Arabs are 21% of population but 50% of serious COVID patients

Arab-Israelis are disproportionately affected by serious COVID-19 cases, highlighting stark gaps between the minority group and the population as a whole.

A nurse works in the new COVID-19 ICU for children at Hadassah-University Medical Center (photo credit: Courtesy)
A nurse works in the new COVID-19 ICU for children at Hadassah-University Medical Center
(photo credit: Courtesy)

The numbers are staggering: Arab-Israelis account for nearly 40% of new coronavirus cases and constitute almost 50% of COVID-19 patients in serious condition, but they comprise about 21% of the population.

“There is a gap between the Arab and general community, but we are closing the gap,” according to the Arab sector’s COVID czar, Ayman Saif.

The day after he presented a new plan to tackle low vaccination rates and high infection in his community to the coronavirus cabinet, Saif on Monday told The Jerusalem Post numbers alone can be deceiving, and he believes the Arab population is at a turning point when it comes to COVID-19.

“We are seeing a decline like the rest of the country,” Saif said. “If we had 2,500 new cases a day last week, this week we are seeing 1,000. And the ‘red’ cities – there were more than 50 two weeks ago, and today there are only around 15.”

So, what’s going on?

 Bennett instructs health funds to help get Arab Israelis vaccinated. (credit: Avi Ohayon/GPO) Bennett instructs health funds to help get Arab Israelis vaccinated. (credit: Avi Ohayon/GPO)

For starters, coronavirus testing among the Arab community spiked in September, from an average of 50 people tested out of every 10,000 to 140 people – the highest number of individuals per capita screened in any community last month.

As more people were screened, unexpected asymptomatic infection was discovered, especially among children. In contrast, the Jewish community spent September at home for the High Holy Days and Sukkot, testing fewer people than average.

The Arab community returned to its schools in September, too, and kept children in their classrooms while Jewish students enjoyed a break. For perspective, with just six to nine days of school for Jewish students, depending on age and type of school, more than 150,000 students ended up in isolation.

About 50% of new infections were students during the first two weeks of September. Many of these children were Arab.

Moreover, all of the coronavirus waves have caught on later in the Arab community, according to Prof. Bishara Bisharat, chairman of the Arab Population Health Society-Israel Medical Association and a medical coordinator in the Health Ministry’s coronavirus headquarters.

“The first wave did not really impact Arabs,” he said. “Then, the second and third waves hit the Arab population after they hit the Jewish community. And here, too, at the beginning of this fourth wave, we did not have infection, and then slowly, slowly the numbers started to climb.

“Now, the infection rates in the Arab and Jewish communities are declining, but the Jewish infection rate is going down first and faster.”

As the rate of infection drops among the Jewish community, it is logical that Arabs would account for a higher percentage of total cases.

Finally, the Arab community has double the number of people suffering from some chronic illnesses, such as diabetes, compared with the general Jewish community, Bisharat said.

Diabetes is one of the underlying medical conditions that leads to serious COVID-19, as are heart and kidney disease, both which can result from diabetes.

In 2020, the average age of Jewish Israelis who died of COVID-19 was around 80, whereas it was closer to 72 due to these conditions.

The elephant in the room, of course, is the lower vaccination rate among the Arab population, spawned by a combination of lack of health literacy, stymied accessibility to vaccines and misinformation, or so-called fake news.

The overwhelming majority of Israel’s more than 550 serious cases are unvaccinated. The next highest percentage are those who received two shots of the Pfizer vaccine more than two months ago and have not gotten a booster shot.

Only 74% of the Arab population has had a first dose, compared with 86% of all eligible Israelis. Some 63% of Arabs have received a second dose, compared with 79% of the population overall. And 44% of Arabs have received a booster shot, compared with 50% overall.

But Saif said the “stigma that the Arab community is not vaccinating is not correct” if the percentages are examined by age group. More than 85% of the Arab population over the age of 50 are vaccinated, compared with about 50% of children ages 12 to 15, he said.

Similarly, close to 70% of people over the age of 60 have received a third shot, although the number of booster shots is low among the Arab population in general.

In other words, there are low vaccination rates among the Arab community, but they are not across the board. And the numbers are quickly rising, according to Saif and Bisharat.

“Every vaccine complex in the Arab community has been filled with people this week, many more than we saw even a week ago,” Bisharat said. “There is a big wave of people asking for vaccines.”

Last week, 35% of the population had received a booster shot, compared with the current 44%, the Health Ministry reported.

What hinders Arab vaccination first and foremost is that many members of the community have what Bisharat calls “low health literacy,” meaning they do not understand coronavirus, the health rules or their importance.

A Health Ministry internal report showed that only around a quarter of the Arab population said they understand the coronavirus rules, according to Bisharat. Moreover, when the ministry runs public Facebook sessions or Zooms for community members to ask questions, the questions are often totally disconnected from reality, he said.

On a recent talk, for example, one attendee asked why America stopped vaccinating, referring to the US Food and Drug Administration’s decision to provide booster shots only to people over the age of 65 or at high risk for infection or serious disease.

“People need things explained to them in their own language,” Bisharat said.

The second issue is fake news. Much of the younger Arab community is engaged in social networks where they are indoctrinated by some Arab influencers to fear nonexistent vaccine side effects. These could be that the vaccine will harm fertility, which has been proven incorrect, or simply that it will make you sick.

Moreover, there is a cultural disconnect among the most devout Muslim members, some of whom believe they do not need to vaccinate because, “If God wants to keep me safe, he will,” Bisharat said.

Finally, there has been an issue of accessibility.

Vaccination complexes were sparse in Arab communities and towns, especially in Bedouin villages. Increasing accessibility has been a big thrust of the Health Ministry, including special “Intensive Vaccine Care” mobile units that launched in late August and are being operated by Magen David Adom, Saif said. These units are being sent across towns and neighborhoods with a low inoculation level to offer those in need the opportunity to get the jab in their community.

“The rich get vaccinated more; the weaker sectors of the population much less,” Health Minister Nitzan Horowitz said when he launched that campaign.

Another focus has been on recruiting a team of family doctors in each community to help convince their clients of the need to get inoculated.

“Family doctors have real influence in the Arab community,” Bisharat said. “People listen to them and do what they say.”

The Health Ministry has been providing lectures to Arab primary-care physicians to help them help their own people, he said.

Saif said the ministry has also reached out to school principals and religious leaders.

“We are really trying to recruit as many influential people as possible to get them to convince others to vaccinate, and it is starting to work,” he said.

The highlight of the plan that Saif presented to the cabinet and which he said should be launched within the next couple of days is appointing a state-funded coronavirus commissioner for each Arab town and city who will set vaccination goals for the place they are assigned and delineate the efforts needed to accomplish them.

“Things are not perfect, but we are improving,” Saif said. “I think with the right efforts and the right messages, we will see the improvements we need in the next few weeks.”