Experts reveal what Israel must do in order to avoid a fifth COVID wave this winter

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With all the metrics suggesting that Israel’s fourth coronavirus wave is receding, Haaretz asked a group of COVID-19 experts what needs to be done in order to avoid a fifth wave this winter.

They all stressed that, despite the encouraging trends of the last few weeks, it is still too early to celebrate and declare victory. That’s one major lesson Israel learned the hard way from the fourth wave.

At the start of the summer, COVID-19 infections had reached a record low and the government lifted most restrictions. Israelis celebrated what they thought was the end of the pandemic. But the arrival of the delta variant in July and the waning effectiveness of the Pfizer vaccine triggered a fourth wave – and the return of mask-wearing, remote working and social distancing.

“The main mistake we did between April and July was to celebrate the end of COVID because we had high vaccination rates, and we now understand that we’re not going to eradicate COVID,” said Prof. Nadav Davidovitch, director of the School of Public Health at Ben-Gurion University of the Desert, Be’er Sheva, and head of the Israeli Association of Public Health Physicians.

Davidovitch said that, going forward, it will be important for the government not to become complacent as it did after the third wave dissipated.

“In order to prepare for a possible next wave, especially during the winter, we must continue with vaccinating the population, including in hard-to-get places,” he said.

“We need to continue with the Green Pass, and we need to strengthen the health care system as much as we can,” he added, referring to the COVID vaccination certificate that grants Israelis access to public spaces.

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Rivka Abulafia-Lapid, a virologist at Hebrew University, believes Israel made a mistake after the third wave by welcoming tourists back too soon, thus helping spread the delta variant. This time around, she said, more attention needs to be paid to the risk of variants arriving from abroad, as international travel is once more taking off around the world and tourists are set to return to Israel.

She also highlighted the importance of developing more vaccines that will target future COVID variants. The Pfizer vaccine used in Israel, she noted, only targets one protein on the virus, so more robust vaccines are necessary. “I guess in the future, like the flu, every year we will get a combination of two or three strains and get a injection of the vaccine,” she said.

Getting the message out

According to Prof. Eyal Leshem, director of the Center for Travel Medicine and Tropical Diseases at Sheba Medical Center, Israel’s early and rigorous vaccination drive was commendable, but further waves are still possible due to waning immunity and new variants.

Medics working on the coronavirus ward at Shaare Zedek Medical Center, Jerusalem, last week.Emil Salman

The mitigation of future waves, he said, will depend on monitoring both the vaccine’s effectiveness and the emergence of new variants. “We need to maximize our use of the interventions that are the most effective – mainly vaccines,” he said.

Like Davidovitch, Leshem also recommended increasing Israel’s hospital capacity and improving the messaging in the public health sector. This, they both stressed, is crucial in order to fight misinformation around vaccines.

In Israel, around 15 percent of the eligible population over the age of 12 is still unvaccinated, yet this group represents more than 75 percent of the country’s serious cases.

Diane Levin-Zamir, who heads the Department of Health Promotion at Clalit Health Services, also put an emphasis on communications.

“We all have to be advocates, to learn how to convey the message and how to listen to people who are worried about messages they’re getting from other sources,” Levin-Zamir said. She said masks are vital as long as the virus is still spreading around the world: “We have to make sure we are protecting ourselves and be vigilant.”

Members of the public walking in Jerusalem on Monday, with most still wearing masks.Ohad Zwigenberg

According to Prof. Hagai Levine, an epidemiologist at Hebrew University and until recently head of the Israeli Association of Public Health Physicians, Israel’s experts have to begin a “whole learning process and investigation for understanding how we can improve.”

He believes the largest gaps in Israel’s ability to handle public health emergencies are already known. These include insufficient hospital capacity and lackluster data infrastructure.

He said Israel must set up a permanent epidemiological unit at Ben-Gurion Airport and hire public health coordinators at schools, municipalities and other institutions. Often, data belonging to the country’s four major health maintenance organizations is “unavailable to the Health Ministry” and “we don’t have good-enough coordination of data” between various agencies, he warned. That’s one thing Israel must improve if it wants to avoid a fifth COVID wave, he said.