How Israel's Coronavirus Czar Plans to Tackle the Pandemic

Prof. Ronni Gamzu plans to implement a new model for predicting the death rate from the virus and attempt to curb its spread

Ido Efrati
Ido Efrati
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Ronni Gamzu introducing a coronavirus response program for nursing homes, Tel Aviv, April 20, 2020.
Ronni Gamzu introducing a coronavirus response program for nursing homes, Tel Aviv, April 20, 2020.Credit: Moti Milrod
Ido Efrati
Ido Efrati

Prof. Ronni Gamzu, who was appointed coronavirus czar last week, is expected to expand the system of epidemiological investigations and adopt a new model for predicting the death rate of the disease in a bid to reform the effort against the coronavirus and halt its spread.

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Gamzu met over the weekend with Defense Minister Benny Gantz to discuss increasing cooperation between health and defense officials in order to boost the speed of epidemiological investigations aimed at cutting the chain of infection.

The two spoke of increasing the staff of investigators by around 1,000 by enlisting discharged soldiers who specialized in investigations and analysis during their service, such as those from the Intelligence Corps, Military Police and Air Force. There have been recent reports of a plan to make the entire investigation process subordinate to the Defense Ministry, but associates of Health Minister Yuli Edelstein and Health Ministry officials said the system would remain under their authority.

Gamzu is expected to head the control center responsible for conducting epidemiological investigations, the logistics system, the organization of information and data analysis. As part of this, Gamzu is expected to manage all operational aspects of the fight against the virus, including investigations and testing.

At the same time, Gamzu is supposed to plan ahead by setting goals for managing the crisis, and formulating models for predicting the path of the pandemic. These measures are aimed at realizing Gamzu’s policy of avoiding another lockdown. “[A lockdown] is at the bottom of the toolbox,” he told Haaretz in a recent podcast. “It’s not smart; it’s a management failure.”

A person wears a mask in Jerusalem, June 25, 2020.Credit: Ohad Zwigenberg

The Health Ministry has so far relied on data from its epidemiology division and a team of researchers from the Gertner Institute for Epidemiology and Health Policy Research to get a snapshot of the outbreak and its continued spread. Gamzu is seeking to expand the number of prediction models and reference scenarios; he has adopted a model developed by Ichilov Hospital’s deputy director general for research and development, Prof. Eli Sprecher, and instructed all teams dealing with the pandemic to work with this model.

“The different models rely on a number of different assumptions and perspectives, and the important thing is a dialogue between researchers and coming to compatible conclusions,” Gamzu said over the weekend. He urged those researchers working with Sprecher and those at the Gertner Institute to formulate an “integrated model that will form a single, uniform and reliable basis for decision-makers.”

Avoiding a lockdown

Gamzu told Haaretz explained that the model developed by Sprecher can predict the morbidity situation two to three weeks in advance. “We built a very simple model, which is also the reason it predicts accurately, but its weakness is that it relies on the recent past and thus can only predict the near future,” he said. “We chose this model because it is most suited to the needs of a hospital. It allows the hospitals to prepare for everything connected to the closing and opening of wards and what sort of people to train.”

He added, “When speaking about decisions of balancing between economics and morbidity and quarantining in the community, this model doesn’t deal with that.”

The model focuses on the connection between the number of new infections and the number of patients in serious condition and predicts the morbidity situation eight days forward by analyzing the data from the previous eight days. Using algorithms that examine the morbidity in countries similar to Israel, the model provides a forecast for two to three weeks. According to Sprecher, the most decisive factor with regard to the rate of infection is the infection coefficient (the number people on average that each infected person will infect). “This is the dynamic that decides in the end,” and it is at the heart of the model.

The model presents several forecasts based on the infection level and how it changes. According to the pessimistic model, steps the government takes won’t impact the infection rate. The optimistic model, by contrast, assumes the government and the public will act appropriately to lower the infection rate.

The various assumptions the model is based upon are taken by researchers from countries with similar characteristics to Israel’s, but have “preceded” it in terms of coping with the pandemic. Thus, Sprecher explained, one can ascertain when the infection rate starts to drop in a country like Croatia and use that to create an optimistic forecast for Israel and predict the minimum number of seriously ill patients during the coming days.

According to the model devised by Sprecher and his team, the number of people in serious condition on August 2 will be between 358 and 371. On August 8, the number will rise to 387 under the optimistic forecast, and 450 in the pessimistic one. On August 15, there will be 600 patients in serious condition under the pessimistic model, compared to 336 in the optimistic scenario, in which the infection rate is successfully lowered.

Like Gamzu, Sprecher objects to a lockdown. “Unfortunately, we have proof in the field of what a lockdown does,” he said. “It definitely can bring down the infection rate significantly, but there are two things that weren’t stressed enough – understanding the socioeconomic damage, and using the time provided by the lockdown to prepare and establish a system of epidemiological investigations. If these are not done, what you achieve during the lockdown goes down the drain.”