Without Policy Shift, Israel Will See Hundreds of Seriously Ill COVID-19 Patients in a Month, Officials Warn

The current low number of seriously ill patients gives a dangerous illusion that the situation is good, but ‘the rapid spread of the virus may lead to the health system’s collapse,’ an expert explains

Ido Efrati
Ido Efrati
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A Jerusalem street in the midst of the coronavirus pandemic.
A Jerusalem street in the midst of the coronavirus pandemic.Credit: Ohad Zwigenberg
Ido Efrati
Ido Efrati

Public health officials in Israel are warning that the surge in coronavirus infections will lead to a steep rise in the number of acutely ill COVID-19 patients unless immediate measures are taken.

Some speak of hundreds of seriously ill patients within five weeks.

A total of 1,013 new cases of the virus were recorded Wednesday, the highest number of new cases in a day since the outbreak began in Israel in February. Of these, 12 people are seriously ill, bringing the number of these patients in Israel to 58, from 38 just two weeks ago. At the peak of the crisis in mid-April, 180 patients were seriously ill, with 130 on ventilators.

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The number of people who are hospitalized with COVID-19 also spiked over the past two weeks, to 270 Thursday from 146 on June 18. Of the 270 patients in hospital, 71 were in moderate condition and 141 were in good condition, while 24 of the seriously ill patients were on ventilators.

An average of 20,000 coronavirus tests are performed each day, more than at the peak of the crisis. Most of those tested are young adults, some of them without symptoms. One fear expressed by public health figures is that young people who have been infected with the coronavirus but are not aware of this due to a lack of symptoms can easily infect older people with whom they are in regular contact, and may have already done so. This could lead to a spike in the number of acutely ill patients.

According to sources in the health establishment, the rise in the number of coronavirus patients is already so significant that there is no point in defining communities as hot spots, since there are so many of them. Therefore stopping outbreaks in individual locations will be very difficult.

Prof. Eli Waxman of the Weizmann Institute of Science, who is heading a team advising the National Security Council, explains that the current low number of seriously ill patients gives a dangerous illusion that the situation is not bad.

“Due to the rapid spread of the virus, if we take steps only when this number rises, we won’t be able to prevent much higher numbers, which will lead to the health system’s collapse. This stems from the fact that it takes a week or longer from confirmation of infection to an acutely ill condition, as well as a further two-week delay until a high number of seriously ill patients accumulates.”

To illustrate this, he said that “in the two weeks preceding last week, there were 3,850 newly-infected people. The number of acutely ill patients comprises 2 percent of those people. If the present infection rate continues, we would have 2,000 new patients within 15 days. Two percent of them would be seriously ill a week later, with 40 new acutely ill patients a day.”

Waxman added that such a patient requires 15 days in intensive care, so that 600 patients would occupy these units at one time. If we don’t stanch this rise quickly over the next two weeks, we’ll have 600 gravely ill people in three weeks, with no way back.”

Waxman’s team sent an urgent letter to Prime Minister Benjamin Netanyahu and Health Minister Yuli Edelstein Saturday, warning that “Israel has lost control of this epidemic.”

The team recommended taking immediate steps to block the spread of the virus, including new restrictions on the public. They proposed taking responsibility for blocking the chain of infection from Prof. Siegal Sadetzki, the head of public health services at the Health Ministry. The Society of Infectious Diseases made similar recommendations, warning of a point of no return, following which it would be impossible to prevent massive infection rates with a high load of seriously ill patients.

A drive-through coronvirus testing site in Jerusalem.Credit: Emil Salman

In preparing for a scenario with hundreds of acutely ill patients, hospitals have reopened corona departments that they had shut down. In contrast to the earlier outbreak, they are treating COVID-19 patients while conducting routine hospital business.

If the number of acutely ill patients rises, hospitals will need to cope with them while hundreds of their employees could be either sick with the virus or in isolation after exposure to an infected person. A total of 1,591 medical staff people are currently in quarantine, including 276 doctors and 443 nurses. The head of the Shamir Medical Center, Dr. Osnat Levtzion-Korach, said that “because the virus is everywhere, with more random testing of asymptomatic people, we are seeing a rise in the number of quarantined employees, many of them infected outside the hospital.”

Levtzion-Korach believes that medical teams have more knowledge now on how to treat COVID-19 patients. “Teams have learned a lot since the first wave” she said. “The infrastructure and equipment are in place. What’s missing is positions for medical staff. We anticipate higher acute patient numbers and we lack skilled manpower.” To improve treatment, she said, more staff is urgently required in emergency medicine and in intensive care and internal medicine departments.

“The low number of acutely ill patients is due to the fact that most of the recently infected patients were young. They’ll visit their grandparents and we’ll soon see a rise in acutely ill patients,” she predicted.

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