'Hospitals won't be overwhelmed; this is not a fourth wave'

Israel ‘underreacting’ to COVID? Or justified optimism? Hospital chiefs split

With Muslim festival and Israeli wedding season approaching and COVID cases rising, some are filled with foreboding while others relax, saying vaccines doing their job

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

A medical worker tests an Israeli youth for coronavirus at a basketball court turned into a coronavirus testing center in Binyamina, June 29, 2021. (AP Photo/Ariel Schalit)
A medical worker tests an Israeli youth for coronavirus at a basketball court turned into a coronavirus testing center in Binyamina, June 29, 2021. (AP Photo/Ariel Schalit)

With their premises quiet despite the spike in COVID diagnoses, Israel’s hospital directors are split on whether it’s time to breathe easy or to plan for the worst.

At the Galilee Medical Center in Nahariya, Prof. Masad Barhoum thinks that the very slow rise in the number of hospitalized patients is temporary, and there could soon be many more. The government, he argues, is “underreacting” to the increase in coronavirus cases, especially since Eid al-Adha, a Muslim festival marked with large gatherings, starts in two weeks.

By contrast, at Shaare Zedek Medical Center in Jerusalem, Prof. Jonathan Halevy is against the very measures that Barhoum wants to see, like reviving the Green Pass, which limited entry to some venues to only vaccinated people and those who have recovered from the coronavirus.

“I’m not very concerned and I’m certainly not concerned hospitals will be overwhelmed,” Halevy, the hospital’s president, told The Times of Israel. “This is certainly not a fourth wave.”

Barhoum, one of the country’s most prominent Arab doctors, told The Times of Israel that he was particularly concerned by the timing of the current spike, which has raised the total number of active cases in Israel to 2,600.

Israel is grappling with new daily caseloads of around 300 and facing warnings from experts that this could more than triple soon. “It’s better to have restrictions now rather than when we have 600 or 1,000 patients a day,” Barhoum said, adding that while he doesn’t fear anything on the scale of the first three waves, he is concerned about the coming weeks.

A medic at a COVID-19 ward at the Galilee Medical Center during the height of Israel’s coronavirus crisis. (Shlomi Tova)

The government is considering some new restrictions, but Barhoum thinks that social distancing and hand sanitization should be brought back, as should the Green Pass. “We are currently underreacting,” he said.

Barhoum and Halevy’s analysis converges only on the issue of Israel’s airport, which both recognize as the entry point for more new variants, and they therefore favor more control. But beyond this, Barhoum wants to see caution, while Halevy, who focuses less on the numbers of people diagnosed and more on hospital stats, feels confident.

As of Monday, there are 68 people in the hospital, 16 of them on ventilators, reflecting minimal extra strain on hospitals since the spike in new cases began.

Masad Barhoum, director-general of the Galilee Medical Center in Nahariya (courtesy of the Galilee Medical Center)

Health Ministry data suggests that the Pfizer-BioNTech COVID vaccine largely prevents hospitalization and serious cases, and Halevy said this is reflected on the ground, with vaccinated patients experiencing the virus very lightly. He added that even those who are hospitalized are faring well. “We just had a vaccinated patient who was brought in after testing positive. He was admitted because his oxygen saturation level was below 92 percent and he needed oxygenation, but he was released after 24 hours. This is the kind of thing we are seeing across Israel.”

Barhoum said a large part of his concern focuses on the Arab sector and the ultra-Orthodox community — two drivers of infection in previous waves, and the very populations where vaccination rates are low and where large gatherings are likely to be especially common over coming weeks. If significant numbers from these sectors are infected, he said, it will cause disproportionate levels of hospitalization, he predicted.

Eid in the Muslim calendar, and the Ninth of Av fast day in the Jewish calendar, which falls around the same time, normally signal the start of a busy wedding season in Israel. Barhoum noted that this disproportionately involves members of the Arab community and the ultra-Orthodox sector, with their low vaccination rates.

Eid will be marked by large family gatherings, some of which will involve Palestinian relatives from the largely unvaccinated West Bank.

“We are coming to Eid al-Adha, plus there are weddings and we also have people traveling abroad, so we’ll have problems,” he warned.

Illustrative image: Muslim worshippers wearing face masks offer Eid al-Adha prayer at a park as mosques are limited for ten people following the government’s measures to help stop the spread of the coronavirus, in the mixed Arab Jewish city of Jaffa, near Tel Aviv, Israel, Friday, July 31, 2020. (AP Photo/Oded Balilty)

Halevy’s perspective is that even if there is an increase in the spread of the virus, the bottom line is that most of the population is protected by vaccines. “We see day to day that the vaccine still gives very good protection against serious disease,” he said.

“We know the vaccine is the answer. Of those who are getting infected, hardly any have serious disease,” Halevy said.

But Barhoum thinks that a serious response is needed despite the vaccine. “First of all, five percent of those who are vaccinated aren’t truly vaccinated,” he said, noting that the vaccine is effective among 95% of those who receive it, not all.

“Secondly, we don’t know for sure how much the vaccine protects from the Delta variant and we also have adults who are not vaccinated, and a high number of people aged 12 to 16 who aren’t vaccinated. We need to be careful.”

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