The panel of health experts advising the government on policy in relation to Covid-19 met yesterday for the first time in two months. The halt in the panel’s meetings indicates that its members believed that the disease was under control in Israel, which was probably the case, until the Delta variant struck. Because of the upturn in the number of cases of Covid-19 in Israel, the wearing of masks in closed spaces was made mandatory again on Friday.
The panel considered allowing the disease to spread without restrictions, as would happen with other diseases. It was argued that the public would perceive the mortality rate as reasonable. The difference, however, is in morbidity that does not prove fatal, involving isolated and traumatic stays in hospital for tens of thousands of people, and an unknown level of risk of “long Covid” including among children and young people. The experts decided that this scenario could not be tolerated, especially in the light of the assessment that the process could be stopped through proportionate measures. The experts pointed out with relief that if in the end we are dragged into such a scenario, it will not be as terrible as was feared when the pandemic first struck (until the next variant arrives).
At the same time, it was decided that it was probably unrealistic to attempt to reach eradication again, as this would mean measures that the public was not at present prepared to accept, and because the process would be constantly disrupted through the Delta variant and new variants being brought into the country from overseas. The panel therefore chose a holding strategy, as in the past, with the aim of disrupting routine as little as possible.
In the measures that were recommended, the emphasis is on tightening control at Ben Gurion Airport, the main gateway into Israel; continuing the vaccination campaign; reducing morbidity among youths and children by moving as much activity as possible into the open air and ensuring maximum ventilation of closed spaces; and making tests accessible. Testing of sewage has recently been introduced, making it possible to identify outbreaks in new neighborhoods of which the residents may not yet be aware, and also to detect new variants.
Continuing the vaccination campaign, especially among those at high risk, was marked as the most important step. About 200,000 people in Israel over 50 have not yet been vaccinated at all, and another 700,000 have had Covid-19 and recovered from it; it is not known how far they are immune to the variant. There are also 450,000 people aged 20-50 who have not been vaccinated. The Ministry of Health is to carry out a public information campaign to explain that those who have not been vaccinated are again at substantial risk. The ministry will act to remove any logistical bottlenecks that may exist.
As far as teenagers are concerned, the panel said that parents should be informed that the risk of injury from the vaccine was one in ten thousand, which means that if all 12-15 year-olds in Israel are vaccinated, not more than 20-30 will experience inflammation, which with rare exceptions passes quickly and causes no long-term harm. This is as against the higher risk from Covid-19. The panel unequivocally supports vaccination for this age group.
As for the “green tag” certifying vaccination as a condition of entry to restaurants, concert halls and so on, the panel recommends not reinstating it at this stage. There was no agreement on what situation would trigger reintroduction, but it was agreed that the legal and logistical basis for it should be laid.
If on the other hand the moderate measures bring the disease under control, and outbreaks once more become localized, it will be possible to return to regard the situation as near-eradication, and to return to routine.
The experts sought to communicate two things to the Israeli public. One is that there is no cause for alarm. In a population largely vaccinated the risk of contracting the disease severely is low. The other is that if the variant becomes very widespread, even low probability phenomena will become more common, so that spreading the disease needs to be avoided. If the assessments of the Delta variant are correct, overcoming it should prove simpler in a vaccinated population than what was seen in the three previous waves.
The members of the panel of experts are: Prof. Ran Balicer (chairman), Chief Innovation Officer – Clalit Health Services; Prof. Nachman Ash, national coronavirus coordinator; Dr. Sharon Alroy-Preis, head of Public Health Services at the Ministry of Health; Prof. Arnon Afek, Associate Director General Director of Sheba Medical Center; Prof. Nadav Davidovitch, director of the School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev; Dr. Dror Dicker, head of the Department of Internal Medicine at the Rabin Medical Center; Yoram Hamou, formerly IDF head of technological intelligence; Dr. Boaz Lev, head of the government advisory committee for coronavirus vaccines; Dr. Adi Niv-Yagoda, an expert on health policy; Dr. Dorit Nitzan, a senior person in the World Health Organization; Dr. Ohad Kleiner, deputy head of Public Health Services in the Ministry of Health; and Prof. Galia Rahav, head of the Infectious Disease Unit and Laboratories at the Sheba Medical Center. Other participants in the current discussion were Dr. Noa Triki, head of the Medical Technology Policy Department at Maccabi Health Services; and the experts who built the morbidity forecasting model, Dr. Amit Huppert, head of the Biostatistics and Biomathematics Unit at the Gertner Institute for Epidemiology and Health Policy Research, and Nir Gavish, an associate professor and mathematical modelling expert at the Technion.
Published by Globes, Israel business news – en.globes.co.il – on June 27, 2021
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