Israel and COVID-19: A national obsession or out-of-the-box thinking?

HEALTH AFFAIRS: Three takes on the country’s vaccination campaign.

 ‘THE GENERAL Israeli discussion turns everything into an issue of life or death.’ (photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
‘THE GENERAL Israeli discussion turns everything into an issue of life or death.’
(photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)

Israel is the Start-up Nation – it is hummus with a side of chutzpah.

Israeli ingenuity invented Intel’s first microprocessor, the disk on key and the Iron Dome defense system. It also helped convince Pfizer CEO Albert Bourla that “Israel is the place with the right conditions” to lead the world in coronavirus vaccination, as he told N12 in March – a move that transformed the country into the vaccination nation.

The Jewish state was the first to shut its skies and lock down, the first to open up, and the first to lock down a second time.

Israel was the first to vaccinate the majority of its at-risk population. The first to jab immunosuppressed teens. And earlier this month it became the first to offer a third shot to people over the age of 60 – a move that is since being followed by a handful of other countries, despite it lacking regulatory approval.

Since Israel’s vaccination campaign began on December 20, 2020, the country has become vaccine obsessed.

It’s not unexpected, according to Prof. Hagai Levine, a faculty member of the Braun School of Public Health and Community Medicine at Hebrew University, who also signed up to run with Moshe Ya’alon’s Telem Party before it dropped out of the previous election.

“The general Israeli discussion turns everything into an issue of life or death,” he said, meaning that when Israelis decide to do something, they grab the bull by the horns, wrestle it down and vanquish it.

This is the case with how both former prime minister Benjamin Netanyahu and now Prime Minister Naftali Bennett have led the country’s vaccination campaigns.

Employing a strategy that other world leaders subsequently followed, Netanyahu was the first person to get a vaccine, and he did it on public television. He then visited dozens of vaccination complexes and cheered on citizens as they received their shots.

The former prime minister greeted the delivery of vaccines at Ben-Gurion Airport as though they were a cherished visiting dignitary.

He nearly nightly appeared in citizen’s living rooms at prime time to motivate the public to get the jab.

“I was obsessive about the vaccines,” Netanyahu said during his last election campaign, turning vaccination in Israel into a highly political issue.

He boasted of Israel’s No. 1 vaccination percentage in the world as his top asset and the No. 1 reason for people to vote for him.

Bennett also ran on the issue of COVID-19, after writing a book on how the country could beat it. He used the pandemic to transition himself from a sectarian leader of a religious-Zionist party to a national leader who could be trusted to handle Israel’s greatest challenges professionally.

Since taking office in June, Bennett has tried to manage the pandemic in a professional manner without pandering to politics and populism. However, he has adopted Netanyahu’s vaccine rhetoric when it comes to trying to convince citizens that the only solution to the crisis is getting inoculated.

With a strong team of the nation’s top scientific and medical experts backing him up, Bennett has not only urged the public to get vaccinated, he has been threatening those who have not yet gotten the jab that they would be the reason if the entire country faces a Rosh Hashanah lockdown.

“One million Israelis are refusing to get vaccinated,” Bennett said at a July press conference. “They are endangering the entire population; they are endangering the other eight million citizens in the country.”

Levine said that Israel’s leaders should take the time to study and understand the part of the population that is choosing not to get vaccinated, and manage its response to them professionally and accordingly.

“Who are the people who are not vaccinated?” Levine asked. “Why are they not vaccinated? Is it fear of side effects? Have they lost trust in the government or the Health Ministry? Do they not fear the risk of COVID-19? Do they think that the vaccine is not effective, especially given recent reports?”

He said that the vaccine is highly effective and doing what it is meant to: stopping severe disease and death. However, he said that if discussions around vaccination were removed from the political sphere to the professional arena, this data might be more convincing.

There is a well-known Hebrew idiom, “not with might but with brains,” which Israeli politicians have hijacked to “if might does not work, use more might” instead of thinking it through, he said.

“This is not the right way in medicine,” Levine said, noting that after seven months, if these one million Israelis have not gotten vaccinated, perhaps Israel’s leaders should take another approach.

