Israel's Maccabi Healthcare: Coronavirus Will Not Infect Many, but Economic Cost May Be High

Ran Saar, CEO of Maccabi Health Services, says epidemic may not exceed a few hundred patients, but economic toll could be high and he’s planning for the worst

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Passengers wear masks to help protect against coronavirus, at the Ben Gurion Airport near Tel Aviv, Israel, March 8, 2020.
Passengers wear masks to help protect against coronavirus, at the Ben Gurion Airport near Tel Aviv, Israel, March 8, 2020.Credit: Ariel Schalit,AP

“I don’t believe we will get to a situation of tens of thousands of sick people. There will be hundreds and perhaps a few more. Within one or two months it will be nearly over.”

That’s the optimistic prediction of Ran Saar, the CEO of Maccabi Health Services, Israel’s second-biggest health maintenance organization, with 2.4 million members.

“It’s a disease akin to a severe flu, which spreads easily and is more violent, to which you have to add a strong element of uncertainty. About the flu, we know that when the spring and summer arrive, it disappears,” Saar told TheMarker in an interview Monday night’s tightening of quarantine requirements, extending the measure to travelers from arriving from all countries.

“Concerning the coronavirus, we still don’t know for sure that will happen. But even in the case of the coronavirus, eventually most of those who get it will get a mild case. In some cases, we can’t even be sure they are sick at all,” he said.

However, Saar’s rosy outlook doesn’t extend to the economic implications of the epidemic. “I agree with the Health Ministry’s directive, even if they are severe,” he said. “They are putting health first and aren’t looking at the economic angle. Nevertheless, as a health professional I say they we need to look at the economic side and in that context we can’t impose a general quarantine for an extended period. We need to figure out how to create a breaking and balancing mechanism.”

He noted concerns that the global quarantine will cause economic collapse. That will mean lost jobs and lost businesses and the risk of a higher suicide rate.

In Italy, we’re starting to witness the collapse of the healthcare system.

“That’s because in Italy they acted too late and didn’t address the problem from the start. We’re dealing with the matter well, monitoring the sick and tracking their progress, isolating at high risk and doing everything needed to slow the epidemic.”

What about the United States?

“About the U.S., I am worried because medicine there is less good – it’s not public. There’s no national system for testing and I’m quite sure there is a much greater incidence of the coronavirus than they know about due to a lack of testing. We know there were three sick at the AIPAC conference last week (a figure that has since been updated to five past the interview). We needed to announce that all Israelis returning from AIPAC must go into quarantine.”

We’re trying not to anger the Americans?

“I am certain that we can’t let political factors become involved. There are a lot of countries in the world with few coronavirus cases, and there’s no justification in imposing a ban on them.

“In the U.S., there’s a crisis situation which I’m not sure how well the Americans are succeeding in controlling. If we close the border and decided that people arriving from Spain or France must be quarantined, then it seems to me that the same decision should apply to the U.S.”

Maccabi is planning for the most extreme scenarios of large numbers of infected people put in quarantine.

“The Health Ministry is right when it bans healthcare workers from travelling abroad because if whole teams end up in quarantine, we’ll have a real problem,” said Saar.

“Maccabi today has hundreds of doctors who have returned from overseas and are in quarantine. We’re preparing for an extended and worsening situation. We need to be ready to quarantine thousands of doctors and caregivers, which would put enormous pressure on the system,” he said.

How are you preparing?

“There are a lot of remote services we have developed, both for doctors and for other caregivers, for a wide variety of circumstances that can be used for coronavirus sufferers and those in quarantine.

“We have 7,000-8,000 patients in quarantine and the number will only grow. We have to be able to continue giving them medical services and to do that we will use the tools we already have, for instance through a service in which the doctor can communicate via video with quarantined patients from his home on their smartphones.”

Saar also pointed to a Maccabi app that enables a member to reach out to their personal physician with a non-urgent question and get an answer back in days – a time, he added, that could be cut to three hours. The HMO also has a remote conversation service designed for the elderly and those confined to their homes. “We can easily expand this to other populations and certainly to coronavirus sufferers,” he added.

Maccabi medical staff conducts 100,000 examinations, tests, consultations and other service every day, of which 30,000 are done digitally. Saar said the HMO could easily adjust the balance to 60% remote and 40% face-to-face treatments. “That’s the strength of the Israeli system because we are advanced,” he said.

What about people who can work from home. Should employers be required to let them at a time like this?

“No employer is obligated, but it’s worthwhile for him to allow it, otherwise he could find himself in a situation where he has no workers at all – if we reach an extreme epidemic situation. We all want the economy to function, so we need to encourage and explain even to small businesses how to do it. I haven’t seen any manufacturers encouraging employees to work at home, and it’s a pity.”

The Health Ministry has instructed HMOs to have four to six months of medicine and equipment in stock in light of the merging global shortage, especially for surgical masks. Have you succeeded?

“That means tripling our inventory. We understand the reason for the order, but it is difficult for pharmaceutical makers to meet these requirements, because, of course, the entire world market has entered a slowdown and the pharma companies themselves don’t have enough inventory. If the world market deteriorates and the world economy deteriorates, there will be production delays, which will make it hard to get additional supplies. The biggest problem is protective gear, mainly masks, We ordered a huge supply and we’re getting it, but there’s a worldwide shortage.”

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