Prof. Eli Waxman is worried. A month ago, the head of the team of experts that’s advising the National Security Council and two of his colleagues were interviewed in Haaretz and surveyed the first stage in the confrontation with COVID-19. The bottom line was positive: All in all, Israel made the right decisions at the right time. Halting flights, followed by a lockdown, succeeded in containing the virus and in enabling Israel to avert an experience like that of Italy, Britain and the United States.
The previous time I spoke with Waxman, who is from the Weizmann Institute of Science in Rehovot, only a few dozen new infections a day were turning up in Israel. This week the average surged to above 300. In May, the team suggested to the government that it reconsider the restart of the economy if the daily number of infections exceeded 200. Coronavirus doubters point to two important data, where no similar steep rise has been encountered: the number of those being ventilated is stable (around 30) and the number of seriously ill, though it has risen (to more than 40), has done so at a relatively moderate pace.
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However, the stability in the number of those on ventilators is apparently due to a change in the treatment procedure, by which the hospitals in Israel are putting off ventilation to a later stage of the disease, if at all, for fear of long-term damage. And the change in the number of seriously ill, which usually stands at about two percent of the total number of infected, takes place about two weeks after the detection of the newly infected. It’s also possible that the increase is more moderate this time, because compared to the onset of the country's outbreak, in March, fewer elderly people are being infected.
“It’s true that the rate of increase is slower than in March, but if we do nothing, the figures will go on rising,” Waxman said. “In another three weeks we are liable to reach a thousand new infections a day. And even if a small percentage of them turn serious, an overload will gradually be inflicted on the hospitals.”
Waxman believes that there are two main reasons for the rise in the incidence of disease: a speedy and uncontrolled reopening of the schools and the economy, and the failure to implement the team’s recommendation to the Health Ministry to create “rapid takeover ability” to halt the chain of infection – a reference to the epidemiological investigative teams that were not expanded, were not budgeted and are still under centralized, restrictive control of the ministry’s directorate.
“Both things were known and were stated more than a month ago. I do not blame the Israeli public. There was a deep failure of management. The Health Ministry must operate according to defined goals in the struggle against the virus, and examine itself in terms of meeting quantitative goals. The fact that you tried, worked hard and didn’t sleep nights is not enough.”
On March 22, not long after Waxman’s team started to work, Military Intelligence agreed to make suitable people available to the investigative groups. Three days later, Prof. Siegal Sadetzki, the Health Ministry’s director of public health services, claimed that no such help was needed. It’s only in the past few days that the Health Ministry has announced the intention to recruit 300 investigators – three months late. The opposition of the Health Ministry’s senior staff is a key reason for the absence of the required ability today, leaving Israel in a default situation of imposing a lockdown, a method that was developed in the Middle Ages.
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This week, the Waxman team met with the Health Ministry’s new director general, Prof. Hezi Levy, and the ministry’s ranking officials. Waxman formed the impression that there’s a new spirit there and a greater readiness to listen to outside opinions. In the meeting a target of 72 hours was set between the moment a person is referred to a test, its analysis and locating the chain of contacts.
“Rapid development of the ability to disrupt chains [of infection] – that is the most important mission now,” Waxman says, adding, “However, with the present rate of infection that is not enough. In order to avoid another full lockdown, we need to stop and even reverse some of the lifting of the restrictions. I’m afraid that there will be no choice but to again limit participation in mass events, such as family celebrations or cultural events. And yes, I would also consider closing the restaurants.”