Is the COVID-19 pandemic really over for Israel?

Health officials say that Netanyahu's remarks about the virus being "behind us" are dangerous and could send Israel back to lockdown.

DINERS TAKE to reopened cafés with a vengeance in Jerusalem. (photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
DINERS TAKE to reopened cafés with a vengeance in Jerusalem.
“It ain’t over till it’s over,” American baseball legend Yogi Berra legendarily uttered in 1973 about baseball’s National League pennant race. 
But Prime Minister Benjamin Netanyahu and Jerusalem Mayor Moshe Lion didn’t even wait until the final inning before they clinked their coffee mugs and dug into pastries this week at Sacher Park in the Holy City. 
The sight of the two men without masks sitting shoulder to shoulder delivered the message that Israel is “coming back to life,” in Netanyahu’s words, and that the coronavirus pandemic is behind us.
“We’re coming out of it, and there’s not much more,” the prime minister told Reuters in a scene eerily reminiscent of the speech Netanyahu delivered back on May 27, when he then also wanted to convince the public that he had saved Israel from the deadly coronavirus pandemic.
“We received a lot of joyful news today,” Netanyahu said late on that Tuesday night during a TV briefing, as the government approved lifting more coronavirus regulations. “Drink a cup of coffee and a beer, too,” he encouraged. “Go out and make a living.”
In May, the speech was made just as Netanyahu and Alternate Prime Minister Benny Gantz had formed a unity “coronavirus” emergency government. This time, less than a year later, Netanyahu is on the campaign trail and hoping his success in turning Israel into the “vaccination nation” will translate into victory at the ballot box. 
He told Fox News last week that Israel is “the first country in the world to emerge from corona.” He announced on Monday as the country’s five millionth citizen was inoculated that by the end of April the entire over-16 population will be vaccinated, and then Israel will be “out of the coronavirus” pandemic.
BUT MANY health officials do not agree with Netanyahu. 
“It is not over,” coronavirus commissioner Prof. Nachman Ash said this week in an interview with Ynet. “We must continue to be careful, keep social distancing and wearing masks. We have a way until it is over.” He said that “this is clear to everyone, and the prime minister knows this.”
Health officials told The Jerusalem Post that remarks made by the prime minister such as COVID-19 is “behind us” are dangerous and could send Israel back to lockdown. They said that while the nature of the coronavirus pandemic in Israel has changed, the virus has not left the country – and certainly not the world.
“We have not finished with coronavirus, and it will be with us for a lot longer,” stressed Herzog Medical Center director-general Dr. Jacob Haviv. “Coronavirus will be with us every day and every hour, for sure for at least the next year.”
He pointed out that Israel continues to have thousands of new cases per day, not dozens or even hundreds, although the number of new daily cases is on the decline and on average less than 4% of people screened are testing positive. On Wednesday, only 2.9% of people tested positive, the Health Ministry showed. Last month, Israel had days where 10% of people tested positive. 
Serious patients are also going down. On Wednesday, the Health Ministry reported that there were 79 new serious patients, compared to 136 only one month prior. 
However, on the day that Netanyahu and Lion drank their coffee in the park and claimed Israel had beaten the pandemic, 15 people died of COVID-19. The next day, another 23 succumbed to the disease. 
And it was less than 10 days ago, on March 3, that Prof. Eran Segal, a computational biologist at the Weizmann Institute of Science, tweeted that the decline in morbidity is not consistent across the country. 
“In the Arab sector, morbidity continues to spread,” Segal wrote. “A 32% increase this week in the number of new serious patients there, compared with a 10% decrease in the general sector and a 32% decrease in the ultra-Orthodox [sector].” 
He said that the Arab sector constituted 44% of the new severe patients, compared with their share of the high-risk group of people over the age of 50, which is 13%. 
“Severe illness is three times higher in the Arab sector per capita than in other sectors,” he said. 
Vaccination has been lowest among the Arab-Israeli population. According to the most recent situation report provided by the ministry, 79% of Arabs over 50 have gotten the jab, compared to 96% in the general community and 93% overall.
Haviv told the Post that he predicts there will be another coronavirus outbreak in the coming fall or winter, perhaps centered around a new variant or due to the complacency and lack of compliance of the Israeli people.
Israelis feel similarly. A survey conducted for 103FM earlier this week showed that 62% of Israelis believe a fourth lockdown is only a matter of time. 
The poll, conducted by Panels Politics research institute, included answers from some 591 Jewish and Arab Israelis.
“Children under 16 cannot get vaccinated, and they are 30% of our community, which keeps us from developing herd immunity,” Haviv explained, noting that if the Pfizer, Moderna or AstraZeneca clinical trials prove the vaccine is effect in the next few months, then it is likely that Israel will inoculate children 12 and up, who constitute about 20% of youth.
“We have a huge group that can get sick. And even if they are not seriously ill themselves, they could transmit the virus, including new variants” that could be vaccine resistant.
There are still one million Israelis over 16 who have not yet been vaccinated. 
