Analysis |

Israeli Physicians, Scientists Warn Against Lockdown, Call to Adopt Swedish Model

Experts' petition recommends protecting vulnerable populations as opposed to taking far-reaching collective action to curb the spread of the virus

Amos Harel
Amos Harel
People walk through a crowded street wearing face masks, Jerusalem, August 31, 2020.
People walk through a crowded street wearing face masks, Jerusalem, August 31, 2020.Credit: Emil Salman
Amos Harel
Amos Harel

Dozens of Israeli physicians and scientists have signed an open letter calling on the cabinet not to impose a new countrywide lockdown, despite a rise in the number of confirmed coronavirus cases.

The signatories recommend focusing on steps to protect the groups that are most vulnerable to infection – above all older adults – and to avoid broader, more collective measures. They called for adopting, with certain adjustments, the Swedish model for handling the pandemic.

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The petition follows the government's decision on Thursday to impose a lockdown on "red" cities and towns, with high infection rates. Some ministers and senior officials have warned that a countrywide lockdown over the High Holy Days may be inevitable should infection rates keep rising.

It was signed by some of the most prominent voices that have criticized the approach of the Israeli government and many other countries in dealing with the virus, both on social media and traditional media platforms. They include Dr. Udi Qimron, a professor of microbiology at Tel Aviv University; Amnon Shashua, the founder of autonomous-driving technology developer Mobileye and a professor of computer science at the Hebrew University of Jerusalem; Michael Levitt, a professor of structural biology at Stanford University who was awarded the 2013 Nobel Prize in chemistry; Prof. Eitan Friedman, a professor of internal medicine specializing in cancer; and Dr. Ifat Abadi-Korek, the head of the pharmacoeconomics department at the Israeli Center for Technology Assessment in Health Care.

Missing from the list, at least for now, is the most prominent and outspoken coronavirus contrarian voice in Israel, Prof. Yoram Lass, a former director general of the Health Ministry.

Prof. Eitan Friedman, a professor of internal medicine specializing in cancer and a signatory of the letter to curb coronavirus restrictions, May 29, 2012.Credit: Alon Ron

The letter reflects an increasingly strident disagreement in the medical-scientific community in Israel and abroad. In the outbreak's first months, and particularly after tens of thousands of deaths were recorded in China, Italy, Spain and other countries, many governments enacted similar policies involving the strict enforcement of social distancing measures. The most serious of such measures was a full lockdown that in many countries remained in place for weeks and even months.

In Israel, the measures paralyzed the economy and caused massive damage, but the restrictions were lifted after slightly over a month – earlier than in other countries.

Israel is now in the grip of a second wave of infection, albeit with a relatively low death rate – around 0.6 percent of COVID-19 patients in recent months. The government initially followed the advice of epidemiologists in northern Italy, an area that was struck particularly fiercely by the disease; Israel halted incoming flights and shortly afterward imposed a lockdown.

Prime Minister Benjamin Netanyahu, the heads of the public health establishment and advisory panels spoke nearly as one at the time: The March-April lockdown flattened the curve of infection, preventing the country’s hospitals from collapsing under the strain of a massive number of severely ill patients. This, it was claimed, prevented hundreds if not thousands of additional deaths from COVID-19.

But as time passes, a contrarian voice has been increasingly heard. Some of the comments on social media are very extreme, spreading global conspiracy theories involving the virus. Other commenters, including some physicians and scientists, are more measured. But they still think that governments have been too restrictive, resulting in economic, psychological and medical harm, including to people with other medical issues who choose or are forced to forgo or postpone testing or treatment, which outweighs that of the pandemic itself.

Israel’s response to the virus was somewhere between that of Sweden on the one hand and New Zealand on the other. Sweden, led by its chief epidemiologist, Anders Tegnell, did not impose a lockdown, instead calling on citizens to observe limited social distancing. While in the pandemic’s first months, it appeared that Sweden was hit much harder by the virus than other Scandinavian states, in the past two months the infection rate has dropped steeply, without signs of a second wave.

New Zealand, in contrast, declared all-out war on the virus early on, nearly eliminating it from the Pacific island nation. The country boasted about its low illness and fatality numbers, including weeks without any new cases. The infection rate has picked up recently, however, leading to strict measures to stop the virus’ spread that are wreaking economic havoc. Detractors say that after this lockdown, New Zealand will be more vulnerable than other countries to a new wave of infection, precisely because the virus has not spread throughout the country. They add that in the absence of a vaccine, victory cannot be declared over the virus.

The petition comes amid reports that the rise in COVID-19 infections in Israel will lead to a new lockdown during the Rosh Hashanah holiday weekend, which starts on the evening of September 18.

“A lockdown does not stop the pandemic, it merely slows its spread slightly and temporarily,” the letter’s signatories write. “When the restrictions are lifted, the virus continues its spread, and this after the country’s citizens have been weakened emotionally, economically and above all in terms of their health. A lockdown does not prevent deaths. On the contrary, it extends the period of time during which populations at risk are exposed to the virus ... thus paradoxically causing excess mortality.”

People enjoy the sun at an outdoor restaurant, despite the continuing spread of the coronavirus, Stockholm, March 26, 2020.Credit: Janerik Henriksson / TT NEWS AGE

The physicians and scientists call on the government to adopt the Swedish model, with modifications to better protect older Israelis, as many of the people who died in Sweden during the first wave of the pandemic were in nursing or retirement homes, and the government has apologized for failing to protect this population. They call for keeping schools open while reinforcing the public health system, in order to handle the expected rise in illness this winter.

The letter’s authors do not explicitly say that obtaining herd immunity to the coronavirus is their goal. They speak instead of “Obtaining a depth of immunity while preventing infection in high-risk populations.” They rely on a number of studies suggesting that from 20 percent to 50 percent of the population may benefit from cross immunity to the coronavirus that causes COVID-19 due to exposure to other, similar respiratory coronaviruses in the past. The petition also mentions the hypothesis, as yet unproven, that prior immunity could lower the bar for reaching herd immunity – the point at which the virus gradually stops spreading – to just 20 percent of the population.

This is an argument that is mainly used today in regard to cities and areas that were badly affected by the pandemic during the winter, such as London, New York City and Italy’s Lombardy region. These places have not yet experienced a dramatic uptick in new infections. The question of whose forecasts about the course of the pandemic are correct will be answered in the months to come, in accordance with developments in these locations.

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