Curbing Delta’s force, vaccines keep Israel’s hospitals calm and avert lockdown

‘If we weren’t so well-vaccinated, lockdown would be looming,’ says top government adviser; doctors breathe sigh of relief, but worries linger about ‘weak spot’ in COVID fight

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

An Israeli teen receives a coronavirus vaccination in Jerusalem on June 24, 2021. (Yonatan Sindel/Flash90)
An Israeli teen receives a coronavirus vaccination in Jerusalem on June 24, 2021. (Yonatan Sindel/Flash90)

Israel would be in the throes of a huge virus spike and hurtling toward a new lockdown, had it not reached such high vaccine coverage, the government’s top COVID adviser said.

Speaking to The Times of Israel on Thursday, as the extra-infectious Delta variant pushed the number of citizens confirmed COVID-positive close to 2,000, Ran Balicer, chief innovation officer at Clalit Health Services, said: “If we weren’t so well vaccinated, a lockdown would now be looming in our future, and we certainly wouldn’t be able to take such mild decisions.”

Despite having a large population 12 years old and younger who cannot currently receive shots, Israel is upholding its reputation as the world leader in inoculation against the coronavirus, with 60 percent of the population fully vaccinated.

Still, Israel’s current infection numbers are a real problem for officials, who have reinstituted mask-wearing indoors, tightened border controls, and delayed the relaunch of large-scale incoming tourism. In mid-June, there were under 20 new cases per day. Now, there are around 300 and the number is expected to rise to 500 next week.

However, the spike isn’t translating into an increase in serious cases. If a virus spike results in serious cases, it normally takes a week to ten days for the effect to be felt in hospitals, which would mean that patient numbers should now be rising. They aren’t.

As of Thursday, there were 54 Israelis hospitalized with the coronavirus, just two more than a week ago. The number of patients on ventilators now is the same as it was then: 18.

Illustrative image: Nurses put a hospitalized coronavirus patient on a ventilator. (AP Photo/Jae C. Hong, File)

At hospitals, doctors are breathing a sigh of relief, and saying the situation shows that while some vaccinated people are being infected, it’s clear that inoculation is downgrading their illness and preventing deterioration.

“This is very good news,” Alon Hershko, head of the coronavirus department at Jerusalem’s Hadassah Medical Center, told The Times of Israel. “This was what we anticipated as most people are vaccinated, which lessens the severity of the disease. But it’s extremely reassuring to see that our hypothesis is correct.”

He is hoping for the best, but prepared for the worst. “There is no way we can know what is going to happen in the next couple of weeks,” he said. “But we have accumulated a lot of experience with the virus, and the serious disease it can cause.”

Balicer, head of the advisory committee to coronavirus czar Nachman Ash, was “relieved and optimistic” by the high vaccine uptake, which he said is proving itself as a bulwark against severe infection.

He said that widespread vaccination rates across adult age groups is protecting against a major spread of cases, and the particularly high rate among the elderly (well over 90%), who are most at risk of serious illness and death, has “dramatically reduced the population-level risk of overwhelming hospital capacity.”

In Balicer’s analysis, this isn’t only preventing morbidity, but also allowing life to continue as normal, with educational institutions, workplaces and recreation venues all operating restriction-free, apart from the need to wear masks. The Health Ministry is also understood to be mulling the reintroduction of the so-called “green pass” limiting some recreation to people who are vaccinated or recovered from COVID.

Illustrative image: A restaurant in Tel Aviv. Recreation is unaffected by the recent spike in coronavirus cases. (Miriam Alster/FLASH90)

“We’re still one of the most widely fully vaccinated countries, which potentially gives us the space to take more moderate decisions than we had a few months ago, had we needed to tackle the Delta variant then,” Balicer said.

He played down fears that vaccines will prove significantly less effective against the Delta variant than other variants, saying that research so far suggests otherwise.

“We are still in the information-gathering phase and the most important thing is to not take bits and pieces of information and put them together,” he said.

“The most advanced data is coming from the UK, where Delta hit first, and excellent data is being collected and shared in a timely manner, a commendable effort in a global perspective. Facing the Delta variant, two doses of the vaccine still seem to be highly effective in preventing hospitalization and serious disease, which is a great comfort.”

Professor Ran Balicer, head of innovation at Clalit, Israel’s biggest health services provider, in Tel Aviv, on June 10, 2020 (Emmanuel Dunand / AFP)

Balicer acknowledges that many of those currently getting infected are vaccinated, but said those who are concluding that this clearly undermines vaccine effectiveness are getting the wrong impression.

“The vaccine is highly effective but not bulletproof effective,” he said. “So it makes sense in a country where 85% of the adult population is vaccinated that a considerable proportion of those getting infected are vaccinated.

“It’s simple math, and it doesn’t necessarily point to very low vaccine effectiveness. It could be the case, but it is too early to tell.”

While Israel is in a strong position vis-a-vis the coronavirus, there are challenges. There is a sharp rise in the number of 12- to 15-year-olds who are getting vaccinated, but most children are still unprotected, as are around 200,000 people over the age of 50, which Hershko said underscores the need for vigilance.

And to his disappointment, most of the Palestinian population is still unvaccinated, after a deal that would have transferred vaccines from Israel to the Palestinians fell through.

“I would be much more relaxed right now if the Palestinians were vaccinated as well,” Hershko said. “We’re in constant contact with the Palestinian population.”

Contact with Palestinians is one potential source of COVID from outside of Israel. The other is Ben Gurion Airport, where testing operations have been dogged with problems and overwhelmed at times, even as a whole on-site lab stands largely idle.  

A health care worker takes a nasal swab sample from a Palestinian woman at a COVID-19 testing center, in the West Bank city of Ramallah, on Sunday, June 6, 2021. (AP Photo/Nasser Nasser)

Prime Minister Naftali Bennett has called the airport a “weak spot” in the  fight against the virus, and appointed a special commissioner to tackle the problem. Doctors are raising concerns that the airport will be the entry point for more variants.

“We need much better control of our entry gate. And now that a specific person has been appointed for dealing with this, I believe the situation will be better,” Balicer said.

Asked why the border has not been better controlled, when it has been seen as a “weak spot” throughout the pandemic, he declined to comment.

Balicer believes that while Israel’s overall situation is good, caution should be maintained. “There are several reasons to reduce or delay dissemination of the virus if we can,” he said.

“We still have 200,000 people over the age of 50 who have not been vaccinated and are at severe risk of serious illness. And while the vaccine gives 95% protection against hospital admission, [the number] of hospitalizations arising from the remaining 5% could have a public health impact if dissemination [of the virus] continues to escalate.”

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