Moreover, Israel has yet to vaccinate the Palestinians, although it began a campaign this week to jab more than 100,000 Palestinians who work inside the country. Israelis and Palestinians not only live side by side, but Palestinians travel regularly into east Jerusalem and other parts of the country, where their Arab-Israeli relatives often reside. Arab-Israelis also visit their family members over the Green Line.
Finally, no country in the world has vaccinated as rapidly as Israel, which means their levels of infection and their propensity for spreading the virus are likely higher. The United States and the European Union, as well the United Arab Emirates, for example, are working to catch up to Israel. But experts say that will likely take between six to 12 months. 
In the meantime, as Israel opens its skies, new variants could enter that could lead to an unexpected outbreak, if Ben-Gurion Airport is not effectively managed.
“Global movement will create new opportunities for the virus,” said Dr. Yariv Wine, a researcher at Tel Aviv University. 
He explained that “beating the coronavirus is not a point in time in which we can say it is behind us.” 
“Biology does not function like engineering,” said Prof. Eyal Leshem, director of the Center for Travel Medicine and Tropical Diseases at Sheba Medical Center. “We are not either [living with] COVID or done with it. We are not going to wake up one day and it is over.”
Haviv said that he is “nervous” that people will start to let down their guards when they hear statements like those made by Netanyahu – will stop wearing masks, social distancing and even begin shaking hands (rather than bumping elbows) like they did before corona. 
The ministry on Wednesday felt it necessary to call on the public to continue to adhere to the guidelines – mask, hygiene and social distancing – making it seem that Haviv’s concerns had started to come to fruition.
“At this stage, the guidelines regarding mask wearing in Israel have not changed, and these measures are also required among vaccinated people,” the ministry stressed. 
Haviv said the virus has “surprised us” many times in the past. “Whenever we don’t pay attention to it, people get sick, then seriously ill and die.”
ADMITTEDLY, THOUGH, the country is at a turning point. Infection is far below its peak during the third wave. Older patients are becoming few and far between. Around half of serious patients in the country are now under the age of 50, making them more likely to survive serious COVID-19. 
The shift is because of the vaccines, which in every relevant study conducted in Israel so far have proven effective at both reducing the spread of the virus and curtailing serious cases in those who do still contract coronavirus after being jabbed.
“Vaccines changed the nature of the pandemic,’ said head of Public Health Services Sharon Alroy-Preis in a press briefing earlier this week. 
Leshem told the Post that in May, when Netanyahu made his first “we beat the pandemic” statements, “there was no reason to think we were done with coronavirus then. This time “things are different.”
Israel has much better tools to combat corona, including new outbreaks, than it did back then. Aside from the vaccine, there are new treatments, rapid testing options and genetic sequencing, all of which could help reduce the likelihood of another spike in serious cases and deaths.
The country saw firsthand the effectiveness of the vaccine over the Purim holiday, when Israel witnessed mass illegal gatherings that did not result in increased infection like the year prior. 
“There are good reasons to think that we can control the disease and go back to normal life,” Leshem said.
But he noted that “normal” has different definitions. While Israelis should be able to return to routine school and work, living as before the pandemic will likely take several years. And en route to recovery, there could be any number of “surprises” for which Israel will have to watch.
“There is a low but real risk that some variant may make the vaccine substantially less effective, and then we may need a booster that is adjusted to the new variant,” Leshem said. 
“We may find out that we cannot use the vaccine on children,” he added. “Then, we may need to address how to prevent or eliminate the virus among children in a different way.”
Another challenge is that the vaccine effectiveness could wane quickly, which would also require a booster that fewer among the population may be motivated to receive. Wine said that in this case, Israel could see local outbreaks, such as those it has seen with measles. 
“We still do not know whether corona will become part of our vaccination regime, equivalent to influenza, and if we will have to be vaccinated every six months or two years,” Wine said. “If the healthcare system requires people to get vaccinated every six months, I am not sure the public will be happy to do so. So that can cause outbreaks.”
FINALLY, THE coronavirus pandemic has created several “shadow pandemics” – other crises in the country and the world that will need to be dealt with even after the daily number of new cases almost completely subsides. 
The pandemic has had a huge and negative impact on the country’s economic situation and the mental health of its citizens. It has ruined businesses, increased anxiety and depression. 
“Some of these things are going to be much more challenging than recovering from COVID,” Leshem said, adding that there are likely other transparent impacts from the virus that Israel has yet to discover. “We cannot count [these effects] like COVID cases, but there is huge damage that this outbreak has caused, and we don’t yet know the full cost of it.”
“We need to learn these lessons and see how we can recover now,” said Prof. Nadav Davidovitch, chairman of the Israeli Association of Public Health Physicians. “The public health system in Israel suffered, and now we need to make an investment [in repairing it]. The worst thing that could happen is to think it is over and turn to other issues.”
Wine added, “Whoever thinks he knows everything about the future of this virus can release dangerous statements.”
Put into a baseball metaphor, Israel is at the plate. Hitting a home run is possible and even increasingly likely. But if this year has taught Israelis anything, it is that against COVID-19 there is always the risk of striking out.
Israel has likely not reached the final inning, let alone the end of the game.