Israel’s Coronavirus Roller Coaster Israel had won the fight against Covid-19 so impressively that people doubted the disease was even real. Then came the second wave.
Tags: Coronavirus, Covid 19 Pandemic, Health, Israel

Israel’s Coronavirus Roller Coaster Israel had won the fight against Covid-19 so impressively that people doubted the disease was even real. Then came the second wave. Jarin Dec 12, 2020·8 min read

Tel Aviv-Yafo, Israel. Photo: Daniel Klein/Unsplash

Israel vs. Covid-19: Part one

Israel had reason to approach the Covid-19 crisis with a certain amount of optimism. For one, it is a small country with less than 10 million citizens. It is also a youthful country, with a median citizen age of 30.5 years. Israel is also vastly experienced in emergencies. It has a world-class public health system, despite a below-average number of doctors, nurses, and beds.

It is an island — not geographically, but practically — mostly surrounded by countries that hold no diplomatic relations with it and offer no form of passage. Israel’s only entrance gate is one international airport: Ben-Gurion in Tel-Aviv. This one entrance is relatively easy to control.

The Israeli government recognized the danger of Covid-19 early on. In late January, Israel initiated an entry ban to Chinese citizens, a move that the Chinese ambassador compared to the rejection of Jewish refugees during the Holocaust. During late February and the beginning of March, the virus reached Israel by way of citizens who reentered the country from abroad. Swift action was taken to curb this impact. Every person entering the country was put in mandatory quarantine for 14 days.

Later, the government even financed and repurposed hotels into designated quarantine zones for Israeli citizens returning home. Each diagnosed person was numbered and a full report as to their whereabouts was published. Israelis even joked that one should pay close attention to the places one visits in case it all becomes public due to a positive test result.

For a moment, it appeared that Israel’s fight against Covid-19 might end with a clear victory.

There was one place where the Israeli government notably hesitated. While banning entry to many foreigners, the choice to ban U.S. citizens was debated and delayed. Those in favor of such a ban were concerned this move might harm Israel’s political and economic ties with the U.S. Eventually, it was decided to ban all foreigners from entering Israel. It was later reported that much of the virus spreading in Israel was likely due to Americans coming into the country.

The warnings by Israeli experts and health officials as to the dire risks of Covid-19 were harsh. Prime Minister Benjamin Netanyahu even went so far as to say that 10,000 Israelis might die, and 1 million could get sick. Officials regularly warned Israelis of reaching the same situation as seen in Italy, Spain, New York, and Brazil.

From mid-March onward, shops and schools were closed, all cultural events were canceled, and people weren’t allowed to move more than 100 meters (328 feet) from their homes. More ventilators were purchased, and special coronavirus units were established in the hospitals. During the major holidays, Passover and independence day, a total lockdown was announced. The Israeli government even made the tough and emotionally complex decision to ask families of fallen soldiers not to visit the graves of their loved ones on Memorial Day.

While there were a few glitches and mistakes along the way, Israel largely handled the pandemic well. The number of new daily cases started dwindling and then dropping steadily from early April through late May. Source: Our World in Data

For a moment, it appeared that Israel’s fight against Covid-19 might end with a clear victory. Prime Minister Netanyahu was invited to take part in an online conference with six other leaders of countries who managed to control the outbreak. Israel was proclaimed a success story of international proportions.

The “Preemptive Medicine Paradox” in action

At its peak, Israel saw hundreds of new cases every day — yet this did not translate to a flood of hospital admissions, critical patients, or deaths. In mid-May, Israel reported 268 confirmed deaths from Covid-19, one of the lowest deaths per 100,000 population ratios in the world. The number of recoveries was constantly outpacing the number of new cases. The number of critically ill who needed respiratory support was, at that time, fewer than 30.

There is no doubt, or at least there shouldn’t be, that the extreme measures taken by the Israeli government were at least somewhat responsible for the initial behavior of the virus. Yet, some claim otherwise. Most notably, Professor Yoram Lass, a former director of the Israeli health ministry, said at a very early stage of the outbreak that “Covid-19 is nothing but a publicized flu.” There were others like him. Once the peak was over, and numbers did not match the initial alarming predictions, Lass’ view increased in popularity. Israel’s win over Covid-19 was so impressive, so clear, and unequivocal — the logic went — that people started believing the disease wasn’t all it was alleged to be.

Israelis saw what the virus had done to other countries, but those who held the belief that the response to Covid-19 was more a matter of hysteria than a true need rationalized it with a few theories. Among the theories was that the virus has a natural expiry date. Some concluded that the virus impacted the Middle East differently and that we shouldn’t compare Israel to European countries. Some experts said that the lockdown was unnecessary and that the Israeli health system could have handled an outbreak. As the effects of the lockdown became more and more apparent, and people started to realize the huge economic implications, more Israelis tended to agree that the cost was higher than the gain.

