Will coronavirus ‘czar’ Gamzu pass the COVID-19 finish line?

HEALTH AFFAIRS: He may not be a basketball player, but he is a marathon runner, and that may explain how he is sticking it out long after his critics expected him to resign.

CORONAVIRUS ‘CZAR’ Prof. Ronni Gamzu is under fire from Israel’s politicians. How much longer will he stay on? (photo credit: OLIVIER FITOUSSI/FLASH90)
CORONAVIRUS ‘CZAR’ Prof. Ronni Gamzu is under fire from Israel’s politicians. How much longer will he stay on?
(photo credit: OLIVIER FITOUSSI/FLASH90)
Coronavirus “czar” Prof. Ronni Gamzu may look small, but he has big ideas for conquering a pandemic of enormous proportions. Only 5 feet, 3 inches (1.6 m.), he has towered over cabinet ministers of all heights to block the populism that threatens to make Israel sicker than the novel coronavirus.
He may not be a basketball player, but he is a marathon runner, and that may explain how he is sticking it out long after his critics expected him to resign.
The Jerusalem Post sat down with Gamzu at his new office in Airport City, near Ben-Gurion Airport, five weeks into a race that could change the trajectory of his career and the lives of countless Israelis.
The commissioner admitted that solving Israel’s coronavirus crisis is “much more complex” than he originally thought and he has considered resigning. But he said that “I am a person who tries everything but quitting... I’m determined. I have thick enough skin.”
He said that if he quits, it means that “really, really they made it so, so unbearable.” After all, he added, “No one is standing in line to replace me. I’m doing the job.”
Gamzu was the last person tapped for the role of coronavirus commissioner.
“Yesterday, in the late evening, the prime minister and health minister appealed to me to help with the coronavirus crisis at the national level,” Gamzu wrote in a Facebook post the Thursday morning after his appointment in late July. “I immediately responded in the affirmative.”
Inside sources said that although there had been informal conversations with Gamzu about the position, he accepted without knowing to whom he would report or even the scope of his formal authority.
“Israel needs all of its people who have some influence to fight this epidemic,” he told the Post on Wednesday. “When you are a leader, you do not choose not to take leadership and responsibility. This is your duty.”
Gamzu did not put down the others who came before him – Prof. Gabriel Barbash, Maj.-Gen. (ret.) Roni Numa, former Health Ministry director-general Moshe Bar Siman Tov and Maj.-Gen. Amir Abulafia – for refusing the post. Rather, he said, “People sometimes do not want to take risks. I have been taking risks all of my life.
“I don’t need some members of the Knesset telling me what is right and what is wrong,” he continued. “I am coming from a professional standpoint and not a political standpoint.... I’m not looking for someone who strengthens me every day. I go with my professional truth.”
However, some said he was difficult to work with – he was nicknamed “Napoleon” by some in the Health Ministry when he served as director-general between 2010 and 2014, according to stories published back then. When he resigned, many reported it was because of challenges he had working with former health minister Yael German.
“He is a man with high self-esteem,” said Prof. Shuki Shemer, chairman of the board of directors of Assuta Medical Centers Network. “He is a very talented man, targeted, goal-focused, and when he takes something on, he takes it on until the end – nothing stops him.”
Shemer said that “he is the right person in the right place,” but that is not enough. In order to succeed he will need all parties to work together – the IDF, the municipalities, the government and the Knesset,” he said.
IT IS on this front that Gamzu continues to struggle.
He said that ministers have difficulties doing the right thing because politics get in the way. He said he sees them under “huge pressures, almost violent ones, from many streams of people” and that the threat of losing votes in a future election “makes them lose all logical judgment. There is a lot of illogical judgment here,” he told the Post.
Earlier in the week, Likud faction leader Miki Zohar accused Gamzu of not taking action against the tens of thousands of people protesting against the government’s handling of the novel coronavirus crisis and corruption because he “fears the media and is scared the media will criticize him.” Zohar said that if the professor could not stop the protests, “he needs to know he also cannot stop travel to Uman,” where tens of thousands of haredi (ultra-Orthodox) hassidim gather every Rosh Hashanah at the burial site of Rabbi Nahman of Breslov.
