Analysis, guidance, some pleading: How an Arab Israeli city is crushing COVID-19
In early September, municipality officials in Kafr Qasim realized they had a crisis on their hands: in only a few weeks, the coronavirus pandemic in their city had spiraled out of control.
“We had days where we watched 50% of tests in the city come back positive,” said Kafr Qasim mayor Adil Badir.
With a population of around 25,000, Kafr Qasim lies east of Tel Aviv just inside the Green Line separating Israel and the West Bank. While the first wave of coronavirus in Israel had spared Kafr Qasim, the city was facing 170 coronavirus infections per 10,000 residents, the second-highest rate in the country.
“Looking back, we saw that several large weddings had made us not just a red city, but an exceptionally red city,” said city manager Eyal Kuntz. “That’s all it took.”
Kuntz is a rarity in Israel: a Jewish city manager of a major Arab municipality. He spent years working for Injaz, a nonprofit which supports Arab local governance, before becoming city manager of Kafr Qasim.
Kafr Qasim was far from alone: Before Israel’s second lockdown came into force almost a month ago, Arab citizens of Israel, one-fifth of the country’s population, constituted around 30% of Israel’s cases — the most significant sector for contagion along with the ultra-Orthodox.
Mass weddings, traditionally held in summer, were often blamed as the source of the outbreak in the Arab sector. “There is no doubt that mass gatherings and weddings had an enormous impact on the Arab sector. For us, weddings can be seven, or even ten day affairs, with thousands of attendees,” said Dr. Fahd Hakim, the director of the English Hospital in Nazareth.
“We were on the brink of disaster. We saw our medical staff entering quarantine in huge numbers,” Hakim concluded.
But over the past month, the proportion of infections among Arab Israelis has now dwindled to around 10% and continues to fall, according to deputy coronavirus czar Ayman Seif.
How did Kafr Qasim do it?
Municipality officials attribute Kafr Qasim’s success in flattening the curve to a number of factors, including a campaign in local media and close collaboration with national authorities. The municipality also acted fast, closing its schools even before the September lockdown mandated it.
One of the most important projects, however, was a concerted effort to track and isolate those exposed to the virus. As the number of cases shot up in late August and early September, municipality officials understood that they were missing a crucial piece of the puzzle: Who needed to quarantine?
Local authorities receive lists of those confirmed to be infected with the coronavirus from the Health Ministry, but there is no breakdown by city of those potentially exposed, Kuntz said. This makes breaking the chain of infection difficult — especially when combined with what Kuntz called a lack of compliance with national orders to quarantine.
“Across the country, not just in Kafr Qasim, there was a lack of compliance with quarantine restrictions. Those who were asked to enter quarantine by some text [sent to their cellphones] by the Shin Bet security service often did not pay attention to it at all, and those who did often wouldn’t quarantine properly at home and infected members of their family,” Kuntz said.
In a sense, Kuntz and his team built a makeshift contact tracing system in Kafr Qasim. And each day, when the municipality received word from the Health Ministry about dozens of new infections, it kicked into gear.
“From the first day, sometimes from the first hour, that we knew that they had the virus, we identified and contacted their immediate circles, and then those with two and three degrees of separation to inform them that they’d be in contact with an infected person,” said Badir.
Kuntz’s team conducted hundreds of phone calls, providing guidance and follow-up on quarantine and testing. Kuntz credits collaboration with the Home Front Command — who provided technical assistance and manpower — as crucial to the project’s success.
“We conducted our own analyses, based on our familiarity with the residents and their families, to create a database on who needed to quarantine. Then we called and warned them that they should enter isolation and urged them to get tested,” Kuntz said.
The local effort paid off, with residents demonstrably persuaded that heeding the advice of the local leadership was in their vital interest. As of Sunday evening, Kafr Qasim had only 21 infections per 10,000 residents, and just 19 infections recorded in the last 7 days. And it’s not because local authorities aren’t testing: the rate of tests coming back positive is around 5 percent, slightly better than the national average.
“At this point, half of the city has been tested,” Kuntz said.
Kafr Qasim’s method of quashing the coronavirus has drawn praise from figures across the political spectrum. Right-wing politician Naftali Bennett — not known for his close ties with Arab Israeli communities — commended Kafr Qasim’s success in a post on his Twitter account.
‘Give us the tools’
After a summer of deadly weddings, many Arab Israelis entered lockdown a week before many others in the country. All of coronavirus czar Ronnie Gamzu’s forty so-called “red cities” with high infection rates, which his plan placed under a nightly curfew, were Arab or Ultra-Orthodox.
Gamzu’s “traffic light plan” — so-called because it would have applied different types of restrictions in areas designated red, yellow, and green depending on their levels of coronavirus infection — was denounced by many Ultra-Orthodox mayors.
