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Explainer

Rising cases, empty wards: Israel’s COVID situation explained in six graphs

In mid-November, when Israel felt Delta was defeated, cases began to go up once again. How has the rise in infections progressed and where does Israel stand now?

Nathan Jeffay

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

A healthcare worker at a drive testing complex in Modi'in, (Yossi Aloni/Flash90)
A healthcare worker at a drive testing complex in Modi'in, (Yossi Aloni/Flash90)

Where does Israel actually stand in terms of COVID?

As the government and some of its medical advisers voice deep concern, and some other experts suggest that they are overreacting, we take a closer look at some of the graphs that shape the discussion.

The first is the so-called R-naught statistic.

This assesses how many people, on average, each confirmed patient infects.

The reason that policy-makers care so much about this statistic is that it gives a good indication of whether the caseload is growing or shrinking, depending on whether it is below or above one.

It hit one on November 8 and has kept rising, reaching 1.34 at the latest count (the latest statistic available is for 10 days ago).

Israel’s R-naught statistic, showing how many people on average each conformed patient infects. The date is on the horizontal axis and the R-naught on the vertical axis. (Israel Ministry of Health)

Israel was enjoying a feeling that Delta was defeated when case numbers started to grow again. Back in late September, there were more than 6,600 new daily cases on average. That number started dropping, reaching a low of just over 400 in mid-November but rising again to 1,420 on Thursday, making a seven-day average of 1,014 new daily cases over the past week.

It should be noted that the rise started around two weeks before the first Omicron case in Israel. This highlights the fact that the ongoing rise is only partly due to Omicron, and even now government stats suggest that only around one in ten of Israel’s 9,960 active coronavirus cases have the Omicron strain.

Below is what the climb in cases has looked like, with daily averages in blue and a seven-day average, which gives a more accurate picture of trends, marked in red.

The number of new daily infections by date (which is marked on the horizontal axis). The daily statistics are in blue, and the red line shows a seven-day moving average (Israel Ministry of Health)

The daily average of new cases over the last week is double that of the previous week.

This next graph, which resembles a staircase with steps that are increasingly steeper as case numbers grow, clearly shows the rise:

The daily number of verified COVID-19 patients, as weekly averages (Israel Ministry of Health)

From the graphs so far, the situation seems pessimistic: a rising R-naught and growing new daily cases.

But hospitalizations aren’t rising. In fact, the number of COVID-19 patients currently in hospital, 123, is lower than at any point since the fourth wave of infections. 

The number of serious cases stands at 81, compared to nearly 700 in late September.

The following graph, with serious cases at the bottom, moderate cases in the middle, and light cases on top, shows the fall in hospitalizations.

The number of hospitalized coronavirus patients (vertical axis) in Israel by date (horizontal axis), up to December 22, 2021. (Israel Ministry of Health)

And Israel isn’t seeing a rise in mortality, as the following graph shows, with the number of deaths on the vertical axis and dates on the horizontal axis.

The number of COVID-19 deaths (vertical axis) in Israel by date (horizontal axis) up to December 22, 2021 (Israel Ministry of Health)

We know that vaccines are less effective against Omicron than other variants, but the finer details are still emerging.

A recent study by Sheba Medical Center concluded that people who were vaccinated with Pfizer shots six months ago or more have “almost no neutralizing ability” against the Omicron variant, while those who received boosters are in reasonably good shape.

A majority of each age group eligible for vaccines, excluding young children who only just became eligible, is immunized in Israel.

The following graph shows the age group on the vertical axis. On the horizontal axis it shows vaccination status, with the first segment for each age group denoting fully vaccinated, then people who received vaccines more than six months ago whose protection is deemed lapsed as they haven’t taken a booster, followed by the unvaccinated.

For children, there are only two categories, vaccinated or unvaccinated, as almost all who received vaccines did so within the last six months.

A graph showing the vaccination status of Israelis by age group. It shows the age group on the vertical axis, and then vaccination status on the horizontal axis, with the first segment for each adult age group denoting fully vaccinated, then people who received vaccines more than six months ago and haven’t taken a booster, followed by the unvaccinated. For kids, there are only two categories: vaccinated and unvaccinated. (Israel Ministry of Health)

Some will interpret this graph as a half-glass-full picture, focusing on the numbers that are vaccinated; others will see the opposite, focusing on the numbers that are unvaccinated or with immunity status that the government considers lapsed.

The graphs above show much of what we know until now. The question is how all of this will fit together to shape the situation over the coming weeks.

Unless there is a major surprise, Omicron is expected to account for a higher and higher proportion of cases.

Are the empty hospital wards and low mortality rates a good omen, suggesting that Israel will weather Omicron without a major health crisis? Or is it too early to tell because it takes time for those getting infected with a new variant to filter through to hospitals?

Supporting the optimists is data suggesting that Omicron patients are far less likely to deteriorate compared to those infected by other variants. They are between 50 and 70 percent less likely to need hospitalization than those with the Delta strain, Britain’s public health agency said Thursday.

On the other hand, it is early days and data is preliminary. And it’s also unclear whether, if the belief the variant is lighter does pan out, hospitals will be off the hook. Should the increased infectiousness cause cases to snowball massively, even if just an unprecedentedly small proportion of cases end up in hospital, doctors could have their hands full, and mortality rates could rise.

Even the most detailed data and wisest expert insight can’t tell us, with any certainty, how exactly this will pan out.

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