Analysis |

As Israel Passes 5,000 COVID Deaths, Strains and Anti-vaxxers Lurk Around the Corner

All the models predicting a sharp January decline in serious COVID cases have turned out wrong. But there is also good news

Amos Harel
Amos Harel
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Vaccine in Netivot, Israel, February 2021.
Vaccine in Netivot, Israel, February 2021. Credit: AMIR COHEN/ REUTERS
Amos Harel
Amos Harel

An unmistakable pall descended on the coronavirus dialogue in Israel over the past week. The expectations of a speedy exit from the crisis thanks to the extensive vaccination project have yet to be realized. In the first place, the pace of the vaccination operation has slowed down because of a falloff in the public’s response.

As a result, on Thursday the Health Ministry was compelled to accede to the request of the health maintenance organizations and make vaccinations available to the 18-35 age group as well as the older population.

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And second, the vaccinations haven’t yet significantly curbed the virus’ spread or, concomitantly, the extent of morbidity. The decline in morbidity among the elderly, thanks to the vaccination program, is apparently being offset so far by a combination of contrary trends. Namely, the dominance of the new and highly infections British variant of the coronavirus, and the diminishing readiness of the Israeli public to obey the lockdown regulations.

All the mathematical models presented to the government at the end of December predicted a steep fall in the number of seriously ill patients beginning the middle of January, as a result of the vaccinations. All the models were wrong. In practice, there has been a decline of only about 10 percent, to about 1,100, in the number of seriously ill patients – a number that still represents an extremely heavy burden on the hospitals.

The number of new carriers per day has remained quite stable, at between 6,000 and 7,000. If a decision is made to ease the lockdown next week, it will come when the daily number of newly infected is as high as it was when the third lockdown was imposed, at the end of December.

These data don’t leave the health system, in its perception, sufficiently wide margins for error in managing the struggle against the virus. The coronavirus cabinet’s advisory team of experts, headed by Prof. Ran Balicer, has voiced its concern that a rapid and uncontrolled opening of educational institutions and workplaces is liable to cause a broader outbreak of COVID-19, which will be intensified by the British variant.

According to all assessments, the new strain is more infectious. And because children under the age of 16 have not been vaccinated, the (very necessary) opening of the schools could create hothouses of heightened infection.

Vaccination in Petah Tikva, last week, 2021.Credit: JACK GUEZ - AFP

The danger becomes even more acute in the absence of the planning and supervision that the Education Ministry displayed in putting into practice the division into “learning capsules” in the schools after the exit from the two previous lockdowns.

On the positive side, the immunity of the elderly population is proceeding apace. About 84 percent of those 60 and above have already had at least the first dose. By the end of the month, the great majority of the at-risk population in Israel will have reached the maximum immunity level, which is attained about a week after the second shot. These data place Israel first in the world in terms of vaccination – and they are producing the first fruits in the form of a decrease in the number of the seriously ill among the elderly.

Now, though, the real difficulty begins: persuading those who are in no hurry to be vaccinated. The anti-vaccine types, who are spreading fake news about imaginary hazards liable to result from vaccination, are contributing to this situation. But the grudging approach of the Health Ministry is also a problem. The more its senior officials explain to the public that getting vaccinated won’t bring them any benefits, the less inclination young Israelis have to be inoculated.

The government had hoped to vaccinate 5 million Israelis by mid-March. As of February 4, some 3.3 million Israelis had been inoculated (35.8 percent of the population), of whom 1.9 million (20.7 percent) had received both shots. The rate of vaccination this week, about 100,000 a day, is less than half the capacity of the HMOs. At this rate, the original goal looks far from being attainable.

An additional difficulty exists in regard to children and adolescents: About 30 percent of Israel’s population – those aged 16 and below – can’t get vaccinated at this time. Only if Pfizer will assert, toward the beginning of summer, that its vaccine is safe for the 12-16 age group will it be possible to start vaccinating them as well – and thereby to finally approach the herd immunity bar.

According to the scientists, the more infectious variants have pushed up the bar to 80 percent of the population. In the hope that the vaccines will be effective against the coming strains that will develop, the vaccination of the vast majority of the over-12 population, together with those who have recovered from COVID-19, is needed to reach the goal. Even Israel, the world leader in vaccination, isn’t close to that.

The virus’ current growth rate is also attested to by difficulties that the Israeli army foresaw. On Thursday the Israel Defense Forces recorded a record number of 3,000 soldiers confirmed as carriers of the coronavirus and about 14,000 in quarantine, though the young age of those serving means there is very little serious illness among them. Just last week there were large outbreaks in a naval officers’ course and in the Paratroops’ boot camp, which adversely affected training.

At the same time, the IDF’s insistence on receiving a large number of vaccine doses at an early stage has led to rapid progress in its vaccination program. More than 130,000 soldiers have already received the first dose. The level of response is high, under considerable pressure being exerted by the commanding officers. The commander of an elite unit said this week that 89 percent of his soldiers had been vaccinated, including all the unit’s combat troops.

A pep talk with the commander and with the unit’s medic is needed for the last of the hesitant ones, to persuade them that refusal to be vaccinated might prevent their continued participation in action in the field.

Running against the dead and the sick

The vaccination project still looks like Israel’s only possible exit from the crisis, in the hope that no vaccine-proof variants appear. A document released last week by Military Intelligence’s National Information Center raised the possibility that just such a vaccine-immune variant will develop precisely in Israel, as a result of the interaction between the large-scale vaccination program and the spread of the virus.

At the moment, there is no indication that this pessimistic scenario is materializing. But concern about this possibility has already been voiced in the latest consultations in the government, not least because Israel will not want to be associated with a strain of its own that will cause the virus to spread worldwide. This is probably part of the reason for the panic that’s accompanying the imposition of sweeping restrictions on flights to and from Ben-Gurion Airport, after months of negligence by the government at that portal.

A month ago, when Prime Minister Benjamin Netanyahu spoke of his intention to open the economy in March and allow the Passover seder to be celebrated by the extended family, he was relying on the vaccine. But the British variant undercut him – Netanyahu knows that he will not be able to declare a festive return to normal before the March 23 election.

If the three inconclusive elections held in 2019 and 2020 revolved around the voters’ attitude toward Netanyahu in view of the corruption indictments filed against him, this time the focus of the election appears to have changed. The key question is Netanyahu’s performance in the coronavirus crisis – in the health and economic arenas. If the vaccinations don’t bring about a dramatic reduction in the incidence of illness, voters might remember the bar of 5,000 dead, which was due to be passed Thursday night, the impotence in the face of the violations by the Haredi public and the tardy closing of the airport.

Netanyahu’s personal involvement in the striking of the deal on the political far-right shows that this time, too, he’s entering the fray as one who’s decided to take no prisoners. With his political rivals confused and split, Netanyahu is determined not to lose even one vote for his coalition, including the votes of avowed Kahanists.

To a degree, it seems as though he’s not running against Yair Lapid or Gideon Sa’ar, but against the dead and the sick. If at the end of March the crisis is still at its peak, it’s possible that the most Netanyahu will be able to strive for is another stalemate, in the hope of continuing the rounds of electoral attrition and staying in power through an almost everlasting transition government.

In contrast to the March 2020 election, the election a year later will take place with tens of thousands of Israelis ill with COVID-19 and more than 100,000 in quarantine. What will the policy be regarding Israelis living abroad who want to come here to vote and perhaps also be vaccinated? It’s a safe gamble that Netanyahu is taking into account a scenario in which widespread morbidity raises anew the question of postponing the election, notwithstanding the legal difficulties this would entail.

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