COVID: As Israel opens schools, cases are expected to rise. How badly?

The Coronavirus Knowledge and Information Center warned that the authorities should be ready for a situation where schools need to be closed, at least partially.

 A CHILD takes a coronavirus test as part of a simulation presented by Sheba Medical Center for how pupils can return to study at the beginning of the new school year.  (photo credit: MIRIAM ALSTER / FLASH 90)
A CHILD takes a coronavirus test as part of a simulation presented by Sheba Medical Center for how pupils can return to study at the beginning of the new school year.
(photo credit: MIRIAM ALSTER / FLASH 90)

As Israel opened its schools on Wednesday, experts and health officials expected the morbidity in the country – which is already registering record numbers of daily cases – to further grow in the upcoming days.

The question is, how badly? Will the rise be limited to the number of infected, or will it also involve an increase in serious patients? And will schools be forced to close again?

“I pledge, as prime minister, that we will continue to make super efforts so that all Israeli pupils can learn,” Prime Minister Naftali Bennett said, as he visited the Eli Cohen Meuhad School in Yeroham with Education Minister Yifat Shasha-Biton. “We cannot guarantee the result, but we can guarantee 100% effort. This is what the education minister, the Health Ministry and all of us did together to reach this day.”

On Tuesday, the country surpassed 10,000 cases for the second day in a row for the first time since the beginning of the pandemic, with some 10,313 new virus carriers identified – or 6.74% of people screened testing positive.

Following the spike in morbidity on Monday, the European Union recommended its member states reintroduce restrictions on travelers from Israel, and on Wednesday, Portugal was the first country that followed the suggestion.

At the same time, however, the number of serious patients dropped to 689 – several dozen less than the fourth wave peak of 753 – which was registered on Sunday.

 Israeli student receiving her negative COVID-19 results ahead of the first day of school, August 31, 2021. (credit: AVSHALOM SASSONI/MAARIV)
Israeli student receiving her negative COVID-19 results ahead of the first day of school, August 31, 2021. (credit: AVSHALOM SASSONI/MAARIV)

The reproduction rate, or R, continued to drop on Wednesday, when it stood at 1.07, the lowest since the beginning of the current wave. The R measures the average number of people each carrier infects. The figure, released by the Health Ministry, reflects the situation of about two weeks prior to the day of release.

As long as the R is above 1, the disease is still spreading. When it descends below 1, it is receding.

For several weeks during the fourth wave, the number remained stable between 1.3 and 1.4.

Authorities decided to open the school year, taking some precautions – above all, requiring all children to take a test before the first day, but choosing to maintain the date of September 1 and full in-person classes – with the exception of classes in grades seven-12 in red cities where the vaccination rate does not reach 70%.

After education institutions reopened about three weeks ago in the ultra-Orthodox sector, cases spiked from 4% to 23% of morbidity in the country.

WHILE ALL health experts and officials seem to agree that Israel should expect a further increase in cases following the general reopening of schools, forecasts about how bad the situation can get vary.

“There is a reasonable possibility that despite the extensive scope of the third dose vaccination drive, the increase in the number of verified cases will continue,” the Coronavirus National Information and Knowledge Center wrote in its Wednesday report. “This increase in the number of infected may in turn also lead to an increase in serious morbidity and in the burden on the hospitalization system.”

The center warned that in the upcoming weeks, the authorities might be forced to close the education system again, at least partially.

“It is recommended to examine the effect of the opening of the school year during the coming month and to prepare an option for a significant reduction in activity, in accordance with the morbidity indices and, in particular. the severe morbidity,” the report reads.

However, according to Prof. Nadav Davidovitch, director of Ben-Gurion University of the Negev’s School of Public Health, a member of the expert committee advising the ministry on the crisis, the measures taken to limit the risks in conjunction with the progress with the vaccination campaign – both for the booster shots and for people who had never been inoculated – will be enough to keep the situation under control.

“The R rate has been going down, and we expect a further decrease by next week,” he said. “We expect there is going to be a 5% to 10% increase in the number of daily cases, but keeping schools closed would have had much worse consequences.”

He stressed the emotional and health costs of keeping children at home.

“We have to remember that even if they are not in school, children are still somewhere, and they can get infected and infect,” Davidovitch noted.

According to the expert, morbidity is possibly going to peak at around 12,000 to 13,000 cases per day. Before the positive effect of the third shot, as well as restrictions such as the Green Pass system were introduced, some experts suggested that daily cases could surpass 20,000.

Davidovitch said he believes the effect of the campaign will be enough to keep the number of serious patients under control, noting that in the past it had been predicted that Israel would have over 2,000 such patients by the beginning of September, which has not happened.

“We have to remember that the preparation to reopen schools comprised several steps – increasing vaccinations, including in schools themselves, tests and consulting with all relevant actors, such as parents, teachers and local municipalities, to find creative solutions,” he said. “In addition, from a public health perspective, choosing to keep schools closed would be much worse.”

According to Davidovitch, the significant rise in cases in the ultra-Orthodox sector cannot be attributed just to the beginning of the school year.

“The Delta variant arrived later there,” he said.

He acknowledged that by going to school, many children will likely be exposed to verified cases and therefore will be forced to enter isolation.

“But it is better to have a high number of children in quarantine than to keep all schools closed,” he said.

As of Tuesday, more than 38,000 students were infected and another 55,000 were in isolation. The number is expected to increase as a consequence of the new cases detected ahead of the first day of school. According to the Education Ministry, some 90% of the students were present on Wednesday.

ALSO ON Wednesday, public hospitals continued their protests over their prolonged financial crisis.

The hospitals had been working in “Shabbat mode” – accepting only patients who need emergency care – for a week. They added that they will shut down their operation rooms on Thursday.

“It is sad that it has already been a week, we have canceled thousands of patients’ appointments and surgeries, and the Finance and Health ministries have not found a way to keep the agreement with us,” Jerusalem’s Hadassah-University Medical Center Prof. Yoram Weiss said during a press conference in front of the Prime Minister’s Residence.

So-called public hospitals are independent organizations that rely mostly on donations, as opposed to facilities directly owned and funded by the state or the health funds.

They include Jerusalem’s Hadassah-University Medical Center and Shaare Zedek Medical Center, Ma’aynei Hayeshua Medical Center in Bnei Brak, Laniado Medical Center in Netanya and three small hospitals in Nazareth.

The hospitals said they have received only NIS 400 million of the NIS 630m. that was promised to them to cover expenses between January and June. An additional NIS 55m. per month they were supposed to receive in July and August has also not been forthcoming.

Health and finance officials have been vowing that the funds will be transferred soon, but so far to no avail.

According to the hospitals, they are not able to pay suppliers anymore, and have problems even in guaranteeing salaries to their employees.

During the protests, the hospital heads asked Bennett to intervene directly and announced they will set up a tent in front of his residence until the crisis is solved.

Later in the day, the government approved Bennett’s proposal to transfer NIS 55m. in grants to medical staff and healthcare workers on the front lines battling the COVID-19 pandemic.

In addition, Health Minister Nitzan Horowitz announced that the health funds will receive a NIS 60m. per month budget increase for four months in order to help fight the virus.

Maayan Hoffman contributed to this report.