Even after the Ukrainian government on Wednesday announced that it would not accept foreigners into the country until after the Jewish New Year in order to allay a spike in coronavirus cases, rumors swirled that Israelis politicians were still making efforts to get some hassidim to Uman.
“After everything that happened, you are still trying to design an outline for travel to Uman? Are you crazy?” Gamzu said in an interview with Army Radio. “This obsessive preoccupation – the chairman of the coalition is making tremendous efforts. I want him to make efforts to reduce morbidity!”
Gamzu told the Post: “Sometimes, I feel like politicians are saying, ‘It’s your duty to reduce the numbers, and it is our job to do what is popular. And if you don’t succeed, we will just lock down.”
But Gamzu did not come into his role to put Israel under lockdown. He came to prevent a closure, he said. He is hoping to build the infrastructure necessary for the country to dance with the coronavirus, to live in its shadow without shutting down.
He said it will take time, and in the meantime he needs all parties on board. He said mayors need to work with the Home Front Command to keep infection down in their cities.
“We cannot cut the chain [of infection around the country] from [the Health Ministry headquarters in] Jerusalem,” Gamzu said.
ON TUESDAY and Wednesday combined, nearly 4,000 new cases of coronavirus were diagnosed. About 2% of all patients become serious – down from around 5% in the first wave. This is largely because of the younger ages of the patients. However, the country is already seeing an increase in ages, more people aged 60 and over than there were two or three weeks ago.
President Reuven Rivlin has defined four Israeli tribes (five, if you count Diaspora Jews) that he said are “absorbed by a struggle for survival, a struggle over budgets and resources for education, housing or infrastructure – each on behalf of its own sector.”
Gamzu, similarly, has defined three sectors: Arabs, ultra-Orthodox and everyone else.
He said the general population started the second wave in schools and through large gatherings, and the haredim joined within a few weeks. In the last four weeks, Gamzu said, he has succeeded in containing the infection rate in both.
Even in Jerusalem, the recovery rate is significantly higher than the rate of infection, and there is also a decrease in the number of new patients in Jerusalem.
“People are looking at the numbers as a whole, but if you look closely, the general population went down from like 1,200 to 800” new cases diagnosed per day, Gamzu said. “We are stuck there – but it’s OK to stay there and gradually go down more.”
However, in the last two-and-a-half weeks, the Arab population has seen four times as much infection – from about 150 daily cases to 500 or 600 per day.
He said the increase is a result of gatherings for last month's Muslim holiday of Eid al-Adha, wedding season and exchanges between family members and friends in the West Bank, where infection is also high, and that enforcement does not really work among Arab society. He added that he cannot shut down Arab cities and towns “for political reasons, and the population would not stand for it.”
On Wednesday, Defense Minister Benny Gantz said that his team would intensify work in Arab localities to help stop the spread of the disease.
In five places – Sakhnin, Majd el-Kurum, Judeida-Makr, Rahat and east Jerusalem – an Arabic educational program about coronavirus is being offered, as is a special information hotline to help answer community members’ questions. The Home Front Command is deployed and testing centers are being established. Sick people are being encouraged to evacuate to hotels.
Gamzu said people should be cautious looking at graphs and models and rather go into the field. He said the infection rate is high, but the hospitals are doing OK and they are encouraging him to keep going with his plans.
Does he worry about opening schools?
“It is a risk,” he told the Post. “But, again: Not opening the education system? We are opening the educational system in a way that is reasonable. But nobody knows 100%. When it comes to coronavirus, many decisions governments are making are being made with a high degree of uncertainty. You only have one option: making decisions or freezing life.”
On how synagogues will operate on Rosh Hashanah, he said that the decision is not being made for the ultra-Orthodox but for the people of Israel.
“Hopefully, there will be prayers and no restrictions on movement,” Gamzu said. But he added that “a general closure during the holidays is still on the table.”
Barbash questioned Gamzu’s plan last week, in an interview with Maariv. He said, “I do not know how they will decide on the closure. I know two things: no country has succeeded, and it is impossible by the usual means to reduce the numbers from 1,500 infected per day to 200-300 infected per day, an amount with which one can live and return the economy.”
He added that Gamzu has to understand that he cannot “play too many times with this closure; he must bring results.”
GAMZU IS a doctor, an academician and an activist.
