Top doc: If schools open, COVID-19 will crash health system by December

Health Ministry approves list of 'green states' from which Israelis can return to Israel without isolation

By MAAYAN JAFFE-HOFFMAN
Israeli students at the Orot Etzion school in Efrat wear protective face masks as they return to school for the first time since the outbreak of the coronavirus, May 3, 2020 (photo credit: GERSHON ELINSON/FLASH90)
Israeli students at the Orot Etzion school in Efrat wear protective face masks as they return to school for the first time since the outbreak of the coronavirus, May 3, 2020
(photo credit: GERSHON ELINSON/FLASH90)
If Israel opens schools on September 1 and allows worshipers to pray together on the High Holy Days, the health system likely will crash, according to a prominent Israeli health official.
The prediction by Dr. Erez Barenboim, director-general of Samson Assuta Ashdod University Hospital, came on the same day the Health Ministry approved the list of countries from which Israelis can return from and not have to enter isolation.
“If we don’t deal with the infection rate now, we will be in a place in December in which we cannot handle it anymore,” he told The Jerusalem Post.
Israeli hospitals are currently treating some 400 patients who are in serious condition, and there is an average of 1,600 to 1,700 new diagnoses per day, Barenboim said. Over the weekend, about 8.2% of people who were tested had the coronavirus.
At press time, Laniado Hospital in Netanya was reporting that its coronavirus unit was 137% full, and Hadassah-University Medical Center in Jerusalem’s Ein Kerem was 104% full. Most other major hospitals were between 90% and 95% capacity.
“We have gotten to a place where we are not seeing exponential growth,” Barenboim said. “But we are still not seeing the numbers go down.”
He said he was concerned that when schools open on September 1, and a few weeks later Jews gather for Rosh Hashanah and Yom Kippur prayers, the infection rate will rise, pushing hospitals over the edge.
“One does not have to be a genius to see what happened in May and know that when schools open in full, teachers and students are going to get sick,” Barenboim told the Post. “Unless something major has changed between now and May, we are likely to see an increase.”
The Education Ministry should consider opening on September 1 only for preschoolers through fourth grade, he said.
Furthermore, it is unlikely the public will adhere to Health Ministry regulations on the High Holy Days and limit prayer gatherings, which would lead to a spike in infection, Barenboim said.
On Sunday, the coronavirus cabinet approved allowing 30 people to pray outside and 20 people inside, wearing masks and positioned at least two meters apart.
Barenboim advised that the government consider instituting a similar lockdown on Rosh Hashanah to the one it required on Passover.
“September will cause us to break down in December,” he said.
The Israeli public would prefer a lockdown over the High Holy Days rather than at the end of August or the beginning of the school year, a new survey by N12 showed Sunday. Some 37,3% said they would prefer a closure during Rosh Hashanah rather than at the end of August (2.67%) or at the beginning of the school year (9.9%). The other 26.1% had no preferred period.
However, Israelis are divided over whether or not a lockdown should be implemented. The poll found that 49.6 % of Israelis think a closure should not be implemented even if the infection rate does not improve. At the same time, 43% said a closure should be put into effect. Some 7% had no position.
The majority (64%) of respondents said they would abide by the closure.
Coronavirus coordinator Ronni Gamzu last week presented several ideas for how Israel might slow the spread of the virus, but none of them involve locking down the general public. The most stringent of Gamzu’s options would be putting a total lockdown on red zones alongside operating the standard restrictions among the general public.
Barenboim’s warning was corroborated by a paper published last week by a team of American and South African researchers who tested their new coronavirus Web app by surveying the COVID-19 outbreak in Israel.
University of California at Berkeley Prof. Wayne Getz, a co-author of the paper that was published on MedRxiv, said because no versatile Web app existed that allows epidemiologists and managers around the world to fully analyze the impacts of COVID-19 mitigation, they set out to create one. NMB-DSA (Numerus Model Builder Data and Simulation Analysis) is meant to fill the gap.
The tool is used to “address questions regarding the impact of social distancing, social relaxation, changes in surveillance, implementation of contact tracing with quarantining, patient isolation and vaccination (when widely available) on incidence and mortality rates,” the researchers wrote.
The tool requires users to provide a comma-separated values file that contains the incidence and mortality time series of the particular outbreak to be analyzed, which is what was done with data gathered from Israel.
Getz said Israel’s coronavirus outbreak could be divided into four phases: initial outbreak, social distancing, social relaxation and second wave. The tool showed Getz that Israel would need to revert back to nearly complete social distancing to substantially decrease the spread of coronavirus.
“Our projections beyond the relaxation phase indicate that an 85% drop in social relaxation rates is needed just to stabilize the current incident rate, and that at least a 95% drop is needed to quell the outbreak,” he said, meaning that “if you want to bring the epidemic under control in Israel at this point, you have to go 95% of the way to what you were doing when the strict measures were in place. You are not going to get it done otherwise.”
Specifically, with an 85% lockdown, Israel would get down to 800 to 1,000 cases per day for the months August to November. With at least a 95% lockdown, Israel could get back to a few dozen cases by late October.
“Anything less than an 80% reduction [in social relaxation] is completely ineffective in containing the outbreak,” he said.
These challenging predictions come against the backdrop of an announcement by the Health Ministry that director-general Chezy Levy had signed an order Sunday approving that anyone returning to Israel from the following countries would not have to enter isolation in Israel: Austria, Italy, Estonia, Bulgaria, the United Kingdom, Georgia, Germany, Denmark, Hong Kong, Hungary, Greece, Jordan, Latvia, Lithuania, New Zealand, Slovenia, Finland, Canada, Cyprus and Croatia.