6 tips for DIY coronavirus management

I am. I wrote Who’s afraid of Corona in Israel? (aka Part 1) on February 23, 2020, well before our first lockdown and third election, and before our newly elected prime minister bragged about our admirable post-lockdown numbers, advising citizens to go out and “have fun, have a cup of coffee, a beer.” We did that and we are now leading most of the world in new COVID-19 cases and facing another economically-crushing “hermetic” lockdown.

I won’t bore you with the ugly details I outlined in Part 1 of how broken our healthcare system was going in and how politicized our response to the global pandemic that is now a national health and economics emergency on par with war could (DID!) become.

I have written on these pages frequently that this is a DIY country. More often than not, you have to manage emergencies like this in Israel yourself, with the help of friends and family. In the absence of adequate health education on the part of our government, we have to do that ourselves too. So here goes:

• Wear a mask for your sake — not mine — to ensure that you and yours have milder symptoms! There is mounting evidence that mask-wearing could reduce the symptoms of COVID-19 in those who wear them by reducing the virus load. Among others, Dr. Monica Gandhi, head of Zuckerberg SF General Hospital’s HIV Clinic and professor of medicine at UCSF, argues that this may explain why in countries where masks have been universally accepted for years — such as Taiwan, Thailand, South Korea, and Singapore — “They have all seen cases as they opened … but not deaths.”
• Note to the Under-the-Nose community: Wear your mask over your nose for your sake — not mine! Goblet and ciliated cells in your nose have high levels of the entry proteins that the COVID-19 virus uses to get into your other cells and make you sick and/or asymptomatic. Your insistence on wearing your mask under your nose could be key to our surging number of cases and our need for a lockdown that threatens your economy and mine — not only our health.
• Hospital beds in public health terms include a bed, equipment, and staff to treat the patients in them. We must refuse to settle for a government increase in the number of mattresses and four legs that we could get from Aminach or Bed Barn.
• Hospitals in Israel are already making use of basements and parking lots to manage the surge in coronavirus cases. The question is who will be treating those patients. The government argues that recertified medical staff, paramedics, and first responders who register to do so will handle the overflow.We must ask how long it will take to put these people in place. It takes an incredibly long time under normal circumstances to certify staff (months at best) and check their credentials.

  Will the called-up paramedics come from the ranks of those who are already treating COVID-19 patients inside ambulances waiting hours to be admitted to a hospital — from one parking lot to another at Haifa’s Rambam Medical Center?

  Will the Health Ministry provide these new and returning workers with “t’kanim” — job slots that make them or new- or almost-graduates new hires in our healthcare system? Maytal Yasur Beit-Or reported in our PM’s house rag Israel Hayom on Sept 21 that despite Health Minister Yuli Edelstein’s promise to add another 400 t’kanim for physicians after the nurses’ strike, the treasury included the 200 t’kanim added in its first addition for coronavirus to that new number. Moreover, the Knesset’s own Center for Information and Research reported a month ago that only 156 of those slots were filled. (My math comes out to some 156 of the 600 promised to date.)

  Unless we provide t’kanim now based on our new caseload — not the t’kanim we were promised and did not receive back in April — we will be in the same atrocious shape when this lockdown ends. Nurses and doctors are superheroes — but there is only so far you can stretch us before even we break down. And we have families too.

• The current lockdown will not buy us enough time to deploy a vaccine. But it can buy the government time to create the exit plan that was absent after the last lockdown and the IDF time to continue in its honorable task of implementing the efficient contact-tracing that we still lack.
• It is not my intention to scare anyone — least of all myself. Fear will get us nowhere. Our emergence from this virus relies in large part on our resilience — emotional, as well as physical. I have advised friends and family to spend their time in this lockdown designing their own exit plan from coronavirus. You and those with whom you are locked down should make personal exit plans as individuals and as a group. If, for no other reason, having and working your plan will shore up your emotional resilience and that of your loved ones (see, Israel is a DIY country!). I would love to see your personal exit plans on social media. My personal plan would include: Wear a mask, unite safely, and socially and distance physically for our sake!

Inspiration: “Whoever destroys a soul, it is considered as if he destroyed an entire world. And whoever saves a life of Israel, it is considered as if he saved an entire world.” (Mishnah Sanhedrin 4:5; Yerushalmi Talmud 4:9)