Israel's six-step strategy to exit the coronavirus lockdown

Stage one is where we are now: reducing infection through a near-total lockdown.

Police at a temporary roadblock on road number 1 outside Jerusalem on September 29, 2020, during a nationwide lockdown. (photo credit: YONATAN SINDEL/FLASH90)
Police at a temporary roadblock on road number 1 outside Jerusalem on September 29, 2020, during a nationwide lockdown.
(photo credit: YONATAN SINDEL/FLASH90)
Unlike during the first coronavirus closure, the government hopes to use the one month or more of restricted movement to implement a slow and strategic exit strategy.
The first formal plan known to be presented to the government was designed by Prof. Eli Waxman and his team of Technion-Israel Institute of Technology scientists. They advised the National Security Council during the first wave.
 
Waxman provided The Jerusalem Post with a copy of the six-part plan, which does not involve any loosening of restrictions before October 12 and likely even a couple weeks afterward. The plan also involves only opening schools for grades five and up after January 1.
Stage one is now: near-total lockdown. It has one goal: to reduce infection.
According to the plan, when around 2,000 new patients per day are diagnosed, which Waxman expects to happen no earlier than October 12, industrial factories and businesses that customers do not go to in person would resume operation in full. Preschoolers and students in grades one and two would also return to school.
It could take as long as three to five weeks to reach the 2,000-patient mark, Waxman told the Post.
“If lockdown is not enforced and people do not cooperate, we will not achieve anything,” he said. “I am assuming people will cooperate based on our experience in the first wave and experiences in other regions. We expect the numbers first to sort of stabilize, and that might happen even by the end of this week. Then, they will continue dropping week after week. In the last round, they dropped by almost 50% per week.”
When the infection rate drops to no more than 1,000 patients per day, and the decline is at a rate of 20% per week, customer-facing roadside stores and marketplaces could open under the “Purple Ribbon” outline. This would be stage three.
The way to determine if Israel is dropping by an average of 20% new daily patients per week is to look at the average number of daily patients week-on-week when testing is kept consistent at no less than 30,000 to 35,000 people tested per day, Waxman said.
At the conclusion of the first wave, Israel dramatically dropped daily screenings, making it appear like there was a low number of patients. This is still the case on weekends.
“Using a weekly average of cases should alleviate the challenge of comparing daily numbers,” he said.
The next stage, stage four, would happen when the number of daily patients is around 400. Then, malls would open, as would classrooms for students in grades three and four. Also, gatherings could be expanded.
Stage five, opening restaurants and some leisure activities, would occur when the daily number of new patients is around 100 people.
Finally, stage six, which Waxman said would not happen before January 1, would allow resumption of events and concerts. Israel would need to have fewer than 100 new patients per day for at least three weeks to move to this stage. Even then, events and concerts would only take place with limited numbers of people (50-100) and under the Purple Ribbon outline.
Regarding grades five and up, he said he does not envision those grades opening up until after January 1 and after “we see how opening the schools for lower grades works out.”
Each stage of the plan will last a minimum of two weeks and allow time to measure the impact of any loosening of restrictions. If there is a spike in infection, then the country will not move on to the next phase.
“We are careful not to state dates as goals,” Waxman said. “We need to achieve the [number of infections] goals before we move from one step to another.”
Asked whether a government that gave in to populism and pressure groups the first time around will be able to stick with a solid and data-driven exit strategy, Waxman said: “Last time, they announced they adopted [my plan]. But the plan was not implemented, and this was due to pressures and also probably to different feelings. There was an atmosphere of ‘We have beaten the virus’ and ‘We are over it.’”
“The understanding was not that the virus was still around and that when we resumed normal activities new outbreaks would take place,” he told the Post. “Now, I think we all know that. I hope the actions taken by the government will reflect that.”
During a public address on Tuesday, Health Minister Yuli Edelstein said no exit strategy has been approved by the government. However, he also said that “We will be very careful not to give into pressure. No lobby will be able to help. We will release the economy and life with medically necessary care.” 
Waxman said he knows the Health Ministry is working on its own exit strategy, “but there are many pressures around it, and I am not certain yet what that program will look like in the end.”
“If we relieve the restrictions too early and the numbers get too high, we will not be able to control the pandemic, and we will have another lockdown shortly afterward,” Waxman said. “This would be a huge mistake.”


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