Cotton Swabs and Hazmat Gowns: The Sacrament of the Sick During COVID

Chaplains recount their sacramental challenges.

Father Stephan, a Ukrainian Greek Catholic Church priest, wearing a special suit to protect himself against coronavirus, stands, after visiting patients with COVID-19 at an intensive care unit of the emergency hospital in Lviv, Western Ukraine, Saturday, Jan. 9, 2021.
Father Stephan, a Ukrainian Greek Catholic Church priest, wearing a special suit to protect himself against coronavirus, stands, after visiting patients with COVID-19 at an intensive care unit of the emergency hospital in Lviv, Western Ukraine, Saturday, Jan. 9, 2021. (photo: Evgeniy Maloletka / AP)

Celebrating the sacrament of the sick in the era of COVID has required a combination of extra technology, grace and courage, chaplains told the Register in interviews last month marking the one-year anniversary of the pandemic in the United States. 

“I was really, really nervous — really frightened,” said Father Lawrence Chellaian, vice president of mission integration at Irving, Texas-based Christus Health, recalling when he first started going into COVID-19 patients’ rooms.

Father Chellaian said he drew strength from the nurses who had to spend more time with COVID patients than the minutes-long encounters he had. “Those nurses are with the patient the whole day, about 12 hours,” Father Chellaian said. “Looking at their faces gave me a lot of peace and comfort.”

A year later, the fear is gone: since he works in health care, Father Chellaian is among those who have received the vaccine early. 

And yet much remains the same. With just under a fifth of the population vaccinated by April and some warning of a potential fourth surge, Father Chellaian and chaplains like him remain on the front lines of the fight against a pandemic that limited reception of the sacraments, which depend on touch and physical proximity — contrary to the social distancing mantra of public health officials. 

While much of work, recreational, and social life in the U.S. has shifted over to online platforms like Zoom, the sacraments like confession cannot be done remotely. 

“We don’t absolve over Zoom. No, no, no, we don’t do that. We’re not Zoomophiles when it comes to sacraments,” said Msgr. Kevin Irwin, a theologian at the Catholic University of America who has written a book about the sacraments and COVID-19, Liturgy and Sacraments in a Covid World: Renewal not Restoration

“The problem is sacraments are always live. You have to be there — sight, sound, taste, smell, and touch,” Msgr. Irwin said. 

That meant that the sacrament of the sick still had to be done in person — or not at all. At Christus Health, Father Chellaian, who oversees 83 staff chaplains in four states and two countries, issued a statement declaring that the sacrament of the sick was to be considered an “essential service” for patients. 

And that meant that priests going into a room would have to wear a mask along with protective gowns, booties, and a face shield. Priests also need added training — first, in how to properly wear an N95 mask and, second, in how to properly put on and take off all of the other gear, Father Chellaian said. 

“It’s most uncomfortable because you’re so hot. You’re steaming up with the mask and with the goggles or with the shield over you,” said Father Richard Bartoszek, a chaplain at Beaumont Hospital in Grosse Pointe, Michigan, next to Detroit.


Non-Verbal Communication

While the ability to have conversations with patients may have been impeded by their protective gear, priests and patients turned to non-verbal communications, like holding hands, Father Bartoszek said. In many instances, the inability to talk clearly through the mask and face shield didn’t matter since the patient was unconscious, sedated, and on a ventilator, he noted. 

Church guidelines that were already in place before COVID allow priests to use a cotton swab to deliver the oil used for the anointing of the sick, but chaplains like Fathers Bartoszek and Chellaian said they went ahead and applied it directly. Priests also have to take special care with the oil after the anointing, disposing of it in the patient’s room before they leave. Likewise, the ritual prayers need to be printed out and disposed of with the oil, according to guidelines published by the National Association of Catholic Chaplains and the Catholic Health Association of the United States. 

