Israel’s COVID-19 fight now a war of attrition

Israel’s war on COVID-19 is changing shape. Lockdowns that in previous waves of the outbreak proved effective at quickly lowering morbidity are now having a much slower, more moderate effect. We are now in a war of attrition that will be harder for us to deal with financially, physically and emotionally.

In this third lockdown, we are witness to thousands of new infections every day, high rates of positive COVID-19 tests and a decrease in the age of the seriously ill packing coronavirus wards. This is most likely to do with the spread of the so-called UK virus variant. According to Health Ministry data, this mutation, known for being far more infectious and possibly more violent, is responsible for between 50 percent to 70 percent of all current confirmed cases.

Fortunately, the scientists at pharmaceutical giant Pfizer have reported that their vaccine is effective against the British variant. Another advantage to both Pfizer’s and Moderna’s vaccines is the ability to quickly adapt them to any mutation, so that, as with the seasonal flu shot, even if a vaccine-resistant variant is discovered, a new vaccine targeting that mutation can be quickly rolled out.

The mutations’ spread requires an expansion of Israel’s vaccination campaign. The success of the Israeli public health-care system’s efforts thus far has no doubt had an effect on the morbidity rate.

Last Thursday, the ministry published its findings on the efficacy of the Pfizer BioNTech vaccine. One week after receiving the second dose, 0.04 percent of the 715,525 people who were inoculated contracted the coronavirus, and of those infected, just 0.002 percent required hospitalization.

Given the serious morbidity we are now seeing among pregnant women and the increasing number of young people requiring intubation or an extracorporeal membrane oxygenation (ECMO) machine, the importance and effectiveness of the vaccine and the protection it provides are clear.

Nevertheless, since the efficacy of the vaccine on variants may be below 95 percent, everyone who can do so must receive the vaccine. We cannot suffice with the inoculation of just 75 percent of the population, which is the point where herd immunity is normally achieved. We also expect Pfizer to study a vaccine for children aged 16 and under, who will also require inoculation. In order to expand the vaccination campaign, Israel must adapt its outreach efforts to address those who are hesitant to get the vaccine.

This war of attrition demands we learn how to live alongside the virus, with the understanding that it will be quite some time before we can go back to what we once considered our normal, day-to-day lives. At the same time, the state must invest in the healthcare system, which lacks intensive care beds, inpatient wards and medical staff. The images we saw last week of hospital directors being forced to kick and scream on TV to have their cries for help heard are unnecessary.

It is clear that our inability to turn any sick patient away is being taken advantage of. We will rise to any challenge, but we must do it in a way that doesn’t harm the quality of care we provide or the resilience of medical staff, who find it very emotionally difficult to deal with the vast number of daily lives lost to this disease.

I know many are disappointed that we will not see a quick and clear end to the pandemic. Alongside the emotional and financial price we are all paying due to the blow to market activity and the shuttered education system, I believe that we can come up with a strategy for exiting the lockdown that will allow us to build new, normal lives alongside COVID-19.

Professor Arnon Afek is deputy director of Sheba Medical Center at Tel Hashomer and a member of the team that advises Israel’s national coronavirus project coordinator.