Is Israel draining bathtub with a running tap when it comes to COVID-19?

There is no reason to believe that the outbreak won’t come back, experts said. In other words, the coronavirus crisis is not over.

By MAAYAN JAFFE-HOFFMAN
Shops begin to open in Jerusalem's Mahane Yehuda Market. (photo credit: MARC ISRAEL SELLEM)
Shops begin to open in Jerusalem's Mahane Yehuda Market.
(photo credit: MARC ISRAEL SELLEM)
This is our moment of truth on whether Israel has a good exit strategy from COVID-19 or if it can even safely bring people out of lockdown.
“Our exit strategy is basically a hodgepodge of makeshift patches based on estimates emanating from partial testing and gut feelings,” Tel Aviv University Prof. Dan Ben-David, president and founder, Shoresh Institution for Socioeconomic Research told The Jerusalem Post. 
There is no reason to believe the outbreak won’t come back, experts said. In other words, the coronavirus crisis is not over.
“The outbreak is highly contagious, and if you don’t do anything to stop it, it will come back and create even more sick and dying people,” said MIT-trained physicist Yaneer Bar-Yam, born in the US to Israeli parents. “Whatever you do has consequences.”
There are those who claim the low death toll is proof that the country’s policy failed, given the huge cost to the economy. Others maintain the lockdown ended too quickly as a result of political and economic pressure, and the result will be seen in the death toll.
The Israeli public has gone above and beyond: suffering through mixed messages such as wear a mask or don’t; spending days metaphorically chained inside; facing fines for venturing more than 100 meters from home.
Shoppers lined up outside IKEA while police swarmed a Tel Aviv surfer who refused to leave the water. Academicians – including Amnon Shashua, the man who developed the driverless-technology firm Mobileye and then sold it to Intel for $15.3 billion – went head to head with the Health Ministry, while the country sat dumbfounded in the middle.
This suffering is worth nothing if Israel is back to where it started in two weeks, and there is little reason to believe it won’t be.
The government opened up the economy without a functioning and efficient testing system, a quick isolation system, effective data analysis and absent guidelines based on statistics and not hunches.
“Israel is clearly still a red zone altogether,” Bar-Yam told the Post. “The fact that they know the hottest spots does not mean the rest of the country is free of cases. You have to be really clear about where you don’t have cases and about controlling boundaries between those that do and don’t. Yet they have relaxed restrictions. We are in real trouble.”
The only way to solve the problem, according to Ben-David and Bar-Yam: immediately step up testing, as Prime Minister Benjamin Netanyahu and Health Ministry director-general Moshe Bar Siman Tov promised.
Bar-Yam said these tests can include molecular (PCR) ones, which Israel currently conducts, and also CT scans, improved symptomatic screening or others.
“In the first stage, it’s possible to utilize serological tests to identify who among all of the healthy persons in Israel has already been exposed to the virus and developed antibodies against it,” Ben-David said. He admitted that this is not a perfect, danger-free route. “Alongside the need for serological tests, there is a need to immediately identify everyone in Israel who is sick and to quarantine them – only them – in a surgical manner without quarantining entire towns or communities,” he said. “This necessitates the administration of PCR tests, with results available within hours, to every single person in Israel.”
PCR tests can render false negatives up to 30% of the time,” Ben-David said. As such, he recommended administering two or three separate tests in every sitting to considerably reduce the likelihood of releasing sick people to the street. 
Similarly, every individual arriving in Israel from abroad must undergo the procedures described above immediately upon entry, which would make it possible to quarantine only the infected arrivals and to release the remainder to their destinations within hours.
“The considerable expense that so many tests will cost is dwarfed by the huge economic toll to the entire economy from a non-return to full activity,” he said.
There is a chance the virus will naturally peter out. Some scientists have predicted that this coronavirus’s life cycle is around six to eight weeks, with its peak appearing after about two to four weeks from the time when incidents begin to occur at a substantial rate.
But that does not mean Israel is safe, Ben-David said. It is more like a ceasefire.
“This is not the end of the war – just a ceasefire,” he said, noting that there will likely be a second wave of COVID-19 by fall or winter, and it might be worse than the first time. 
“The various exit strategies from the coronavirus pandemic currently being considered in Israel focus primarily on symptomatic solutions aimed at flattening the infection curve alongside a minimization of the economic damage to the extent possible,” Ben-David said. “These solutions do not prepare for the possibility that while development of vaccines takes at least a year, there may be additional, potentially much worse, waves of the pandemic in the coming year.”
The Spanish Flu broke out in three main waves, he said: The first began in the spring of 1918 and faded toward summer; the second (and most fatal) was in the fall; and the third lasted through the spring and summer of 1919.
Armies use a ceasefire to prepare for the next escalation, and that is what Ben-David said Israel should do via a three-pronged approach: Stockpile testing kits, train lab technicians and promote a coronavirus chief.
There are two primary obstacles inhibiting massive testing: a lack of material and skilled lab technicians to conduct the tests, he said.
“Within Israel are sufficient know-how and improvisational skills to attain the ability to domestically produce all reagents not obtainable abroad,” Ben-David said. “The number of lab technicians can be resolved by calling up – just as the State of Israel calls up its reserves when war breaks out – the many Israelis with serious backgrounds in medicine/biology.  These individuals can be quickly trained to become temporary lab technicians during the next crisis.”
The ability to measure, evaluate and administrate effectively are not among the stronger attributes of Israeli bureaucracy, he said, adding: “One need only look at how the health, education and welfare systems are run in normal times to understand how severely mismanaged they are.”
A coronavirus chief – and it cannot be Netanyahu – is essential to help delineate a clear game plan, as any country should have in the time of an emergency, Ben-David said.
Israel’s small size and physical isolation internationally are hurdles that can turn into huge advantages when it comes to combating a deadly pandemic, he said. In addition, the lack of open and unhindered passage across Israel’s borders provides the country with conditions that other countries could only dream about in this period of crisis.
“Israel has the potential to remove this threat from seriously endangering its citizens while enabling its economy to return to near normalcy, taking into consideration that many of the country’s primary trading partners may not be as fortunate, with some of the economic damage inflicted upon them washing ashore on Israel’s economy,” Ben-David said. “This is an historic opportunity for Israel to not only deal with the immediate effects of the coronavirus, but to also implement measures with far-reaching positive socioeconomic effects on the country’s future.”
Bar-Yam said: “Maintain forward progress by preventing backward retreat. Otherwise, you will have a never-ending cycle of coronavirus. It’s like draining a bathtub with a running tap.”