As Coronavirus Spreads, These Are the Burning Questions on Israeli Authorities' Minds

How many people are carrying the coronavirus, and where have they been?

Ido Efrati
Ido Efrati
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A visitor being checked at Hadassah University Hospital, Ein Karem, Jerusalem, March 2020.
A visitor being checked at Hadassah University Hospital, Ein Karem, Jerusalem, March 2020.Credit: Ohad Zwigenberg
Ido Efrati
Ido Efrati

The number of Israelis testing positive for the coronavirus shot nearly to 300 on Monday, but health officials say that at the very least hundreds more may have been infected.

They say that as the number of tests grows, an entire layer of the virus’ spread will be exposed, as suggested by Defense Minister Naftali Bennett on Sunday.

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“It’s possible that there are 500 now; maybe there are 1,000 or 5,000 carriers among us,” Bennett said. “This week is a critical week because we’ll know whether the infection rate is climbing or stable.”

Another key question is where Israelis with COVID-19 have been.

Israel isn’t testing enough people for the virus, helping cause the uncertainty, health officials say. Last week more than 700 people were tested; this week the Health Ministry hopes to top 2,000.

Most of the people tested had returned from abroad or were near someone who has since tested positive. But Israel now has patients whose source of infection is unknown, not a good sign when it comes to the likely spread of the infection.

As reported by Haaretz over the weekend, the Health Ministry has been conservative about who should be tested. “I released 15 patients today – every one of them might have undiagnosed corona,” an emergency room doctor in Jerusalem said.

“Patients come in with classic corona symptoms and circumstances that put them at especially high risk – like a person who shops at a supermarket frequented by many French tourists – and the Health Ministry doesn’t approve the test. We take samples that we end up throwing out because we’re not allowed to send them to a lab.”

A makeshift ward at Sheba Medical Center, Tel Hashomer, February 2020.Credit: Tomer Appelbaum

On Saturday, the Health Ministry said hospital staff were now approved to do testing, but capacity is just as much a question. Some health officials say the government will not be able to meet its goal for the number of tests.

A host of questions have no answer yet because of the scant number of tests conducted. What is the infection rate and incubation period? What areas of the country are particularly afflicted? Are certain segments of the population particularly susceptible?

Are there differences in how COVID-19 affects men and women? Does the local climate have an influence? What percentage of medical staff have been infected while treating the sick?

“We assume there is morbidity that has still not been exposed and there are people with corona-lite walking around among us, with mild symptoms, who have not yet been identified as being ill,” said Sigal Regev Rosenberg, the CEO of Meuhedet Health Services. “I assume that in the next week, with the rise in the number of tests, we will see a significant increase in the number of infected.”

All eyes are on the elderly. Meuhedet and the other health maintenance organizations have contacted their members 70 and older, asked about their health and briefed them about the coronavirus.

Later the HMOs plan to contact everyone between 65 and 70. They are also offering psychological support for anyone in isolation and for the HMOs’ medical staff.

If you experience symptoms of the coronavirus, you are not supposed to go immediately to a clinic – on its website the Health Ministry recommends phoning the 101 MDA Emergency Services Hotline. Still, the clinics are preparing to protect their staff as well as the visitors.

“Every patient undergoes questioning at the entrance to the clinic,” Regev Rosenberg said. “A staff member with a mask questions the visitors about their symptoms. And we’re seeing a really heavy load in digital requests to doctors,” Regev Rosenberg said.

The HMOs are seeing increased demand for medication at pharmacies; not surprisingly, fewer appointments are being made for alternative medicine, physiotherapy and dental care, and there have been cancellations.

In addition, people are increasingly seeking online medical consultations instead of going to the clinics. Regev Rosenberg also said she was worried about a shortage of masks and disinfectants.

Over the next few weeks, the HMOs are expected to face an increase in the number of patients – as the number of medical staff who must be put in isolation grows. As part of the preparations for this, the government has begun to put people in isolation in hotels.

“These are patients in mild condition; there’s no need to hospitalize them, but they’re still infectious,” Regev Rosenberg said.

So far, the Defense Ministry and the army’s Home Front Command have said they will operate four such hotels.

“The patients will be isolated under supervision and support for periods of up to 10 days. It’s possible other hotels will be added later according to need,” Regev Rosenberg said, adding that the crisis shows the importance of a strong community health system.

“We will overcome the crisis, but we could have been better prepared,” she said.

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