Test every single Israeli to avoid a second COVID-19 wave, top economist urges

Dan Ben-David of the Shoresh Institution for Socioeconomic Research says effort would be hard and costly, but worthwhile to avoid economic devastation of a new outbreak

Magen David Adom medical workers seen at a drive-through site to collect samples for coronavirus testing, alongside the security barrier outside Shuafat Refugee Camp, Jerusalem, April 16, 2020. (Yonatan Sindel/Flash90)
Magen David Adom medical workers seen at a drive-through site to collect samples for coronavirus testing, alongside the security barrier outside Shuafat Refugee Camp, Jerusalem, April 16, 2020. (Yonatan Sindel/Flash90)

As health officials voice fears of a second COVID-19 wave, a public policy analyst has called for Israel to become the first country in the world to test the entire population.

Prof. Dan Ben-David said that because of Israel’s relatively small population and its lack of open borders with neighbors, it is uniquely positioned to try blanket testing.

“This prescription is less relevant for other countries,” he told The Times of Israel. “The thing that costs us diplomatically and economically is we’re an island in our area. But for once, this benefits us. Because we have complete control over our borders, we can clean the country from the infection and keep the virus outside the borders.”

Ben-David, head of the Shoresh Institution for Socioeconomic Research and economist at Tel Aviv University’s Department of Public Policy, released a paper with this proposal, aimed at politicians and policymakers, on Wednesday afternoon.

Israel’s current plans to ease the restrictions imposed to stem the pandemic “are basically a hodge-podge of makeshift patches based on estimates emanating from partial testing and gut feelings,” the report said. “There is no semblance of significant preparation for additional, potential worse, waves that may wash upon the world in the coming year.”

Professor Dan Ben-David during a Knesset committee discussion on June 25, 2014 (Hadas Parush/Flash90)

Hours earlier Sigal Sadetsky, the head of the Health Ministry’s Public Health Services, raised concerns of a second wave in May. On Monday her boss Moshe Bar Siman-Tov, the ministry’s director-general, spoke of the danger of several subsequent waves, including a winter outbreak which he said could be “much more complicated and challenging” than the current one.

The Health Ministry has come under pressure to increase testing, with some experts saying it is the key to fighting the crisis and several politicians, especially Defense Minister Naftali Bennett, constantly pressuring for more swabbing.

Elsewhere in the world too, pressure for increased testing is mounting. One of the world’s largest foundations, the Rockefeller Foundation, has proposed a National COVID-19 Testing Action Plan for America, which would involve testing 30 million people per week.

But Ben-David’s proposal is highly unusual in its scale.

He said he shared concerns of Israeli officials about “subsequent terrible waves,” and said that if the current outbreak was subsiding, the aftermath must be used as a “ceasefire” during which the next phase of battle is planned.

He proposed that Israel set up massive labs, import and manufacture huge amounts of testing equipment, and recruit big teams of personnel to test all citizens within the space of a few days. He suggested to then repeat tests a few days later to identify people who were infected, but at too early a stage to show up in the initial test.

“Yes, it will be difficult to implement and expensive, but each work day lost to coronavirus costs more than NIS 3 billion ($850 million), and in a second wave this could dwarf the cost of testing,” Ben-David argued. “And many human lives could be saved.”

Everyone who tests positive should be sent to special quarantine facilities, like the hotels that the state is currently using for coronavirus patients, he said. He argued that the risk of a second wave could be significantly lowered as all coronavirus patients would have been isolated until recovery, and Israel’s high degree of border control can be used to ensure that no new cases arrive from abroad.

Meanwhile, in light of the very low percentage of repeat infections around the world and in light of the “potential economic catastrophe” heading in Israel’s direction, all those found to have positive antibodies to the virus should be returned to work immediately, he asserted.

He added: “There may not be a next wave and we may spend this money and see it all go down the drain, but it’s like an insurance policy.”

Computational biologist Eran Segal, pioneer of an assessment model that is being used to help Israel manage the coronavirus crisis, told The Times of Israel: “If this is what the country decided, it could be done technically. You can train lots of people to be technicians and get the equipment.”

But while Segal is a proponent of spot testing healthy people, he said it was unrealistic that the government would throw its weight on blanket testing, asserted it would not be the best use of state resources, and argued that even if all citizens were tested, some infected people would be missed due to false negatives.

Ben-David said he would overcome false negatives by asking epidemiologists to calculate how many tests are needed to address the problem, even if it means swabbing each person more than twice. And he said that people who think that blanket testing is unrealistic should consider that the cost could prove a “drop in the bucket” compared to the economic loss from future waves.

“If there are subsequent waves, there will be a lot of people who will regret not doing this when we had the chance,” he said.

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