The healthcare system and the government expect the start of the decline of the fifth coronavirus wave, based on information from overseas. But even if these forecasts are correct, the peak of the wave is still ahead of us – and the next two weeks are expected to be very challenging.
In the coming week the omicron wave is expected to reach a peak, and in early February there should be a decline in the number of verified patients. The number of seriously ill patients is expected to increase accordingly, after a two-week delay, with a record number of about 1,500 in the hospitals in the first half of February.
Prof. Eran Segal of the Weizmann Institute estimates that in the coming days Israel may reach 800 to 1,000 seriously ill patients in the hospitals. The coronavirus monitoring team at Hebrew University gave a similar estimate.
The experts believe the infection figures will stabilize in early February. “The rate of infection in the coming week will be high, with almost 100,000 verified patients a day. A significant decline is expected only in the first week of February, due to the development of herd immunity,” said the Hebrew University team.
As of Sunday there were almost 2,000 COVID-19 patients in the hospitals, about 750 of them seriously ill and about 150 in critical condition. But unlike with previous waves, the number of seriously ill is not the only measure of the burden on the hospitals; it also stems from a serious shortage of personnel.
Israeli medical personnel treating coronavirus patients.Avishag Shaar-Yashuv
Almost 10,000 medical personnel are in isolation – either because they are verified carriers of the virus or because of exposure to it – including 1,379 doctors and 2,913 nurses. The large hospitals report hundreds of staff members absent because of quarantine, making it even more difficult to operate the hospitals and forcing them to limit elective activity.
“There’s an increase in seriously ill patients, although it has moderated in recent days,” says Prof. Amit Assa of Shaare Zedek Medical Center in Jerusalem. “At the moment we have 140 COVID patients, with 40 to 50 seriously ill patients every day, about 15 in critical condition in intensive care.
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Someone with underlying conditions in his 70s or 80s can easily be defined as ‘seriously ill,’ but the criterion for the seriousness of the illness is the number of critically ill patients, and in this wave there are fewer than in previous waves. The majority of critical patients are over 60, with over 90 percent unvaccinated. “The vaccinated are elderly people with additional illnesses, such as chronic pulmonary disease or cardiac insufficiency, who are not sufficiently protected by the vaccine.”
About 250 staff members are in isolation, most after being verified COVID patients. Assa says that shortening the isolation period to five days doesn’t make much difference. “Most of those infected still test positive in the antigen tests on the fourth and fifth days of isolation and have to remain in isolation until they recover. There’s always a gap between the decline in the number of verified patients and serious illness, so that if there is improvement in another week it will be felt in the hospitals only about three weeks from now.”
Dr. Eran Rotman, director of Beilinson Hospital (aka Rabin Medical Center), says that the serious illness now differs from that in previous waves. “The seriously ill patients don’t present a clinical picture characteristic of delta or alpha. It’s more like the elderly chronically ill patients we see every winter. There are almost no cases of dramatic deterioration within hours, where the patients collapse before our eyes.”
There are 115 COVID patients at Beilinson, about 40 in serious condition, with 250 staff members missing. “In previous waves we didn’t see much illness among medical personnel, because they were vaccinated, but now, although the vaccine protects from serious illness, it doesn’t prevent infection. In units where many staff members are in isolation we’ll probably see a decline in elective activity in the next two weeks.”
COVID tests.Emil Salman
In Shamir Medical Center (aka Assaf Harofeh) there are six coronavirus wards, with about 300 staff members in isolation. That causes a tremendous burden on the hospital. The hospital now has 143 COVID patients, about two thirds in serious condition. Dr. Eddie Ilgiayev, director of intensive care, says that taking care of COVID patients harms other patients and the regular activity of the hospital.
“When we talk about ‘collapse,’ people think we’re referring to the collapse of the medical personnel, but collapse means we’re unable to maintain the hospital’s ongoing activity,” Ilgiayev says. “If the number of COVID patients continues to increase we’ll have to shift all the wards to COVID wards, and the price will be paid by the regular patients.”
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