Ta’anis Esther for Ill, Elderly, and COVID Patients and Pregnant or Nursing Women
Ta’anis Esther is more lenient than other public fast days. Though it is Minhag Yisrael to observe the fast, and it is an extremely powerful time for Tefila, the lenient approach of Halacha has important ramifications for the sick, the elderly, and pregnant or nursing women. This year, these Halachos are particularly relevant in light of the ongoing COVID pandemic, both for patients at high risk if they were to be infected and patients recovering from recent infections.
The Shulchan Aruch (O.C. 686:2) rules:
We fast on the 13th Adar. If Purim falls on Sunday, the fast is moved forward up to the previous Thursday.
The Rema adds:
This fast is not an obligation, therefore, one may be lenient when necessary. For example, pregnant or nursing women, sick people who are not dangerously ill, and even those who merely have eye pain if it is causing great distress, should not fast, and they can repay it later. However, healthy people should not separate themselves from the public (Aguda, citing the Machzor Vitri).
Ta’anis Esther is considered one of the more lenient fasts because it isn’t
mentioned by the Navi Zecharia (8:19), nor by the Gemara. It
is more lenient even than Tzom Gedalia
(which is only a Minhag that was accepted as an obligation – Tur 550). Nevertheless, it is customary
to observe the fast. Some say it is based on the Pasuk in Megilas Esther – “Lekayem …
Divrei haTzomos v’Za’akasam”
(9:31, see Tur and Beis Yosef). The Levush (cited by the Mishna
Berura) adds that the purpose of the fast is to remind us that Hashem hears
our Tefilos at times of difficulty, as He did in the times of Mordechai and
The following Halachos of Ta’anis Esther include several that are particularly relevant to those who are sick:
- The fast begins at Alos haShachar (daybreak) and concludes at Tzeis haKochavim (nightfall).
- On this fast, like other fasts aside from Yom Kippur and Tisha b’Av, bathing, anointing, leather shoes, and marital relations are permitted (Shulchan Aruch 550:2). Some Poskim say that a “Ba’al Nefesh” should refrain from washing his whole body with hot water, but it is certainly permissible for him to wash his whole body with cold water or his face, hands and feet with hot water. There are also Poskim who are stringent regarding marital relations, unless it is Leil Tevila (Mishna Berura ibid. 6, and Sha’ar haTziyun). Rav Shlomo Zalman Auerbach zt”l held that one should only be stringent and refrain from bathing and marital relations on Shiva Assar b’Tammuz and Tisha b’Av (Halichos Shlomo 13). Sefardim are lenient in this regard (Or l’Tzion 3:25, footnote 1).
- Certainly, a person may bathe if necessary for medical reasons.
- The Poskim agree that if a person wishes to bathe in honor of Purim, he may do so (Piskei Teshuvos 686 citing Nitei Gavriel, Purim 7:18).
- If a person ate during the Ta’anis, he should nevertheless complete it, even if he ate a Kezayis (Mishna Berura 549:3). He has no need to fast another day instead, though he may do so if he wishes to atone for his mistake (ibid. 568:8). If he has a weak constitution and doesn’t fast well, he should redeem the fast by giving Tzedaka (Kaf haChaim 549:7).
- The Shulchan Aruch (O.C. 567:3) maintains that it is not appropriate to wash one’s mouth on the morning of the fast. The Magen Avraham (ibid. 6) rules that it is permissible with less than a Revi’is, however, the Mishna Berura (ibid. 10, 6-11) concludes that it is preferable to be stringent. Nevertheless, if it is causing distress, he may wash his mouth out and tilt his head forward so that he is sure not to swallow anything.
- The same would apply if a person needs to wash out his mouth for medical reasons, such as if he had recent dental surgery. It is certainly permissible if he is using a medical mouthwash which is not Ra’uy l’Shtiya (fit for consumption).
- Children do not observe this fast. Although the Mishna Berura (550:5) rules that if the child understands the fast, he should only be given bread and water, this is not common practice and he may eat in regular fashion (Halichos Shlomo 13, footnote 10).
- Pregnant women do not observe this fast (Shulchan Aruch O.C. 554:5). The practice of the Sefardim is that pregnant women only fast on Tisha b’Av and Yom Kippur (Or l’Tzion 25:7). However, the Rema’s view (O.C. 550:1) is that pregnant women customarily fast, unless it would cause them great distress. The Mishna Berura (ibid. 3) clarifies that they should not fast if they are weak in any way.
- Today, it is commonly held, that since people are generally of weaker constitution, and pregnant women are likely to be distressed by fasting, they should not do so (Halichos Shlomo 16:1 & Chut Shani, Shabbos 4, p261). [Some cite Rav Shmuel Wosner zt”l as ruling that they should begin fasting, but if they feel weak they should discontinue the fast immediately.] Since Ta’anis Esther is the most lenient of the public fast days, the Poskim agree that pregnant women should not fast at all (Piskei Teshuvos, 686, footnote 9).