Problems with politics

The Covid-19 response has not been a solely health-centered debate in Israel. It quickly turned political as well. The international crisis emerged during an unprecedented Israeli political crisis. Prime Minister Benjamin Netanyahu was in the midst of a rivalry with Benny Gantz, the former IDF chief and a newcomer to the Israeli political scene. Two election campaigns couldn’t bring about a decisive vote, and neither of the two men managed to form a government. The third election cycle in the same year was held at the peak of the outbreak.

The leadership situation has turned Israel into a politically divided country. During the first wave of the pandemic, Netanyahu led the country as the head of a transition government. Without a clear mandate, with a pending corruption trial, and a growing protest, the political debate about whether or not he is even morally entitled to lead the crisis started to overshadow the pandemic, which was by then shrinking.

The fact that the Israeli president, the PM, some ministers, and members of Parliament, were caught acting against lockdown rules didn’t help build the public’s trust. Furthermore, the financial aid measures offered to business owners and workers were slim compared to other countries, and so many Israelis started pressuring the government to remove lockdown restrictions.

Finally, due to the major health and financial crisis, Netanyahu and Gantz agreed to form a unity government and created the largest, most expensive government Israel had ever seen. Seeing that the emergency unity government was dealing more with politics than health or economic issues, the public’s trust and willingness to cooperate with its representatives came crashing down.

The political climate, the extreme protection measures, the relatively low rates of morbidity, and a few experts claiming the reaction to the outbreak was mainly a form of hysteria, all made Israelis doubt the true severity of the situation.

Israel’s win over Covid-19 was so impressive, so clear, and unequivocal — the logic went — that people started believing the disease wasn’t all it was alleged to be.

Israel vs. Covid-19: Part two

At the beginning of May, the two crises Israel was facing came to a simultaneous end. The political tangle ended with the new unity government, and so did the first Covid-19 wave. A press conference held by the prime minister felt more like a victory celebration, and many Israelis got the wrong impression that the risk of the pandemic was a thing of the past.

A few weeks later, Israel officially reopened. Most of the restrictions were lifted; schools were opened and shops, restaurants, and bars resumed services. “We received a lot of joyful news today,” said Prime Minister Netanyahu. “Drink a cup of coffee and a beer too. Go out and have fun.”

The preemptive action paradox appeared to be coloring the perspective of Israel’s leadership, as they fell prey to the idea that the relatively good outcome now meant the initial preventive measures were not needed then.

During the two months of lockdown, and the decrease in morbidity, no major long-term Covid-19 plan was formulated. Moreover, no useful test and trace method was organized. Lately, Israel has resorted again to the highly controversial tracing services of the national internal security agency, a measure usually operated to fight terrorism.

Today, Israel is performing many Covid-19 tests. It has one of the highest tests per 1 million population rates in the world, and yet the diagnostics process is too slow — sometimes requiring four to five days to obtain results. No real epidemiologic inquiry center has been created. Currently, 27 nurses who specialize in epidemiology and 200 “regular” nurses are responsible for tracing the behavior of those infected, noting their movements, and informing potential at-risk people who came in close contact with those infected. At present, the prevention and education efforts are too few, and they aren’t working.

Since mid-June, Israel has experienced a spike of Covid-19 cases, reaching record numbers in early July. Source: Our World in Data

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The situation appears to now be out of hand. On July 18, 1,906 new daily cases were diagnosed, the second-highest figure since the beginning of the outbreak. Just a few days earlier, on July 13, 1,962 cases were diagnosed. It is true that Israel is testing more — including people who do not show symptoms. However, the geographical spread of the infected, the percentage of positive results, and the fact that it is currently impossible to identify the source of many infections have made health officials declare the situation out of control. The number of critical cases is gradually rising, and the number of dead is slowly climbing too. Israel is now considered a “red country” in the EU, meaning its citizens are barred from free entry. With numbers still on the rise, the Israeli government introduced a new round of old restrictions including the closure of bars, event halls, and gyms. High ranking officials, among them Netanyahu himself, are publicly warning of another full lockdown.

The case of Israel should be a lesson to all. The coronavirus is a tough opponent. Ultimate victory is not achieved by a knockout. This fight is long and complicated with many wins and losses. Sometimes the predictions are alarming, and sometimes they do not fully come true. And yet, this doesn’t mean that the threat isn’t real — or that we can go on living as we did before.