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As ‘red zones’ reopen, concern Haredi test avoidance exaggerates improvement

Decision-makers cite falling COVID cases in hotspots to support canceling their restrictions, but Dr. Ian Miskin says his empty test centers suggest that stats are faulty

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative: United Hatzalah workers wearing protective clothing as a preventive measure against the coronavirus test ultra-Orthodox Jewish men, at the Wolfson Yeshiva in Jerusalem on August 27, 2020. (Yonatan Sindel/Flash90)
Illustrative: United Hatzalah workers wearing protective clothing as a preventive measure against the coronavirus test ultra-Orthodox Jewish men, at the Wolfson Yeshiva in Jerusalem on August 27, 2020. (Yonatan Sindel/Flash90)

As Israel lifts restrictions on all-but-one of the country’s virus hotspots, citing dropping coronavirus cases, a top doctor has said it’s acting on questionable data, asserting the some of the ultra-Orthodox community is avoiding testing.

Just four days after the government voted to ease national lockdown rules — to a chorus of experts warning that virus success hinges on hotspots staying locked down — local restrictions have been lifted.

A government statement said that only the Jerusalem neighborhood of Ramat Shlomo will remain a red zone with special restrictions, while others, including Bnei Brak, which has a reputation as the city most impacted by coronavirus, are now classed as “orange.”

The Jerusalem neighborhoods of Mattersdorf, Maalot Dafna and Ramot Eshkol have all had their status as restricted zones rescinded.

A mask-clad ultra-Orthodox Jewish man and youngsters walk along a street in Jerusalem during the second nationwide lockdown imposed by the government in a bid to stem the spread of the coronavirus, on September 26, 2020. (MENAHEM KAHANA / AFP)

In a media briefing just before the government decision, coronavirus czar Ronni Gamzu said he had recommended the move based on falling case numbers, and praised residents in these areas for their “excellent work.”

But some doctors are questioning how sound the statistics are, and infectious diseases expert Ian Miskin told The Times of Israel that in some ultra-Orthodox locales “you can’t tell what is going on because people aren’t being tested.”

He said: “People don’t realize how much of the disease there is in the Haredi community.”

Falling infection rates naturally cause a drop in demand for testing, but Miskin said this doesn’t fully explain significantly-reduced demand in test centers under his control. He said he believed the test rates also reflect a trend of people whose health condition suggests they should get tested avoiding doing so.

Nadav Katz, a Hebrew University coronavirus statistician, said that testing avoidance in parts of the Haredi community was evident in his latest analysis.

Katz said that he had seen a “huge” and “precipitous” drop in testing in his facilities serving Jerusalem’s Haredi neighborhoods since the Jewish holiday season, which ended on October 10, and said he believes it reflects an effort to avoid towns’ categorization as hotspots, and the restrictions that go along with that.

“People don’t want to be stigmatized again, they don’t want to be forced to be at home, so people aren’t getting tested,” he asserted, saying that the labs of the Clalit health maintenance organization currently have significant spare capacity due to the drop in demand.

Israeli police seen at the entrance to the neighborhood of Ramot in Jerusalem as Israel enforces a night curfew on September 8, 2020. (Yonatan Sindel/Flash90)

“What sent us spinning in late September and early October was the Haredi sector being tested, and now there are few tests coming back,” he said.

He commented: “People aren’t using the facilities provided for them to be tested in their neighborhoods which they have previously used. This has caused a drop in the number of positive tests, and with a lack of positive tests it’s easy to understand that these areas are ceasing to be red areas.”

Katz said he has concerns of this “skewing decision-making” in the future, but believed that the current decisions regarding red zones were backed up by other indicators, such as levels of hospitalizations and deaths from those areas, meaning those actions may be sound regardless of the drop in testing.

Medical team members take swabs to test for the coronavirus at Shaare Zedek hospital in Jerusalem, on October 8, 2020 (Nati Shohat/Flash90)

Miskin said that aside from impacting statistics used by policymakers, the lack of testing is one of the biggest obstacles to his work, leaving him “highly concerned” about an inability to focus his team’s medical efforts where they are needed. “The lack of testing information is hindering our work in knowing where to concentrate our efforts in coronavirus protection,” he said.

Earlier this month, Hebrew media reported that there is a network of volunteers in ultra-Orthodox areas that has reportedly been secretly treating thousands of coronavirus patients in their homes. Miskin said that some well-connected Haredim are also sourcing COVID-19 care on an entirely private basis, which means they aren’t showing in statistics, and he estimated that around 150 Jerusalem Haredim who would otherwise be hospitalized are receiving this kind of care.

“You won’t see them in figures,” he said. ‘Even though they need oxygen, you won’t see them in the statistics.”

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