Israel could “easily” enter a third lockdown before the vaccines become effective, coronavirus commissioner Prof. Nachman Ash told The Jerusalem Post on Tuesday when the Health Ministry reported more than 2,000 cases in a single day.
Ash said he would push for tightening restrictions as soon as possible in order to avoid such a closure. He presented the idea of “tightening restrictions” last week to the coronavirus cabinet but was turned down by the ministers, who instead, chose to open shopping malls and museums.
Since then, infection has been climbing, surging to 2,284 new cases on Monday – the highest number in two months. Some 3.2% of the 72,667 people who were screened tested positive.
There were 683 patients were being treated in the hospital at press time, including 378 who were in serious condition on Tuesday, among them 98 who were intubated. The death toll hit 3,014, ten people died on Tuesday.
The numbers represent a 28% increase in new cases since the week before, and an 11% increase in the number of people who were hospitalized.
“In the last two days, the number of patients admitted to the underground coronavirus ward at Rambam Medical Center has increased,” the hospital said Tuesday morning in a statement. “After weeks in which things were calming down and the number of inpatients were declining, we have now returned to 50 sick people.”
Likewise, at Herzog Medical Center in Jerusalem, where 70% of all coronavirus patients in the country are being treated, the number have reached 78, including 42 in serious condition. The youngest patient is 49 years old.
The virus is spreading throughout the country, including once again in ultra-Orthodox neighborhoods. Bnei Brak saw 146 new cases over the last day, for example, and some 6% of people who were screened there tested positive. Likewise, several ultra-Orthodox neighborhoods in Jerusalem and in Modi’in Illit turned orange.
There were 41 red cities in Israel and 48 orange, which together account for around 60% of all infections.
Last Thursday, the government decided not to increase restrictions over the Hanukkah holiday. However, the cabinet agreed that if at any point the number of coronavirus cases exceeds 2,500 a day or reaches a reproduction rate (R) of 1.32 – every three sick people infect four more – a period of “tightened restraint” will be applied.
The idea then was that the tightening would last three weeks. If the reproduction rate fell to one, or lower, by the end of that period, current restrictions would be reimposed. If the R rate rose or remained the same, the country would head into a lockdown.
“If these efforts fail and we see another increase in morbidity, we will have to completely lock down again,” Ash said.
During the period of tightened restraint, shops, malls and marketplaces would be closed. Gatherings would be limited to 10 people in closed spaces and 20 in open spaces. The education system would stay open in green and yellow cities, but would close in orange and red ones.
While the country has not yet reached the dreaded 2,500 daily infections figure, a report by the Coronavirus National Information and Knowledge Center said Tuesday that Israel is likely to hit that number by the end of the month.
Ash said the implication is that even when the country starts vaccinating, it is possible that morbidity will continue to rise “because the morbidity increases rapidly and the vaccine has a slow effect.”
He said that tightened restrictions at this point could last at least five weeks, and possibly until the vaccines start to take effect, which could be as late as March or April.
“There is this feeling that [coronavirus] is going to end anytime now. People have made a switch in their heads that they don’t have to hold on much longer and so they have relaxed,” Ash told the Post. “The danger is not less now than it was two weeks ago when we did not know that we would have vaccines. And until the vaccines [arrive and work] the risk is just as high.
“From what I am seeing, what I hear in the field” people are not keeping the rules. “I call on everyone to stop being complacent.”
But Ash also admitted that part of the reason for the complacency is the zigzagging of the government, which has led to a lack of public trust in regulations being put forth.
“What happened around Hanukkah was very problematic,” he said, referring to the government’s decision to enact a night curfew against health experts’ opinions. Then, at the warning of the attorney-general, the government backtracked toward new restrictions and ultimately left the status quo.
He told the Post that the ministers listen to him – but only sometimes.
“I went to the cabinet and I asked them to tighten restrictions and they opened malls, so I cannot say they listened to me,” he said. “We bring the professional opinion and we fight for it. Sometimes we are more successful and sometimes less.”
In the meantime, another 300,000 Pfizer vaccines are expected to arrive on Wednesday, Channel 12 reported. With this new shipment, the country will have 600,000 doses.
“I am in isolation, but I keep working to bring the vaccines – they are coming in the millions,” Prime Minister Benjamin Netanyahu said Tuesday in a video message.
Last week, the CEO of Teva SLE Logistics said that some four million Pfizer vaccines and another three million Moderna vaccines were expected at his center by January 1.
On Tuesday, the Food and Drug Administration announced that it found the Moderna vaccine highly effective. Israel signed with Moderna in June and is expected to be among the first to receive its vaccine.
But even as the vaccines arrive, the question remains: How many Israelis will take them?
According to a survey conducted by the University of Haifa, with Israel reportedly set to begin its COVID-19 vaccination drive next week, less than one-fifth of the Israeli public is actually willing to take a new vaccine immediately. The survey, which was overseen by Haifa University Prof. Manfred Green, also found that 7.7% of Jewish men, 29.4% of Arab men, 17.2% of Jewish women, and 41.2% of Arab women would refuse the vaccine under any circumstances.
Ash said there is concern that people will not go to be vaccinated, a challenge the country has experienced in the past, such as in 2013-2014 when there was a need to inoculate Israelis against polio.
“There are those who will be nervous and our goal is to tell them that the danger of the virus is greater than that of the vaccine – a lot greater,” Ash told the Post.
He said the key will be getting medical personnel to vaccinate.
“This is the challenge,” he stressed. “If only 50% of them get vaccinated then the public will not vaccinate either… We are doing a lot to convince them.”
At the same time, some ministers are pushing to prioritize teachers and the defense establishment – anyone who comes in contact with large parts of the public. Ash said that if enough vaccines arrive in Israel, then vaccination will be open almost immediately to anyone who wants it.
He said that it is logical to first vaccinate the elderly and those most at risk of developing serious cases of coronavirus, because then, the country should not have to lock down again, even if herd immunity – which he estimates will occur when around 60% of the population is vaccinated or has had the virus – is not yet achieved.
Hospitals are ready to get started, they have said. The Health Ministry explained that the largest hospitals will vaccinate staff first, followed by the medium and small ones.
Health funds could start vaccinating on Sunday, too, reports indicate. However, as Ash told the Post, the vaccines have not yet received Health Ministry approval.
“It should happen in the coming days,” he said. “The plan is to be ready by Sunday – but it is hard to say for certain.”
Those who do vaccinate will receive a green passport, the details of which are still being worked out, Ash said. But the passports are expected to allow people to eat at restaurants, for example, attend cultural events and travel more freely in Israel and potentially, abroad.
Ash said the passports will work alongside PCR testing for those who are ineligible to be vaccinated, such as children and pregnant women. He added that in the beginning people will likely still have to wear masks and take certain other precautions until enough people are vaccinated and their efficacy is known.
“Our lives will not be the same immediately – probably not even until the end of next year,” he told the Post. And even then, he cautioned, the virus will still be here and outbreaks now and then should be expected.
Is Ash glad he took on the role of coronavirus commissioner?
“When they came to me, I knew it was very hard and would be complicated. I can say now that it is even harder than I thought,” he said. “But I felt I could not say no. We are in a big war and someone has to fight it. It seemed like the right thing to do. I have no regrets.”
And how long will he stay in the job?
Unlike his predecessor Prof. Ronni Gamzu, he said that he did not set a deadline for leaving. He is supposed to return to teach at Ariel University in March. “But if I need to, I can stay longer,” he said. “I hope there is not a need.”