Over 800 coronavirus patients have died in Israel since the beginning of January, according to Health Ministry data released Wednesday, with some medical experts saying that the high mortality rate is linked to the British mutation of the virus – whose presence has been discovered in at least half the new cases.
The number of deaths crossed the 4,000 level at the beginning of the week, and reached 4,212 on Wednesday morning.
Experts say the number of patients in serious condition who die derives directly from the number of confirmed cases, but some of the physicians have concluded that the British mutation has had a much broader effect than just its impact on the rate of infection and its spread – which also concerns the treatment of patients.
The head of the COVID-19 intensive care unit at Hasharon Hospital, Dr. Shaul Lev told Haaretz that “The new variant is highly contagious, and the rate of infection is enormous. This of course influences the number of confirmed cases, from which is derived the number of patients in serious condition and deaths, but it is possible that it has broader implications."
“That this variant is more infectious, we know that. The question is why? What are the implications? And what does the behavior of the virus mean? Does its high infectiousness lie only in its strong or fast bonding to the cell, so a small quantity of it is enough to be infected?"
"Is it expressed in the speed of its replication? Something that could affect the potency of the disease. We are dealing with a (COVID-19) variation whose biological behavior is a bit different. We still don’t understand the biology and what the full significance beyond the rate of infection is,” Lev said.
"The effect of the mutation is not measured just in the characteristics of its level of lethality compared to the better-known strain, but in its adaptation to the regular treatment," he added.
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“The fact that a small amount of it is needed for infection, for example, can have different clinical implications – such as a change in the regular timetables for the process of the disease, how much time passes before the immune system responds, how and what the strength of the response is," Lev said.
The patients Lev sees in the coronavirus intensive care ward are younger: “We are seeing less people who are 70 and older. It might be because they are now among the first people to be vaccinated. We know that in the first two weeks after the first dose, the protection is minimal to nonexistent. So, it is still a bit too early to assess it accurately. In addition, we have identified characteristics of an inflammatory storm in the current wave of patients in serious condition, like the first wave, which is typical for a younger group.”
Prof. Gili Regev-Yochay, the director of the infectious diseases and epidemiology unit at Sheba Medical Center in Tel Hashomer, said the numbers do not look at all to be derived from the general infection rate, but it is possible that other factors are responsible for that. “I still think it is a direct result of the levels of infection, but without a doubt it requires study and investigation,” she said.
Dr. Khetam Hussein, the head of the coronavirus department at Rambam Medical Center in Haifa, also found the severity of coronavirus has worsened. "The patients are in worse condition and it seems the virus is more virulent, and we are yet to see the effect of the vaccinations, she said. Most of the patients she sees arrive in more serious condition than in the past and their conditions deteriorate more rapidly."
Prof. Dror Mevorach, the director of the COVID-19 unit at Hadassah Medical Center in Ein Karem in Jerusalem, said the main variable is the high number of confirmed cases, but along with this there are other components.
"The system can provide a certain amount of care, but there is not enough staff in intensive care for everyone who needs it – and this has a price. This includes providing suboptimal care – which is already happening. Does the British virus also cause a more serious illness? Possibly, but there are enough causes of mortality even without it.”
Virus spread has slowed down
The country’s coronavirus czar, Prof. Nachman Ash, meanwhile said Wednesday that the rate at which the virus is spreading is slowly decreasing, in an interview with the Kan Bet public broadcaster on Wednesday. “We are seeing a decrease in the past few days, I estimate that this trend will continue and we will be able to end the lockdown on the scheduled date” of January 31, he said.
The national coronavirus information center agreed with Ash in a report released Tuesday that said there are “signs of a halt in the rise in the rate of infection.” Even though the current spread in infection is high, “the infection rate [the average number of people every patient infects] continues to drop – evidence of the spread stopping soon,” wrote the authors of the report.
Ash said Wednesday that it is first and foremost necessary to reduce the overburdening of the health system, saying the load is “unbearable and costing human lives. We also need to lower the number of patients in serious condition and the number of confirmed cases – though this measure is less important for now. We want to look at the number of patients in serious condition and the load on the [health] system.”
On Tuesday, the cabinet extended the present lockdown for another 10 days, until January 31. It also approved a requirement for every passenger arriving in Israel to undergo a coronavirus test within 72 hours of their flight, starting on Friday night, and extending the use of location tracking of patients by the Shin Bet security service through February 10.
Israel has begun administering over 200,000 vaccines a day, over 2.27 million people have received at least one dose, and 550,000 Israelis have received their second dose of the vaccine, Health Minister Yuli Edelstein announced Wednesday. The goal is to reach a quarter million vaccinations a day, Ash told the cabinet in its meeting on Tuesday.
“We see signs the vaccinations are having an effect,” Ash said Wednesday, adding that authorities expected to see a drop in the number of patients in serious condition in the next few days.