Israeli, German, Swedish experts speak about learning from virus mistakes

‘You cannot disconnect our response from the political situation’

Israelis perform tests for the coronavirus at a Maccabi Test Center, in Ramle. January 7, 2021 (photo credit: YOSSI ALONI/FLASH90)
Israelis perform tests for the coronavirus at a Maccabi Test Center, in Ramle. January 7, 2021
(photo credit: YOSSI ALONI/FLASH90)
As Israelis struggle with the management of the third lockdown, a webinar sponsored by the Jerusalem Press Club on Wednesday on the topic “Pandemic Policy: German, Swedish and Israeli Models” featured experts who set policy in all three countries, and it turns out that every country has been surprised by COVID-19.
As Prof. Lothar H. Wieler, president of the Robert Koch Institute in Berlin, the national public health institute in Germany; Dr. Karin Tegmark Wisell, head of the Swedish Public Health Agency’s Department for Microbiology; and Prof. Nadav Davidovitch, director of Ben-Gurion University of the Negev’s School of Public Health, a member of the expert committee handling the corona crisis and the official Israeli representative to the Executive Committee at the European Public Health Association, discussed the crisis with KAN’s chief international correspondent, Moav Vardi, it became clear that one of the best predictors of success in the fight against the virus is the ability to learn from your mistakes – because every country has made many.
While the public perception is that Sweden kept just about everything open as normal and then paid a high price in terms of its current death rate, that is not quite the case, according to Wisell.
When the pandemic first struck in February and March 2020, Sweden was initially well-prepared to test travelers who had been in China, Italy and a few other countries. But when it became clear that there was substantial community transmission, the government requested citizens to isolate at home if they had the slightest symptoms of the virus, and the vast majority cooperated.
There was little transmission in the spring and summer when people practiced social-distancing measures outdoors, but then the morbidity rate spiked in the fall, Wisell said.
“We instituted supportive measures to help compliance,” she said, such as making it very easy for employees to take sick days the moment they felt unwell, and making sure they would be compensated, including those who work in both the public and private sector.
Another resource that Sweden invested in was home testing for the virus, to free up medical personnel to treat those who most needed care.
“We realized we couldn’t contain the pandemic, so our focus was on flattening the curve and making sure there would be enough hospital beds,” she explained.
Schools for children up to 15 did stay open for most of this time, but the biggest challenge in Sweden, as well as in Germany and Israel, was protecting the elderly, and especially those who live in nursing homes.
“More than 50% of deaths occurred in nursing homes,” she said.
“There was a strong focus on adapting to the evolving pandemic,” she said.
Now Sweden is trying to monitor the effect of mutations and to build confidence in the vaccination process, especially among the elderly.
Germany was well-prepared to cope with the crisis – at first, according to Wieler. The country used its many laboratories and converted them quickly to virus testing and used strategies that were in place for coping with flu outbreaks.
The three pillars of Germany’s strategies, he said, were “containment, protection and mitigation,” he said.
In the interests of containment, they used security systems in place for contact tracing.
Germany locked down its schools in its first lockdown, but not in subsequent ones, and said that they could have done more to promote hygiene and social distancing in schools.
Another area where Wieler said there was room for improvement was protective gear for medical teams at the beginning of the crisis.
Davidovitch said that in Israel, “you cannot disconnect our response from the political situation,” noting that there was a provisional government in place at the very beginning of the pandemic, in March 2020, when the third elections were held. He also noted that the country is now heading into the fourth national election in less than two years.
This temporary government “was not good for democracy, but it was easier to implement stringent measures in the first lockdown.” In the second lockdown, as two factions “that needed approval on everything” vied for control, coronavirus policy and enforcement suffered.
“We closed our borders in the first wave, but because of political issues, it took time to close our borders with the US and certain other countries,” he said.
The failure of the traffic-light plan popularized by former coronavirus commissioner Prof. Ronni Gamzu was principally a political failure, in that there were political considerations about how the communities with the highest morbidity, particularly the ultra-Orthodox community, were treated. The approval process for the  plan “was a political nightmare.”
Weaknesses in the healthcare system, including inequity in the periphery of the country and other issues, became apparent.
“There were lots of structural problems that became more evident as the pandemic continued,” he said.
Israel tried to balance mental health issues exacerbated by lockdown with trying to curb the spread of the virus, as well as trying to find ways to keep the economy afloat and develop a “hybrid system” for education, combining distance and in-person learning, which did not work so well because of the emergence of the third wave.
“We also put our culture way, way back,” he said, emphasizing Israel has to find ways to bring back the arts and culture sectors.
The vaccine campaign has been a huge success for many reasons. These include the fact that Israel has a well-developed network of baby healthcare, the Tipat Halav clinics, which promote vaccination, “so that vaccination is embedded in our country.”
Because Israel is a small centralized nation, computerized health records made it attractive to Pfizer as a place for a major vaccine rollout. And the Health Ministry waged a successful campaign against fake news about vaccines.
“There is no one answer to the pandemic; vaccination and lockdown are not the whole answer.... We need a more sophisticated approach, and we need to be more proactive.
“I wish everything in Israel worked as well as the vaccination campaign,” he said.