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Flu could shut newly opened schools, says doc, amid worries over vaccine supply

So-called twindemic effect may keep kids home, says top hospital physician, as community health leader voices concern flu shots won’t be given as needed

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

A medic works in the underground parking of Haifa's Rambam Health Care Campus, which was transformed into an intensive care facility for coronavirus patients, on September 23, 2020. (Jack Guez/AFP)
A medic works in the underground parking of Haifa's Rambam Health Care Campus, which was transformed into an intensive care facility for coronavirus patients, on September 23, 2020. (Jack Guez/AFP)

Israel’s education system could be forced to shut down soon after its reopening if the country has a bad flu season, according to a senior doctor.

“We know that children are drivers of influenza, and if children are not vaccinated, we could see transmission in schools and preschools, and may have to shut down the education system again,” said Dr. Eyal Leshem of Sheba Medical Center.

Israel’s preschools resumed on Sunday, after a monthlong closure due to the national lockdown, and the government is expected to give instructions for schools for older kids to reopen gradually over the next two months. The timescale for reopening may slow down if a new call by coronavirus czar Ronni Gamzu for caution is heeded.

Leshem cited the potential “psychological and economic damage of lockdown for the third time in a year,” but said that if the flu spread quickly around schools, given the similarity of its symptoms to those of COVID-19, it would wreak havoc.

Israeli parents escort their children for the first day of school, during the coronavirus pandemic, in Tel Aviv on September 1, 2020. (JACK GUEZ / AFP)

The coronavirus testing system may well be unable to quickly and accurately rule out coronavirus for each child who reports flu-like symptoms, which may make it impossible to keep schools open, said Leshem, a member of Sheba’s COVID-19 team and a consultant to the World Health Organization.

Eyal Leshem of Sheba Medical Center (courtesy Sheba Medical Center)

He said that warnings of a so-called twindemic effect, with the flu spreading fast as the coronavirus pandemic continues, are real, and that even in a normal year Israeli internal medicine departments can experience “flooding” due to the flu, with more than 150 percent capacity.

Leshem voiced his concerns in an interview with The Times of Israel on Monday, amid warnings by some community doctors that their best tool for preventing flu outbreaks — timely and wide-scale vaccination — may prove impossible this year.

“I’m very concerned that we will not get enough shots in time,” Dr. Amnon Lahad, chairman of the National Council for Community Health, told The Times of Israel.

The Health Ministry has ordered around 4 million flu vaccines this year for a population of 9 million, higher than the normal number, but only a few hundred thousand have arrived so far. Israel is believed to be planning its first vaccine factory, but currently imports all vaccines.

Lahad, who heads a clinic near Jerusalem, said that is not enough at this point in the year mid-pandemic, adding that he is worried about supply and concerned that many of the shots will come too late for the full benefit, which he says requires injection by early December.

He also warned that precious time will be lost, even when more shots arrive, due to the lack of plans for socially distanced vaccination centers.

Amnon Lahad (Courtesy)

Lahad said that the Health Ministry, which his organization advises on community medicine, is guilty of “huge mismanagement” by failing to build infrastructure so that nurses can quickly administer the vaccines to large numbers of people without compromising on social distancing.

“I don’t feel we are getting ready for administering the vaccines,” he said.

Assaf Librati, spokesman for the Meuhedet HMO, admitted that flu vaccination is likely to drag on into January and February, saying, “There won’t be a shortage, as we see it, but it’s going to be later than other years.” He said that plans are underway for vaccination centers away from clinics.

He added: “We think we’ll be able to supply whoever needs.” Asked to clarify whether he meant whoever needs or wants — in past years flu vaccines have been freely available to any Israeli who wanted — or just to the young, elderly and at risk, he replied: “Whoever needs.” A healthy 30-year-old, for example, doesn’t require a flu vaccine, he said.

Israel’s other three health funds, like Meuhedet, played down concerns and said that shots are on the way and plans for vaccination centers are in progress. Moshe Mosko, spokesman for the Leumit HMO, said, “Last year at this time we didn’t have a single vaccine,” adding that the shots always arrive in batches, and delays in supply are par for the course.

He suggested it boded well that some flu vaccines have already arrived despite sky-high demand internationally due to the pandemic.

Mosko said: “In Israel, in a regular year, there are 2 million people vaccinated and last year it was 15% higher. This year, because of the coronavirus, we ordered 4 million. I don’t think we’ll get 4 million but we will get 3 million.”

A doctor giving a vaccine (iStock)

A spokesman for the Clalit HMO, under which Lahad operates his clinic, gave a much more upbeat assessment than he offered. “Clalit is getting 2 million shots, and there is no reason to believe otherwise,” he said, adding that plans are underway for vaccination centers away from clinics, including outdoor facilities. The Maccabi HMO reported that it has received 200,000 vaccines and expects many more.

Health Ministry spokesman Eyal Basson, asked by The Times of Israel about a possible vaccine shortage, replied: “We believe ‘shortage’ is not an appropriate term for the influenza vaccine situation in Israel.

“Due to COVID issues, in March 2020 the Ministry of Health anticipated high demand for influenza vaccines in the coming season and secured, for Israel, double the amount of vaccine compared to last year, approximately 4 million doses this year as opposed to approximately 2 million last year,” he said,

“The vaccine will be arriving in Israel in known allocations over the coming six weeks. In order to ensure vaccine availability for those in greatest need, vaccines will be offered based upon a Ministry of Health preference list. The Ministry of Health will evaluate supplies and demand throughout the season, and may be able to offer the vaccine to additional groups,” Basson added.

“We have no reason to anticipate supply lapses. Should they occur, we will evaluate our options accordingly.”

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