Why Covid-19 cases are increasing in Israel and what lessons the pandemic is teaching the world

Israel, the world leader in COVID-19 vaccination, lives a paradoxical situation to which scientists approach the answers: Why have cases of the disease increased so much, if you have a significant proportion of the population vaccinated with the full regimen? Does increasing infections mean more deaths? How is the country coping with the regrowth of the predominant appearance of the Delta variant?

The small Middle Eastern country has become in recent weeks one of those with the highest number of people infected with COVID-19 as a proportion of its population. The climax in this regard occurred in the week of September 4, according to figures from the Johns Hopkins University.

Contrary to the trend of previous months, the vaccination rate, which was the best in the world, has fallen in the rankings.

The nation of 9 million people became the test for reopening society and the economy last April, as much of Europe and the United States remained in some form of lockdown. Now, It’s no longer just a question of whether people get the coronavirus, but also the severity of the contagion and ensuring that the vaccines keep working, at a time when the highly contagious Delta variant threatens to undermine the disease. immunity.

“If you can sustain life without confinement and avoid a very high number of hospitalizations and deaths, this is what life looks like with COVID,” Eyal Leshem noted, professor specializing in infectious diseases of Tel Ha-Shomer Sheba Medical Center.

Israel recently conducted vaccination in children and implemented the booster vaccine of Pfizer / BioNTech after that research suggested that the effectiveness declined over time. About 100,000 Israelis are vaccinated every day, the vast majority with a third dose.

By the end of February, Israeli health authorities had administered at least one dose to 50% of the population. The country had practically returned to normal life at the beginning of June. COVID-19 cases remained low and it appeared that vaccination had won the battle against SARS-CoV-2.

Following the spread of the Delta variant during the boreal summer, Israel saw the number of cases increase, reaching a record high of 11,316 daily cases on September 2. However, the number of people who fall seriously ill and are hospitalized has increased less than in the last wave of coronavirus, peaking at 751 at the end of August, compared to 1,183 in mid-January. The trend is now down.

The response of the Israeli authorities to the increase in cases has been a booster vaccination program that was initially offered to people over the age of 60, but has been extended to increasingly younger population groups. Thus, on August 29, vaccination was authorized for the general population, over 12 years of age.

But since April, Israel has dropped from first place to 33 Bloomberg Tracker Vaccine populations considered to be fully vaccinated. The program has stalled amid doubts within some Orthodox and Arab Jewish communities. About 61% of Israelis received two doses, a lower figure than European countries lagging behind a few months ago, such as France and Spain.

Israeli health authorities will be particularly vigilant following the reopening of schools on September 1 and family gatherings that took place this week on the occasion of the Jewish New Year. Rosh Hashanah.

A significant part of the problem in Israel has been immunization coverage, said Micheal Head, a global health researcher at the University of Southampton in England. After getting off to a rapid start, the vaccination program slowed down, Head noted in an article on The Conversation.

“There have been no clear disruptions in the vaccine supply, so factors such as reluctance or access to medical care may have been a problem,” the researcher said. “For example, there is evidence that acceptance is lower among Arab and ultra-Orthodox Jewish groups”.

The proportion of the population that received a dose increased from 50% in February to only 68% in September. Children aged 12 to 15 have been included in the deployment since June 2021. With around 30% of their population unvaccinated, Israel has an estimated 2.7 million people potentially susceptible to infection and disease, he added.

But even without these groups being vaccinated, a few months ago the level of coverage seemed to be sufficient to control cases. So what has changed?

The more infectious Delta variant appears to have escaped some of the vaccine’s protection against infections, although it remains very effective against serious illnesses.

Professor Éran Segal, who advises the Israeli government on issues related to COVID-19, pointed out that five or six months after the Pfizer vaccine, the only one that has been applied in Israel, people are probably only 30-40% protected, compared to over 90% when protection is first turned on.

“This is what drove the wave,” said Segal, a conclusion drawn from a careful analysis of infection rates among people vaccinated in different months.

Despite this decline, vaccination still prevents a large number of serious cases. The unvaccinated become seriously ill with COVID-19 about nine times more than those vaccinated in those over 60, and twice as many in younger people, Schraer said.

Head noted that, according to recent reports, nearly 60% of hospitalizations involve fully vaccinated people. However, these numbers do not necessarily mean that the vaccines have lost their effectiveness.

he.

“The same kind of trend has been seen in the UK, and this may simply reflect the fact that older people are more likely to be vaccinated and at the same time more susceptible to disease, factors which combine to swell cases of COVID -19 and deaths among those vaccinated, ”Head said.

For Head, another important factor is that Israel has ended its restrictions.

As Asher Salmon, director of the international relations department of the Israel Ministry of Health, said last July, Israel “Maybe he lifted the restrictions too soon”.

For Head, the case of Israel is “the latest in a long list of examples showing how community transmission can be easily maintained when national policy encourages mixing of sensitive people with few or no restrictions.”

The researcher cited the severity index of measures against COVID-19 created by Our world in data. This index measures the stringency of policies to contain the pandemic in each country in the world. As of August 28, 2021, Israel’s restriction score was 45.4, much less stringent than that of New Zealand (96.3), where outbreaks remain limited in scope.

Israel has responded to the recent increase in cases by implementing a strengthening program. First, a third dose was offered to people over 60, but the limit was gradually extended to younger people. On August 29, Israeli authorities announced that the third dose is available to anyone 12 years of age or older who received their second dose at least five months earlier.

The third dose “slows down the delta waveSaid Professor Segal. Dr Anat Ekka Zohar, who is leading the booster program study, said three doses were “highly protective, both against infection and against serious illness.” “The third dose is the solution to stop the current epidemic of infection,” he added.

Head explained that in those who receive a booster, the risk of a confirmed coronavirus infection seems to decrease 11 times compared to people who received two doses. However, the researcher warns, the study on this issue is still in a preliminary version, so its findings have not yet been formally reviewed.

The World Health Organization led the global debate generated by the decision of some countries to offer third doses, arguing that it is necessary first to extend vaccination to backward countries. For example, at the beginning of September, only 5.4% of the population from the African continent had received at least one dose of any vaccine against covid-19.

There is also a scientific debate around who should get booster doses and when to give them, as some believe it should be at a similar interval to the flu shot. It is not yet clear what immunity time a booster can grant.

Scientists have hypothesized that repeated exposure to COVID-19 infection, along with the vaccine’s protection and natural immunity against past infections that make it less risky, it could turn the virus into a potentially recurrent but relatively unobtrusive disease over time. Others, however, fear that this will come at a high cost, because serious infections can still affect the most vulnerable and many consequences of a prolonged Covid are unknown.

For Michael Head, the launch of the vaccine in Israel, in general, has been very successful. “But the country is also an example of what can happen when constraints are released too quickly“He added.” This shows that all countries, regardless of their current immunization status, they must maintain longer term plans on how to minimize the impact of COVID-19, during this current pandemic and with minor outbreaks in the future ”.

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