Leading HMO urges preparation for massive second virus outbreak in winter
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Leading HMO urges preparation for massive second virus outbreak in winter

Maccabi warns health minister that as masses catch flu alongside COVID-19 patients, hundreds of thousands could require testing

Stuart Winer is a breaking news editor at The Times of Israel.

Technicians carry out a diagnostic test for coronavirus in a lab at the Rambam Hospital in Haifa, on March 17, 2020. (Yossi Aloni/Flash90)
Technicians carry out a diagnostic test for coronavirus in a lab at the Rambam Hospital in Haifa, on March 17, 2020. (Yossi Aloni/Flash90)

One of the country’s largest health management organizations on Tuesday published its suggestions for preparing the country for a possible second wave of coronavirus infections, warning that Israel must be ready to test hundreds of thousands of people in the coming winter.

Maccabi Healthcare Services presented the plan earlier in the week to Health Minister Yuli Edelstein before making it public.

The plan warned that a second coronavirus wave could come alongside the annual influenza season, which will lead large numbers of people to fear they have COVID-19, the disease caused by the coronavirus, as both ailments have similar symptoms of respiratory difficulties. However, COVID-19 can, apparently more often than the flu, rapidly develop into a more serous condition.

“Two hundred thousand people will have coronavirus symptoms because of the flu and will run to health clinics, requiring us to do tens of thousands of coronavirus tests a day,” wrote Maccabi CEO Ran Saar. “Everyone will be afraid of the coronavirus and we will need to double the tests, to protect the elderly, and work differently in the health management organizations.”

Screen capture from video of Ran Saar, CEO of the Maccabi Health Services. (Twitter)

The Maccabi document depicted scenarios in which there could be 4,000 people diagnosed with coronavirus each week and another 200,000 with breathing difficulties. In the worst case, there could be 25,000 diagnosed each week among 250,000 people with breathing difficulties.

As a result, the country needs to be ready to carry out some 30,000 virus tests a day, Maccabi said. During the recent outbreak, virus tests peaked at around 12,000 tests a day.

Maccabi called for the preparation of a massive testing capacity including testing of waste water for early identification of virus hotspots. There should be clear definitions of what information is needed to track the spread of infections and that data should be made available to all health organizations combating the virus, the plan said.

Also, the HMO advised, a national purchasing system should be established to obtain drugs, vaccines, and protective equipment.

Maccabi — and the country’s other three HMOs, Clalit, Meuhedet and Leumit –should be much more involved in formulating the campaign to counter a second coronavirus outbreak and should be part of the decision-making process, according to the plan.

MDA staff performing coronavirus testing (Photo: Magen David Adom Israel)

Maccabi also urged that treatment of virus patients be carried out as much as possible at home, rather than in hospitals.

“The center of the next wave will be in the community and not in the hospitals,” Saar wrote.

Maccabi estimated that lockdown measures during the recent outbreak had cost the economy NIS 1 billion ($285 million) a day and asked that the government allocate the same sum for all of the country’s health associations to better prepare for a second outbreak.

The Maccabi document also sharply criticized the manner in which the government dealt with the recent virus spread, saying authorities had focused almost entirely on preventing a flood of patients overwhelming hospitals, ordering a strict lockdown that, while curbing the spread, dangerously diminished health care availability to the rest of the population.

Maccabi charged there was no national plan for how to continue providing general health care to the rest of the population during the outbreak, which, it said, caused damage due to the limited access to regular health care.

Though the lockdown measures likely curbed the spread of the virus, Maccabi noted that the entire health system was focused on a disease with which there was a 0.2% chance of becoming infected, “while providing significantly reduced attention to the treatment of other diseases.”

It found that recently there was a 30% reduction in the diagnosis of heart attacks and a 40% reduction in diagnosis of strokes in emergency rooms, which it said was due to many patients fearing they could become infected with COVID-19 if they went to the hospital.

The government narrative led to “distorted overall planning” in the campaign against the virus and caused significant secondary damage to public health and the economy, Maccabi said.

Prime Minister Benjamin Netanyahu (L), Health minister Yaakov Litzman (R) and Health Ministry Director General Moshe Bar Siman-Tov at a press conference about the coronavirus at the Prime Minister’s Office in Jerusalem on March 11, 2020. (Flash90)

Maccabi also said that by initially entrusting virus testing to a non-HMO group — the Magen David Adom ambulance service — there were bureaucratic issues due to the lack of a comprehensive computer system to track the testing.

As a result there were delays in testing and some results were lost, leading to an overall delay in stopping the spread of infection. Testing, Maccabi said, should have been given to the HMOs, which have resources spread out across the country. When HMOs were eventually brought onboard for testing it dramatically increased the virus testing rate, the plan noted.

The Health Ministry, which during the virus outbreak was under now-Housing Minister Yaakov Litzman and his director-general, Moshe Bar Siman-Tov, has come under fire for its handling of the crisis.

As of Tuesday, 16,743 people have been diagnosed with COVID-19 in Israel, of whom 281 died.

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