Outrage as coronavirus committee debates lockdown: 'Critical hit to public health'

"Nothing will help. No plan and no model will help if everyone in the public decides for themselves what they do and what they do not do."

MAGEN DAVID ADOM workers, wearing protective clothing, bring a patient to the coronavirus unit at Sheba Medical Center in Ramat Gan (photo credit: FLASH90)
MAGEN DAVID ADOM workers, wearing protective clothing, bring a patient to the coronavirus unit at Sheba Medical Center in Ramat Gan
(photo credit: FLASH90)
Members of the coronavirus committee expressed outrage on Monday at the decision to implement a three-week lockdown starting Friday, claiming the lockdown would be a “critical hit to public health” and could be avoided by improving the healthcare system.
Knesset Coronavirus Committee Chair MK Yifat Shasha-Biton warned that a national lockdown will be a "critical hit" to public health, adding that medical experts were advising against a lockdown.
"I had many conversations with hospital administrators. Quite a few of them went out to the media in recent days and said unequivocally that they oppose the closure," said Shasha-Biton. "It is true that there are hospitals that have congestion but are not yet in failure."
"I will never argue with any profession in the medical field, but from the data and information that I've gotten from senior doctors and hospital administrators are saying not only to us but outside as well that there cannot be a lockdown," added Shasha-Biton. "A lockdown is a critical hit to public health. There were those who said that no decision or consideration of health was behind the lockdown decision."
The committee chair also expressed concern about the lack of clarity concerning an exit strategy from the lockdown.
Deputy Director-General of the Health Ministry Prof. Itamar Grotto stressed that while the data is not 100% precise, it is accurate enough to see what is happening, adding that the number of deaths due to the virus is likely higher than recorded due to the uncertainty surrounding the behavior of the virus.
Shasha-Biton responded that she was not referring to marginal data, citing a statistic that 23% out of 30 patients who died in one of the largest hospitals in Israel definitely did not die due to the coronavirus.
"I do not know such a figure and I vehemently deny it," replied Grotto. "I'm not ready to continue the conversation. I'm not willing for you to bring me such a statistic. Tell me the name of a hospital director who said this nonsense."
Shasha-Biton and other members of the committee questioned how it was being decided who died from the virus and not from background issues and if the data on the matter was actually accurate. 
 
