Israel has in practice given up trying to rein in the coronavirus pandemic within its borders. With the rapid spread of the omicron variant, Israel has lost all control in its efforts to combat the virus using the methods it employed with partial success for almost two years. This is now happening in many other countries as well, including most Western democracies. Prime Minister Naftali Bennett has started broadcasting to the public that this is the new reality, but he is still speaking cautiously, with some vagueness as to the full implications of the new reality.
When the epidemic started spreading around the world almost two years ago, most countries responded by using variations of a model presented by the World Health Organization, with varying degrees of success. This response included massive testing, the isolation of people exposed to carriers, and an effort (which often failed) to trace infected people and sever chains of infection. To this, some governments added extended lockdowns in an attempt to prevent their hospitals from collapsing under the load.
After two years, lockdowns are no longer a realistic option. First, much of the population is protected, at least from serious illness, due to the vaccine and booster shots. Secondly, the public in Israel and other countries is worn down and exhausted, and chances are slim that people will again accept extreme measures, at least as long as the rate of mortality remains low.
Those at the Israel Defense Forces’ "Alon" headquarters, which monitors infection chains, admit that this effort became less effective once Israel crossed the threshold of 2,000 daily infections a week ago. The huge lineups at testing centers indicate that they are reaching their maximum capacity. In many cases people need to wait one or two hours to get tested, which is expected to slow down the delivery of results significantly and in turn make some forgo testing at all. In hundreds of classrooms and kindergartens across the country, an exceptionally high number of carriers among students and staff led to a cessation of studies.
Regarding isolation, if the government had not eased existing regulations the number of people in isolation would have skyrocketed this week, totally paralyzing the economy.
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The practical significance of all this is that the known measures have lost their effectiveness. The government could have taken complementary steps a few weeks ago, such as restricting mass gatherings, more vigorously encouraging people to work from homes, or an order to switch to remote classes at higher learning institutions. It postponed taking these steps mainly for reasons related to the economy and a wish to avoid another round of compensating affected businesses.
At this point it seems that imposing such restrictions will have only a relatively marginal effect. Thus, the government is making do with a reasonable call on citizens to use their judgement and take personal responsibility for their health.
At the same time, it is starting to encourage at-risk groups to stay home until the storm abates. This week, approval was given to administer a fourth vaccine dose to medical personnel and to people over the age of 60.
The cabinet heard expert reviews revealing an extremely high contagion factor of the new variant. According to most estimates, Israel will have tens of thousands of new carriers a day already by next week.
The main unknown factor is the rate of seriously ill people among these new carriers. Estimates based on data from South Africa and preliminary results from Britain and Denmark show that the rate will be significantly lower, perhaps three-fold lower, in comparison to the previous delta variant. Thus, if between two million and three people in Israel become carriers within weeks, will even a relatively low incidence of serious illness (apparently between one third to one half of a percent) inundate hospitals?
The health system in Israel is relatively strong, the population is young in comparison to other Western countries and the rate of vaccination is very high. Vaccines are supposed to grant an additional layer of protection against serious illness.
Furthermore, critical experience has been gained in treating people with COVID-19. In early January, a new drug will be added to the medical arsenal in Israel – one that can prevent a deterioration in the condition of many people in at-risk groups, if they are given these drugs on time. On the other hand, for the first time the rise in coronavirus infections is occurring during the flu season (last year flu didn’t spread very much between countries due to travel restrictions). This imposes an extra burden on medical personnel, who are already exhausted and wiped out after two particularly demanding years.
In previous waves there were different definitions of the threshold at which health services would collapse. These ranged between 1,000 to 1,500 seriously ill patients. During the second wave in September 2020, there were 1,200 such cases in Israel. Subsequent studies showed that this affected the level of care, and it’s likely that it increased mortality as well, from COVID-19 and other diseases. A “collapse” is hard to define a priori. Hospitals will continue to function in any event. The question is at what level and at what cost in human lives.
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Bennett is familiar with these facts and is cautiously beginning to market his insights to the public. The difficulties he faces are known: He has no electoral base; he is regarded with suspicion and is finding it hard to come across as someone leading the government towards clear and well-formulated goals. This has led to a confidence crisis between the public and government, which began during Netanyahu’s term but continues to this day. To his credit, and in contrast to his predecessor, Bennett has no extraneous considerations while handling the pandemic (he is not facing any indictments). He is also not dependent on pressure groups looking for special treatment (the ultra-Orthodox).
Estimates are that the omicron wave will be strong but short. If the prime minister is lucky and manages to stave off a collapse of the health system, voters may think more highly of him and his government. There is some hope that the extreme levels of infection, coupled with the lower mortality rate of this variant, will bring us closer to the end of the pandemic. This will only become clear after the coming tsunami is over.