Some Odd Coronavirus Advice From Israel’s Virus Experts

The team advising the National Security Council often made suggestions with no basis in fact

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A COVID-19 laboratory at the Hadassah University Hospital - Ein Kerem in Jerusalem, last week.
A COVID-19 laboratory at the Hadassah University Hospital - Ein Kerem in Jerusalem.Credit: Emil Salman

If the number of new coronavirus cases grows by more than a few dozen per day, the Israeli economy will have to re-enter lockdown out of fear that the pandemic is again out of control. That is what the special team of advisers to the National Security Council on coping with the crisis is recommending.

The team, which is headed by Weizmann Institute Prof. Eli Waxman, has had enormous influence on how the government manages the pandemic because it plays a key role in determining the NSC’s position, which in turn influences Prime Minister Benjamin Netanyahu.

The team counts scores of experts, but has come under criticism due to the fact that it includes no women or minorities. In many cases, it lacks relevant expertise, such as in epidemiology, and has no government officials with inside knowledge of how the system works and its limitations.

Some of its recommendations, such as an early one not to end the lockdown until the number of coronavirus cases had fallen to 10 a day were ridiculed and never adopted. In fact, the lockdown was mostly lifted after the number of new cases was 300 a day, a figure that has now fallen to about 20.

The team’s 80-page final report, which was released at the end of last week, urges the government to manage the coronavirus through extensive and rapid testing, i.e., with results coming back in no more than 48 hours. The tests should be expanded to include all those who have gone into quarantine and those who show symptoms similar to the coronavirus, even if they haven’t come into contact with anyone who has been infected.

That last recommendation would be difficult to put into practice because thousands of people arrive at health maintenance organization clinics every day with symptoms that resemble COVID-19.

The team observed that most coronavirus cases occurred in a limited number of areas, where about 700,000 Israelis reside in a country of about nine million people. That being the case, in the future Israel should impose lockdowns in targeted areas, which it said would be much more efficient than a nationwide lockdown.

Waxman’s team was particularly concerned about the government’s losing control of the pandemic’s spread. Thus, it set as its benchmark for a renewed nationwide lockdown, including closing schools again, a few-dozen new cases a day (not counting people who have returned from overseas).

As to the decision-making process, the team believes it should remain exclusively with the Health Ministry. That said, the advisors urged the formation within the ministry of a permanent unit to deal with emergency situations, with its own epidemiological research unit that can help authorities contain the next epidemic early.

A national coronavirus database should be set up and its information made available to the public. It was one of the few instances where the team hinted at criticism of Health Ministry policies, which has released almost none of the data it has collected on the pandemic.

Its recommendation on setting up an emergency unit raises some question marks since one like that already exists. However, the unit didn’t operate during the crisis and has no permanent director, which elicited criticism about the ministry’s management of the crisis by its director general, Moshe Bar Siman Tov. The Waxman team didn’t comment on that at all.

Vis a via the economy, the recommendations were written by former Bank of Israel Governor Karnit Flug and a group of former treasury officials. They urge the government to begin reducing the budget deficit and national debt as early as next year while at the same time spending to accelerate economic growth.

To square these contradictory recommendations, the team suggests creating a “box,” which is treasury jargon for spending outside the budget framework, on the order of 30 billion shekels ($8.5 billion). That money should go toward extended unemployment benefits (including aid for the self-employed). The benefits, however, should be gradually reduced to encourage people to go back into the job market.

Other measures it proposes include letting people make use of their advanced-training funds (kranot hishtalmut) with full tax benefits before they mature, more spending on professional re-training; and funds for job-generating public works on a local level, such as building bicycle paths and parks. It also urges bigger, nationwide infrastructure spending on ports and internet as well as more investment in the Arab sector and encouraging general education in ultra-Orthodox schools.

The economic proposals are all pretty conventional; those concerning health care policy are extremely conservative and based on some unusual assumptions. For instance, it asserts that without a full lockdown, the coronavirus would have spread uncontrolled and Israel would have found itself in a situation like Italy, France and Spain.

But it’s not at all clear on what basis the advisors made that assertion because in Europe many countries did not impose a full lockdown but did not suffer high contagion levels.

The team warned against Israel’s adopting a herd immunity policy to control the pandemic. If it had been put into practice, the number of deaths would have reached 45,000, with 10,000 of them people under age 70, and 130,000 people needing ventilators. But in Sweden, which has a population about the size of Israel’s and where such a policy was adopted, the number of deaths has been about 3,000.

Another surprising assumption in the report is that the number of coronavirus cases was 25% to 50% higher than the number diagnosed. But nearly all experts say the number is probably two, or even 10, times the number of confirmed cases.

Finally, it is difficult to understand why, if the Israeli health care system can’t cope with more than 1,000 serious coronavirus cases, as the team says, should the government be spending 1.5 billion shekels to buy 15,000 ventilators?

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