Coronavirus check-in: What’s the story with Israel’s ventilators?

At the heights of the coronavirus crisis in Israel, 137 people were ventilated. As of Thursday, at 3:45 p.m., some 29 people were ventilated.

A patient suffering from coronavirus disease (COVID-19) wears a full-face Easybreath snorkelling mask given by sport chain Decathlon and turned into a ventilator for coronavirus treatment (photo credit: REUTERS/BENOIT TESSIER)
A patient suffering from coronavirus disease (COVID-19) wears a full-face Easybreath snorkelling mask given by sport chain Decathlon and turned into a ventilator for coronavirus treatment
(photo credit: REUTERS/BENOIT TESSIER)
There are only 1,794 ventilators available to provide mechanical or invasive ventilation in Israel, according to a report disseminated this week by the Knesset Research and Information Center (RIC).
Patients with severe COVID-19 most often die from acute viral pneumonitis that evolves to acute respiratory distress syndrome (ARDS) and is best treated by this type of ventilation.
At the height of the coronavirus crisis in Israel, 137 people were ventilated. As of Thursday night,  some 28 people were ventilated.
Come winter, several hundreds to even as many as 2,000 patients are expected to require ventilation due to respiratory challenges associated with the seasonal flu. Hospital health professionals have said they could handle about another 1,000 intubated coronavirus patients. After that, the hospitals would need more ventilators, more doctors, more nurses and an increased budget.
The report, which was requested by MK Yifat Shasha-Biton for discussion by the coronavirus committee that she heads, showed that there are a total of 5,372 ventilators in Israel, of which 272 are under repair, 400 are being stored in warehouses for emergency use, 1,000 are with the IDF and the rest – 3,700 or around 70% – are being used in 29 hospitals.
Of those, some 2,900 are designed to provide invasive respiratory support. And, of those, some 700 are in use, 46 are in need of repair and 360 are handheld devices. That leaves 1,794.
Since the start of the coronavirus crisis, the country has tried to purchase 15,339 additional ventilators, the report showed. Of those, 707 have arrived in Israel, and of those 581 are for invasive respiratory support. Many more are expected to come throughout the summer: 3,203 in June, 3,530 in July, 1,749 in August and 849 in September.
How many ventilators is Israel still waiting for?How many ventilators is Israel still waiting for?
However, some 5,301 (4,729 or one-third of all ventilators that can provide mechanical ventilation) have no target date for their arrival.
The numbers in the report, however, do not align to previous numbers released by the Health Ministry or the numbers presented to The Jerusalem Post on Thursday.
In May, as the coronavirus crisis was winding down, the Defense Ministry reported that it had secured 811 ventilators for the country during the crisis and that thousands more were expected by the end of summer. On Thursday, the Health Ministry said that Israel has around 3,000 ventilators in hospitals, that 1,000 have arrived in Israel thus far and that it expects around another 3,000 by the end of summer – bringing the country’s total to 7,000 ventilators.
The Health and Defense ministries did not differentiate between invasive and non-invasive ventilation.
Tal Brosh, head of the infectious disease unit at Samson Assuta Ashdod University Hospital and a member of the Health Ministry committee that evaluates the coronavirus threat in the country, explained in a previous interview that the public should not see ventilators as the miracle and sole solution to the coronavirus crisis.
“You cannot just take a patient, connect him to a ventilator, and that’s it,” Brosh said. “If you take someone and just connect him to a ventilator, he will die.”
 
MK Yifat Shasha-BitonMK Yifat Shasha-Biton
A person who is ventilated needs around-the-clock care and must be monitored by nursing and other professional staff to prevent ventilator-associated infections and lung damage, which the country currently lacks, he said. Coronavirus causes extensive damage to one’s respiratory system, and most people, even those who will have a full recovery, will require weeks of care, he added.

Brosh said that the country should focus on training more medical staff to treat ventilated patients, as much as it needs to procure more ventilators.
Amir Onn, chair of the Department of Pulmonary Medicine at Sheba Medical Center, Tel Hashomer told the Post that it takes around three nurses and one doctor to care for one ventilated patient over a 24-hour period.
“The committee requires accurate clarification regarding the number of ventilators, their distribution and the expected arrival times of the additional machines,” Biton said.