Israel's Battle Against Omicron Turns to Chaos, Testing Public's Patience

The frustration of the Israeli public grows amid ever-changing COVID regulations, a shift to the less-reliable antigen tests, and long lines at testing facilities across the country

Ido Efrati
Ido Efrati
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A line for coronavirus testing at a movie theater in Jerusalem, last week.
A line for coronavirus testing at a movie theater in Jerusalem, last week.Credit: Emil Salman
Ido Efrati
Ido Efrati

“We prepared and ran simulations,” Health Minister Nitzan Horowitz said last week. “As is true everywhere, we can’t completely stop omicron’s spread ... [but] we prepared for this new situation, so the situation is definitely under control.”

In reality, however, chaos prevails throughout Israel. And the public’s patience with the government is rapidly eroding.

Both the public and the experts increasingly feel that the time supposedly bought by limiting overseas flights, which indeed delayed the new variant’s spread, wasn’t properly used to prepare. The chaos is reflected in the constantly changing regulations, the government’s difficulty in explaining them and the doubtful reliability of antigen tests, which have become the main form of testing.

Even people who until now managed to follow the regulations scrupulously are finding it hard to keep track of them now. Thus, people are increasingly ignoring the rules and using their own judgment, based on how worried they are about infection.

With roughly 18,000 new cases a day, the poor preparations are also evident in the long lines and logistical problems at testing stations. At a rapid-antigen testing station in Petah Tikva’s biggest mall, for instance, parents and children who had already been waiting a long time were told that the station was out of swabs and it would be another half hour before more arrived. Some parents offered to bring their own swabs, and the testing staff agreed.

A worker at a testing facility in Jerusalem, last week.Credit: Ohad Zwigenberg

“Everyone ran to the mall’s Super-Pharm to buy rapid tests to get a swab,” said Yevgeny Lvov, who was waiting with his 7-year-old daughter. “But I knew the Super-Pharm would also soon run out, so I went home and brought a swab from my home testing kit.”

When he returned with the swab, his daughter was tested immediately. But other parents told him that even two and a half hours later, the new swabs hadn’t arrived.

Lvov also said he has been trying to get his daughter vaccinated for a long time. But because she is constantly in and out of quarantine due to contact with children who have the virus, this has proven impossible.

The number of PCR tests also remained high on Sunday, even though these tests have now been restricted to people over 60 and others deemed at high risk.

Due to this restriction, antigen tests have become the main form of testing, after a long time in which Israel refused to allow them at all due to their lower reliability. Yet that lower reliability, combined with the fact that people are told to make do with a single test immediately after exposure to a carrier, creates serious problems.

First, the virus’ incubation time is up to three days from the moment of infection. Consequently, many people test negative despite having been infected and then turn into new sources of infection.

On Saturday, more than 120,000 people were tested at the country’s 315 antigen testing stations, alongside an unknown number who did home tests after being informed that they had been in contact with a carrier. Based on these tests, many returned to school or work.

“The antigen tests are less sensitive, so at early stages of the disease, it’s possible to have a negative antigen and a positive PCR,” said a source in one testing laboratory. “On the other hand, the assumption is that at this point, the viral load is low, so the risk of infecting others is also low.”

Nevertheless, he added, “Both antigen and PCR tests are valid only for the moment when they were taken. In other words, it’s very possible for an exposed person to test negative after one day and positive after two or three days.”

People wait to be tested for the coronavirus in Tel Aviv, last week.Credit: Hadas Parush

From this perspective, he said, “antigen tests actually have an advantage, because it’s easy to do another test a day or two later and therefore increase their reliability.”

PCR tests with rapid results for everyone would be preferable, he acknowledged. But since that’s impossible, “effective use of antigen tests requires a repeat test two or three days after the test done immediately following exposure.” Nevertheless, the Health Ministry hasn’t imposed any such requirement.

Yet even if it did, attempting to control omicron’s spread through testing is doomed to fail, he warned. “You have to understand that we will miss, and have missed in the past, many patients. Therefore, the focus must be on severe symptoms and risk groups.”

Prof. Nachman Ash, the Health Ministry’s director general, said Sunday that the ministry will consider requiring rapid tests to use both throat and nasal swabs to improve their reliability. Currently, only nasal swabs are required.

Given the virus’ incubation time, it’s hard to believe this will make any difference for people tested within 24 hours after exposure. Nor has any other country adopted throat swabs as a solution to the antigen tests’ reliability problem.

But Prof. Gili Regev-Yochay of Sheba Medical Center, Tel Hashomer said she actually thought throat swabs would help, and that one reason PCR tests are more accurate is because they include throat swabs. “Omicron apparently multiplies more in the throat,” she explained, adding that Sheba is currently conducting tests to see if throat swabs indeed improve reliability.

Nevertheless, she warned, any test is “meaningless” if conducted immediately after exposure.

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