He began his medical career at Tel Aviv Sourasky Medical Center around 25 years ago as a medical student. A graduate of Tel Aviv University, he is a professor of gynecology and an associate professor in public health and health and business administration. He joined Sourasky’s management team in 2002.
In 2010, he was appointed director-general of the Health Ministry, where he served for four years. In that role, he worked to reduce gaps in the healthcare system, spearheading efforts to make healthcare services and support more accessible to non-Hebrew speakers.
He worked with then-deputy health minister Ya’acov Litzman to provide free dental care to all Israeli children up to age 12. He also led efforts to transfer responsibility for the mental health system from his ministry to the health funds, increasing the money and services available to people suffering from mental illness.
In a stepping stone to what he is doing today, Gamzu managed the polio outbreak in 2013-2014. Gamzu reportedly understood the need to communicate clearly with all sectors, including the ultra-Orthodox and Arab sectors, and he met personally with opinion leaders in these communities.
“The polio crisis was defined as an emergency... and the crisis was handled through mobilization of, and cooperation among, many players – doctors and experts, HMOs, local governments and others,” a senior official told Israeli media then.
Ultimately, some 980,000 children were vaccinated against polio between August 2013 and January 2014, and the disease caused no injuries or deaths.
During the first wave, Prime Minister Benjamin Netanyahu served as the “general,” and at his side was “lieutenant” Bar Siman Tov, 43, affectionately known as “Barsi.” Multiple times per week, the former director-general would appear on TV in his gray and blue shirts, open jackets and dark-rimmed glasses, alongside the prime minister in prime time, instilling fear in the Israeli people.
When the infection rate dropped, many – including Gamzu – credited Bar Siman Tov for his decisive, swift and confident early decisions, such as completely closing Israel’s borders to foreigners – a reaction that helped stop the spread and ensure the virus did not overtax the country’s health system.
However, as the dust settled, many also began to criticize his actions, saying his later decisions to tackle the crisis lacked focus, strategy and leadership, and that Bar Siman Tov and Netanyahu controlled the crisis in a way that blocked out the opinions of others, to the detriment of the country.
“There was only one way, and that was Barsi’s way,” a health fund head told the Post in a previous interview. “Bar Siman Tov ran the show. He had the ear of the health and prime ministers, and everyone knows that.”
Health officials said that if Bar Siman Tov said it, the prime minister followed – sometimes to the detriment of the country.
Gamzu works differently. He has a professional board that includes the heads of most major hospitals. He also has a barometer board of hospital emergency department and intensive care unit doctors who have their finger on the pulse of the day-to-day running of the health system.
At the same time, Gamzu told the Post, he believes the prime minister still has a “sincere urge to cut down the infection” and that he “is trying to do whatever is necessary and going into details in a remarkable way.” He said he believes he enjoys Netanyahu’s backing.
Unlike how he spoke about most politicians, Gamzu said he does not hold Netanyahu responsible for the “complexity of the political system in Israel,” and that he believes the prime minister “understands the benefit of a professional like me with his hand on the wheel.”
On Wednesday, Netanyahu even defended the “czar”: “Prime Minister Benjamin Netanyahu, who appointed Prof. Ronni Gamzu as national coronavirus project manager and holds his dedicated work in great esteem, works and cooperates with him on a daily basis and calls on everyone to do likewise,” the Prime Minister’s Office shared in a statement.
Gamzu credited Netanyahu for taking his side a few weeks ago, when several ministers and the head of the National Security Council wanted to shut down the country for most of the month of August and Gamzu wanted to focus on red areas. At first, it appeared that Netanyahu would side with his colleagues, but Gamzu said “he changed his view and went with me on this very complex course.”
Gamzu said he expected Netanyahu to push for locking down and then to stand up “and explain to the public, in his charismatic, leadership way, why we are doing this to save the country and the people.”
But he didn’t, Gamzu said. “Netanyahu is taking the right measures.”
Shemer said that the novel coronavirus is likely to be around for at least another two years. As such, short-term fixes, lockdowns and the like will not ensure Israel’s survival.
“We need a long-term plan, and that is what he is putting in place,” Shemer told the Post. “He is building the infrastructure so we can live with the virus.”
Gamzu knows that in the end he will be “easy to blame,” no matter the results. But the marathon runner said he does not worry about the fame but about helping Israel make it to the COVID-19 finish line.•