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Experienced doctors severely criticize the treatment of the recent measles epidemic by the Ministry of Health, saying it had waited months before acting, before doing so hesitantly, disorganized and deploying resources insufficient human resources.
This has created confusion and even panic among the public, they added.
"The penny did not lose it was an important event," said an infectious disease specialist. "The ministry should have realized this summer that we were facing an emergency and we needed to mobilize all the systems."
After several cases of measles during the summer have raised fears of an epidemic, he added, the ministry has been content to recommend vaccination to people traveling abroad.
>>All you need to know about the measles epidemic in Israel
Officials from the government's phone line, Kol Habriyut, said that they informed the ministry's chief executive, Moshe Bar Siman Tov, in 2017, that they had received many calls about measles, but he did not say anything about it. 39 did nothing with this information.
The ministry first acknowledged that there was a real problem only six months after the media started reporting the outbreak. The number of measles cases began to increase significantly in March and in August, 250 cases were diagnosed, about eight times more than in 2017.
In addition, many measles patients have been discovered on flights to and from Israel. But as noted, the ministry simply recommended that people get vaccinated before traveling to parts of Europe, where the outbreak began.
In October, there were nearly 700 known cases. The largest epidemics occurred in the ultra-Orthodox neighborhoods of Jerusalem, Beit Shemesh and Betar Ilit, due to overcrowding and vaccination rates of about 50%. Smaller epidemics have occurred in the north and settlements in the West Bank; dozens of cases have also been reported in Tel Aviv.
Last week, an 18-month-old infant in the ultra-orthodox Mea She'arim district of Jerusalem died of the disease – the first measles death in 15 years. To date, there have been more than 1,400 cases of measles, and doctors in Jerusalem hospitals have expressed fear of losing control.
"It's a scandal," said a senior official at one of Israel's leading health maintenance organizations about the ministry's conduct. "We are lucky that it is only measles and not another disease."
The ministry "has made every possible mistake in managing and explaining the crisis," he added. "What's happened in recent days is an attempt to hide that by working with the media to make them feel like they're doing something. But the result was panic. "
The management of the epidemic by the Ministry differs greatly from that of a polio outbreak in 2013-14 led by Professor Ronni Gamzu, then Director General. To combat the mistrust of the system of some communities and the influence of opponents of vaccination on social media, he personally met with opinion leaders from various communities, including rabbis and imams. As a result, 980,000 children were immunized against polio between August 2013 and January 2014 and this disease caused no injuries or death.
The difference in managing these two crises "is huge," said an experienced doctor. "The polio crisis was defined as an emergency at an early stage and it was managed by the mobilization and cooperation of many actors – doctors and experts, HMOs, local governments and others."
"There is a key leadership problem here," added a person involved in the treatment of several previous health crises. "I do not think the person who runs the ministry today can handle the response to such an event."
"This is both a professional crisis and a crisis of communication," he continued. "This requires a lot of knowledge and experience in both areas and requires active management … and a much more detailed level of information than exists today."
The crisis also revealed the poor state of Israel's public health services and its lack of preparedness for an emergency. In 2012, this service employed 1,227 nurses who administered vaccines and monitored epidemics by locating anyone exposed to a particular disease.
Today, however, their number has been reduced to 920, resulting in an expectation of vaccinations and follow-up visits. In addition, exams have become less extensive and less frequent.
Since the beginning of the measles epidemic, these nurses work 12 hours a day. This week, the ministry asked nursing students to help them.
"The 920 nurses are now all struggling with measles; all routine activities have been stopped, "said Moriah Ashkenazi, a leader of the nurses union. "The workload is so heavy that nurses can not collect information or send reports to the Ministry of Health in real time."
"We are seeing families whose children have never been vaccinated," she added. "We need to supplement not only their measles vaccines, but also other vaccines, with all their explanations, registers and instructions."
Ilana Cohen, who heads the nurses' union, said the epidemic had shown how neglected the public health service was. "There was no match between population growth and the number of nurses," she said. "We are missing at least 140 nursing positions in the public health unit."
The problem is compounded by the fact that no ministry official has communicated directly with the public or granted media interviews to explain the situation. And the wait time at the Kol Habriyut hotline is 10 minutes or so.
Parents said that they felt pressured, confused and angry. They feel that they lack information to cope with the crisis and have complained of lack of access to medical staff. The private line operators do not seem to know much, they added, and it is difficult to make appointments. In addition, the recommendations issued by the department are confusing.
A mother from Herzliya, for example, said she had been trying for three days to call her local vaccine provider to arrange a booster shot for her son, but no response had been given .
And when Haaretz tried to make an appointment for a recall reminder for an adult, he was told that the next available appointment at the Tel Aviv District Health Unit would be on February 11th.
Another problem is that the responsibility for vaccinations is shared between several agencies – district health offices, childcare clinics, companies engaged to provide health services to students, HMOs and clinics – depending on the age and condition of the patient.
"The first thing that stands out is the confusion and ignorance of people calling to ask questions," said a senior HMO official. "Even our hotline operators do not have all the answers."
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