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Severity of Israel's Omicron Wave Depends on One Metric

Even if omicron leads to lighter illness, the infection rate can still spell trouble for Israel's health system

Amos Harel
Amos Harel
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Prime Minister Naftali Bennett, this week.
Prime Minister Naftali Bennett, this week.Credit: Emil Salman
Amos Harel
Amos Harel

This was the week the omicron variant really crashed onto our shores. The first signs of the new coronavirus variant had already been identified in Israel a few weeks ago, but this week saw a significant increase, which will quickly lead to a flood of new cases.

Doubling itself at a rate of somewhere between every two and three days, omicron will become the dominant variant of the coronavirus in Israel, shunting aside the more veteran delta variant within about two weeks. One practical result of this is already clear – Israel, within a few weeks, will break its daily infection record that was set back in January, during the third wave of the pandemic: more than 10,000 new cases in a single day.

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Some of the projections heard at the coronavirus cabinet on Tuesday were exceedingly bleak. The daily number of new cases could rise to 20,000 and more; it will be necessary to prioritize coronavirus medications according to the condition of the patients (Israel has purchased a first shipment from Pfizer, which will arrive next month); there will possibly be a shortage of hospital beds and ECMO respiratory machines. The worrisome phrase “insufficiency” was also heard several times during the discussion.

Several doses of the COVID vaccine, this month.

The head of the panel of experts that advises the cabinet, Prof. Ran Balicer, explained to the cabinet ministers that in light of the fact that the omicron variant also infects people who have been vaccinated (and even vaccinated with a booster shot, the third dose), the Green Pass strictures no longer give sufficient protection at mass events. Balicer proposed considering a recommendation to senior citizens not to go out to crowded places. Public Security Minister Omer Bar-Lev went one step further: Citizens over the age of 60 should, in his opinion, stay home in light of the new situation (Bar-Lev himself is 67).

The discussion, as well as the generally depressed atmosphere, sounded like a travel back through the time tunnel to the gloomy days of the first waves of the pandemic, nearly two years ago. Still, the circumstances are different this time. First of all, nearly 60 percent of Israelis are still fully vaccinated, which scientists say will protect them well against serious illness. Secondly, despite the contradictory signs, overall encouraging data is coming in from abroad about how the death and hospitalization rates due to the new variant will be far lower than those of the previous strains.

The key question that will determine the severity of the wave is the final proportion of the seriously ill. If the daily number of new cases increases by a factor of five, it will not be possible to take comfort in the fact that the number of the seriously ill among them has been cut in half, because the result will still mean a flooding of hospitals – the scenario that Israel has feared throughout the pandemic. Apart from one time, at the peak of the second wave in September of 2020, it has managed to avoid such a situation.

A coronavirus ward in Shaare Zedek Medical Center, Jerusalem, in October.

Prime Minister Naftali Bennett, who responded quickly to the first reports of the new variant abroad, at first found it difficult to line up with his government. He inundated the cabinet ministers with ideas, some of them half-baked, that did not win much support. This week, oddly enough at that meeting with abundant leaks and recordings, it appeared that things were beginning to stabilize.

Bennett believes that now, after the approval of additional restrictions, the Israeli response is getting on track. However, the government is far from presenting a united front. Education Minister Yifat Shasha-Biton is not really committed to the effort to vaccinate young children, and Finance Minister Avigdor Lieberman, who doesn’t want to reopen the discussion of compensation for businesses, is casting doubt on the gravity of omicron and is opposed to imposing strict constraints.

This week Bennett pushed for the idea of giving a fourth vaccination to the elderly, the immunocompromised and medical personnel (the third dose of the vaccine was in fact a success).

This time, the decision is very controversial among the experts. Many of them think there is not yet sufficient evidence that the effectiveness of the third vaccination has weakened. Others note that an accelerated fourth dose would not be adapted to the threat posed by omicron. Bennett believes that next week, once the impression of infection running wild in Western countries is digested here, there will be a rush to get children vaccinated and the additional boosters. But even this is liable to happen too late: Many people will fall ill before they get a new vaccination, and vaccinated people will also be infected.

On the basis of the figures coming in from South Africa, Bennett assesses that the current wave will be powerful but shorter: eight or nine weeks, with the curve of the decline in the infection rate also being steep.

In light of the expected number of cases, there will also be an astronomical number of people in quarantine who have been exposed to cases of infection. Next week, the cabinet will discuss changing the quarantine rules, with the aim of reducing the number of people in quarantine and the number of days they will have to remain there. However, the most critical question, as noted, has to do with the number of seriously ill. The doctors in South Africa, which has already passed the peak of its wave, are spreading optimism. Their colleagues in Britain, Denmark and the United States, which are among the countries that are currently in the midst of the deluge, are still a lot more hesitant and worried.

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