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AnalysisWhere Israel stands in the COVID-19 fight

A week into lockdown exit, plunging infection rates tempered by mounting worries

With some restrictions rolled back and more relaxing of rules on the way, virus stats are encouraging, but deaths are still accumulating and the social fabric has ruptured

Nathan Jeffay

Nathan Jeffay is The Times of Israel's health and science correspondent

A staff member at Haifa's Bnai Zion Medical Center during the 2020 coronavirus. (courtesy, Micha Brikman)
A staff member at Haifa's Bnai Zion Medical Center during the 2020 coronavirus. (courtesy, Micha Brikman)

Israel has shaken its reputation as a coronavirus black sheep. It has been a week since the country took its first steps out of national lockdown, and it is now happily cascading down the global coronavirus stats table from the top spot it once occupied.

As the country entered its second week of reduced restrictions on Sunday, the coronavirus cabinet met and voted to reopen schools for children in first to fourth grade early next week, if morbidity rates remain low.

Ministers have yet to decide whether to allow the reopening of customer-facing businesses. If approved, this is expected to happen on a limited basis, with only a handful of people allowed in the premises at the same time.

The government appears to be resisting the pressure of lobbies pushing for a quicker return to routine, eager to avoid repeating the speedy reopening after the spring lockdown which has been lambasted as a failure. Ministers decided at Sunday’s meeting to keep most health restrictions in place for at least another week.

The government is eager to avoid reliving the humiliation of the past few months, during which Israel, a self-declared coronavirus success story after the first wave, became the country with the highest level of new COVID-19 cases, and then the first country to reimpose a lockdown.

In late September, 10 days into the closure, new infection numbers per capita calculated as an average over seven days were almost three times higher than the next-worst-hit country.

A person rides a bicycle on an empty street, as the sun sets on the first day of a scheduled three-week lockdown in Tel Aviv, September 18, 2020. (AP Photo/Ariel Schalit)

Now, Israel is down to 11th place, reporting notably fewer new cases per capita than America, the UK and — with seven times the Jewish state’s current average — Belgium.

But the question of where Israel stands, and how its prognosis looks, is more complicated than a glance at a single table. To get proper insight, one must examine the good, the bad, and the ugly of Israel’s exit from the COVID-19 lockdown.

The good

In hospitals, staff can breathe again. When Israel entered its second lockdown on September 18, there were almost 1,200 patients in hospitals, a number that swelled to around 1,700 in early October, with nearly 900 in serious condition.

After four weeks of intense lockdown, plus a week after that under a state of lightened restrictions, there are 969 people in hospitals for the coronavirus, 548 of them in serious condition.

There were 46,370 active cases at the start of lockdown; now there are 15,833.

Testing, which is important in the virus fight, is working well — so well, in fact, that there is plenty of spare capacity, and, in many areas, there are walk-in open-to-all screening sessions. Screening capacity is being ramped up from 70,000 tests a day to 100,000, which theoretically means the whole country could get tested in the space of three months.

A medical worker in protective clothing tests a man for the coronavirus, at the Hebrew University of Jerusalem, on October 21, 2020. (Olivier Fitoussi/Flash90)

The state has seemingly realized it was a mistake to send teachers back to school in September without offering them testing. It encouraged kindergarten teachers to test before their October 18 return to work, and is now planning the same for elementary school teachers.

The number of daily new cases countrywide, which had hit a seven-day average of more than 6,000 at the height of the second wave (taking a snapshot of one day is unreliable) is now under 1,000.

Israel can be put in a global context by way of an analysis of new daily cases over the last week per million citizens, in which Belgium averaged 963, the UK came in at 288 and the United States averaged 186. The Jewish state, which led the pack with 703 in late September, is now down to 132, placing it 11th.

The question, of course, is whether Israel will manage to hold on to these hard-won gains and make further improvements, or whether we are headed for a deja vu scenario with an increase in cases and a new spike around the corner.

Giving rise to optimism, key politicians do seem to have internalized the foolishness of jubilation when the first lockdown was lifted in the spring. Then, an Independence Day aerobatics show over hospitals felt, to many, like a victory lap.

Medical staff cheer an Israeli air force aerobatic team flying over Ichilov Hospital in Tel Aviv on Israel’s 72nd Independence Day, April 29, 2020. (Miriam Alster/Flash90)

Israel initially treated the coronavirus battle as the equivalent of the Six Day War: a short, intense fight with a dream result. Now, it is clear that the fight is actually more akin to the three-year War of Attrition that followed, which took patience and determination.

Unlike last time, when talk of a measured reopening gave way to a disorganized sprint back to normalcy, this time there is a transition plan. It is gradual, and there is an understanding that the “new normal” will need to remain in place for some time.

So far, the government is not advocating shortcuts. Sunday’s coronavirus cabinet meeting didn’t end with firm plans for a more significant rollback of restrictions apart from reopening school for the youngest grades — those who are thought to pose the lowest risk of catching and spreading the virus.

They will learn in small groups, as an extra precaution, which means that first and second graders will only go to school for half the week.

Prime Minister Benjamin Netanyahu’s word of the day on Sunday was “gradually.” He stressed ahead of the meeting: “If morbidity goes down, then the restrictions will also gradually come down. If morbidity goes up, there will be no choice but to reimpose the restrictions.”

And while there are still severe problems with public trust in the state’s virus efforts, leaders have become far more transparent in recent weeks, making a much-needed change in the way they communicate about plans.

Health Minister Yuli Edelstein speaks during a press conference at Airport City, outside Tel Aviv, on September 17, 2020. (Flash90)

The government alienated the public with the way it went about the imposition of the lockdown and then the decision to tighten it. But as the closure progressed, leaders started to provide a better sense of their plans, outlining the statistical targets they are aiming for in order to ease restrictions and giving an idea of what the rolling back of restrictions will look like.

