As New COVID Cases Near Zero, Experts Urge Israel to Prepare for Next Pandemic

Despite over 75 percent of adults vaccinated and fewer than 350 active cases in Israel, experts warn 'no one knows what will happen in the winter'

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The Pfizer vaccine being administered in Israel in March.
The Pfizer vaccine being administered in Israel in March.Credit: Emil Salman
Samuel Sokol is a freelance journalist based in Jerusalem. He was previously a correspondent at the Jerusalem Post and has reported for the Jewish Telegraphic Agency, the Israel Broadcasting Authority and the Times of Israel. He is the author of Putin’s Hybrid War and the Jews.
Sam Sokol

As COVID-19 infections reached a record low and Israel lifted most of its public health restrictions on Tuesday, experts warned that the risk of future pandemics remains high and called on the government to take immediate steps to prepare the country’s health system.

Infections reached a nadir this week, with the Health Ministry only reporting four confirmed cases on Sunday. And while this subsequently rose to 35 on Tuesday, that number represents only 0.1 percent of all people tested nationally and is far short of the weekly moving average of over 6,600 new patients recorded in February. 

In Israel as a whole, there are currently 338 active cases, 46 of them serious. 6,413 Israelis have died of COVID-19 since the beginning of the pandemic. 77.4 percent of Israelis aged 20-29 have been vaccinated, with the vaccination rate rising with each subsequent age cohort, reaching 98.1 percent among people in their seventies.

“The fact that currently we see very low incidence doesn’t necessarily mean we won’t see minor outbreaks” but the current risk of a significant public health crisis is “very low,” Prof. Hagai Levine, an epidemiologist at Hebrew University and, until recently, the chairman of the Israeli Association of Public Health Physicians, told Haaretz on Tuesday.

However, he cautioned, new variants of the virus and changes in the environment could overcome the immunity of vaccinated patients, stating that “no one knows what will happen in the winter.” 

Even in the wake of Israel’s successful vaccine campaign, in which 5,452,298 people have been inoculated to date, we still “need to learn how to live with the virus,” he continued, calling for the government to bolster its epidemiological surveillance systems and to “be careful about the possibility of new variants, especially from abroad.”

“In Israel especially, the shortage of infrastructure and personnel in the health system is more burning than ever,” he warned, calling for the establishment of permanent public health teams within Israel’s major healthcare providers and municipal governments across the country.

Earlier this month, the Israel Medical Association organized a national 24-hour strike in protest of a Finance Ministry decision not to renew funding for an additional 600 medical personnel hired to help the country’s overburdened health system cope with the pandemic. Both the OECD and the Health Ministry have warned of a pending shortage of doctors in the coming years.

In an op-ed on the Ynet news site explaining the reasons for the strike, IMA chairman Prof. Zion Hagay complained of being “forced to wage a struggle here to prevent the dismissal of 600 doctors, while we [still need an additional] 4,500 personnel just to reach the average of [other] developed countries.”

According to Levine, other necessary steps include the establishment of a permanent epidemiological unit at the airport, so that travel restrictions and the hiring of additional epidemiological nurses can be determined by medical professionals instead of politicians.

“We need to set up good surveillance and to use this time to prepare for the winter, for other pandemics and to recover the health system from this tough, challenging year. We have a lot of work to do,” he said.

While Israel cannot technically be said to have reached herd immunity, in practice the population’s high level of vaccination has led to a sharp reduction in cases that in many ways feels “almost” as if that milestone had been reached, said Prof. Nadav Davidovich, director of the School of Public Health at Ben-Gurion University and Levine’s interim successor at the physicians' association.

“In many ways it’s a dream come true, and it’s mainly because of the very successful vaccination campaign,” he said.

However, like Levine, Davidovich cautioned that COVID has not been eradicated and that the nearby presence of a largely unvaccinated Palestinian population and the eventual resumption of international travel mean that the possibility of new variants arriving in Israel cannot be discounted.

The majority of people flying into Ben Gurion Airport do not quarantine as required after their arrival.

Travelers at Ben Gurion airport in April.Credit: Hadas Parush

Davidovich said that he was concerned that the government was not doing enough to track people coming into the country to make sure that they were staying in quarantine and decried what he said was a “lack of coordination” preventing the rollout of electronic bracelets for incoming travelers which had previously been announced by the Health Ministry.

“We need to remember that this is a pandemic, so you can’t isolate Israel from what’s going on on a global scale and especially in the Middle East,” he said. 

According to Davidovich, one of the reasons that Israel has yet to reach herd immunity is its unvaccinated population children under 16. However, that may soon change.

The Health Ministry announced on Wednesday that it expects to begin vaccinating minors over the age of 12 next week. The announcement came after the ministry announced that it had determined that a small number of heart inflammation cases observed mainly in young men who received Pfizer's COVID-19 vaccine were likely linked to their vaccination.

Pfizer has said it has not observed a higher rate of the condition, known as myocarditis, than would normally be expected in the general population.

Students at a school in Jerusalem in April.Credit: Ohad Zwigenberg

In Israel, 275 cases of myocarditis were reported between December 2020 and May 2021 among more than 5 million vaccinated people, the ministry said in disclosing the findings of a study it commissioned to examine the matter.

Most patients who experienced heart inflammation spent no more than four days in hospital and 95 percent of the cases were classified as mild, according to the study, which the ministry said was conducted by three teams of experts.

A team appointed by the ministry determined that the risk of serious illness from the virus outweighed concerns about the connection between the second dose of the vaccine and the appearance of myocarditis.

The chairman of the Israel Association of Pediatricians, Prof. Tzahi Grossman, who participated in the ministry committee's discussions on the subject, explained that although there is a desire to raise the overall vaccination rate, there is no urgency regarding the vaccine due to low morbidity among children.

“The golden path between these two considerations is to allow those who want to be vaccinated” to receive a shot, he said, adding that current recommendations may be revised ahead of the beginning of the school year in September.

Reuters and Ido Efrati contributed to this report.

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