Since my previous opinion piece on the new coronavirus epidemic, there have been significant developments in the global picture, the policies implemented by Israel and the economic and societal implications of these policies, which require a fresh approach to address what the future may bring. It’s important to note that Israel’s current policy is more extreme than that of most developed nations, including those that have been harder hit by the disease.
The following are the key new findings and observations in Israel and around the world:
- The mortality rate from COVID-19 is clearly connected to age and preexisting conditions. This was found first in China and then in Italy, which was hit later but no less severely. In both these countries, the death rate from the new coronavirus for the general population under age 60 is less than 1 percent and very close to the mortality rate from “ordinary” seasonal flu (according to data published on JAMA Network).
- The transmission rates for the novel coronavirus in the general population of most affected countries are either unknown or the figures are inaccurate because there has not been widespread testing and most of the people tested already went to the hospital with symptoms.
- A significant but unknown percentage of people who were tested have no symptoms. The published infection rates do not reflect this fact, which of course distorts the mortality rate. The situation is less serious than the statistics suggest.
- An infected person can transmit the coronavirus to other people, mainly through coughs and sneezes, for an average period of seven days that can in some cases even exceed 21 days. So far, however, tests for the virus have not been conducted on such individuals throughout the duration of the isolation period.
- Restricting travel by Israelis to major European countries and requiring people returning from these countries to self-quarantine has already caused enormous economic damage, particularly to tourism and airlines.
- In light of the rise in the number of infections in additional countries including the United States, the Health Ministry and the prime minister are considering banning the entry of travelers from the United States as well.
- The main message that the Health Ministry is conveying is negative: what not to do and how to guarantee the isolation of the suspects.
The Health Ministry is currently focusing on containing the coronavirus outbreak, using all means possible to keep the virus out of the country by refusing entry or isolating anyone coming from a country where the disease has appeared. According to this approach, any price is worth paying if it can save us from the “catastrophe” that would follow if we let the virus enter.
Is there an alternative approach to fighting the disease right now? Yes. It’s called mitigation. It involves using less drastic methods that are likely to yield similar results regarding the damage caused by the virus but that significantly reduce the negative social and economic consequences of containment.
This approach recognizes that because the free countries of the world don’t operate according to the centralized and totalitarian Chinese model, they can’t be closed to all traffic except in the case of a widespread existential danger, a danger not posed by COVID-19. Free countries must first do everything possible to isolate the sources of infection without taking drastic measures. This is the policy that most countries, including the United States, have employed.
What then should Israel do at this stage? For now, tightening the restrictions on entry and exit should be avoided. Testing for the virus should be increased significantly, starting with the people in home quarantine and continuing to the general population.
That will help determine how long the isolation period should be and could provide more precise information on the extent of the virus’ spread in Israel. The content, form and subtext of the communication with the public must be changed; the message should be that most of us don’t face mortal danger, though older people and people in institutions should receive clear instructions.
In addition, all available information about the virus and how to live with it should be shared with the public. Every effort should be made to avoid closing schools, workplaces and places of entertainment. All means possible should be used to prepare for a possible increase in the number of people needing respiratory intensive care.
The coronavirus, too, shall pass, and until it does the damage should be minimized as far as is possible. We must accept the possibility that it won’t be the last viral epidemic and that it’s important to find the optimal way to cope with such epidemics, at a reasonable cost.
Prof. Zvi Bentwich is the director of Ben-Gurion University of the Negev’s Center for Emerging Diseases, Tropical Diseases and AIDS.
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