Think tank: Israel wouldn’t be grinding to halt if hospitals were better funded
Situation where government orders ever-increasing restrictions on public life to curb virus could have been avoided, says Shoresh Institution chief
Nathan Jeffay is The Times of Israel's health and science correspondent
Schools would still be open and Israel would not be in partial lockdown if hospitals weren’t underfunded, a public policy analyst has claimed.
Dan Ben-David told The Times of Israel that the government’s decision to impose emergency restrictions was “warranted under the circumstances, but we should never have reached this point in the first place.”
Ben-David made his comments as the Health Ministry considered further expanding restrictions, and confining Israelis to their homes. On Monday, the ministry’s deputy director general, Itamar Grotto, said: “The government is considering a general closure on all citizens, and if that happens it would mean all age groups will be asked to stay home until further notice.”
Ben-David, head of the Shoresh Institution for Socioeconomic Research and economist at Tel Aviv University’s Department of Public Policy, said that under-investment in health led directly to the shut-down of many aspects of life in Israel. “The fact that Israeli governments have let the country’s health system deteriorate steadily for years left it no choice when the pandemic hit,” he said.
He argued: “If the hospitals had more beds, more nurses, more respiratory equipment, more test kits – essentially, more degrees of freedom to deal with emergencies — then we may have been able to choose less extreme options than closing down an entire country.”
Asher Shalmon, the Health Ministry’s director of international relations, acknowledged on Saturday that Israel will be unable to stop the coronavirus from spreading, and explained that the policy is guided in large part by a desire to pace the growth.
Shalmon said that attempts to “flatten the curve” are intended to allow the health system to provide optimal services to virus patients who need them and to reequip supplies.
Ben-David claimed that “flattening the curve” is only so urgent because hospital budgets have been squeezed, meaning that Israel needs to bide more time than it should before it is ready for the inevitable influx of coronavirus patients.
He argued: “The government is not responsible for the pandemic, but it is responsible for having the most congested infrastructure in the developed world, and having the highest rate of deaths from infections anywhere in the developed world, and that is on the head of whoever is in power. It’s been spiraling out of control.”
Ben-David said that statistics support his view, noting that Israel has the highest hospital occupancy of all 36 countries in the Organization for Economic Co-operation and Development (OECD). He cited OECD statistics, which also show that, from 2013 to 2016, Israel had the highest rate of deaths from infectious and parasitic diseases out of any member country.
Ben-David made his claims a day after a leading doctor argued that harsh regulations in Israel were motivated by the leaders’ acknowledged awareness that the Israeli health system will buckle under any further strain.
Jihad Bishara, director of the Infectious Disease Unit at Petah Tikva’s Beilinson Hospital, told Channel 12 that he thinks home quarantine rules are so strict “because they know that our health system cannot withstand coming under any more strain, because we are perennially stretched to the limit.”
Among doctors who believe that current restrictions were unavoidable, it is still common to hear complaints that inadequate health funding has made facing the crisis harder than necessary.
Zeev Feldman, deputy president of the Israeli Medical Association, said that Israel would need the current measures, however well-funded its health system, as “there are no systems that can contain the surge of sick people from a pandemic.”
However, he said, “the opening position of the hospitals is bad because hospitals have been neglected for many years.”
He commented: “We are trying to react to the situation, but it’s all on bad basic infrastructure in terms of hospital beds and the numbers of doctors and nurses.”
Feldman added: “It wasn’t a situation of neglected preparation; it was an official policy of limited spending on health.”
The challenge now goes beyond the matter of hospitals trying to deal with coronavirus admissions and all the strain that brings to coping when doctors and nurses are rendered out of action because of the virus, and there is no spare manpower.
Feldman is director of pediatric neurosurgery at Sheba Medical Center in Ramat Gan, where staff are reeling from a revelation on Thursday that one of their colleagues had been diagnosed with the illness. This doctor was in contact with 19 other physicians, and in line with state regulations, all 19 have now been quarantined for two weeks.
“That’s a huge load on any department and in any hospital,” said Feldman.
Some doctors say that they are paying the price now of scrimping in a particular area — purchase of protective gear.
Wards have been closed and doctors have unnecessarily found themselves needing quarantine because of a “failures” in the supply of gear, Rey Biton, head of the Mirsham association for medical interns, wrote in a statement.
A senior Health Ministry official blasted the conduct of his office on the issue during an interview with the Walla news site, saying: “What exactly has the Health Ministry been doing all these years if not preparing for something like this?”
Feldman said that at Sheba, “the doctors are concerned.” He said: “At the moment, there are strict instructions on what gear to use and what protection, but we want that to continue, and want the government to ensure that the necessary supplies will be in place for the coming months.”
Feldman said that the worries are justified. “The reality for Israel is there is a world shortage of masks, and massive buying as large countries make sure they have enough supplies. And we are a little country in a big market.”