Sangha in the Age of Long COVID

As we move toward another winter season, I’m reminded that in the communities I love, there are two separate worlds unfolding. In one, people are looking forward to a season of connection where holiday gatherings, parties, and travel abound. In the other world, people are having difficult conversations about risk tolerance, taking stock of safety measures needed for travel or gatherings, or abstaining from these activities altogether. 

Over the last few years, I have witnessed the incredible dissonance between these two worlds within the Buddhist communities I practice and teach in. This spring, when the US ended the COVID-19 Public Health Emergency, I saw practitioners who were thrilled that meditation centers were dropping mask mandates and couldn’t wait to get back to a “normal” retreat. I also spoke with, sat with, and cried with others who knew that for them, this change meant something close to exile from the dharma communities they cherished. Overwhelmingly, that second group of people were chronically ill, immunocompromised, or disabled.

I feel acutely aware of this in part because I currently live with a chronic, invisible illness that places me at greater risk of long-term suffering and disability were I to contract COVID. Retreat practice and sangha have always been a deep refuge for me, so I was heartbroken as meditation centers that had once been my spiritual home became increasingly risky to access. Even as rates of the virus surged, I have found it difficult, and at times quite unwelcome, to out myself as vulnerable and ask for accommodations. As a result, I have lost the unfettered access to once beloved communities, practice opportunities, and aspects of my livelihood.

For many in the US, the rationale for dropping protections, like masking and free access to testing, has been deceptively simple: today, only members of vulnerable groups or the elderly are likely to die from COVID. Take a moment and really read that carefully. Allow the unspoken part of the sentence to grow louder. Place yourself in the shoes of someone who is chronically ill, disabled, or elderly and is receiving the message from our government and institutions that their life is acceptable collateral damage to neighbors who are eager to get back to normal at all costs. Ableism like this is baked into every aspect of the culture, and our meditation centers are certainly not exempt from it.

It may be helpful to remember that COVID-19 is still among the top leading causes of death in the United States. This year, Long COVID will also induct millions of new people into the ranks of the sick and disabled. Depending on which study you review, Long COVID affects anywhere from 7.5 to 40 percent of people who contract the virus and has more than 200 possible symptoms. It can last for months or indefinitely, and there is no cure or standard effective treatment. Long COVID can negatively impact a person’s quality of life, leave them bedridden, unable to work to support themselves, and more. Unfortunately, as a culture, we seem eager to forget this reality. Our yearning to return to “normal” is incongruent with the fact that vulnerable people must continue to live, work, and practice in a world that often feels like it would rather pretend they don’t exist than adapt in a compassionate way. In the Buddhist community, how do we face this truth, rather than turn toward delusion?

Ableism like this is baked into every aspect of the culture, and our meditation centers are certainly not exempt from it.

This delusion is consistently fortified by the invisibility of sick and disabled people in public spaces. Whether these spaces are physically inaccessible, or a person feels too unwell or unsafe to join them, the end result is a disappearance from the public eye. I often think about this in relation to dharma communities throughout the country. Which sangha members are now absent from your local sitting group? Who are the longtime community pillars that have quietly absented themselves from our meditation centers? Did they just stop practicing, or do they no longer feel safe in the communities that used to be a refuge? 

I’m not alone in longing for a spiritual community that holds on to an ethos of care at a time when masking and other precautions are unpopular. Monica Magtoto, a movement teacher who supports many meditation retreats, shared her concerns about dharma centers dropping mask requirements in a recent conversation:

“As someone who has experienced the life-changing impact of retreat, knowing that that experience is now not an option, or is now a dangerous option, for so many people is disheartening to say the least. It’s a huge reminder that many dharma spaces are only created with the most privileged and able-bodied in mind. Are we living the precepts if we choose to exclude or do active harm to so many? Are we living the eightfold path?”

