When American medical expert Dr. Martin Zand visited Israel recently, the first coronavirus cases in the country were being diagnosed and publicized. He got on a plane back to the United States shortly afterwards, but he’s kept thinking about the COVID-19 pandemic, and the responses to it in both the US and Israel.
Zand is tackling the pandemic from many angles at the University of Rochester Medical Center in Rochester, New York. A practicing physician, he is the medical center’s senior associate dean for clinical research, as well as the co-director of its Clinical and Translational Science Institute. He coordinates the center’s research response to the COVID-19 pandemic.
He described his role in a phone interview with The Times of Israel as “a combination between an air-traffic controller and a matchmaker,” adding, “I match needs with resources, trying to harmonize these efforts.”
Asked how he keeps himself calm, Zand said that “you have to remain calm in order to be effective and get things done. Pray for the best possible response in bringing cutting-edge therapies to our community and national efforts. Panic is not going to help.”
Zand stayed with family during his visit and he’s been able to continue monitoring the COVID-19 responses in both the US and Israel.
“From what I can see from the news, the response in Israel has actually been right on target,” Zand said. “Social distancing, travel restrictions, the testing and the hospital preparedness, the national response has all been very good.”
He’s a little more critical when it comes to the US. He says there is a “national shortage of a whole variety of supplies for COVID-19 testing.”
Dramatically, in a press conference on March 25, New York Gov. Andrew Cuomo pleaded with the Trump administration to send badly-needed ventilators to help his state, which he called “the canary in the coal mine.”
“We have the highest and the fastest rate of infection,” Cuomo said. “Deal with the issue here. Deploy the resources. Deploy the ventilators here in New York for our apex. And then, after the apex passes here, once we’re [past] that critical point, deploy the ventilators to the other parts of the country where they are needed.”
Asked about such a system of sequential sharing, Zand said that its concept “is to make sure we shift resources to places that have the most need,” and that his labs have shifted to provide reagents for tests.
He said there is “a national shifting in the US of resources,” and although he has “not been involved in these discussions,” he said, “I know there is coordination in the Rochester health care system to make sure that everyone has adequate resource bases to take care of patients, and at this point there were some discussions about shifting resources to other parts of the country.”
Pros and cons of centralized health care
Zand feels that the decentralized American system of state and county government sometimes works to the nation’s disadvantage. He notes that states and counties all have their own departments of public health, “and at a national level, you don’t have an overruling coordinator of those state efforts in the same way that Israel does.”
According to Zand, “I think the most important contrast between Israel and the US health care system with respect to the COVID-19 pandemic is that Israel has a centralized health care system as well as a central public health care system. That has really helped coordinate the response across the country.”
He said that there are also efforts being coordinated in the US, “but it’s easier to achieve synchrony when you have an integrated national public health system.”
One way Zand sees this reflected in the two countries is in terms of social distancing. He explained that “in the US, because there’s no centralized public health system, social distancing measures are being adapted or defined differently by states.”
He cited “nuances of social distancing in different areas, attempts to deal with hardships of social distancing, especially for people who are involved in critical industries or health care during the crisis and need to work.” And, he asked, “what do you do for single parents who have children at home? How do you work from home when taking care of your elderly family members? … I think we’re all struggling with it.”
Yet, he said, social distancing is one of the “essential pieces” in fighting the virus, a practice that is “really widely accepted and recognized,” along with sheltering in place, maintaining a distance of two meters from people outside, hand-washing, only going out for groceries, medical care or medications, and closing all nonessential businesses in high-risk areas.
“That’s certainly what Israel did early,” Zand said. “Those are a good thing.”
That doesn’t necessarily mean that everyone will follow social distancing even in Israel’s centralized system, he notes.
“It’s going to depend on what the local character of social distancing is,” Zand said, “how often people take that guidance. Social distancing is only as good as the individuals who adhere to it. These kinds of local, regional differences make a difference in how effective it is, how the virus spreads in different regions in Israel.”
Whether it’s a centralized or decentralized system, whether in Israel or the US, Zand recommends following basic guidelines.
“If I had one message to leave to you,” he said, it’s that there is “hope for vaccines and treatments for COVID-19, but it’s going to take a while. We really need to focus on slowing this epidemic” through “public health measures like washing your hands, social distancing, staying home except for very, very essential things, shopping for food and medical concerns. Give the system a chance to come up with this treatment.”