the use of the common spoon for communion, for which there exists scientific evidence supporting this custom as a definitive entry route of viral infection. Specific to Orthodox Christians is the manner in which Holy Communion is distributed via the use of a common spoon which is shared among all communicants within a congregation. Sharing a common spoon (or any object) among different individuals is a critical consideration because the oral cavity is lined with epithelial cells equipped with a receptor (angiotensin converting enzyme 2 – ACE2) which enables the entry of SARS-CoV2 (virus) into these human host cells,. Such ACE2-expressing cells also line the human nasal cavity , the mucous membrane of our eyes, lung tissue and other organs—hence the unsurprising multiple organ involvement of SARS-CoV2 infection across all age groups ,,.
SARS-CoV2 is a 120-nanometer coronavirus which has accomplished a significant evolutionary feat to bind the human ACE2 receptor with high affinity, ensuring its entrance into host cells for the purpose of its own replication. Viruses exist on this earth for the sole purpose of replicating their genome. This is their only evolutionary pressure. They are harmless on their own and are easy to deactivate in most cases. In addition, certain viruses are paving the way to understanding brain neural circuits of behavior, while other types of viruses are utilized as therapeutics for diseases, including vaccines to protect against diseases.
The symptoms associated with Covid-19 are caused by a response of the immune system and not directly by the virus itself. The virus diminishes significantly in the second week of infection, yet this is the time point at which serious symptoms begin to arise. Therefore, it is the limitations of the human immune system which enables the progression of the disease, rather than the virus. The presence of the ACE2 receptor (and other viral binding factors) on host cells is what makes humans vulnerable because it is this receptor, in part, which enables the entry of this coronavirus into cells—triggering a cascade of immune system events.
While scientific tools fall short in being able to explain mystical changes caused by the action of the Holy Spirit, Orthodox theology compensates for this limitation by (1) affirming that the transformation of the Eucharistic Gifts occur via a mode of profound mystery and (2) distinguishing between the mystical action and the physical elements: bread and wine. Contributing to the latter point regarding the distinction between the mystical and the physical, the fields of biochemistry and molecular biology provide clarification about the actual physical elements of the consecrated Gifts. For example, the consecrated wine is comprised of (1) yeast—a single-celled organism that has genetic material, (2) sugars from the juice of the grapes, and (3) potassium metabisulfite or other sulfites that act as preservatives to ward off acid forming bacteria and wild yeast preventing the wine from turning into vinegar. Similarly, the bread contains yeast, sugar, and flour and has been processed to rise and bake in the oven. These ingredients are naturally occurring physical elements thoroughly described at the biochemical and molecular level. In a similar manner, bacteria, mold, and viruses are also naturally occurring agents thoroughly described through experimental studies in the lab. While, I do not recommend to conduct such an experiment in the Orthodox Church, others have experimentally demonstrated that the communion cup contains bacteria which is inadvertently transferred into the cup after administration of the sacrament . There is, therefore, no reason to believe that SARS-CoV2, a coronavirus with a high rate of infectivity, cannot be inadvertently transferred into the communion cup by clinging to the common spoon (from the saliva of an infected communicant) and introduced into the cup through person-to-person transmission during the distribution of the sacrament.
During pandemics, scientists and physicians have an enormous responsibility to inform the public including clergy with accurate information regarding the mode of pathogen transmission. Since these are biomedical related matters it is, therefore, critically important to correct the dangerous misconception that diseases and viruses cannot be transmitted via the administration of Holy Communion. The first misconception being that it is an illness or disease that is being transferred when in reality it is a virus. SARS-CoV2 is a virus: a collection of genetic code surrounded by a protein coat searching for a host cell to thrive. An “illness” is the manifestation of disorder in the human body. It is, therefore, scientifically, impossible to transmit an illness/disease via the distribution of Holy Communion. The second misconception is the idea that viruses themselves cannot be transmitted via the administration of Holy Communion, which is scientifically incorrect.
In the same manner that scientists and physicians are called to respond to medical related crises, as Orthodox Christians, clergy have a paramount responsibility to teach the faithful. In relation to the transmission of SARS-CoV2, as a Church, we are challenged to ask how far should we go in utilizing the justification of being pious as a reason to ignore the scientific evidence? The practice of utilizing a common spoon poses a severe and potentially fatal health risk not only to Orthodox Christians, but to the broader public.
Sources for Further Reading Robert F. Taft, Byzantine Communion Spoons: A Review of the Evidence, Vol 50, 1996. Dumbarton Oaks, Trustees for Harvard University  Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, Li T, Chen Q. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa, Int J Oral Sci. 2020 Feb 24;12(1):8.  Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Müller MA, Drosten C, Pöhlmann S. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020 Apr 16; 181(2):271-280.e8.  Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M, Talavera-López C, Maatz H, Reichart D, Sampaziotis F, Worlock KB, Yoshida M, Barnes JL; HCA Lung Biological Network. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med. 2020 May;26(5):681-687.  Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and Multiorgan Response. Curr Probl Cardiol. 2020 Apr 28:100618.  Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, Auriau J, Grimaud M, Oualha M, Beghetti M, Wacker J, Ovaert C, Hascoet S, Selegny M, Malekzadeh-Milani S, Maltret A, Bosser G, Giroux N, Bonnemains L, Bordet J, Di Filippo S, Mauran P, Falcon-Eicher S, Thambo JB, Lefort B, Moceri P, Houyel L, Renolleau S, Bonnet D. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic. Circulation. 2020 May 17.  Latimer G, Corriveau C, DeBiasi RL, Jantausch B, Delaney M, Jacquot C, Bell M, Dean T.Lancet Child Adolesc Health. Cardiac Dysfunction and Thrombocytopenia-Associated Multiple Organ Failure Inflammation Phenotype in a Severe Paediatric Case of COVID-19. 2020 May 18:S2352-4642(20)30163-2.  Zhu FC, Li YH, Guan XH, Hou LH, Wang WJ, Li JX, Wu SP, Wang BS, Wang Z, Wang L, Jia SY, Jiang HD, Wang L, Jiang T, Hu Y, Gou JB, Xu SB, Xu JJ, Wang XW, Wang W, Chen W. Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial. Lancet. 2020 May 22: S0140-6736(20)31208-3.  Burrows, W and Hemmes, S.E, Survival of Bacteria on the Silver Communion Cup, Journal of Infectious Diseases. 1943, 73:180-190
Hermina Nedelescu is a neuroscientist who utilizes viruses to study brain neural circuits of motivated behaviors. She holds a B.S. degree in Biological Sciences from the University of California Irvine, an M.S. in Biology from New York University, and a Ph.D. in Biomedical Sciences from the University of Antwerp in Belgium.
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