Analysis |

January Was the Best and Worst of Times in Israel's Battle Against COVID

Ido Efrati
Ido Efrati
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A staff room at the coronavirus ward at Shamir Medical Center, Tel Aviv and Tzrifin (IDF base), January 2020.
A staff room at the coronavirus ward at Shamir Medical Center, Tel Aviv and Tzrifin (IDF base), January 2020.Credit: Hadas Frosh
Ido Efrati
Ido Efrati

January was the most tragic and the most hopeful month in Israel since the start of the pandemic.

There is hardly any graph or data that provide consolation as Israel enters its fourth week of lockdown, a week in which the number of fatalities from the virus will cross the 5,000 mark. Last month was the worst one by far since the outbreak of the pandemic.

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But at the same time, one must note that the grim numbers reflect the current and past situation; there is still room for optimism for the future.

The new mutations and the strain on hospitals continue to vex senior officials and workers in the health system, but, along with that, many believe that the continued vaccinations at the present rate will bring about a dramatic change which will be clearly felt within two to three months, and that Israel is on the correct path to emerge from the crisis.

January was a confusing month. There were two conflicting narratives at play. On the one hand, there were more than 200,000 people getting vaccinated daily, while on the other hand the number of confirmed cases remained high, with troubling scenes of overwhelmed coronavirus wards, with dozens of deaths each day. Against that backdrop, the emergence of new mutations only deepened the uncertainty over how to exit the lockdown.

Some three million people have been vaccinated in Israel, 1.7 million of whom are already entitled to receive a document showing they have been vaccinated, one week after receiving the second dose. The rate of inoculation among people over 60 years of age is 82 percent (including 92 percent among people aged 70-79 and 86 percent among those who are 80 or older). In early January, 10 days after the vaccination drive began, 1.1 million people had already received their first dose.

A Clalit vaccination center at a sports facility in Petah Tikva, January 27, 2021.Credit: Hadas Frosh

Vaccinations

There is now an increase in vaccination rates among those who are under 60. Some 530,000 people aged 50-59, 64 percent have been vaccinated. Among those in the 40-49 age group, 541,000 Israelis have been vaccinated, 50 percent of the total for that group. Over the last week, 16 to 18-year-olds have started receiving the vaccine, with 109,000 having received the first dose (19 percent of the 574,000 in this group). The health maintenance organizations are seeking the opening of vaccination centers to the entire public, with an end to prioritization.

“We think it would be correct to open vaccination to everyone so that vaccination centers can work at full capacity” says the CEO of Leumit Health Services, Haim Fernandes. “There has been a sharp learning curve on the part of the health funds and since the campaign started, we’ve acquired skills, and we now can do this much faster, without affecting safety. If we started out with 6-8 minutes for each person being vaccinated, in some places we can now give a dose every three minutes. The conclusion is to open it up for everyone and utilize the capabilities of these health funds.”

Figures shown by the Health Ministry, presented in a discussion Sunday morning, indicate growing effectiveness of the vaccine. Out of 668,000 Israelis who are 60 or older and who were vaccinated one week earlier (and entitled to that document), supposedly enjoying the maximal immunity conferred by the vaccine, 437 people were infected. This is a rate of only 0.066 percent. Forty of these people required hospitalization, 11 of them in serious condition. Three were in critical condition and two of them died. Among people under 60 who received the vaccine, out of 325,000 receiving two doses, 231 contracted the virus, an incidence of 0.071 percent. Only five of these required hospitalization, one in serious and two in critical condition.

These numbers are much better than the numbers in the general population. They indicate that the vaccine clearly prevents significant morbidity, greatly reducing the need for hospitalization.

A coronavirus ward in a hospital in northern Israel, September 16, 2020.Credit: Ohad Zwigenberg

Within Arab communities, however, there is greater reluctance to get vaccinated. The HMOs are trying to increase the dissemination of information there, partly by recruiting Arab doctors for this purpose and by improving accessibility to vaccination centers. However, the number of people over 60 who have been vaccinated amounts to 59 percent of this group, compared with 82 percent in the general population. Only 18 percent of Arab citizens have been vaccinated so far, compared to 33 percent of the general population. Among the ultra-Orthodox, the rate among people over 60 is 65 percent, but health system sources say that when one adds the large number of people in this age group who have recovered from coronavirus, the numbers are similar to that of the general population.

Mutations

The raging wave of infections, despite the lockdown, is attributed partly to new mutations which have arrived in Israel. Last week there were reports of the first people to contract the South African variant. It was found in random testing, and not through a chain of infection starting with people who had returned from abroad. This means that this mutation is already active in Israel, apparently at low rates of infection. So far, only 30 such cases have been identified here.

The British variant is much more dominant and is now found in 60-70 percent of new cases. Its high contagiousness compared to the earlier variant was particularly apparent during the lockdown. Israel entered a tight lockdown on January 8, with the daily number of confirmed cases at about 8,000. Over the next two weeks, the numbers climbed, but starting in the third week, they began to decline, with the number currently at 6000-7000 daily new infections.

Ben-Gurion International Airport, Lod, January 2021.Credit: David Bachar

A critical question now facing senior health officials is whether the mutation can foil the vaccination drive. Last week, Pfizer announced that the its test results showed that the genetic changes the virus had undergone decrease the effectiveness of the vaccine, but do not nullify it. Moderna also announced something similar, adding that it was developing a new version of the vaccine that could be used as an extra booster, if needed.

Accordingly, the Health Ministry is already talking about possible solutions in collaboration with the vaccine manufacturers. This may involve a third round of vaccination with the current vaccine, or with the updated version being developed by Pfizer.

“It’s possible to contend with it,” says Fernandes. “The method used for producing the RNA-based vaccine makes it possible to easily adapt the vaccine so that it addresses new mutations. It’s possible that the issue of vaccines will be with us for a long time, but one shouldn’t be alarmed. We know how to effectively and rapidly carry out additional vaccination rounds. I believe that in April, with five million people vaccinated, with additional people recovering from the virus, we’ll be in a much better place. We won’t be rid of masks so fast but we are clearly moving towards a much better place, to be reached within two months,” he says.

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