Priests cannot do the sacrament over FaceTime or other digital platform, according to Msgr. Irwin and David Lichter, the executive director of the National Association of Catholic Chaplains, which issued a series of guidelines for administering the sacrament of the sick during the pandemic. However, chaplains have used video conferencing or simple phone calls to talk with patients in advance, cutting down on the amount of time they’ll spend with them in person, according to Fathers Chellaian and Bartoszek. 

Nurses cannot do the anointing for priests, but they can bring patients last Communion, called Viaticum. “In situations like this, you’ve got to say what overrides a three-year commissioning service is really that the Catholic patient receive the Eucharist,” Msgr. Irwin said, referencing the three-year term of commission that normally applies to lay ministers of Holy Communion. 


‘There Was No Playbook’

Some priests have chaffed under all the restrictions. Father Bartoszek recalled being on a conference call with younger parish priests in his area, advising them against going into COVID patients’ homes or attempting to hear confessions outside their windows. Other priests are on the opposite end of the spectrum: too uncomfortable with exposure to the virus to go near a patient, instead standing outside the room and saying the prayers for the sacrament of the sick. 

According to one account in the Los Angeles Times, a priest dispensed with the anointing and recited the prayers for the sacrament to the patient over video chat, telling the patient that a plenary indulgence from Vatican had the same effect as if he’d done the sacrament of the sick.

“To be very fair to the priests they there was no playbook for this. They woke up one day [and] the bishop said, ‘Close the church’ and then he said two months later, ‘Find yourself a camera and do a livestream Mass. … And don’t give out Communion and don’t anoint the sick. And don’t do this and don’t do that,’” Msgr. Irwin said. “So every couple of weeks these guys are getting totally turned at the post.”

For confession to dying patients, the National Association of Catholic Chaplains and the Catholic Health Association of the United States’ guidelines outline a couple of possible options for priests. The first is private confession with the priest wearing all the usual protective wear. If that’s not possible, they suggest that priests consider general absolution to “groups of patients from the doorway of a ward” if the local bishop has authorized general absolution. A third option is phone calls, which “can be considered important and healing pastoral visits” according to the guidelines, even though such conversations aren’t the same as sacramental confession. 


Plenary Indulgence Provision

While priests like Fathers Chellaian and Bartoszek have been let into COVID-19 patient rooms, some hospitals won’t allow it, meaning that some Catholic patients have inevitably died, without receiving the sacrament of the sick and the forgiveness of sins that comes with it. In those instances, the Vatican has deployed a particular spiritual weapon in its arsenal of grace: a plenary indulgence to those suffering with the coronavirus. 

The decree, issued little over a year ago, states in part, “The Church prays for those who find themselves unable to receive the Sacrament of the Anointing of the Sick and of the Viaticum, entrusting each and every one to divine Mercy by virtue of the communion of saints and granting the faithful a Plenary Indulgence on the point of death, provided that they are duly disposed and have recited a few prayers during their lifetime (in this case the Church makes up for the three usual conditions required). For the attainment of this indulgence the use of the crucifix or the cross is recommended.” 

For many patients and the priests endeavoring to serve them, the pressures of the pandemic have led to something of a paradox: Many patients are missing out on the normal rituals. Many have died without family present, are receiving the sacrament of the sick without the full Liturgy of the Word or Communion, and have yet to receive funerals. 

At the same time, the demands on priests have risen sharply. In addition to ministering to patients, Father Bartoszek started making rounds with the midnight and day shifts at the onset of the pandemic, checking on how nurses and other hospital staff were doing. 

“Can you imagine people in ICU working 12 hours doing that day after day month after month?” Father Bartoszek said. “I saw what it was doing to the staff, how it was tearing them apart.”

“I couldn’t imagine being on a battlefield being anything worse. And I’m sure it’s worse when you have guns blowing up and bombs going off but we had our own type of bombs going off,” Father Bartoszek added. “I think it was the worst thing that any of us in healthcare have ever, ever lived through.”