Knesset Coronavirus Committee: Health System Decisions Based on Unlikely Doomsday Scenarios

Economic stranglehold is already as great a threat to Israel as pandemic, says report, which calls on government to roll back work ban immediately after Passover

Jonathan Lis
Jonathan Lis
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Israeli police in protective gear walk through the coronavirus-stricken neighborhood of Meah Sheaarim, Jerusalem, April 6, 2020.
Israeli police in protective gear walk through the coronavirus-stricken neighborhood of Meah Sheaarim, Jerusalem, April 6, 2020.Credit: Ohad Zwigenberg
Jonathan Lis
Jonathan Lis

The economic stranglehold has already become as major a threat to Israel as the pandemic, warns an interim report issued Tuesday by the Knesset Coronavirus Committee. The report also slams the decision to task the National Security Council − a part of the Prime Minister’s Office − with management of the crisis and calls for the mission to be assigned to a new body for handling national crises. It also questions the crisis managers’ decision to rely on highly unlikely doomsday scenarios. 

The members of the committee, headed by Kahol Lavan MK Ofer Shelah, call on the government to provide masks and protective gear for free to at-risk groups, including medical staff. In the report, which was compiled in the last few days, the committee calls on the government to change the policy of travel and work prohibitions immediately after Passover, contrary to the position expressed to the committee by the Health Ministry deputy director general Prof. Itamar Grotto. “The committee members are unanimous in the view that the approach of “flattening the curve,” which is intended to avert a situation in which we will be unable to treat critically ill patients, has a cost in that it greatly extends the amount of time that the severe restrictions are in place. The economic stranglehold, with all of its social implications as well as current and future health implications, has already become just as genuine and major a threat as the pandemic itself,” the report says. 

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Haredi leaders learn harsh corona lesson as Israel sends in the troopsCredit: Haaretz

The committee – which includes members of Kahol Lavan, Yesh Atid-Telem, the Joint List and Yisrael Beiteinu  – also noted that, “besides the mighty and praiseworthy struggle to reach each patient and person requiring isolation, and the tremendous welfare efforts being made with the aid of the IDF and the police, currently the system has no plan for how to prevent Bnei Brak from turning into a giant coronavirus ship.” The report says that Bnei Brak should be at the center of the national effort, and that the effort there should be coordinated by a special project leader of the top operative level who will be in continuous communication with city officials.

The report is critical of the indexes used by the government in setting policy. “It appears that a substantial portion of the policy was formulated on the basis of deficiencies in the system: It’s hard to know whether the opposition to mass testing derived from a clear belief in this policy or merely from the fact that there was an insufficient number of testing kits or insufficient preparedness of the labs; the contradictory announcements regarding the efficacy of masks also coincides with the fact that until the end of March, the number of masks in Israel was insufficient.” 

The committee members wrote that they believe that clear procedures should be formulated for anytime there are reports of a disease that authorities in Israel and abroad believe could evolve into an epidemic that would also affect Israel. The Health Ministry should present an assessment of the likelihood of the threat and its potential impact and notify the prime minister of the need to activate the “National Emergency Center.” 

Ofer Shelah leads a meeting of the special Knesset committee on the coronavirus response, March 31, 2020.
Ofer Shelah leads a meeting of the special Knesset committee on the coronavirus response, March 31, 2020.Credit: עדינה ולמן / דוברו

  'Doomsday scenarios'

In the report, the MKs say that when the Health Ministry director general appeared before them, he could not give any estimate of the rate of the illness’s spread and the number of patients who will need a ventilator. He speculated that a week after his appearance before the committee there would be 200 such patients, but in fact, on that date there were 83 patients on ventilators and 107 “seriously ill” patients not requiring ventilators. “It is the committee’s impression that in making decisions of vast health and economic consequence, the decision-makers also relied on unfounded doomsday scenarios and not on what the IDF calls a ‘reference scenario’  – a realistic scenario validated by credible and carefully analyzed information.” 