He said that coronavirus vaccination needs to become a social norm and not something to be elevated as Israel’s only savior, which would make inoculation more approachable for some people who still have their doubts.

“I think that we should not be obsessive, but give people time and create an environment to make the decision without pressure,” Levine said. “Netanyahu bragged about being ‘obsessive.’ I don’t think it is a good thing. You don’t want a physician or a surgeon to be obsessive. You want him to be assertive, oriented to a solution and resilient – but open-minded and not obsessive.”

FORMER KNESSET SPEAKER Avraham Burg said that the government’s die-hard vaccination campaign is a snapshot of the relationship between Israel’s elected officials and the people.

He said that Israelis have an ethos of “the government will do and I have no responsibility” that plays out in several aspects of citizens’ lives.

For example, large segments of the population are apathetic to issues of religion and state and would rather let officials decide on their relationship to Judaism. Voter turnout is not as high as it could be, with people not seeing upholding Israeli democracy as a personal, political or civic responsibility.

“It is the same thing with coronavirus,” Burg said. “You have to ask yourself: If Israelis would have had two options, to get rid of the pandemic with no vaccination but good inner discipline, social distancing, the Green Pass – New Zealand-style – or have it all chaotic but get vaccinated 10 times a year, what would Israelis choose?

“We have the answer: vaccination.”

According to Burg, the lack of a healthy exchange between the government and its citizens means that the people do not want to share responsibility for the pandemic, making it nearly impossible to enforce COVID restrictions and the country instead reliant on vaccination.

“The challenge for this government is not just to get people to take a first, second or third shot, but to persuade the people that they are honest brokers,” Burg said, “that there can be a real conversation between the government and its citizens.”

Three major issues have plagued Israeli society for decades before COVID, he said: economics, religion and state and the Israeli-Palestinian conflict.

It took 400% inflation in the mid-1980s for Israel to take its first much-needed economic steps. Similarly, it took the first Intifada to embark on a serious peace process with the Palestinians in Oslo.

Burg believes that three lockdowns provided Israelis with a similar wake-up call, but this time instead of making needed changes in their society, they took what Netanyahu spun as the easy way out by “giving a shoulder.”

“Only when we resume the discourse on key issues, will it be possible to speak about shared responsibility,” he concluded.

SHALEM COLLEGE vice president Daniel Gordis put Israel’s reaction to the vaccination campaign in historical context and explained how the behavior of the state and its citizens is no different than when facing past significant threats, calling the country’s leaders “medically assertive.”

Gordis contended, “When Israel is faced with a national threat, it just does what needs to be done.”

Netanyahu from the very beginning spun the pandemic as a “war against an invisible enemy” that had to be won.

Gordis said that since the founding of the state, Israel has largely understood what it needs to survive and thrive and found a way to make it happen.

“The whole idea that you can build a state out of nothing in 50 years – from the first Zionist Congress and the United Nations Partition Plan vote to a state – is ludicrous,” Gordis said.

Other examples he cited since the country’s founding include building the National Water Carrier, building the Dimona nuclear reactor, developing the Iron Dome missile defense system and the technology to solve the problem of tunnels on the Gaza border.

When it comes to COVID-19, Israel is among the world leaders in research and developing biotechnology to understand and enable life alongside the pandemic.

From the Sonovia mask that has been proven to neutralize the novel coronavirus at an effectiveness of 99% to the virus-blocking nasal spray, Israel has shown just how innovative it can be.

The coronavirus vaccination campaign is the peak of Israeli out-of-the-box thinking, Gordis said. The country’s decision to leverage its national health database – itself ingenious – to make an early deal with Pfizer that scored millions of doses of vaccines was the first step in becoming the vaccination nation.

The government’s decision to offer a third jab even ahead of the FDA “is a very Israeli move,” Gordis said. “It is this ability to be nimble that lets Israel win wars.”

He said the coronavirus crisis and the vaccines that are being used to help solve it evoke the Israeli ethos that “we are a people that can defeat any problem that needs to be fixed.”