As coronavirus second wave approaches, why isn't Israel shutting down?

The state of the country’s economy and society is worse than it has been in decades and violence, sickness and even deaths tied to coronavirus crisis (as opposed to the disease) are on the rise.

By MAAYAN JAFFE-HOFFMAN
A Tel Aviv pub re-opens after nearly two months of being closed during the Coronavirus outbreak (photo credit: AVSHALOM SASSONI)
A Tel Aviv pub re-opens after nearly two months of being closed during the Coronavirus outbreak
(photo credit: AVSHALOM SASSONI)
On Wednesday, as the Health Ministry revealed that nearly 300 people were diagnosed with the novel coronavirus in one day – the highest number in 24 hours since April – the government announced it was opening the intercity train and that cultural activities would resume on Monday.
Why is the government not shutting us down?
Because “lockdown is lunacy,” according to Prof. Yoram Lass, a member of the Sackler Faculty of Medicine, and as Finance Minister Israel Katz told Israeli media on Wednesday, “There is no room for a general closure” this time around.
The state of the country’s economy and society is worse than it has been in decades and violence, sickness and even deaths tied to the coronavirus crisis (as opposed to the disease) are on the rise.
“By the end of the year, we will reach an even bigger deficit,” Katz said. “We won’t close anything across the board. We can deal with it in a pinpoint manner with enforcement and quarantine… Even if we experience what happened here at the beginning, there is no room for a general closure.”
Lass said that he reads into Katz’s statement “a confession: the shutdown was a big mistake and the price” was too high.
In his estimation, the number of people that will perish as a result of suicide, domestic violence, alcoholism, drugs, crime or even starvation will be much higher than the number that have or will ultimately die from coronavirus.
“I can tell you that the number of people dying as a result of the shutdown is larger than the number of people protected by the shutdown,” Lass said.
As of Friday morning, 304 people had died from COVID-19.
Multiple reports have warned that a historic wave of mental-health problems is approaching. Last month, the Central Bureau of Statistics showed that one-third of Israelis over the age of 21 are stressed and anxious as a result of the coronavirus crisis. At the same time, the Welfare and Social Services Ministry reported that there has been a 20% increase in domestic violence.
Moreover, many people who required treatment for diseases like cancer, cardiovascular disease and diabetes did not receive the health services and medicines they needed since the COVID-19 pandemic began – in Israel or the rest of the world.
In Israel, hospitals were asked by the Health Ministry to halt elective procedures and some outpatient clinic work to make beds available for an expected flood of coronavirus patients that never came.
Former Health Ministry director-general Moshe Bar Siman Tov predicted at least 5,000 patients would be intubated. But the beds stayed empty, causing harm to patients and financial distress to hospitals that are paid for their services.
A survey by the World Health Organization of 155 countries showed that 53% of the countries surveyed had partially or completely disrupted services for hypertension treatment; 49% for treatment for diabetes and diabetes-related complications; 42% for cancer treatment and 31% for cardiovascular emergencies.
Rehabilitation services had been disrupted in almost two-thirds (63%) of the countries. Furthermore, according to WHO, the postponement of public screening programs (for example for breast and cervical cancer) was also widespread, reported by more than 50% of countries.
“The downstream health effects... are being massively under-estimated and under-reported,” read a letter sent last month by some 600 US physicians to US President Donald Trump. In the letter they called the coronavirus lockdown “a mass casualty event” that could cost the lives of millions of non-coronavirus patients.
“When diagnoses are not made, treatments start later and people present [themselves at the hospital] with more severe diseases,” Arnon Afek, deputy director-general of Sheba Medical Center, Tel Hashomer, said in a previous interview. “The result is that patients will be sicker when they come in for care and more deaths.”
Moreover, Israel has drastically increased the number of people screened for the novel virus each day over the last few weeks, which inherently leads to more diagnoses. Healthcare professionals say that the total number of cases is less important than understanding who those cases represent.
“The Health Ministry cannot distinguish between healthy and sick people,” he said. “They keep calling healthy people sick people.”
In other words, the number of people infected with SARS-Co-V-2 are just people who are carriers of the virus. The vast majority (99.6% as of Thursday morning) were asymptomatic or had few symptoms of the disease.
Dr. Shuki Shemer, chairman of the board of the Assuta Medical Centers, and Tal Brosh, head of Samson Assuta Ashdod University Hospital’s infectious disease unit, expressed similar sentiments. They said that the question is not how many people have the virus, but how many are ill, as well as where they are from.
The government has designated a number of red zones, cities and neighborhoods in which the infection rate is high. These areas are put under partial closure to help stop the spread of the virus. However, only 50 of the new patients Thursday morning were from these red zones, while more than 200 were from all over the country – including some residents of senior living facilities – which should raise a red flag for the government.
Brosh added that Israel’s hospitals are more equipped to treat seriously ill COVID-19 patients than they were at the start of the crisis in late February.
“We built departments, bought ventilators,” he said. “Today, I have zero corona patients. But next week, if I had to handle 50, I could.”
Brosh said that an increase in the number of people infected with coronavirus was expected when the government opened up the economy.
“We could shut down and do another lockdown,” he said. “But in two months nothing will be different. The same thing will happen after the next lockdown.”
He added that the only way to stop the spread of the virus is for the public to take responsibility: to wear masks, social distance and maintain good hygiene. He also said that Israel needed to improve its ability to contact trace, so it can be more efficient at isolating the people who spread the virus.
“The coronavirus is going to follow us at least for another year or two,” said Shemer. “You cannot put the public under lockdown. Life must go on.”