The committee was also critical of the testing system: “Initially, a limited testing policy was set, and as noted it is unclear whether this was due to professional analysis or lack of capability; when the order was given to expand it, the acquisition process was conducted by bodies for which this is not their expertise, such as the Mossad, and at critical points in time, the wrong materials were brought to Israel; and all of this time there were large information gaps, including what was presented to the committee, regarding the actual execution and capabilities,” the report says.

More tests needed

The committee said that the amount of tests should be immediately expanded significantly, using a much wider range of tests. “The emphasis should be placed on testing three main groups: at-risk populations (seniors, people with preexisting conditions); medical personnel and those treating the at-risk populations, including social workers and Home Front Command soldiers; and those living in close proximity to confirmed virus carriers and other sample populations that should be tested with serological tests and not just PCR tests,” says the report, referring to the current tests which detect the presence of the virus, as opposed to serological tests, which detect antibodies to the virus.

“We note that serological tests are in the advanced stages of FDA approval and European CE approval, and that these tests must be brought into Israel at this critical time.” The report says the goal of testing the third subset of the population should be to formulate an intelligence picture as soon as possible, without which it will be impossible to design an “exit strategy” or any other kind of long-term strategy. “Without such monitoring tests, the system will be constantly chasing its tail, identifying the ill and isolating those near them, with no ability to see beyond that.” 

A Magen David employee at a drive-through testing center in East Jerusalem.
A Magen David employee at a drive-through coronavirus testing center in East Jerusalem.Credit: Ohad Zwigenberg

As for the policy regarding wearing face masks, the committee called on the government to supply masks and other personal protective gear to the groups that need it, especially those who come in contact with at-risk populations. “For the rest of the population, the policy should be continued of maintaining a supervised low price for various types of protective masks, and to ensure their regular supply to the pharmacies and shops so the stock won’t run out.”

The committee was highly critical of how the Health Ministry presented the issue of the shortage of ventilators. “From the committee hearings and unofficial talks it appears that the focus on the number of ventilators is misleading. There are other elements involved in being able to intubate a patient, including trained medical personnel to do this and oxygen systems that can handle the load. The committee has seen that the hospitals are aware of this and their directors testified to us that they are making efforts to train medical teams from other departments for this task. However, it was difficult to obtain a credible picture of the situation from the relevant officials.” 

The report is also highly critical of the decision to task the National Security Council — part of the Prime Minister’s Office — with managing the crisis and called for the establishment of a special body for managing national crises to be headed by an expert in the management of large public systems. “The committee members feel that the approach taken attests to an intellectual and organizational failure. The National Security Council does not have better organizational tools than any other staff headquarters not even one that would be set up temporarily for the specific mission of dealing with the coronavirus crisis. And in such a profound and multidimensional crisis such as this, the government should not be making “quick decisions on the fly.”

The report says: “We cannot ignore that in recent years the National Security Council has become less of a center for improving decision-making processes on diplomatic and security matters, its original purpose according to the National Security Council Law, and more of a branch for doing the prime minister’s errands. The application of this approach to the coronavirus crisis has had a negative impact on the decision-making.”

The iconic Carmel Market for fresh produce and sundry stuff is closed down
The iconic Carmel Market for fresh produce and sundry stuff is closed downCredit: Moti Milrod

How to restore economy

The report also includes an outline for restoring the economy to regular activity. The steps include a substantial increase in the number of tests and the addition as soon as possible of serological tests which will not only determine if a person is ill at the time of the test but also significantly boost the amount of information gleaned from each test, which can then be used in deciding policy. The committee calls for the isolation policy to be shifted to regional isolation rather than isolation of the total population. “The differential isolation policy should apply not just to at-risk populations but also to high-risk geographic hubs, such as the city of Bnei Brak and other localities where there incidence of disease is higher than average. Effective isolation of geographic areas with serious outbreaks will enable us to free up places where the risk is lower as quickly as possible."

Sources close to Prime Minister Benjamin Netanyahu said that "the coronavirus committee turns out to be a totally political committee. At a time in which the entire world is praising Israel's great success in the struggle against the coronavirus, the attacks of the committee on the decision-making and on the closure policy are more ridiculous than ever. Let  [committee head] Ofer Shelah stop traveling with three people in his car and tell his boss [Yesh Atid leader] Yair Lapid to stop telling people to violate the closure."

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