Analysis |

Israel's Coronavirus Testing Limits Could Lead to New Lockdown

Without proper tracking of coronavirus patients, cases climb but experts are split on true infection rate, with some seeing exponential rise

Amos Harel
Amos Harel
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Israeli medical personnel take samples at a drive through COVID-19 testing facility in Ramat Hasharon in the suburbs of Tel Aviv, on June 1, 2020.
Israeli medical personnel take samples at a drive through COVID-19 testing facility in Ramat Hasharon in the suburbs of Tel Aviv, on June 1, 2020.Credit: JACK GUEZ/AFP
Amos Harel
Amos Harel

The coronavirus cabinet on Monday held its second meeting since it was established, due to the renewed spread of the virus in Israel. Prime Minister Benjamin Netanyahu announced that he was “applying the hand brakes” on relaxing restrictions because of the increased number of infections. Thus, for example, train service will not be restored for now, even though a relatively large number of people are dependent on it. On the other hand, in a move that wasn’t explained, officials are debating relaxing restrictions even more for event halls and weddings.

Netanyahu, who hasn’t said much recently about the coronavirus, is also trying to advance legislation that’s close to his heart – a bill that would extend the authority of the Shin Bet security service to locate people who may have been exposed to the coronavirus. But here Shin Bet head Nadav Argaman pulled a fast one when he told the ministers that there’s no need for the Shin Bet to be involved anymore, given the current rate of infection, so that bill is not being advanced for now.

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The cabinet’s discussions follow various assessments regarding the pace of the increased infection rate in Israel and the question of whether a second major outbreak is in the offing. The downward trend in the number of new cases began in the last week of April and continued until May 25. Since then, the numbers have been going up almost steadily. At the beginning of June the number of new daily cases started to exceed 100. Some experts are warning that the virus is poised to once again spread exponentially.

Prof. Ran Balicer of Clalit Health Services, a voice of sanity and reason during the days of hysteria, is doubtful. This week, in a series of tweets, Balicer explained that it’s too early to determine anything, because the morbidity we’re seeing now expresses more or less what happened two weeks ago. In any case, he added, “It’s my understanding that the numbers don’t reflect any kind of catastrophe.”

One of the reasons for the increase in the number of new cases is the marked increase in the scope of daily testing, following a change in policy by the new health minister, Yuli Edelstein. But the ratio of positive tests is remaining stable at nearly 1 percent. In other words, the more the health system tests for coronavirus, the more cases it will find, but most of them will be younger people who aren’t showing any symptoms. As of now, the increase in new cases is not being translated into a rise in the number of critically ill, the number of those on ventilators, or even the number of hospitalizations.

Balicer did say that the large number of new cases increases the risk of mass infection. However, he still believes schools should remain open until the end of the school year, except those schools where cases of illness were found.

A worker disinfects a classroom at Jerusalem’s Gymnasia Rehavia high school, June 2020.Credit: Ohad Zwigenberg

This is a controversial position. Some experts believe that given the increase in infection, it would be best to close the high schools now, since in any case there isn’t much formal learning going on in June. Unlike with elementary schools, halting studies in the high schools barely affects the economy because parents don’t have to stay home to watch teenagers. Moreover, though the full numbers aren’t in, it looks like there are more infections among high schoolers than among younger children.

A retroactive analysis indicates that opening the high schools in mid-May accelerated the rise in infections, along with the increasing neglect of social distancing guidelines and the wearing of masks. During the crisis, Israel often compared itself to Austria (and Netanyahu even boasted that the Austrians were asking him for advice). But Austria opened high schools later than Israel did, and hurried to restrict them again when the number of Covid-19 cases rose.

Another Achilles’ heel, and it’s unfortunate to have to repeat this, relates to the slowness and limited effectiveness of the mechanism that was set up to trace the chains of infection. Epidemiological studies of the virus are still cumbersome, even after the Health Ministry made a festive announcement that it was removing some of the obstacles that caused this.

First of all, the increased number of tests has created a backlog in the labs, producing quite a bit of turmoil and a considerable delay in getting results to those tested. This fact itself slows down the detection of people who have come in contact with a confirmed patient.

Secondly, the staff work that was meant to coordinate the epidemiological study continues to limp along. The team members don’t have enough independence and are operating primarily according to Health Ministry instructions. The bottom line is that although this problem has been known for two months, Israel still doesn’t have a fast and effective enough way to identify those who are ill and thus cut off the chains of infection.

This is a substantial problem that makes it difficult to prevent a new outbreak of the virus. If the pessimistic assessments of exponential increases in morbidity are realized, the lack of a proper tracking mechanism could force the cabinet to impose another lockdown, even though all the experts advising the government warn of the huge economic damage that another lockdown would cause.

What’s worse is that in contrast to the way the public pretty much accepted the decisions made in March with understanding, the response to renewed restrictions is likely to be very different. The increasing skepticism toward the government’s judgment, along with the very dispute over the inherent dangers posed by the coronavirus, could lead numerous Israelis to refuse to obey instructions.

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