Management of the biggest public health crisis in the country’s history is being taken out of health officials’ hands by Prime Minister Benjamin Netanyahu, health officials familiar with the situation said.
What began a few weeks ago as questions by health care professionals has become criticism that bubbles under the surface and is threatening to burst into the open, exposing a flawed decision-making process that is having an unprecedented impact on Israelis’ daily lives.
Haaretz Weekly Ep. 70
The public may believe that the coronavirus crisis is being managed through professional deliberations at which a variety of opinions are voiced, but that isn’t the case, the sources said. In reality, both senior Health Ministry officials and the ministry’s task force on epidemics have been excluded from the discussions.
The coronavirus crisis is being run by Netanyahu and a few officials who support his views. Health Minister Yaakov Litzman is out of the picture, the sources said.
One key member of Netanyahu’s team is Prof. Ran Balicer, who heads the research institute of the Clalit health maintenance organization and is its director of health policy planning. He is also an adviser to the Health Ministry on infectious disease, epidemiology, health policy and emergency preparedness. In his media appearances, he supports harsh measures to slow the spread of the virus.
The team also includes Prof. Yitshak Kreiss, director of the Sheba Medical Center in Tel Hashomer, and sometimes Prof. Shmuel Shapira, director of the Israel Institute for Biological Research. The Health Ministry is represented by its director general, Moshe Bar Siman Tov, and its director of public health services, Prof. Sigal Sadetsky.
But no one on this decision-making team has training or experience in handling infectious diseases and epidemics.
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“The orders come from above and the professionals are expected to fall in line,” one source in the health care system said. “The proper situation would be for decisions of this kind to be discussed in depth by the professionals and the epidemic task force, including every line of thought, its implications and objections to it, and then presented to the decision-makers. But none of this is happening.”
He said Bar Siman Tov, who as the ministry’s director general should be leading this process, is instead collaborating with Netanyahu and stifling anyone opposed to Netanyahu’s approach.
Since Bar Siman Tov has no medical training, the ministry’s top medical authority is its deputy director general, Prof. Itamar Grotto. Its other key official is Dr. Boaz Lev, a former director general at the ministry who now heads its epidemic task force.
But anyone talking to these two men in recent days has had trouble getting clear answers. The reason, according to Health Ministry sources, is that they don’t know the answers because the decisions are being made without them.
Already two weeks ago, health care officials were claiming that the decision-making process was flawed and the epidemic task force was rarely being consulted. But since then, the situation has worsened, the officials say.
This weekend, Channel 12 television’s health correspondent, Yoav Even, reported that Grotto and Lev weren’t taking part in the prime minister’s meetings on the subject because of their bad relationship with Bar Siman Tov, who rejected this claim.
“Itamar is a very significant figure in managing this event,” Bar Siman Tov wrote on Twitter, referring to Grotto. “He allows me to disconnect from day-to-day affairs and be calm when I have to be at meetings at the Prime Minister’s Office. So too is Dr. Boaz Lev.”
As if to underscore this claim, the Health Ministry then announced that the daily press briefing that day would be given by Grotto. Unusually, Grotto was then also invited to a meeting with the national security adviser, though not to the prime minister’s meetings.
Health Ministry officials said Grotto is being excluded because he has reservations about Netanyahu’s policy of imposing harsh restrictions on Israelis’ daily lives in an attempt to slow the spread of the virus. Grotto reportedly believes that other options should be considered.
But an incident Thursday also helped make Grotto persona non grata for Netanyahu. After the media reported that the Mossad had secured 100,000 badly needed coronavirus test kits for Israel, Grotto told the Ynet news site that what the Mossad obtained “isn’t exactly what we were lacking.”
What Israel needs, he said, are swabs, and that isn’t what the Mossad brought.
Anyone with basic knowledge of the coronavirus test knows Grotto was right, but far from receiving backing from his superiors, he received complaints from on high, ministry sources said.
And that evening, Grotto wrote on his Facebook page that the kits the Mossad secured “were of high quality and are needed for the continuation of our laboratory work in the coming weeks,” and that the ministry would continue cooperating with the agency to secure vital equipment for addressing the crisis.
Unusually, this Facebook post was then published on the ministry’s Telegram page for coronavirus updates, which is supposed to be reserved for official announcements. That was a clear sign to both Grotto and other senior ministry officials about his place in the hierarchy.
Moreover, Bar Siman Tov has handled most of the ministry’s dealings with the media personally, despite his lack of medical knowledge.
The incident that first sparked professionals’ discomfort with Bar Siman Tov’s handling of the crisis occurred at the very beginning, when he sent Grotto to monitor five Israeli patients who contracted the virus aboard the Diamond Princess cruise ship. This, too, made clear that Grotto wasn’t at the forefront of the decision-making.
“It’s unbelievable,”a senior medical official said. “The director general sends his senior medical authority, who is supposed to guide him in this crisis, to monitor five patients with runny noses in Japan and then return to two weeks of quarantine, instead of staying at his side and helping him manage the crisis.”
The role of providing a medical seal of approval for the ministry’s decisions has therefore fallen on Sadetsky. Before becoming its director of public health services in February 2019, she spent almost two decades at the cancer and radiation epidemiology unit at the ministry’s Gertner Institute. She also teaches and does academic research, and is widely admired by both colleagues and students.
Still, some professionals said her experience and training are insufficient for the current crisis, especially when she is the only medical professional involved in the decision-making. They also said it is not clear she has the stature to oppose decisions made by the Prime Minister’s Office or propose alternatives.
Many ministry officials and other health care professionals said they are extremely uncomfortable watching Netanyahu’s nightly media appearances about the crisis while knowing that his decisions have such a limited professional basis.
“We have a prime minister who teaches us how to use tissues, a health minister who talks about ushering in the Messiah and a [ministry] director general who frightens everyone to spin the situation and create an image for himself of presiding over the crisis,” one senior health care official said.
As another put it, “I don’t see much advantage to the press conferences aside from the opportunity for someone to appear on prime time. The instructions could be explained much more professionally and clearly.”