MK Yulia Malinovsky added that a 19-year-old who died in a car accident had been recorded as a death due to the coronavirus.
"There was one like this. Is that a reason to say it's all a conspiracy?" replied Meretz MK Tamar Zandberg.
Zandberg stressed that patients of the health system "are entitled to treatment even if they are about to die in two months. We do not want to get into a situation where the health care system will start triage."
"In Italy at what stage do you choose whom to give treatment to? Where do we place the line?" added Zandberg, stressing that the issue with the virus is that it's causing a wave of patients to hit hospitals all at once and at that point it doesn't matter what the patient dies of.
Dr. Sharon Alroy-Preis, head of public health at the Health Ministry, told the committee that the red flag had been raised for a variety of different reasons, including the number of serious cases, deaths, testing capabilities and the situation in hospitals.
"If two weeks ago there were 20 red cities and today there are over 70 [red] cities and 97% of the cities in the country are in the doubling rate above 1, this means that the epidemic is still growing," said Alroy-Preis. "We are looking at the whole picture and it is complicated."
"We see that a large number of young people are in serious condition. Medical staff in the coronavirus wards are exhausted and tired. People can not survive in the corona ward for more than two hours.  It is difficult and complex treatment. Some of these teams go into quarantine," added Alroy-Preis.
According to data provided to the committee by Alroy-Preis, a majority of those who have died due to the virus are over the age of 80, although a noticeable portion is under the age of 60. Some 30% of the patients in serious condition are under the age of 60 and 45% are under the age of 70.
On Sunday, some 3,182 new cases of the coronavirus were reported, bringing the total number of cases since the beginning of the outbreak to 156,823, according to a mid-day update by the Health Ministry on Monday. Of those infected, 529 patients are in serious condition, with 135 patients on ventilators. The death toll rose to 1,126 overnight.
"Nothing will help. No plan and no model will help if everyone in the public decides for themselves what they do and what they do not do. Whether weddings of a thousand people or sitting in pubs without masks on top of each other or anything else," warned Alroy-Preis. "Neither [coronavirus commissioner Ronni] Gamzu nor [Health Minister Yuli] Edelstein knew how to beat coronavirus. We need the public to put on a mask and not be in crowds. We will leave the lockdown if the public is with us!"
Malinovsky replied that she was attempting to throw responsibility on the public. Shasha-Biton added that "without the public, we will not overcome this."
Alroy-Preis berated the coronavirus committee for questioning data, saying that it was lowering the public’s trust in the ministry. Shasha-Biton expressed outrage at Alroy-Preis, saying that holding the committee responsible was "removing responsibility from the system."
Alroy-Preis stressed that she and other Health Ministry officials did not have the stage that others had and asked the committee not to claim that they were making decisions without any data. "There are plenty of people who say that everything is fine and they are given a stage. It should be given in an equal way!" added Alroy-Preis.
Shasha-Biton and MK Meirav Michaeli questioned why the health system was not receiving more manpower and resources, instead of implementing a lockdown.
"For years we have been shouting on every stage that the health care system is collapsing. Now as part of the usual accusations in this government, the finance minister says that billions [of shekel] were received for the health system. Where are these billions and why are they not reflected both in manpower and in the indemnification of these teams?" asked Michaeli.
Dr. Vered Ezra, head of Medical Management at the Health Ministry, replied that the overall good results that the healthcare system has had during the pandemic has been due to skilled teams treating patients and that recruiting less skilled staff would lower the quality of care.
Prof. Zvika Granot from the Hebrew University warned the committee that the country would exit the lockdown in the same point that it started it, as the country's healthcare system is seriously lacking.
"How can we stand in front of the public and say that we have been dealing with the coronavirus for seven months and that Hadassah has only 90 beds?" said Granot. "You can not tell the public that it is their fault that they gathered, this was not conducted properly. The price of quarantine will be in human life."
Granot stressed that for the price of the last lockdown, Israel could have built 50 hospitals with 300 beds each.
"The question that is being asked is why a lockdown and not a strengthening of the health care system? Why not strengthen and reward the teams that worked for a very long time and were eroded?" asked Shasha-Biton. "The second thing I want to know is what the exit strategy is for the day after the lockdown."
The committee chair added that for NIS 3 billion, the healthcare system could be provided with safety net. "We want to know how many new beds have been added to the system for the various departments. How many doctors and nurses were actually absorbed and most importantly the number of devices added to the system."
A representative of the Finance Ministry provided the committee with an estimate that the upcoming lockdown will cost the country NIS 6.5 billion.
Director-generals from multiple hospitals around the country told Channel 12 on Monday that they had not expressed opposition to a lockdown, despite reports that they had done so during a cabinet meeting on Sunday. "They distorted the things we said, we did not object to the lockdown."
The director-generals stressed that while the hospitals are still functioning and have not collapsed, measures must be taken to prevent an overloading of the health system and the deterioration of general care.
Prof. Masad Barhoum, the administrator of the Galilee Medical Center in Nahariya, ordered the hospital to stop receiving any more coronavirus patients due to overcrowding in the coronavirus wards and intensive care units.
Some 85 coronavirus patients are hospitalized at the hospital, with 30 patients in serious condition.
"The amount of skilled staff that is currently available to me and can treat severe corona patients is extremely small. There is no reason for me to treat critically ill and respiratory patients by unskilled staff, if I can move them to the center of the country."
While the hospital is currently not transferring any patients, it is no longer able to take in any additional coronavirus patients. The three coronavirus wards at the hospital are at 90% capacity.