Israeli officials in the coming weeks will be closely watching the coronavirus numbers in Britain, where most restrictions were lifted Monday. The British share two key variables with Israel: the immunization rate and the dominance of the highly contagious delta variant.
Britain’s easing of restrictions is being promoted by Prime Minister Boris Johnson, who himself is in quarantine after being exposed to a confirmed case. The easing is stoking controversy among scientists and the public; even businesspeople are worried that ending the restrictions will send the virus spreading further and ultimately cause even more damage.
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This isn’t the first time Britain has pursued a bold if not outright brazen policy. At the onset of the coronavirus crisis last year, months before vaccines were available, Johnson tried a similar tack and was forced to backtrack. This time he’s backed by a sturdy vaccination rate: 53 percent of British citizens are fully vaccinated against COVID-19 and 69 percent have received at least one dose.
On the other hand, the number of daily new cases is near 50,000, with the daily death toll between 20 and 50. Currently, more than 4,000 people with COVID-19 are hospitalized in Britain.
According to Prof. Ran Balicer, the head of Israel’s panel of experts advising the Health Ministry on the pandemic, Israel is only a bit more than a month behind Britain in terms of the rate at which new cases are multiplying.
“The infection rate per capita among the British is six times that of Israel, and the rate of serious illness is five times greater, but we’re constantly narrowing the gap,” he said.
Balicer recently published two graphs for Britain and Israel showing the number of new cases and hospitalizations per million people; the similarities were striking.
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If Israel continues on Britain's path, Israel will find itself with 6,000 new cases a day within less than a month, he said. This week, the number of daily new cases topped 1,300.
According to Balicer, even if those 6,000 cases a day don’t push up the number of seriously ill to a level that threatens the health system, “the ramifications of widespread quarantines for the economy and the educational system will be unbearable.”
He added: “The conclusion from all this is that Israel needs to take a month in which it focuses on containment – to buy time and keep track of what’s happening in Britain. If it turns out that Britain’s gamble has gone well, Israel can behave in a similar way. If not, it will still have effective tools to cope.”
Israel, like Britain, is counting on the effectiveness of the vaccines. The numbers in both countries leave no room for doubt: The coronavirus crisis has been divided sharply into before the vaccines and after.
Even after the delta variant infiltrated into Israel and stoked the latest outbreak that began in mid-June, the numbers of seriously ill and hospitalized have been markedly lower compared to the previous outbreaks.
But the question of the vaccine’s effectiveness continues to vex experts trying to plan for what comes next. The latest raw data presented to Israel’s coronavirus task force looks worrisome, showing that the Pfizer-BioNTech vaccine administered to Israelis is proving only 42 percent effective in preventing infection and 60 percent effective in preventing serious illness.
These are preliminary statistics based on very small numbers that could quickly change, but even if the drop in effectiveness proves less dramatic, it would translate into a totally different situation in terms of modeling and forecasting.
According to Prof. Eyal Leshem, an expert in travel medicine and tropical diseases at Sheba Medical Center near Tel Aviv, the level of the vaccine’s effectiveness is still not clear. He said Britain had done some excellent studies showing that two doses of the vaccine are 95 percent effective in preventing hospitalizations.
Israel, however, uses a different methodology for testing this, “and the minute the methodology is different … you get different results and it’s harder to estimate the effectiveness data,” Leshem said.
He added: “In England there really are far fewer hospitalizations compared to past waves, and that’s with a population mix that’s different [than Israel’s], with a greater ratio of older people. Moreover, a significant portion of the older population received the AstraZeneca vaccine, which is considered somewhat less effective.”
Leshem considers Britain’s decision to lift restrictions under the current conditions reasonable, especially now that much of the adult population has been vaccinated.
He says there are approaches “that support the notion that infecting children and young people, who are lightly affected in most cases, will lead to a kind of equilibrium and a situation where most of the population is protected. This approach, [already] taken by the British and the Swedes, was unsuccessful before the vaccinations. The British decision at this time can be described as bold, but it’s not unreasonable.”
Questions about the vaccine’s effectiveness are particularly focused on older people, who are far more susceptible to serious illness. The concern is not just about the original claims of effectiveness but the possibility that the vaccine loses its potency over time.
In recent weeks the pandemic task force has repeatedly debated giving older people a third dose of the vaccine. Most task force members have argued against this, but as the infection rate in Israel rises, the question become more acute.
So far, Health Ministry Director General Nachman Ash has merely called on older people to be vigilant, wear masks, observe social distancing and avoid crowded places as much as possible.