A leading health expert has warned Israeli leaders to have a plan ready to snap restrictions back in place if and when cases of coronavirus infection begin to spread out of control again, as the country presses ahead with easing emergency regulations and restarting the economy.
Marc Lipsitch, a Harvard University epidemiologist who is advising Prime Minister Benjamin Netanyahu on possible strategies for returning the country to some semblance of normal, said officials need to carefully consider now what they will do should cases rebound, rather than wait until that actually happens.
“There need to be clear plans for how you reimpose restrictions, if it turns out to be that cases are going up faster than anticipated,” said Lipsitch, a professor of epidemiology, immunology and infectious diseases at Harvard’s T.H. Chan School of Public Health.
“That could be at the level of one village, or even a factory or a small outbreak in one place. Or it could be at the level of a whole region or the whole country,” he explained. “I wouldn’t automatically say the entire country needs to go back into lockdown because of one neighborhood or town.”
Lipsitch, who also directs the Center for Communicable Disease Dynamics at Harvard, said the government does not necessarily need to prepare in advance fallback plans for every possible scenario in every single locality.
“I don’t know if it needs to be formula-based,” he said. “It will ultimately be up to the judgment of the public health officials, but it should not be like, ‘We’ll try this and see how it goes, and if there’s a problem then we will re-evaluate.’ It should be more sophisticated than that.
“You need some ongoing ways to figure out if cases are spreading faster than the system can handle, and a response to that needs to be planned in advance, so it doesn’t become a tug of war between factions about how much we should open up or close down.”
While Netanyahu cited Lipsitch twice in a Saturday night address announcing eased restrictions, the premier has never publicly elucidated what rolling back restrictions entails or what metric might be used to determine whether restrictions need to be reimposed beyond warning that the process would be gradual and reversible.
In his conversation with Netanyahu on Saturday — a few hours before the prime minister announced, in a televised address to the nation, that Israel “will start to ease restrictions in both the personal sphere and the economic sphere” — Lipsitch said he stressed that it was crucial to think in advance about what to do if the experiment fails.
But while the prime minister spoke about the potential to walk back the steps he announced, he did not indicate that he had made any concrete plans on how to react if coronavirus infections soared again.
“If, within the next two weeks, we see the positive trend continuing, we ease additional restrictions. However, if there is an additional outbreak of the coronavirus, we will be compelled to backtrack,” Netanyahu said.
“I want to make it clear to you that this is what all countries are doing and intend to do, without exception. Some already eased restrictions and were compelled to backtrack because the pandemic broke out again,” he added.
He then noted that he and Health Ministry director-general Moshe Bar-Siman Tov spoke to Lipsitch a short while ago. “And he [Lipsitch ] told me: ‘There is no other way. You open, try and if you need to, you close.’ Of course, success depends, in large measure, on us, on all of us,” Netanyahu said.
Speaking to The Times of Israel via telephone from Boston, Lipsitch said he was not familiar enough with the steps Israel has taken so far to comment on Netanyahu’s specific policies.
But he did criticize US President Donald Trump for announcing a plan to open the economy there back up without addressing ways to reinstate restrictions if the infection rate went up again.
“In our presidential briefing the other night, there was a plan announced where the only thing was about how we would open up, and nothing about how we would know if that was too far or too fast,” he said.
The Trump administration acted wisely by closing the borders when it did, he added. “But then it completely squandered the opportunity [to beat the disease] by not doing anything,” he added. “All it does is buy time.”
Netanyahu has also cited his decision to close borders early as an important part of keeping Israel’s infection rate relatively in check, though some critics have accused the prime minister of risking Israeli lives by hesitating to order arrivals from the US to self-quarantine, ostensibly to avoid tensions with the Trump administration or with his political allies’ Haredi constituency.
Lipsitch merely said that shutting one’s borders is just one of many steps that need to be implemented to effectively combat a pandemic.
“I have mixed feelings because I think border restrictions are imperfect anyway, and should not be a centerpiece of a policy, especially if there’s ongoing transmission in a country already,” he said. “On the other hand, at the low points of an epidemic — at the beginning and at the and of it — then border controls are more important.”