Why is this virus different: A pre-Passover Q&A on what the experts have learned

The experts leading Israel’s efforts to thwart the coronavirus pandemic are citing Passover, which starts Wednesday night, as a fateful juncture.

If Israelis stick by the tightened lockdown and — for 16 hours from Wednesday at 3 p.m. to Thursday at 7 a.m. — the curfew restrictions, and the number of new daily cases doesn’t start to rise in the coming days, there is talk of starting a gradual, phased exit process. If not, however, the concern abides that contagion will rage out of control, and Israel could yet head down the route traveled by Italy, Spain, the US and the UK.

To try and determine what more the medical experts have learned about the virus, and the fight against it in the past few weeks, The Times of Israel held a quick-fire Q&A with Professor Allon Moses, director of the Department of Clinical Microbiology and Infectious Diseases at Jerusalem’s Hadassah Medical Center. It’s not all bad news.

1. How are you feeling, from a professional point of view, about Passover?

Concerned. I’m concerned that Passover will cause a resurgence in cases [because people will gather for Seder], though there’s a big effort being made to prevent it. Normally, it takes 5 to 14 days for symptoms to develop, and at that point, you’ll see the impact of Passover. It’s important people maintain the curfew as is instructed, and don’t go outside.

2. Staying with a Passover theme, based on the knowledge you have gathered in recent weeks, why is this virus different from all other viruses?

There are three characteristics of the virus that make it different. First, it was unknown to humans — it probably came from a bat — and as it’s unknown to humans there was no prior immunity.

Second, it’s very infectious. Its ability to spread from person to person is high — every infected person infects, on average, 2.5 to 4 other people.

And third, there’s the relatively high mortality — the mortality level is about 20 times higher than from influenza, though SARS and MERS have higher mortality.

3. One of the newest regulations in Israel, coming into effect on Sunday, is that people wear masks when they go out. But initially the public was told masks were helpful mostly just for medical professionals. Can you clear up the confusion?

We’re quite confident that the virus is transmitted through droplets, which can be stopped by a mask.

The mask has a double function. It’s most effective on someone who is infected [preventing transmission]. It’s less effective on someone who could become infected, but it still makes sense that people walk around with masks. We have been saying it for a long time; this was my suggestion.

4. When will the virus peak in Israel?

It’s difficult to know. Other countries reached a peak only after they had many more cases and many more deaths than we have. We are fortunate because the first case in Israel came slightly late and we have seen a relatively small number of cases and deaths. The mortality is low. If you look at Spain, they had a high mortality rate; the same with Italy. Right now we’re holding up nicely, though if we let go [in terms of precautions] there will be a setback and an increase in the number of new patients.

5. Is there any indication that the virus will mutate?

At this point it doesn’t look like it.

6. Infection levels are disproportionately high in some ultra-Orthodox communities. Is this because some people were slow in adhering to restrictions, or because of circumstances and environment?

I think it’s both. Because some did not follow the rules they were infected outside of their families. And then, in a community where there are large families in small apartments, so crowding is more intense, [that causes high infection rates]. It’s also because people went to weddings and funerals with higher numbers than allowed.

7. There is lots of talk about the importance of testing. How is Israel faring?

We’re doing well, but it’s not enough. I personally don’t think twice about testing: I send patients for testing even if they have a small fever. Why debate? We should use as many tests as we want.

8. Some young people are taking a relaxed attitude towards coronavirus. Are they right?

Young people sometimes drive without seat belts, despite the risks. The mortality of young people is certainly lower than the mortality of older people, but we know of severe disease and death from coronavirus among young people. So don’t be mistaken: there is a risk.

9. How do you rate the level of risk for the elderly?

The vulnerability of the elderly is horrendous. The death rate of those aged over 80 [who have the virus] is 20%; that is a bad number.

10. If somebody who catches the virus can’t then be reinfected or carry the virus to others it provides some peace of mind. Are we any closer to knowing whether people can be reinfected?

The definitive verdict for this is not out yet, but there’s a good chance that once someone is infected [and recovers] it’s likely he or she can’t be reinfected for a long time. It’s an important issue, but it’s a matter of gathering information and the final answer is just not available yet.

12. What is the latest with serological testing — tests that could show if people have been infected by the virus, even if they have since recovered?

There is no serological test at this point that is approved by regulators.

13. Can people catch the virus from petting an animal — a pet or a stray cat — that an infected person has touched?

Surfaces can transmit the virus for a short time, and a pet would be the same as a surface.

14. Is there something optimistic worth noting from your experiences so far?

The personnel and staff of hospitals have really learned how to protect themselves. [In contrast to a few weeks ago,] we are seeing very little in terms of staff becoming infected.