Exactly a month since the third lockdown was imposed and two-and-a-half weeks since it was tightened, there doesn’t seem to be an exit point in sight. Senior Health Ministry officials, the coronavirus chief, people on the Magen Yisrael coronavirus task force and other professionals convene daily – sometimes twice a day – to assess the situation, but they still have no good news.
This is the first time that a lockdown – the heaviest weapon in the government’s arsenal for managing the pandemic, which has already succeeded in bringing raging numbers under control – is still far from dealing its familiar knockout blow. According to estimates, merely extending the lockdown by another week won’t make a difference.
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Eighteen days into a stringent lockdown and over five weeks since the COVID-19 vaccinations began, the infection statistics in Israel are worse than they were at the time the lockdown was imposed. There are 8,667 new cases a day, nearly 10 percent of all tests are coming back positive, and 1,179 people are hospitalized in serious condition. No one in the ministry or the coronavirus cabinet had predicted or prepared for such a reality, not even in their most pessimistic scenarios. And the socioeconomic-health hourglass, with the schools still closed, the damage to the economy, and the toll on the public’s mental health, is starting to run out.
One of the few rays of light at this point is that the infection coefficient (the famous R factor) has dropped to below 1 (it’s now 0.9). This means that statistically, each sick person is infecting less than one other person. There are also preliminary signs that the number of seriously ill patients is stabilizing and the ongoing vaccination campaign is inoculating well over 200,000 people a day, although its influence is still not being felt in any game-changing way. Health Ministry professionals as well as parts of the public are realizing that the rules of the game have changed during the past month, and one cannot draw any conclusions about the future – even the imminent future – from the past.
“It could be that our expectations were not realistic,” a senior Health Ministry official said, adding, “I think that without the lockdown the numbers would be double, or even higher.”
A month ago, with the festive launch of the vaccinations, the lockdown was portrayed as a kind of “bridge” to bring down the incidence of infection until the vaccines started to have an effect. The last lockdown before we emerge from the pandemic. Now the tone at the ministry is much more skeptical and unsettled.
“We were expecting a more significant drop in both confirmed cases and seriously ill [patients] after two weeks of the lockdown, similar to what we’d seen in previous lockdowns,” said another Health Ministry source, who noted that during the last lockdown in the fall, the R factor dropped to 0.6 after two weeks. “We are seeing the lockdown having some influence, with a slow drop in morbidity. But the number of seriously ill is still high. It seems the lockdown is working, but not enough.”
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The ministry has flagged two factors as being responsible for the current predicament – 1) the presence of new, more contagious variants of the virus, particularly the British variant, which one HMO source said is being identified in more than 50 percent of its new cases, and 2) a weakening of public discipline and adherence to the guidelines, which public health officials refer to as “pandemic fatigue.”
Medical professionals say the new variants have an enhanced ability to attach themselves to a person’s cell receptors and require fewer viral droplets to cause infection. There may be other differences yet to be identified. But the bottom line is that a much shorter exposure is needed to become infected.
The higher level of contagion among the new variants is coming in tandem with the public’s lower-level observance of the guidelines and restrictions. One of the presentations at the beginning of a situation assessment reported “a drastic deterioration in the population’s behavior this past weekend.” The data said there had been an increase of 15 percent in the number of residents defined as “super-spreaders” compared to the previous weekend, an increase of 32 percent in the number of people visiting super-spreaders, a rise of 23 percent in intercity travel, and an 11 percent increase in the number of people infected in locales other than where they live.
Both the new variants’ stronger potency and the public’s weaker self-discipline, as well as possibly other variables – like significantly higher rates of infection in certain communities – put Israel far from the Health Ministry forecasts just before the lockdown began.
“We spoke a month ago of a lockdown that would last three-and-a-half weeks, when there were 5,000-6,000 new cases a day. We wanted to reach less than a thousand new cases a day, and an infection coefficient of less than 1,” said a Health Ministry source. “What we didn’t know a month ago was the influence of the different variants. We are changing our objectives accordingly and trying to see how we can achieve more realistic goals while taking into account the difficulties and impact of the lockdown.”
He said analyzing the situation involves weighing numerous variables like the R factor, the numbers of new cases and of seriously ill patients, death statistics and the progression of the vaccination campaign. “With all these changes it’s very hard to predict the future,” he said. “It’s hard to produce a forecast when there are surprises all the time.”
According to another ministry source, “We will not reach a thousand confirmed cases a day by extending the lockdown for a week. Exiting the lockdown will be possible only when we see a significant drop in the number of seriously ill, which is now static. The number of seriously ill is very high, at a level that undermines the quality and continuity of treatment. That’s why the goal is a drop in the number of seriously ill to numbers that the system can live with, around 500 to 600 seriously ill.”
So aside from the drop in the R factor below 1, there aren’t any signs of progress toward a lower number of new daily cases, nor does it seem likely that the number of seriously ill will drop substantially soon, especially considering the seriousness of the patients’ conditions being described by hospital doctors, who say these patients are fated to either die or need many weeks of hospitalization and rehab. That’s why the ministry itself is having a hard time foreseeing an exit point.