Immune no longer: Israel’s virus-proof city, Haifa, awakens to COVID-19 reality

Mysteriously, the coronavirus had largely left northern city unscathed. But now, as cases rise, local doctors fear their luck is running out

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

A drill at Rambam Medical Center to transform its underground parking and wartime hospital ward facilities into an emergency hospital for large numbers of coronavirus patients, July 2020. (Courtesy of Rambam Health Care Campus)
A drill at Rambam Medical Center to transform its underground parking and wartime hospital ward facilities into an emergency hospital for large numbers of coronavirus patients, July 2020. (Courtesy of Rambam Health Care Campus)

In Israel’s third-largest city, thus far largely untouched by the coronavirus, cases are rapidly climbing and doctors are wondering if the lucky streak they enjoyed until now is coming to an end.

Cases are also climbing nationally. The Health Ministry on Wednesday evening confirmed 980 new coronavirus infections over the previous 24 hours, Israel’s highest single-day total since the start of the pandemic.

Last time this kind of national surge happened, Haifa residents watched, waited, and found that, for some reason, the virus wasn’t making inroads in their area.

As a result, Haifa has enjoyed a reputation as Israel’s coronavirus-proof city. It is home to a little under a third of a million people, but has seen just 304 confirmed coronavirus cases so far.

This compares starkly to Israel’s two bigger cities. Jerusalem, with about three times the population, has seen almost 16 times the number of cases: 4,798. Tel Aviv’s population is not quite double that of Haifa, but it has almost five times the number of cases — 1,419.

But Haifa’s fortunes seem to be changing. “I’m expecting that what is coming now will affect Haifa just as it affects the rest of the country,” said Dr. Oren Caspi, a principal investigator at the Technion-Israel Institute of Technology medical faculty.

Sheba Medical Center staff at the coronavirus isolation ward in Ramat Gan, June 30, 2020 (Yossi Zeliger/Flash90)

He is convinced that there is no rhyme or reason to Haifa’s low caseload so far. “It can be summed up in one word — chance,” he said, stating that the odds are stacked against Haifa getting lucky again, and that the increase in cases shows that a new reality has already arrived.

“We should all be worried,” said Caspi, who is a senior doctor at the Rambam Health Care Campus as well as researching at the Technion.

Haifa’s cases are already climbing in a way that wasn’t seen before. While the overall number of cases, 304, is low, Caspi said it is telling that so many of them are active — a sign of a changing reality.

Haifa’s current active cases, 114, account for the equivalent of more than a third of the patients that the city has seen throughout the pandemic.

This is a pattern familiar to cities that initially get a relatively smooth ride, and then start dealing with significant numbers of cases. In Tel Aviv, almost half of the overall cases, 739 out of 1,419, are active.

Tel Aviv has now overtaken Jerusalem in terms of active cases per 1,000 citizens: 1.33 compared to 0.83. Haifa is still lower than both, at 0.35, but Tel Aviv’s rise above Jerusalem’s level highlights that the situation is fluid.

At Rambam, Haifa’s main hospital, staff are readying for a possible influx of patients. “We have a solution for 900 patients, 300 of them in intensive care or ventilated,” said director-general Michael Halbertal, adding that while this represents a massive rise from the 25 current COVID-19 patients, his institution is prepared.

Michael Halbertal, director-general of Rambam Health Care Campus (courtesy of Rambam Health Care Campus)

There are regular drills to prepare for the possible transformation of a large underground car parking area into an emergency hospital.

Halbertal said he doesn’t have clear answers regarding why Haifa was mostly spared until now, but suggested a possible reason.

Haifa has less tourism than the center of the country and Jerusalem, and fewer residents went on winter vacations — the original entry route for the virus, but one that is no longer relevant as transmission is now within Israel. “Fewer people from this area went abroad than people in the center, where the economy is better and people went skiing,” he said.

Illustrative photo of Israeli travelers arriving at Ben Gurion airport on March 23, 2020. (Tomer Neuberg/Flash90)

This is no longer relevant now, with very few flights arriving in Israel and COVID-19 risks coming from transmission of the virus between Israelis. Now, Haifa is at risk like the rest of the country, Halbertal believes.

“The worst scenario [nationally] is that we’ll have a burden of patients,” he told The Times of Israel. “We could lose control really easily and go from having low numbers of patients to having hundreds or thousands.”

At the pandemic’s previous peak in April, Rambam had 100 patients, from Haifa and elsewhere in northern Israel, with six of them ventilated, and the hospital cleared capacity in regular wards in case there was a larger influx. Now, Halbertal said Rambam must be ready to reduce the number of non-COVID-19 patients from 1,100 to 600 if the virus isn’t contained.

“This would be a major stage. It would affect our ability to treat other patients,” he said, expressing hope that opening up capacity in other northern hospitals — which currently aren’t taking COVID-19 patients but will start doing so if cases rise — will avert this.

Times of Israel staff contributed to this report

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