Israel Has More Serious COVID Cases, but Patients Have Milder Illness, Doctors Say

Medical personnel at Israeli hospitals indicate that while the number of hospitalized COVID patients may be growing, vaccines are likely weakening the severity of symptoms

Ido Efrati
Ido Efrati
Medical staff in Hillel Yaffeh Medical Center, Hadera, on Saturday.
Medical staff in Hillel Yaffeh Medical Center, Hadera, on Saturday.Credit: Amir Levy
Ido Efrati
Ido Efrati

Even though the number of seriously ill coronavirus patients is rising, some doctors say their impression is that hospitalized patients are generally less ill now than they were during previous waves of the virus.

According to Health Ministry data published on Sunday, the number of seriously ill patients has jumped to 97 – an increase of 30 patients since last Wednesday. Of the seriously ill, 22 are in critical condition and 17 are on ventilators. In total, 191 coronavirus patients were hospitalized as of Sunday, of whom 113 were vaccinated.

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But the number of seriously ill patients has risen much more slowly than the number of cases. The latter figure jumped from 132 to more than 1,400 over the last month, a tenfold increase. Over the same period, the number of seriously ill patients rose from 23 to 97, a fourfold increase.

Before vaccinations began, around four percent of patients became seriously ill. But today, with most of the country vaccinated, an estimated 1.5 percent of patients become seriously ill.

And a Health Ministry study of data from January to July concluded that even vaccinated people with preexisting diseases are better protected against serious illness than unvaccinated people of the same age with no preexisting conditions.

Among vaccinated people aged 70 to 79, for instance, serious illness developed in 5.7 percent of the 725 patients with no preexisting conditions and 11 percent of the 727 patients who did have preexisting conditions. Among unvaccinated patients of the same age, in contrast, serious illness developed in 17.1 percent of the 3,053 patients with no preexisting conditions and 20.6 percent of the 2,551 who did have preexisting conditions.

“Even though we don’t have many patients, it’s clear to us that this wave is behaving differently,” said Dr. Noa Eliakim-Raz, who heads the coronavirus ward at Beilinson Hospital in Petah Tikva. “We feel that from a clinical standpoint, the characteristics are different, and we’re dealing with a different illness.”

Her department has treated some 30 patients in recent weeks, and 11 are currently hospitalized – all of them vaccinated. Nine of these patients are over 70, and most have several preexisting conditions. Two others, aged 25 and 39, have the virus but were hospitalized due to other problems.

Elyakim-Raz said that this time around, she is seeing patients who meet the definition of serious illness – a blood oxygen level below 93 percent and a chest x-ray that reveals infection – but are nevertheless in better clinical shape than people with the same characteristics in previous waves. Therefore, she said, their condition often improves more quickly, and they can be released sooner. Alternatively, some remain stable and are then released but kept on oxygen.

So far, “no patient has been sent to intensive care” during the current wave,” she said. “That’s a major difference from previous waves, when patients were sent to or returned from intensive care on a daily basis.”

Prof. Yair Levy, head of the coronavirus department at Meir Hospital in Kfar Sava, also said his seriously ill patients are in better shape than those from previous waves. His department has treated some 60 patients over the last month.

Of these, 16 are currently hospitalized, 10 of them with serious illness. But Levy said only 30 percent of the people technically defined as seriously ill are actually in serious condition.

Unlike Elyakim-Raz, however, he doesn’t see the current wave as essentially different from previous waves in terms of the way the disease behaves. “We don’t see any change in the rate of deterioration or recovery,” he said.

Nevertheless, he added, in previous waves, relatively healthy people aged 40 to 50 sometimes deteriorated rapidly into serious illness and death within 48 hours. “And so far, we haven’t seen that in this wave. The deaths we’re seeing are mostly patients with serious preexisting conditions.”

Dr. Khetam Hussein, who heads the infection control unit and the coronavirus department at Rambam Health Care Campus in Haifa, sided with Elyakim-Raz. “My impression is that the patients are less seriously ill” than they were in the previous wave, she said. Almost all have preexisting conditions or are very old, and the vast majority are vaccinated.

“The symptoms are the same symptoms, but among seriously ill patients, they seem less severe, and fewer deteriorate from moderate to serious condition or from serious to critical,” she added.

But Dr. Kobi Haviv, head of the Herzog rehabilitation hospital in Jerusalem, sided with Levy. “Overall, we don’t see any real difference in the illness compared to previous waves,” he said.

Nevertheless, he does see a difference in how quickly coronavirus patients are arriving at his hospital, which receives patients from other hospitals. Currently, he has 34 patients aged 48 to 97, roughly half of them seriously ill.

“During the peaks of previous waves, they would transfer 80 patients to us in three or four days,” he explained. “Now, it’s sporadic – two or three patients a day, not more. I hope that’s related to the vaccine moderating the illness.”

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