Some other blunders are being fixed too. Israel’s coronavirus fight has failed to effectively deploy scientific research to sway the public toward compliance, but lately there have been some real efforts in that area.

One of the best has been a campaign, shown repeatedly to viewers of popular TV shows and posted on billboards in both Hebrew and Arabic, telling people in simple terms that masks cut infection risk by 85 percent, and if both people in an encounter cover faces, by 95%.

People walk past a billboard posted by the Health Ministry instructing people to wear face masks, in Jerusalem on October 11, 2020. (Yonatan Sindel/Flash90)

The government would have benefitted from sharing such figures when the research became available months ago. But better late than never.

The bad

We are still losing lives to the virus — and at a dizzying speed compared to the first months of the pandemic.

On Saturday night, the Health Ministry announced 37 new COVID-19 fatalities over the weekend, and the death toll now stands at 2,372, reflecting a rapid rise since it hit the 1,000 mark on September 5.

A worker from ‘Hevra Kadisha,’ Israel’s official Jewish burial society, prepares a body before a funeral procession at a special morgue for COVID-19 victims, in Holon, September 23, 2020. (AP Photo/Oded Balilty)

Israel may be sliding down the global table for infections, but it remains at the top of the chart for deaths per capita over the last seven days — joint with Belgium at 3.2 deaths per million citizens.

And many more deaths are inevitable, as doctors express dismay that even at this point in the pandemic, with seven months of treatment experience under their belt, they find that when patients deteriorate to a point that they cannot breathe without a ventilator, survival rates are dire. 

The onset of winter, and the flu season it brings, raises concerns of the so-called twindemic effect, in which the nastiest impacts of COVID-19 and flu combine.

The effect may be limited because social distancing will curb the spread of the flu. Alternatively, its effect may be accentuated if the global rush on flu vaccines delays Israel’s supply, which, some doctors fear, would mean some shots arrive too late to give the best protection. It is too early to predict how intensely Israel will be battling in the winter, but it is clear that the country will still have a fight on its hands.

And it is concerning that Israel could end up squaring up for this fight without a general. The coronavirus czar, Ronni Gamzu, is scheduled to leave his post at the end of October. He has been sharply criticized by some politicians, and various of his plans have been sidelined. The job is seen by many health experts as a poisoned chalice. A replacement has not been named yet and it is entirely possible that the post, only created and filled long after the first wave, will turn out to have been a one-time wonder.

Coronavirus czar Ronni Gamzu visits the Ziv Hospital in Safed, September 27, 2020 (David Cohen/ FLASH90)

As for the lockdown exit itself, the Achilles’ heel is the “red zones,” or virus hotspots. The government failed to include, at the basis of the plan, significantly more cautious steps for the worst-affected areas than the rest of the country. Extra measures were halfhearted and short-lived, with the government on Wednesday abolishing local restrictions, apart from in one Jerusalem neighborhood. (The Druze town of Majdal Shams, where coronavirus morbidity has spiked, will go into lockdown on Monday night for five days.)

Yes, the hotspots, almost all of them ultra-Orthodox, have improved, but virus rates there are still worrying. There are suggestions of testing avoidance by residents motivated by a desire to downplay infection rates. What is more, gains in the hotspots are delicate, as in many of them, schools have reopened based on rabbinic decisions that violate state law. Meanwhile, older students are returning to yeshivah.

In formerly red zones, the sense is not that of a tentative step toward normalcy that is being tried and could be halted if necessary. Rather, there is a feeling that life has hurtled back to normal, with officials largely turning a blind eye to premature school reopening. This restoration of routine is considered a fait accompli, with no looking back.

The ugly

While Israel’s leaders have started to communicate with the public better and more transparently, the trust dynamic is still broken. One of the most damaging aspects is the feeling that politicians are telling the public, “Do as I say, not as I do.”

The list of prominent figures breaking rules keeps on growing, leaving many regular citizens feeling that they are friers, or suckers, if they sacrifice more to stop the virus than those who are leading the battle.

Likud Minister Gila Gamliel speaks at a conference at Tel Aviv University on June 11, 2019. (Flash90)

Environmental Protection Minister Gila Gamliel (Likud) has been under fire since she contracted the coronavirus and reports emerged that she traveled from central Israel to Tiberias for Yom Kippur and prayed indoors at a synagogue.

On the festival of Sukkot, when hosting guests was banned, Aviv Kohavi, chief of staff of the Israel Defense Forces, which plays a prominent role in the coronavirus fight, violated the rules. He apologized, as did Nadav Argaman, head of the Shin Bet security service, which tracks the nation’s phones to issue quarantine instructions to people suspected of having been in contact with a COVID-19 carrier.

As leaders’ conduct dampens compliance to rules, so does frustration over the Haredi issue.

The second lockdown started after ultra-Orthodox politicians blocked attempts to keep the country open and impose closures only on hotspots, generating anti-Haredi sentiment.

For the duration of the lockdown, reports showed restrictions being violated in Haredi areas, some of them with staggeringly large gatherings assembled by rabbis, as doctors warned of health implications.

Ultra-Orthodox Jews from the Vishnitz dynasty attend an event in a sukkah in Bnei Brak on October 12, 2014 (Dror garti/FLASH90/File)

Friction in Israeli society is sky-high, with resentment toward Haredim constantly rising, no discourse in place to dissipate it, and predictions that it could dominate the next election. If the fears of health experts are realized, and Haredi areas give rise to new outbreaks that spread to wider society, this resentment will become increasingly toxic.

Israel has made significant advances in its coronavirus fight since mid-September, but the complex dynamics in Israeli politics and society, together with the virulence of the virus and the onset of winter, mean that we should assess them with the utmost of caution.

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