The coronavirus cabinet’s amusing decision to limit buses to 20 passengers, with open windows and no air conditioning, showed just how disconnected its members are from normal life. The windows on Israel’s new buses don’t open, and how can capacity be cut drastically without a corresponding rise in bus frequency?
A day later, the ministers, including Transportation Minister Miri Regev, realized their mistake and dropped the demand for open windows on buses with windows that stay shut. Only now, however, has Regev’s ministry begun planning to boost headways.
This is just one illustration of the coronavirus cabinet’s disorganized and unprofessional decision-making. Five months into the pandemic in Israel, the government simply can’t get its act together. In Tuesday’s coronavirus cabinet meeting, it emerged that most of the restrictions recommended by the Health Ministry don’t reflect the sources of infection according to contact tracing, only 53% of which determine how a particular patient was infected. In the absence of hard data, the decisions that were made seem to have been shot from the hip.
Take the surprising decision to close outdoor pools in the peak of summer. Epidemiological studies in countries more organized than Israel found clear sources of infections – large-scale indoor events, for example, or gyms. Outdoor swimming pools have never been proved to be a source of infection, as far as is known. Moreover, the restrictions are fairly easy to enforce by limiting the number of visitors and the duration of their visits, and they appear to pose very low risk. Closing pools in the middle of summer comes off as entirely unnecessary and perhaps even dangerous, as it could result in more crowding on beaches.
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We asked the Health Ministry if they’d identified any infections at pools. They pointed us toward the 47% of contact tracings that never found the source of infection. This isn’t by chance, the ministry is breaking under the burden of all the tracings and its own outdated technology.
It turns out that the data from the ministry’s thousands of tracings are dumped in a single, jumbled Excel spreadsheet file. The terms entered in its data fields are inconsistent. An infection transmitted in a synagogue could be termed “synagogue,” “house of prayer” or simply the street address. A gym could appear with the name of just the address, while a center with both a gym and a pool may appear with no mention of where the infection occurred.
The ministry is drowning under tens of thousands of unsorted data points, which cannot be analyzed in order to draw conclusions. Why? Because the ministry’s health services division has been neglected for decades, and it has no advanced data systems that can be used to automatically retrieve data. Until the data system failures are addressed, Israel won’t be able to address the coronavirus crisis in an organized, systematic way.
The organizational and data management failures aren’t limited to the Health Ministry. They pervade the government’s response to the crisis. There are no data systems for analyzing the contact tracing, and not enough people to do the tracing. The Transportation Ministry can’t boost the bus schedules to allow for social distancing. The government doesn’t have the flexibility to raise pay and divert thousands of unemployed Israelis to work at nursing homes (instead, it made the cowardly decision to import 2,500 foreign workers); the education system doesn’t have the capacity to reduce classroom size and hasn’t managed to organize remote learning; the government hasn’t managed to make timely decisions to offer economic aid to the hundreds of thousands of self-employed who lost their income, and once it made a decision, it didn’t manage to distribute money in time; and there’s no systematic aid to the tens of thousands of people who are now isolated and lonely – maybe they need help procuring food or medicine?
Prof. Siegal Sadetzki, head of the Health Ministry’s public health department, resigned Tuesday. Despite the rejoicing – she was painted as the face of Israel’s failure to manage the coronavirus – the problem didn’t start with Sadetzki and it won’t end when she is replaced. (And that won’t be easy: How many public health experts does Israel have?) The problem is broader and deeper: The government is disorganized, has poor executive capacity and is historically weak in microeconomics. It’s not surprising that the countries that have been most successful in handling the crisis have the world’s best governments: Germany, southeast Asian nations, most of Scandinavia. The coronavirus crisis demands discipline, obedience, punctiliousness. This is a crisis that demands good management over time. All the things Israel lacks.
We have other things, like the ability to improvise and rise to the occasion, resilience in the face of crises and perhaps even the capacity to draw conclusions and improve. The emerging failure in handling the coronavirus crisis already brought us to an important change: Prime Minister Benjamin Netanyahu no longer wants to be identified with the crisis; for the first time, this week he sent Health Minister Yuli Edelstein to appear on TV alone. Edelstein surprised by announcing that a “coronavirus czar” is in the works.
No one has been hired, and there’s no defined job description, but we can do that. The work in all of the ministries needs to be organized. They need constant coordination with each other, and they need better troubleshooting skills. Building new data systems for public health, for instance, is complicated at the best of times, how much more so in the midst of a crisis when time is of the essence?
What does the job need? A very experienced, strong manager, ideally with an understanding of public health, who knows how government works and who can get ministries to cooperate with each other to get the job done. There’s no need for new agencies, like the national coronavirus center; that only increases the chaos. Ultimately this is a job that involves coordinating among the government, the Israel Defense Forces and local governments.
Two possible candidates are the heads of Israel’s two best hospitals: Prof. Ronni Gamzu, a former Health Ministry director general, and Prof. Yitzhak Kreis, a former IDF chief health officer. But they’re busy running their hospitals.
Then there are generals, who may lack government experience but are adept at crisis management. Maj. Gen. (res.) Roni Numa, who managed the pandemic crisis in Bnei Brak, apparently was offered the job, and there’s a former chief of staff who is presumably free: Gadi Eisenkot, considered one of the best in that job. His main problem is that our frightened prime minister may see him as a potential political rival, and block the move.
This leaves us with the obvious candidates: Former Prime Minister’s Office chiefs of staff. They have the requisite experience, but all the recent ones can’t bear the idea of returning to work with Netanyahu.
Good luck to Edelstein – and to all of us – in finding the right person.