Finally a politician admits what Israel’s COVID policy is really about

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On Tuesday night we finally witnessed a rare, pure moment of truth: “We’ve made a decision that wasn’t simple but strategic, to live alongside the coronavirus, with the understanding that there are vaccines. To accept serious cases of the disease and to also accept deaths, because this is a pandemic and in a pandemic people die,” Interior Minister Ayelet Shaked said, in an interview with Channel 13 News.

It’s too bad that Shaked hastened to apologize after her remarks drew criticism, because finally someone was looking the public straight in the eye and telling it the truth without trying to make it pretty. She was right. The government’s unwillingness to impose major restrictions, its decision to leave the economy almost totally open and Ben-Gurion Airport pretty open until recently, its determination to open the school year on September 1, even though this is expected to cause around 5,000 new cases among children per day – all this will mean a lot of seriously ill people and a lot of death.

How many exactly? We learned the government’s estimates on Wednesday. Based on the current infection coefficient, within a week there will be 1,200 patients hospitalized, half of them in serious condition; the following week this number will double, with 2,400 hospitalized and 1,200 seriously ill, and by September 10 we will see numbers we’ve never seen before – 4,800 hospitalized and 2,400 seriously ill. Of course, there will also be tens of thousands of other cases, ranging from the asymptomatic, through those mildly sick and who can wait out the illness at home, to those who might have a harder time and will need some support from their HMO.

Yamina lawmaker Ayelet Shaked in a press conference, May 2020. Ohad Zwigenberg

The government’s plan is to “accept” this extreme situation by adding 300 more slots for doctors, 1,500 more jobs for nurses, and 600 more paramedical workers, with help from 3,000 students and army paramedics. Moreover, around half of patients who require hospitalization, including those in serious condition, will remain at home, to be cared for by a family member and a nursing and medical team.

This plan raises a lot of questions about the quality of care the thousands of expected seriously ill patients will receive, about how exactly these new job slots will be filled, and what the level of medical training those providing care will have. It’s true that thousands of nurses will be finishing their training in the coming months, and there are quite a few doctors waiting for residencies who can fill these posts, but physicians and nurses with intensive care training are not exactly an off-the-shelf product, and nurses finishing school don’t acquire overnight the experience and skills to deal with seriously ill.

Regarding home hospitalization, Israel has relatively extensive experience with this, but not at a scope that is even close to the government’s plan. If the HMOs have taken on the task, they presumably don’t plan to fail, but with all due respect, the public ought to know that they have no real experience in dealing with such a huge operation. The ultra-Orthodox model, which apparently kept hundreds of Haredim at home with oxygen machines and private doctors who provided them with medication and occasional support, certainly eased hospital congestion during the third wave, but it was never examined for how effective it was in saving the patients’ own lives.

Then there’s the issue no one is talking about: the number of deaths. It’s almost impossible to accurately estimate how many deaths we will suffer under this model, partly because experience from previous waves, and especially from the third wave, showed that once the number of seriously ill patients increases, the quality of treatment is impaired and mortality increases. In addition, it is known that vaccinated people who become seriously ill survive in higher percentages than the unvaccinated, but nevertheless, if we make a conservative calculation based on the deaths among the seriously ill during the third wave (around 30 percent) and adjust this ratio slightly due to the vaccine advantage, we still end up at nearly 100 deaths a day, under the extreme scenario of 2,400 seriously ill patients. To compare, at the height of the third wave there were around 1,200 seriously ill patients, with some 170 new seriously ill patients a day and an average of 48 deaths per day.

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Let’s take a chance and assume that we will not get to that extreme scenario in the end. Long before we reach those catastrophic numbers of seriously ill cases and deaths, it’s likely that the public will change its behavior or the government will break and impose significant restrictions or a lockdown. Or perhaps a more optimistic scenario will come true, and the third dose will start to bear fruit. Combined with the huge accumulating number of those who’ve recovered from COVID-19, perhaps we will eventually see a downtrend in the number of new cases.

Either way, it’s important to give the public the full story: The State of Israel is embarking on an adventure that will take the lives of many people and cause damage to many others’ health, and is doing so rather recklessly. Ayelet Shaked was the only one who put it all out on the table.