The 2021-22 school year opened Wednesday with subdued excitement, under the regime of the rapid coronavirus tests, as the question remained about how classes would affect the spread of the coronavirus. Two opposing processes will determine the Israeli reality in the coming weeks: The return to class, which is expected to lead to a rise in the number of infections, and the campaign to administer a third vaccine, which evidence increasingly suggests is effective.
The academic year began with more than 10,000 new confirmed cases a day, 689 patients in serious condition in the country’s hospitals and around another 100 in serious condition in geriatric facilities and in the community. Some 95,000 children were absent on their first day because they were ill or in quarantine, and a similar number of students – children in “red” cities (with high levels of infection) in which fewer than 70 percent of the populace is vaccinated – began the year at home.
The rate of increase in the number of seriously ill has in fact moderated and is lower than had been forecast before the third inoculation, but the number of seriously ill – the index that most worries the government and health system professionals, was slowly climbing until recently, though it has started to drop over the past few days. However, the return to the classroom, to be immediately followed by the vacation and family gatherings during the upcoming holidays, could bring Israel to a more serious situation at the beginning of October.
Decision makers are pinning all their hopes on the third-vaccine campaign. A month after it began, some 2.2 million people, 23 percent of the population, have already had the shot, while among those 60 and over the vaccination rate is more than three times that rate. The experts advising the government believe that if more than three million people get a third does, the infection coefficient, now 1.09, will drop.
An analysis presented by Prof. Eran Segal from the Weizmann Institute predicts that getting to the goal of three million vaccinated with the third dose would bring down the infection coefficient by 10 percent, and balance out the expected rise in morbidity in the coming month. He said it’s possible that vaccinating some of the million Israelis who were never vaccinated could bring down the infection coefficient even more, along with all the new cases who will recover. He admitted, however, that the ability to properly weigh all the data in the model is limited.
“Regarding the influence of September events [school’s opening and gatherings on the holidays] it’s of course difficult to assess,” Segal wrote on Twitter. “We also examined a scenario in which the September events raise the infection coefficient by 0.2. Under such a scenario the slowdown [in infections] would be delayed until the end of September, and the number of seriously ill in the hospitals could reach 1,300 to 1,400.”
Prof. Ran Balicer, head of the team of experts advising the government and head of the Clalit HMO’s innovation institute, thinks we’ll see a jump in morbidity during the next few days. “The opening of the school year will raise the number of infections, and bring to the holiday table a record number of contagious people who will put older relatives at risk, particularly the 25 percent of them who haven’t gotten the third shot,” he tweeted. He recommended that those planning a holiday meal with older relatives in a closed space ask anyone who hasn’t gotten the third shot to do a rapid coronavirus test on the eve of the holiday.
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Prof. Eli Waxman of the Weizmann Institute, who also advises decision makers, believes that the schools shouldn’t have opened until three million people had gotten the booster shot. “The steps that were taken – the Green Pass, the Purple Badge, as well as the vaccines – bring down the pace of the virus’ spread, and also the ratio of patients who end up in serious condition,” said Waxman. “On the other hand, we haven’t achieved a slowdown; the morbidity is still rising. You have to understand that the drop in the percentage of those seriously ill will be exhausted at some point.” He noted, “We already have a substantial portion of those who are seriously ill and aren’t in hospitals but at home or in geriatric facilities. In other words, we are already in a relatively bad situation.”
He said it’s difficult to predict the infection status a month from now with a high degree of certainty. “There a risk that we’ll enter a fast increase, and because we don’t have safety margins for hospitalizations, that’s dangerous,” he said. “When you’re in a situation like this, you don’t gamble. We are already getting close to a thousand seriously ill, and there’s no way in the world that the health system will be able to deal with 2,000 seriously ill.”
During the coming month there aren’t very many school days, but even during the few days that the children will be spending in school and preschool could lead to infections among many of their relatives. Amir Argoati, a doctoral student in biology and researcher at the Technion, conducted a simulation of the chances of unvaccinated children getting infected between the start of the school year and Rosh Hashana, which is next week.
To conduct the simulation, he used a particle motion model developed at Duke University. “I entered into the model the size of a typical Israeli classroom, the average number of pupils, the percentage of positive tests among children who took rapid tests, the number of hours they’re in school until Rosh Hashana  and other variables,” he explained on Twitter.
According to this model, in classrooms where the windows are closed, the teacher isn’t vaccinated and the children don’t wear masks, the chance of each child getting infected by Rosh Hashana is 12.66 percent. In classrooms in which the teacher isn’t vaccinated, the windows are closed but the children wear masks, the chance of infection plunges to 4.88 percent. If the windows are kept open, the teacher is vaccinated and the children wear masks, the chance of infection is only 2.44 percent.
Two conditions can bring the morbidity rate down even more: If the windows are kept partially open, the teacher is vaccinated, the children wear masks and do daily coronavirus tests at home, the chance of infection is only 0.49 percent. The chance of infection drops to a minuscule 0.23 percent if classes are held outdoors.