The streets are bustling again. Masks mostly dangle from chins, if they are used at all. Social distancing seems to be a recommendation, at best. The Israeli public has returned – albeit partially – to routine. This has happened due to the drop in new COVID-19 patients and the declarations of the public health system’s heads that they have managed to stop the spread of the virus. What the cabinet is doing during its frequent meetings, where it discusses recommendations to lift some restrictions, is mainly attempting to catch up to the situation on the ground.
As usual, this is happening in an unruly manner. Some of the regulations are vaguely worded, others contradict each other or lack any logic. Enforcement by police and inspectors is also not uniform or explained. The cabinet discussed opening hair salons and beauty parlors and Haaretz reported that Culture Minister Miri Regev insisted on allowing laser hair removal treatments to resume. While lines snaked around IKEA, the police conducted a heroic chase after a lone surfer, far out at sea, off the Tel Aviv beach.
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The state’s entrenched position against swimmers and joggers, who probably don’t endanger anyone in the open air, is hard to understand. The decree imposing a closure on military cemeteries on Memorial Day and a possible lockdown on cities, which will prevent siblings of fallen soldiers from coming to console their parents on their most difficult day of the year, do not sit well with images of throngs of people going shopping.
This is maddening as a matter of principle. In the long run, what’s worse is the absence of a general and well-articulated exit strategy. A recently published article by billionaire Bill Gates, who was among the first to identify the danger of a return of epidemics, emphasizes two critical tools required for a partial return to routine: widespread testing and results obtained within 24 hours, in order to rapidly locate the chain of infection. Last Thursday, the state signed a deal with a Chinese company which could raise the number of tests conducted to 30,000 a day by sometime in May. The second goal is far from being attained.
Other than a few exceptions, Israel has returned to a policy of a nationwide lockdowns instead of focusing on specific areas. In recent days, the Health Ministry has been reporting a few hundred new COVID-19 cases a day. If most of these are in specific communities – and we don’t know this since information is only released partially and belatedly – it seems that these places should warrant a more thorough approach. In contrast, there is no reason not to ease up restrictions on small communities where no coronavirus cases have been identified.
In the first weeks of this crisis, the country’s leaders operated on an assumption of frightening and extreme-case scenarios. The alarmist worldview held by Prime Minister Benjamin Netanyahu led to taking extreme measures at a relatively early stage, which indeed stymied the spread of the virus and the lowered the incidence of mortality in Israel.
Now, in light of the huge economic cost and the weariness many citizens feel, restrictions are being lifted. This is a necessary and required step. The problem is that it isn’t being done systematically enough, and that the confusing instructions meet an exhausted public that isn’t renowned for following instructions and safety regulations in ordinary times. Anyone who thinks that an order can be handed down to 8.5 million citizens like an order given to army recruits will quickly be disabused.
On the positive side, the small and stable number (for now) of seriously ill or ventilated patients indicates that the health system is far from the point of failure, and that the time gained apparently increased its level of readiness. There are some optimistic conjectures, so far not backed by solid scientific research, that the virus will be less contagious in the hot and humid conditions that Israeli summers are known for. One can hope that this is true, and that contagion in open spaces is significantly lower. Otherwise, Israel may face a renewed outbreak, possibly as soon as next month.
A key mystery, still unresolved in Israel or overseas, is connected to the number of asymptomatic carriers of the coronavirus, the extent to which they infect others, and specifically, how common this phenomenon is among children, who we know become ill much less frequently than adults. Over the last two weeks, the results of preliminary studies in New York, California and other places showed that the number of infected people could be 10 times or more higher than the number of confirmed sick people. But the methods used in these studies, particularly the one at Stanford University, have been criticized.
The mystery is directly linked to the question of whether it’s possible to reach, in a deliberate and calculated manner, herd immunity against the coronavirus, which will depend of the infection of 70 percent of the population. Britain considered this idea for a few days in March, but backed away from it out of fear of disastrous results. The Swedish government, which has not imposed a strict lockdown, is in fact conducting a mass experiment in herd immunity, even if it doesn’t openly admit this.
A document published last week by the national center for information on the coronavirus sharply opposes such a policy in Israel. But the document was composed by military intelligence officers who are not epidemiologists, and their statements may be too sweeping in the eyes of scientists.
This document stated that “a common opinion is that herd immunity should be reached in order to solve the problem. However, in case of widespread contagion, tens of thousands of Israelis will die, with hundreds of thousands hospitalized, some of them for prolonged periods. Even if mortality and sickness are spread over a year, the load on the public health system will be enormous, which will cause further mortality, at least in similar numbers.
“As far as we know at present, weighted mortality rates are at 1 percent among all those infected. There is some uncertainty with regard to some countries, but it’s likely that the incidence in Israel will be between 0.5 and 2 percent. Natural mortality in most countries stands at 1 percent. In Israel, in 2016, the incidence of mortality was 0.5 percent, with 44,000 deaths. The expected mortality from the coronavirus in case of widespread contagion is equivalent to the annual natural mortality rate, meaning that twice as many people will die in one year.”
No answer from the comptroller
In the middle of March, when the coronavirus crisis in Israel was in its early stages, a belated State Comptroller report on handling epidemics was published. The report seems to have been somewhat softened by Comptroller Matanyahu Englman. Haaretz has reported that the comptroller is in no rush to launch an investigation of the government’s handling of this new crisis.
Last week, the left-wing nongovernmental organization Movement for Integrity sent a letter to Englman and the head of the Knesset’s coronavirus committee, lawmaker Ofer Shelah. This was their second inquiry. The organization noted that “an extensive investigation of the readiness of all systems is essential, so as to draw lessons for the continued campaign facing the country, particularly in face of expectations of a second wave of the illness next winter.” Englman did not reply to the first letter.
“Many of our colleagues told us that we were wasting our time in writing this letter, since this comptroller, unlike his predecessors, will avoid investigating topics related to responsibilities held by the prime minister, and will not voice criticism in real time, even if the country goes up in flames,” the second letter read. “However, the institution of the state comptroller is not a private fiefdom and the comptroller cannot ignore the historic reality we’re facing. The comptroller is the only state institution which by law must take a broad look, and in real time, at all government systems.”
Movement for Integrity is demanding that the comptroller order an immediate investigation to be launched. If he fails to respond, the group will try to oblige him to do so through the Knesset. The chances for this are slim, but in view of the split and loss of direction among the opposition, it’s good that external organizations are trying to initiate such a move.