With cases rising, Israel hit the halfway point toward its previous high of active coronavirus cases, and some medical professionals are reacting with dread as the situation unfolds.
“It’s rather scary for all of us,” Amer Elemy, head of coronavirus care at Nazareth Hospital told The Times of Israel on Sunday, just after receiving a message from the Health Ministry telling him to prepare to reopen COVID-19 facilities.
Israel’s active case count as of Monday evening, 4,940, is double that of June 7. When the number doubles again, Israel will surpass the peak number of active cases, 9,808, which it hit on April 15.
Elemy believes Israel is in the throes of a second wave of infections and could surpass its previous record within a few weeks, finding itself registering 1,000 new infections daily, with hospitals under pressure.
While the current spike has widely been seen as dominated by light cases, hospitalizations are climbing. Two weeks ago there were 109 patients in hospital wards, a week ago the figure was 133, and now it is 205.
Israel’s infection numbers had been dropping since the peak, but as June hit, they started to rise. The mood in hospitals these days is a far cry from eight weeks ago, when the Israel Air Force treated them to a special aerobatics show.
As planes flew above to honor their work, health employees waved flags to celebrate Independence Day — but also, it seemed, to signal victory against the coronavirus, with case numbers starting to drop as the country prepared to reopen schools.
Today, the “capsules” that kept schoolchildren in small groups have been abolished, meaning that students (apart from some who are already on summer vacation) are studying in full-size classes, alongside new steps that are being taken to reopen the economy.
The cabinet gave the green light on Friday for cultural events for up to 250 people, including theater and cinema, and wedding halls are open. Trains are running again. These changes leave Elemy nervous.
“We need to close areas where there are lots of people — wedding halls, recreational places, and trains, which will be be problematic,” he said.
Former health ministry chief Gabi Barbash said that he fears “mass infection” and thinks that moves to take more steps back to normalcy mean that “we are looking for trouble.”
He commented: “The decision to open halls for weddings is another mistake and we’ll probably pay for that.” Barbash stressed that, in his analysis, it’s not just the number of cases that is concerning, but also their geographic spread, which includes many cases in previously lightly affected places like Tel Aviv.
“My biggest concern is the distribution of cases all over the country,” he said.
At Israel’s health funds, assessments are changing fast. Just a week ago, the head of research at Maccabi Health Services played down concerns about the current spike.
Anat Ekka-Zohar said she was reassured regarding the national impact of the current spike by the fact that the virus seemed to be spreading among the young and sparing the elderly, who are most at risk of severe symptoms.
But now Ido Hadari, senior executive director at Maccabi, says that things have changed. On Sunday, he noted that while last week cases were overwhelmingly concentrated among young people and there were few hospitalizations, “today we see a rise in the number of old people who are positive and a rise in severe cases. so there was a deterioration in our optimism over the past week.”
Still, he said, Maccabi isn’t using the phrase “second wave,” and he voiced reservations about a military report that said a second wave has arrived, warning Israel could soon see thousands of new coronavirus infections every day. The report, released on Saturday by the Coronavirus National Information and Knowledge Center, warned that if immediate measures weren’t taken, there could be hundreds more deaths.
That report had been panned by leading epidemiologist Hagai Levine, chairman of the Israeli Association of Public Health Physicians, for lacking medical expertise and lacking transparency, as it didn’t bear the name of an author. Hadari is also concerned that the research doesn’t include a byline.
“The army released a report and we should know who wrote it and who takes responsibility so we can contact them with more questions and ask for advice,” said Hadari.
He added: “Maccabi is now putting aside the question of what stage we’re in now; we’re working 24/7 without asking whether this is a second wave or not. We’re dealing with thousands of tests a day, and putting a lot of effort into preparing for the winter.”
Virologist Ronit Sarid also took issue with the term “second wave.”
‘Many people are talking about a first and second wave but you can’t differentiate. It’s our way of trying to categorize things but it’s really a continuous event,” she said.
Sarid was more optimistic than Barbash, Hadari and the military researchers, and said the spike “expected” when the lockdown ended and routines were resumed.
The inevitable rise in cases was weighed against other costs of continued intense restrictions, like economic and psychological impacts, said Sarid, who is a professor at Bar-Ilan University.
She said that while there is a rise in the elderly being infected, the tilt toward younger people is reassuring. “Now we have more young people who are being affected and we can handle this; they are not being hospitalized and need less treatment,” she commented.
While Sarid maintained that the spike resulted from a calculated risk, Barbash opined that it reflected a poorly thought-out and rushed reopening, along with improper policies. He believes it was driven by “public pressure with a very weak government.”
Elemy, the Nazareth doctor, also highlighted the speed of reopening, saying that it initiated contacts that cause the virus to spread, and also created a culture of complacency.
“The opening was problematic — they opened the economy very quickly and now people say there isn’t coronavirus and we won’t get it,” he said.
The quick opening resulted in a feeling that Israelis are coronavirus-proof and now, in Elemy’s analysis, “the public doesn’t believe the people who are making decisions and think they are exaggerating.”
There “isn’t public confidence in the government,” he said.
Hadari, of Maccabi Health Services, did not take issue with government policy — just with public behavior, and the lack of adherence to mask-wearing and social distancing regulations.
“We have to learn to live with coronavirus or however you want to put it. It’s not going to go away, and we need to learn how to release the economy and live with it, so i don’t think that we opened too soon,” he said.
“That’s not the problem. The problem is people weren’t cautious enough and didn’t take enough responsibility.”
Although Sarid said that a spike was inevitable, she maintained that the government is failing to convey simple information that could help the public prevent the virus spreading too quickly.
“I’m very concerned about the way things are being brought to the public,” she said. “People are very confused about what they should do. Communication is bad and that’s why people are doing whatever they feel they should do.”
Discussing the return to normal routine, she said: “It’s the right decision but definitely the public needs to know more about the virus and avoiding the virus.”
Asher Shalmon, head of international relations in the Health Ministry, insisted that the government has acted properly given the uncertainty. “It’s a trial and error situation and none of us really knows how the virus behaves,” he said.
“It was clear when we opened, things would shift and spike. The best way to avoid a massive eruption of a pandemic into our lives is to maintain proper measures, including face masks and social distancing.”
But he agreed that the cause for concern is all too real: “It’s above the warning point, and we’re not at the warning point anymore. We’re in the red zone.”
The answer, he said, is stricter adherence to the rules along with moves to limit leisure and recreation if the spike isn’t kept in check. “It’s a lot to do with better enforcement and understanding regarding why it’s so important to keep regulations, and if that’s not enough then we would take measures.”