The 2 keys why Israel, example in pandemic management, fails to reduce COVID-19 cases

Israel is an example of handling the COVID-19 pandemic for being a leader with its vaccination plan, but in recent weeks it has been subjected to a paradox: the exponential increase in cases. Despite this, the number of serious patients or deaths is contained.

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.. By February, at least 50% of its population had received a dose of the Pfizer vaccine, used in that country, and quickly moved towards inoculation of second doses, as cases remained low.

But in July there was a turnaround and infections started to increase until the beginning of this month, up to 11,000 daily infections were reported.. To stop this spread, the health authorities decided to apply a booster dose: it was initially intended for people over 60 years old, but it was gradually extended up to On August 29, all over 12s were called in for a third dose.

Why have the cases of the disease increased so much, if you have a significant proportion of the population vaccinated with the full schedule? How is the country coping with the regrowth of the predominant appearance of the Delta variant?

The peak in infections occurred in the week of September 4, according to figures from 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.

“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,” said Eyal Leshem, professor specializing in infectious diseases at the Tel Ha-Shomer Sheba Medical Center.

Israel recently led childhood immunizations and implemented the Pfizer / BioNTech booster vaccine after research suggested that the effectiveness worsened 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, from 1,183 in mid-January. The trend is now down.

But the numbers have declined in recent days. Yesterday, September 19, they were registered in the country 7,732 infections and last week’s average was 7,982 new patients. In Israel, they had been recorded since the start of the pandemic 1,221,713 infections and 7,511 deaths linked to the new coronavirus.

Since April, Israel has fallen from first place to 33 in Bloomberg’s Vaccine Tracker for populations considered fully vaccinated. The program stagnated amid doubts from some Orthodox and Arab Jewish communities. About 61% of Israelis have received two doses, a lower figure than European countries lagging behind a few months ago, such as France and Spain.

Israeli health authorities are 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, September 6-8, and Yom Kippur. , which was celebrated on the 15th and 16th of this month.

Levels of the vaccinated population

Much of the problem in Israel has been vaccination coverage said Micheal Head, global health researcher at the University of Southampton in England. After its quick start, the vaccination program has slowed downHead noted in an article on The Conversation site.

Around 30% of people in Israel remain unvaccinated, making some 2.7 million people susceptible to infection. This happens when the super contagious Delta variant is raging.

“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,” Head said. “For example, there is evidence that acceptance is lower among Arab and ultra-Orthodox Jewish groups.”

The proportion of the population who received a dose fell from 50% in February to just 68% in September. Children aged 12 to 15 have been included in the launch since June 2021.

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 infection, although it is still very effective against serious diseases.

Professor Eran Segal, who advises the Israeli government on issues related to COVID-19, noted 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 remains prevents a large number of serious cases. The unvaccinated become seriously ill with COVID-19 about nine times more than those vaccinated among those over 60, and twice as many among younger people, Schraer said.

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

“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.

Restrictions

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

As he said last July, the Asher Salmon, Director of the Department of International Relations at the Israeli Ministry of Health, Israel “may have 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 easily be sustained when national policy encourages mixing of susceptible 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.

Third dose

Israel has responded to the recent increase in the number of cases by implementing a reminder 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 wave,” said 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, in early September, only 5.4% of the population of the African continent had received at least one dose of a COVID-19 vaccine.

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 also not known what immunity time a booster can grant.

Scientists have speculated that repeated exposure to COVID-19 infection, along with the vaccine’s protection and natural immunity against past infections that make it less risky, could convert to the virus over time. time. in a potentially recurrent but relatively discreet disease. Others, however, fear that this will come at a high cost, as serious infections can still affect the most vulnerable and many consequences of 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 restrictions are relaxed too quickly,” he added. “This shows that all countries, regardless of their current immunization status, must maintain longer-term plans on how to minimize the impact of COVID-19, during this current pandemic and in the event of minor outbreaks around the world. ‘to come up. “

KEEP READING