It could take as much as six months to a year for the country to exit from the coronavirus closure, Prime Minister Benjamin Netanyahu said on Wednesday during a coronavirus cabinet meeting.
He stressed that this time around, the reopening of the economy will be done slowly.
The cabinet met for several hours to begin discussions on what Israel will look like the day after the lockdown.
The Health Ministry presented a plan that would allow the private sector to operate at 50% and preschools to open in phase one. However, this time reopening will likely not be built around dates but data.
The measurement the ministry is recommending is that when the reproduction number (R) – the number of people that one infected person will pass on the virus to – reaches an average of 0.8 or less, restrictions can be reduced. When it is 0.8 to 1.1, the status quo will be maintained, and when it surges above 1.1, restrictions will be tightened.
The ministry is requesting three weeks between phase one and phase two – as opposed to the expected two – to better gauge its impact on the rate of infection.
The meeting came against the backdrop of another day of high infection.
The ministry reported 4,972 new cases of coronavirus on Wednesday, with a new total of 243,895 infected. Among the sick are some 821 patients who are in serious condition, including 212 who are intubated. The death toll stands at 1,552 – nearly 30 more dead in a single day.
The most recent outbreaks are among the country’s senior living facilities, where residents who become sick are more likely to experience serious symptoms or even die.
The Magen Avot v’Imahot program reported on Wednesday that there are around 200 senior living facility residents who are infected with the virus. A report by KAN News said that the infections were traced to around as many facility workers and aides. Program head Prof. Nimrod Maimon was present at the meeting, at which it was decided to double the number of coronavirus tests in nursing homes to about 20,000 tests a day.
The ministry will also prepare a plan for family members to visit elderly relatives who live alone, and the old age pension will be moved forward by a day to the 28th of each month, when specific hours will be set aside at the Israel Post bank for only elderly customers.
Another aspect of the exit strategy proposed by coronavirus commissioner Prof. Ronni Gamzu would be to increase fines for breaking Health Ministry regulations. Among the proposed fines: increasing fines on events and parties and on opening schools from NIS 5,000 to NIS 50,000; breaking isolation from NIS 5,000 to NIS 10,000; and failing to wear a mask in a public space from NIS 500 to NIS 1,000.
Netanyahu and Defense Minister and Alternate Prime Minister Benny Gantz clashed during the meeting, as the prime minister called for a stronger lockdown. Gantz stressed that the government needs to focus on convincing the public to follow the regulations, not make the regulations stricter.
“We’re driving the public crazy,” warned Gantz after Energy Minister Yuval Steinitz called to restrict the exit from homes to 100 or 200 meters.
“You will not tell me what we are driving crazy or not,” Netanyahu shouted at Gantz. “If the lockdown is not working, it is not working.”
A report by the Hebrew University showed that the percentage of moderately and seriously ill patients who have died rose during September, as the time spent in hospitalization for patients who died dropped significantly. The report stated that this indicates a possible drop in the survival ability of the health system, either due to a failure to arrive for treatment or difficulties with treatment.
The time spent in hospitalization by those who died of coronavirus plummeted from an average of 15 days to an average of 11 over the course of the past few weeks. This could be the result of overcrowded hospitals being unable to treat patients with the same quality of care.
The report was published in the morning and presented to the cabinet, hours before top internal medicine doctors held a press conference, expressing frustration about threats by the government to “take away” positions they were promised if they did not hire fast enough.
The doctors also articulated the challenges of treating coronavirus and other patients in the current climate.
“Up until two months ago, we did not know that we would have these positions,” Dr. Hagith Yonath, director of Internal Medicine Ward A at Sheba Medical Center, said Wednesday, adding that threatening to take the positions away if not filled “does not make sense.”
“In the past year, we had to turn down a number of applications from potential residents because we lacked positions,” she said. “Now, all of a sudden, there is a demand to find quality, worthy residents. Do you think they are just sitting and waiting by the phone? I ask the government of Israel, the prime minister, finance minister, health minister – all officials: Do not play with us. Certainly not on days like these. Do not promise us temporary positions. Do not threaten that if we fail to fill them immediately, they will be taken from us.
“The selection of the appropriate residents for the internal medicine departments should be done wisely, and it may take several months. I am sure we all want to choose quality doctors,” she said.
Dr. Avishay Elis, director of the department of internal medicine C at Petah Tikva’s Beilinson Hospital, explained that of the country’s 111 internal medicine wards, more than 40% of them have been converted to coronavirus units – a total of about 50 wards, and the number is increasing every day.
In three hospitals, the coronavirus wards are 100% full. In general, the coronavirus wards around the country are 85% full. Sheba announced on Wednesday that the first coronavirus ward for children in Israel would open at the hospital on Thursday.
“Unfortunately, politicians and the media for the most part do not understand the drama in the hospitals, the meaning and consequence of the disappearance of this enormous mass in the hospital beds and staff in the internal medicine wards,” Elis stressed. “Let me open your eyes: The preoccupation with the numbers of serious [coronavirus] patients and the deaths – it’s horrible and tragic – but it only reflects a partial picture, and it is not the explanation for the dramatic need to reduce infections and the extent of morbidity.
“What is hidden from the public and decision-makers is the drastic decline in the ability of hospitals to treat routine patients,” he said. “Because we do not have enough doctors, because we do not have enough nurses, because we do not have enough auxiliary and paramedical staff, because we do not have enough hospital beds, because we do not have enough departments.”
Dr. Ayelet Raz Pasteur, director of the department of internal medicine A at Rambam Medical Center, noted that several hospitals have been forced to release patients before they are ready, because of overcrowding.
Finally, Health Ministry director-general Hezi Levi spoke on Wednesday about the increasing rate of infection in the ultra-Orthodox sector. He said that the mortality rate sector is slightly below the average: 2.5 deaths per million citizens vs. 2.8, respectively.
He said that this was due to the young average age in the ultra-Orthodox community, and the fact that large numbers of those infected in the sector are yeshiva students, who are in their late teens and early 20s.
The director-general said, however, that the mortality rate was “on a steep increase” since September, although he did not provide precise data on that point, and added there was also an increase in the weekly average of severe COVID-19 cases in the ultra-Orthodox sector, something he said was “logical” due to the rise in infections.