The margins of the health system are crumbling quickly. After a sharp increase in the number of identified coronavirus carriers in Israel beginning in early September, the numbers are already being translated into data that directly influence the quality of medical care. In recent days there has been a marked increase in the number of hospitalized and seriously ill coronavirus patients. In some of the hospitals, the crowding in the coronavirus wards is beginning to resemble the internal medicine wards of winter.
At the start of the crisis, the “threshold of inadequacy” of Israeli hospitals — that is, the number of seriously ill patients who could be treated at the same time without significantly undermining quality of care — was around 800. On Monday morning, the number of seriously ill coronavirus patients reached 651, and it continues to rise. Health Ministry Director-General Hezi Levi wrote to hospital directors that according to the forecasts shown to his ministry, by Yom Kippur the number could easily rise by another 200 or 300 and cross over the 800 mark. And all this is taking place before we can assess the damage done by Rosh Hashanah – it's too early to know just how many were infected at the numerous large family meals that took place the day before the lockdown went into effect and at mass prayer services in synagogues.
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Many religious and ultra-Orthodox congregations made great efforts to uphold social distancing rules during the holiday prayers, but there are an increasing number of testimonies regarding Hasidic courts that openly flouted the rules and conducted mass prayers in closed spaces. The intentional violation of the guidelines continued Monday, as some Haredi schools reopened without even a trace of police enforcement.
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For some reason, all this doesn’t seem to interest those making concerted efforts day and night to distance Prime Minister Benjamin Netanyahu from even the slightest suspicion of responsibility for anything that’s happening. The Likud’s talking points on Monday included a varied list of those to blame – coronavirus czar Prof. Ronni Gamzu; the educational system that became the focal point of contagion (strange that the education minister's party affiliation — Likud — was never mentioned in the interviews); the undisciplined public, and of course, the anti-Netanyahu demonstrators on Balfour Street. The last of the lot splendidly scored an own goal with a mass holiday dinner that they insisted on holding in front of the prime minister’s residence.
The chaos on Monday, the first day after the holiday, was reminiscent of those first terrifying days of the pandemic last winter. The police checkpoints on the roads generated huge traffic jams that blocked people from going to work for no reason; restaurateurs sought creative ways to circumvent the bans on food service, and in hundreds of thousands of homes, parents lost their patience with a faltering distance learning system that doesn’t seem to have evolved much since the first lockdown.
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I can’t recall such harsh comments about the government even during the Second Intifada or the Second Lebanon War. In the shadow of grief we must also hold a meaningful discussion: Will the imposed partial lockdown be enough to halt the spread of the virus? Are the steps being taken effective at all, or are they just burdening the public?
The coronavirus cabinet will convene again on Tuesday. It seems Netanyahu seeks to tighten the crackdown on the public on the worn-out assumption that the public’s lack of discipline makes it necessary to do so. But it’s possible that internal disagreements in the coronavirus cabinet will delay these decisions until after Yom Kippur.
Better late than never
Prof. Levi ordered a series of new measures on Monday: the operation of a unified hospitalization headquarters that will divert coronavirus patients among hospitals based on their occupancy; the opening up of new coronavirus wards; and the resumption of the policy to postpone less urgent surgeries. At the same time, Defense Minister Benny Gantz announced that the Israel Defense Forces would, by winter, set up a field hospital that could admit some 200 coronavirus patients. The Israel Medical Association called on retired doctors to enlist in the campaign to conduct epidemiological investigations and help cut the chains of infection.
All these moves are necessary, but ultimately beg the question of why they are only happening now when the trend of the virus’ spread has been clear for weeks. That threshold of 800 seriously ill patients was discussed back in the spring.
Physicians who have filled senior posts in large hospitals recently told Haaretz that the definition of the point of collapse is too conservative. They say it doesn’t take into account necessary steps that could have been taken in advance and carried out quickly, like opening new coronavirus wards and assigning retired doctors to hospital departments that don’t deal with the coronavirus (to protect them, due to their age). If we address the crisis in war terms, it’s clear that the health system has yet to take measures parallel with those the army would take in such a situation – a general call-up and the provision of all the resources needed to cope with the challenge.
Not very bright
Netanyahu managed to get mixed up in another scandal on Monday, when two of his aides were caught violating the already (unjustifiably) shortened quarantine period that was imposed on his entourage after they returned from last week’s signing ceremony in Washington. Sometimes it seems as if he is doing everything he can to erode what remains of his credibility in the eyes of his citizens, as he continues to brazenly signal to them that the laws do not apply to him and his people.
This affair was almost inevitable from the moment Netanyahu was hosted by U.S. President Donald Trump’s coronavirus-denying administration. All social distancing rules were violated at the ceremony; it later emerged that some White House employees had been diagnosed as coronavirus carriers. Then, upon the delegation's return to Israel, an aide who was supposed to be in quarantine was apparently sent on a secret mission – documentation of possibly staged coronavirus deniers on the fringes of the Balfour demonstration, with the aim of disgracing all the protesters.
Almost as usual, the Likud response was only loosely connected to the truth. It turned out that the aide, Topaz Luk, was not on his way to take a coronavirus test, but took the liberty to walk around a mass event shortly after undergoing the test; and his test was not taken at the Balfour residence, but rather more than a kilometer away, at the Prime Minister’s Office.
The sharp eyes of one of the protesters caught the aide in the act. That didn’t stop Netanyahu from complaining about selective enforcement against his associates. As if it weren't enough that he is managing the crisis terribly, the prime minister insists on continuing to serve as a bad example to his citizens, flouting the guidelines that he himself set.
Meanwhile, the dirty tricks in Netanyahu’s environment recall the last days of the Nixon administration, even if, in our case, the end is not yet in sight. It seems that the most appropriate quote comes from that film about the Watergate scandal, “All the President’s Men”: “The truth is, these are not very bright guys, and things got out of hand.”