“We will not forget who, time and again, signed onto turning us into disease vectors and enemies of the people through selective punishment of tens of thousands of families in the Haredi community,” the mayors of four prominent Haredi cities — Bnei Brak, Modi’in Illit, Elad, and Emmanuel wrote in a letter to Prime Minister Netanyahu.
Most Arab municipal leaders — including Badir — sent a different message: give us the tools we need to curb the infection in our communities.
“The numbers speak for themselves. There is no escaping a lockdown. It hurts me to say, but it’s the truth,” Umm al-Fahm mayor Samir Mahameed said at the time.
Badir and Kafr Qasim’s city council publicly announced that they were boycotting weddings and told city residents to do the same. Druze local council leader Wajih Suleiman informed his constituents that he would watch his daughter’s wedding over Zoom, saying that he could not in good conscience attend in person.
“This was more than ‘we’re not going.’ This was ‘we’re boycotting these events.’ There’s a difference. Boycotting the weddings signaled to people how horribly destructive these events are,” said Sayyed Abdel Wahed Issa, who directs the Kafr Qasim Popular Committee, a coalition of local activists and nonprofits.
According to Issa, the Popular Committee and the municipality would personally call residents who they heard were holding weddings to speak to them about restrictions and warn them about the consequences.
The results are reflected in a steep reduction in infection: heading into partial lockdown on September 6, the central Arab city of Al-Tira had 204 infections for every 10,000 residents, the highest in the country. As of early October, it has 38 infections for every 10,000 residents.
As for the four Haredi cities whose mayors opposed restrictions so fiercely back in September? Their numbers have spiked dramatically: 23% of coronavirus tests on average have come back positive over the past week in those cities. Overall, positive tests in the ultra-Orthodox sector are running at about three times the national average.
A need for caution
The stark contrast can be attributed in part to the major Arab wedding season ending even as the Jewish holidays began. The number of tests among Israeli Arabs has been falling as well, meaning that numerous cases of coronavirus could be hiding in the community.
“The number of tests issued in the Arab sector has dropped drastically. If just last month we saw 50,000, 60,000 tests per week, now we’re seeing less than half that — around 23,000 per week,” said Ahmad al-Sheikh, director of The Galilee Society, the largest Arab Israeli nonprofit focused on providing health services in the country.
Al-Sheikh emphasized out that despite the overall decline, the scattered collection of northern Arab towns – such as the Druze villages of Majd al-Krum and Deir al-Asad – were still experiencing relatively serious outbreaks.
“We ought to be somewhat careful, because it is still not entirely clear whether the decline we’re seeing is due to the drop in testing or to a real end to the spread of the virus,” hospital director Hakim cautioned.
But despite the drop in testing, even former virus hotspots in the Arab sector are seeing a far lower rate of positive tests — a key indicator of whether or not the virus is spreading undetected. According to Seif, at the peak of the second wave around 15-16% of Arab Israelis tested were deemed to have the virus. That number has dropped to around 7%, slightly better than the national average.
The costs of locking down
Despite the apparent success of the lockdown, both in Kafr Qasim and elsewhere, Arab Israelis have paid a heavy economic price. Arab Israelis work disproportionately in the service industry, few of which are considered essential businesses; many others own small businesses and are thus obligated to pay their own way through furlough.
Recent high school graduates suddenly thrust into unemployment are trapped in a vacuum. Israeli unemployment insurance starts at the age of 20, when many Jewish Israelis begin to leave the army. Arab Israelis between the ages of 18 and 20, most of whom do not serve in the Israeli army, are out of luck.
In Kfar Qasim — as in many other Arab “red cities” — businesses deemed not to be essential entered lockdown a week before other places in the country.
“Our businesses were already feeling the pain before the rest of the country,” said Issa. “Moreover, customers from outside were scared to come, because we’d been labeled a ‘red city’ and were worried about coronavirus, even before the nightly curfew began.”
For Nur Sarsour, who owns a small clothing store in Kafr Qasim, the only bright spot in the past few months was the holiday of Ramadan in July, when many Muslims buy each other clothing as holiday gifts.
“God had mercy on us with the holidays. Nobody was traveling – not abroad, not to the West Bank. People stayed home and bought everything from inside the town. It compensated us for some of our losses,” Sarsour said.
The lockdown since has wiped out much of what Sarsour managed to save; he told The Times of Israel that he supports the restrictions but worries about the future of his business.
“Lots of businesses have closed. I know people who have been forced to go to the black market and take out loans. They’ll have to pay up in two months or so. What are they going to pay it back with?” Sarsour asked rhetorically.
Both Badir and Kuntz emphasized that Kafr Qasim is ready to slowly leave lockdown and begin reopening the economy – even if parts of the rest of the country are not.
“I absolutely support a differential lockdown. The incentive for citizens in a general lockdown is far lower. [It would be far better] if I can tell the residents, ‘if you follow the rules, we can open up the economy; if you follow the rules, there will be school. If you don’t, we’ll be a red city and everything will close,’” Kuntz said.