- Pregnant women are exempt from conception until birth (Mishna Berura 3, and Or l’Tzion ibid.)
- According to the Shulchan Aruch (ibid.) nursing women should not fast at all. This is the custom of the Sefardim. However, the Rema’s view is that nursing women customarily fast, unless it would cause them great distress. Contemporary Poskim rule that they should not fast due to the concern that her supply of milk will be affected (Chut Shani, Shabbos 4, p260). The Chut Shani and Or l’Tzion (ibid.) rule that she is exempt from fasting, even if she only nurses a little bit, or just once a day.
- A woman who has given birth is exempt from fasting for 30 days (Shulchan Aruch O.C. 554:6) as she is considered a Cholah She’ein Bah Sakanah (a non-dangerously ill person) who is exempt from these fasts (see below). After 30 days, if she feels weak she may be lenient and not fast (Kaf haChaim 554:28). Some hold that a woman who has given birth is exempt for fasting for 24 months! Their reasoning is that a nursing woman is not exempt due to the nursing but due to the period of recovery following birth. Chaza”l describe childbirth as “jarring a woman’s limbs”, and she does not fully recover for 24 months.
The Halacha is not in accordance with this ruling, but each case should be examined independently. If she feels weak during those 24 months, and she wishes to be lenient, there are Poskim to rely upon who permit it (Chazon Ovadia, Ta’aniyos p62).
- If a woman suffers a miscarriage more than 40 days post-conception, she has the same status as a woman who has given birth (Biur Halacha 617:4 & Shemiras Shabbos Kehilchasa 36:5).
- A Choleh She’ein Bo Sakanah is exempt from fasting except on Tisha b’Av and Yom Kippur, as the Chachamim did not make enactments that would adversely impact on those who are sick (Shulchan Aruch 554:6). In fact, they may not be stringent and fast (Mishna Berura 550:4).
- Who is considered a Choleh She’ein Bo Sakanah?
- A person’s whose entire body is painful or who is forced to lie down due to illness.
- A temperature above 37.5⁰C degrees is indicative of a medical issue and is grounds to exempt a person from fasting (Or l’Tzion 3, p260). A higher temperature may render a person a Choleh sheYesh Bo Sakanah.
- A person with a headache that causes him to perspire in pain (Or l’Tzion ibid.)
- A person with an internal infection such as a throat or kidney infection, or septic arthritis.
- A person with gastroenteritis causing diarrhea or intestinal distress.
- A cardiac patient who will be harmed by fasting.
- Patients with malignant diseases.
- Patients with diabetes or hypertension should consult with their physician and their Rav or Posek.
- A patient who has undergone a minor surgery, such as the repair of a broken bone, is exempt from fasting for three days following the surgery. If he doesn’t feel well, he is exempt for seven days. If it was a more significant surgery, he is exempt for 30 days, like a woman who gave birth. Each case should be examined individually – if the person feels weak, they are exempt even after 30 days (Or l’Tzion ibid. Teshuva 6).
- Those who feel extremely weak, or who have pain in their eye, or a bad headache, are exempt from fasting, particularly on Ta’anis Esther (Poskim in O.C. 550).
- A person over the age of 80 should not fast (Or l’Tzion 3:29). Below that age – if a doctor maintains that fasting will harm him – he is considered a Choleh She’ein Bo Sakanah and is exempt from fasting. If he is healthy and strong, he should fast (Kaf haChaim 550:6). A person should be smart and not harm himself due to the fast, thus losing more than he gains.
- Symptomatic COVID-19 patients, such as those with a temperature higher than 37.5 degrees, muscle pain, shortness of breath, etc. are exempt from fasting.
- Asymptomatic COVID-19 patients, but who are at risk of severe complications, should seek Halachic guidance. There is room to say that they may be lenient and not fast.
- Recovered COVID-19 patients, who still feel weak due to the residual effects of the virus, are exempt from fasting. For example, a person who had a temperature of higher than 38 degrees for three days, or fever accompanied by infections and diarrhea, and who recovered, is exempt from fasting for three days. If he had high fever (a temperature of 39-40 degrees), he was considered a Choleh sheYesh Bo Sakana and is exempt for fasting for seven days (Or l’Tzion ibid.)
- COVID patients commonly feel very weak after they recover. They therefore should follow what is stated in No. 22.
- A person who is permitted to eat during the fast should slightly limit their food and drink intake so as not to separate themselves from the Tzibur who are fasting. Unless there is a medical need, they should not eat meat or drink wine (Eshel Avraham 686).
- According to the Da’as Torah, citing the Shu”t Besamim Rosh (239) – if due to the fast a person will be severely weakened and will still be in distress over Purim, he is exempt from fasting.
This ruling has not been widely accepted and a person should not be lenient without consulting a Rav (Piskei Teshuvos 686).
- Following the Ta’anis, the Tzibur should not prolong the Megilah reading unnecessarily so as not to delay the elderly and those weak from the fast from eating.