Israeli health experts: This is not a ‘second wave’

Cyrille Cohen: Spike in infection not cause for alarm, is reason for caution

By MAAYAN JAFFE-HOFFMAN
People wear masks as they walk through the Nahalat Binyamin art market which was reopened, following a closure of several weeks due to the Coronavirus. June 2, 2020 (photo credit: MIRIAM ALSTER/FLASH90)
People wear masks as they walk through the Nahalat Binyamin art market which was reopened, following a closure of several weeks due to the Coronavirus. June 2, 2020
(photo credit: MIRIAM ALSTER/FLASH90)
Israel is not experiencing a second coronavirus wave because the first never ended, and the current rate of infection is not reason for alarm, according to senior health experts.
“This is still the first wave,” Assuta Ashdod Medical Center deputy director Dr. Hadar Marom said. “Until recently, Israel kept people at home, which allowed us to minimize the percentage of the population that got contaminated with the virus. However, when we started to mitigate the closure, we started to see that there are still people in our population who have the virus. Some of them are not sick, but they have the virus, and they can spread it to other people.”
As of Sunday morning, Israel had 2,440 active coronavirus cases, a number that has increased each day for about a week. But Assuta Medical Center chairman Prof. Shuki Shemer said he was not surprised by the spike because it is commensurate to the increased number of people screened for coronavirus each day.
“I bless newly appointed Health Minister Yuli Edelstein for changing the Health Ministry’s testing policy… of not doing too many coronavirus tests,” Shemer said, referring to a policy carried out by outgoing deputy director-general Moshe Bar Siman Tov in which only those people who were experiencing disease symptoms would be tested.
Now, among other changes, members of a verified patient’s family, even if they are asymptomatic, are checked on the same day as their family member is diagnosed and then again five days later. Moreover, people who are asymptomatic but have come in close contact with a known patient, whether in school or on a bus or train, are screened, among other changes.
“We are doing more tests, so we are going to find more carriers,” Shemer said.
It is important to pay attention to two statistics: the infection rate (the number of people who test positive out of those tested, which holds around 1%); and the type of people who are being diagnosed with the virus (mostly school children in this new peak), he said.
As of Sunday morning, there were 29 Israelis in serious condition, including 23 who were ventilated. Some 102 people were being treated in hospitals.
“If the infected people are older, that is a concern,” Shemer said. “If they are young people and they are not sick, just really carriers of the virus, it does not matter. Maybe this will even bring us herd immunity.”
In the case of COVID-19, herd immunity refers to a buildup of immunity in the population due to natural immunity.
“We are far away from incapacitating the health system that needs to treat these patients,” Shemer said.
But according to Marom, “We know there is not yet herd immunity, the population is still very sensitive to the virus,” and therefore to ensure that the current spike does not evolve into a crisis, there are a few steps that need to be taken.”
The first is that the Health Ministry needs to be proactive and fast, she said.
“Whenever we find someone contaminated with the virus, we need to do fast epidemiological research to find out who was in contact with them,” Marom said. “We need to test those people and isolate them to stop the possibility that these people will spread the virus to other people.”
This is a formula that Eli Waxman, a professor at the Weizmann Institute of Science, refers to as “test, trace, isolate.”
Moreover, Shemer said when the country does identify areas of high infection, it needs to label them red zones and consider placing restrictions on them so that the virus does not spread.
People need to adhere to the Health Ministry’s basic guidelines, they said.
“People thought that when the number of infected people every day went down to five or six a day that it was over,” added Cyrille Cohen, the head of the immunotherapy laboratory at Bar-Ilan University. But this is Israel’s greatest challenge in the fight against coronavirus today, he said.
“People were confined,” Cohen said. “They could not work, and the economic impact of that is a tragedy. People want it to be finished. But we see people in nightclubs, people not keeping the simplest measures that could really help us. It is not very encouraging.”
The three main recommendations for stopping coronavirus contamination are wear a mask, keep two meters between people and maintain good hygiene.
“Everyone is responsible for avoiding contamination,” Marom said. “With every step, we have to look to the future and remember that if not, we have 200 people sick. Some percentage of those will be in a bad situation in two weeks, maybe even ventilated. So we need to be very careful.”
Cohen said it does not take much to go back to a situation like the one less than two months ago, when hundreds of patients were diagnosed with the novel coronavirus each day, and several people died each day.
“We should not be alarmed, but we must be cautious,” he said.
Marom said we still do not know for sure why Israel’s infection rate was so low, but it likely is a combination of factors. Israel reacted quickly, it was able to easily close its borders, and the population is young, she said. Coronavirus tends to be more lethal for older adults. Scientists are beginning to explore whether there is a genetic connection to how COVID-19 impacts people, she added.
As such, Israel should not be too optimistic too fast, Marom said.
“We have to realize that coronavirus will be with us for many months ahead,” Shemer said. “We have to learn to live with coronavirus.”