Closures are bad, but we can prevent them from happening again

The new regulations rolled out by the government on Monday are a positive step toward stopping the spread of the novel coronavirus.

Israeli prime minister Benjamin Netanyahu at the weekly cabinet meeting on June 28, 2020. (photo credit: OLIVIER FITOUSSI/FLASH90)
Israeli prime minister Benjamin Netanyahu at the weekly cabinet meeting on June 28, 2020.
(photo credit: OLIVIER FITOUSSI/FLASH90)
To avoid a third coronavirus spike, the government should use the next few weeks to prepare for the day after life returns to normal.
The new regulations rolled out by Prime Minister Benjamin Netanyahu and the government on Monday are a positive step toward stopping the spread of the novel coronavirus across Israel, but more must be done for future containment.
“I think they are very good regulations,” said former Health Ministry director-general Prof. Gabi Barbash, since they are focused on limiting large gatherings in closed spaces, places in which research shows there is a high likelihood to spread the disease.
Israel will not be able to tell if the regulations have an impact for about another two weeks, during which time the country will continue to see the side effects of the behavior of the people before the regulations. But by the last week of July, said Barbash, “I believe it may succeed.”
If the new measures work, the infection rate, including the number of serious patients, begins to decline and Israel starts to once again flatten the curve, no doubt Netanyahu will be back on the 8 p.m. news telling the public of his success.
However, before we clink glasses with the prime minister, who in early May told the people to “drink a cup of coffee and a beer, too,” as he lifted restrictions, Israelis should reflect on how we got to a place of having to backtrack in the first place. The people should hold their leaders accountable for preventing a third or fourth round of closures.
“Why are Greece and other countries in different situations? Why are they green and we are red? Why did we need these extra measures?” Hadassah-University Medical Center head Zeev Rotstein asked. “Something was wrong with Israel’s decision-making.”
“We sacrificed everything to lower the number of infections, and here we are again,” he said.
While these new directives might be helpful now, they will not solve the coronavirus crisis here, Rotstein said.
He equated the situation to a firefighter who comes to extinguish a house fire. The firefighter’s goal is to quell the flames, but the homeowner’s goal is to prevent the fire in the first place.
“Now, we need to extinguish a fire that is burning across the whole country, and we have to once again flood the home, which is not good for its property value,” he explained. “By the time the firefighter came to the building, the whole thing was on fire. But what if he had come an hour before? Maybe he could have saved the building? It is a matter of timing and strategy, of extinguishing a small instead of a big fire.
“In medicine, we learn that prevention is the easier and cheapest way of getting rid of disease,” he added.
Before the country reopens its bars, gyms and cultural events, which it closed down on Monday, it needs to provide random testing, Rotstein said.
Because Israel does not randomly screen people, he said, it cannot easily and quickly enough identify and separate the infected people who are asymptomatic, so they continue to spread the disease.
Those who go to their physicians likely have already been sick for four or five days because they have some symptoms or know they have been near a sick person. By this point, they have already infected many people.
“The problem is not the celebration or the wedding; it is that we are not identifying the people who are infected before the wedding and preventing them from coming,” Rotstein said.
Barbash said Israel should use this time to improve its contact-tracing capabilities and to start planning for the 2020-21 school year because “they will not be able to bring back 30 or 40 kids into the same classroom.”
The country must find a solution for the haredi (ultra-Orthodox) population, he added.
The government chose not to shut down yeshivot, which too many felt like a populist move after United Torah Judaism MK Moshe Gafni threatened to quit the government if these schools were closed. However, Barbash said if these children were not at school, they would be at home in densely populated neighborhoods infecting others and getting infected.
“They need a more innovative solution” than closing yeshivot, he said regarding the haredi community.
Additionally, the Health Ministry needs to better support the country’s hospitals through these transitions.
Prof. Arnon Afek, a former director-general of the Health Ministry and current deputy director of Sheba Medical Center in Tel Hashomer, said people who come down with severe coronavirus symptoms require a serious level of care that most of the hospitals are not equipped to give.
“The mortality rate was low in the first wave due to the fact that the numbers were limited, so we could divert the necessary staff from the internal-medicine wards to the intensive care units,” he explained. Nowadays, patients have returned to the hospital to get the treatments that were postponed during the first wave, and “we do not have the capacity to dedicate the staff needed to treat the large numbers of COVID patients.”
Rotstein said his hospital is becoming overwhelmed by the situation, with many staff members becoming infected with the coronavirus. Some staff are reluctant to take shifts with coronavirus patients, and “it is going to get worse,” he said.
At the same time, the hospital has still not financially recovered from the first wave, Rotstein said, adding that the ministry should provide a budget for more medical personnel and cash to ensure the hospitals have enough personal protective equipment and other supplies to get through these times. If not, he warned, “in a couple of weeks the hospital will be paralyzed.”
Finally, Afek said the public needs to do its part by putting on masks and abiding by social distancing.
“There is still a chance to change the fate of the disease by changing the strategy of the government,” Rotstein said.
Barbash said: “I hope they will be more careful this time, [and] the government will not go back to making decisions similar to the ones they did before.”