Today, meditation centers have a wide range of approaches to COVID, and while some protocols are inclusive, many reinforce the message that our sick, elderly, and disabled sangha members are acceptable collateral damage. For drop-in groups and daylong retreats, a vast majority of centers have eliminated previous precautions such as masking and onsite testing. Some communities offer suggested recommendations like vaccination, testing negative with an at-home test, or not attending when sick. Other centers have kept mitigations like air purifiers and CO₂ monitors, and a few even hold occasional outdoor events. For most residential retreats, precautions have typically dropped to a testing requirement on the first day of the retreat. A very small number of retreat centers do offer retreats with a focus on practice outdoors, and some retreat centers have brought back masking for specific retreats this fall as COVID cases see a seasonal increase.

One notable outlier, the East Bay Meditation Center in Oakland, California, still has a wide range of COVID precautions in place, including masking, clear descriptions of the air filtration systems present in their space, and priority seating next to windows and air filters for the elderly and disabled. On their website, they share:

“When we commit to justice movement building and mindfulness, this means that we commit to self-care as collective care, and we also dedicate ourselves to supporting the health of our communities. This is not achieved through policing. It comes about through building relationships of trust that express themselves in our saying to one another, ‘I’ve got your back. Your health and your family’s health and the health of the people with whom you come in physical contact with are important to me.’”

While we may have seen public declarations like this in 2020 and 2021, such an explicit statement committing to collective care today is relatively uncommon. To those living with chronic illness and disability, however, such sentiments can offer tremendous refuge and allow us to better plan where we sit or go on retreat. This refuge is especially needed as meditation centers resume prepandemic levels of programming with fewer safety precautions. In the past year, I have watched the meditation centers I work with make sweeping changes to their COVID policies, often with little to no leadership or input opportunities for vulnerable groups. One colleague who works at a retreat center, and asked to remain anonymous, shared her thoughts about how dharma communities are showing up for the sick and disabled, and her own experience with Long COVID: 

“It feels hypocritical that we wouldn’t ask our sangha, who are dedicated to awakening and freedom from suffering, to put on a mask to alleviate someone else’s suffering. It feels deeply contrary to our mission. How is it that we are not open to being even slightly uncomfortable when it could mean someone else’s life? The stakes are too high and long-term effects are still not even fully known. When I share this view, people often respond, ‘Well, that’s because you have Long COVID.’ Well, yes… that’s precisely the point.”

This is not the first time a dharma community has faced this type of devaluation of sick people. In fact, it goes all the way back to the time of the Buddha, in the Kucchivikara-vatthu Sutta. In this sutta, a monk was incredibly ill with what was likely dysentery. He couldn’t care for himself and, due to his illness, also couldn’t do anything to support his fellow monks. Because of this, the monks stopped caring for him. As you might imagine, the Buddha had some things to say about this. He said to the monks:

“Monks, you have no mother, you have no father, who might tend to you. If you don’t tend to one another, who then will tend to you? Whoever would tend to me, should tend to the sick.” 

This is not far off from what we face today. Without a public safety net that demonstrates true care for us, if we don’t take care of one another, who will? The Buddha is clear that if we would care for him, then that grace should also be extended to others. This is at the heart of our dharma practice: not just to meditate and receive the teachings, but to truly live them. It’s said that the Buddha once shared with his attendant Ananda that sangha, with its admirable friendship and camaraderie, is the whole of the holy life. So many of us know this in our bones: the friendships we’ve made and the support we’ve both given and received within our dharma communities are jewels of immeasurable value. But how are we living this teaching today, if we cannot extend this sacred friendship to our sick and disabled sangha members? 

As we explore this question, perhaps even more questions will reveal themselves, opening up deeper teachings around sangha, sila (right conduct), and our own mortality. We may ask ourselves: What delusions are we clinging to, particularly in terms of how we devalue the sick, elderly, or disabled? Are we denying the inevitable reality that, in time, we too will become sick, disabled, and pass away? Are our decisions truly aligned with our commitment to nonharming? As we sit with these questions, it is likely we will also ask how we might do better. Fortunately, there is a simple place to begin: actively listening to those who are sick, immunocompromised, and disabled and taking their needs for inclusion and safety in our communities seriously.