When in March 2020 the government of then Prime Minister Benjamin Netanyahu imposed restrictions on travelers from Spain, Germany or France due to a worrying outbreak of COVID-19 during the first wave, leaders of half Europe considered the measure “excessive” . Israel became the first country outside of Asia to shield its borders to prevent the spread of a virus about which little was known. “Its effects are similar to that of a common cold or flu,” said some scientists in Spain. “It could be a virus ten times more lethal than the flu,” they said in Israel.
Lessons from Israel to avoid panic in the remainder of the pandemic
Almost two years after the start of the pandemic, Israel, this time led by the ultra-nationalist Naftali Bennett, has once again closed its borders to foreigners, although today the measure is not branded as “alarmist” by the leaders of old Europe but as a preview of what can happen again in its territory, now turned into the epicenter of infections with omicron.
With about 350 confirmed cases in the country and hundreds more under suspicion of carrying the new variant, in Israel they already speak of a “fifth wave”, as the prime minister pointed out on Sunday in a televised speech to the nation in which He assured that the closure to the exterior decreed weeks ago had allowed the country to gain some time, but that this time was running out. “The numbers are not high yet, but it is a very contagious variant, which doubles every two or three days as we see around the world. It is possible to say that the fifth wave has begun,” said the leader of the Executive.
Hours before these statements, the team of advisers of the Ministry of Health, led by Sharon Elroy-Preis, director of Public Health, urged the Cabinet ministers to adopt more drastic measures, adding to the “red list” of countries – places where Israelis are prohibited from traveling – to the United States, Canada, Turkey or Germany. It already included the majority of African States, the United Kingdom, Spain, France, Ireland or Sweden, among others.
However, those two words “fifth wave”, pronounced by the head of Government, were discarded less than a month ago by the same scientists who advise him today. “I would not say that we are in a fifth wave, we have not yet passed the fourth. The delta variant is very infectious and we have not reached the herd immunity that we did achieve in the first vaccination campaign,” Elroy-Preis said then. At that time, the arrival of omicron to the country was still testimonial, which accounts for the rapid spread of the new variety of the virus.
The speed of omicron
Israeli scientists, who are already warning that the new variant could soon be the dominant one in the country, suspect that between 30% and 40% of all positive tests for coronavirus are for omicron. 10 days ago the figure was only 3%.
“The variant shows a partial capacity significantly greater than the delta one to evade the protection provided by the antibodies created after recovering from the virus or by the vaccine,” says a report presented on Tuesday by experts from the Hebrew Government Information and Knowledge Center. for the newspaper Haaretz. In the pages of the document the authors of the study also warn of the presence of the new variant of the virus in the sewage of several cities in the country, which is a sign of purely domestic outbreaks. “It spreads faster than any known variant so far. Of the current 10 new daily infections in the community, we could reach 10,000 in a month and a half,” they warn.
For Shlomo Maayan, director of the Infectious Diseases Unit of the Barzilai Medical Center, in the city of Ashkelon, in southern Israel, the problem is in the short duration of the effect of vaccines against the risk of contagion (not against serious disease ). “Acquired immunity, like that generated by most of them, diminishes over time. For example, the boost of the immune system by a messenger RNA (mRNA) vaccine like Pfizer’s or Moderna’s is episodic, it happens once and, although it is strong, it is not continuous. The vaccine itself is short-lived, “says the virologist who was once part of the committee of experts appointed by the former president of the United States, Barack Obama, to combat the HIV epidemic.
The researcher remarks that the greatest challenge for scientists is to strengthen the diminishing immunity of current doses against new variants such as omicron, in addition to extending its long-term efficacy. Broader protection, he explains, is that vaccines based on live viruses, such as those used to fight measles, mumps or rubella, do, but does not yet exist to fight COVID-19.
This Tuesday the committee of experts that advises the Government has approved, at Bennett’s request, the administration of the fourth dose of the vaccine against COVID-19 to those over 60 years of age and health workers, when four months have passed since the third dose. “This is wonderful news that will help us overcome this wave of the omicron variant that is hitting the entire world,” Bennett said after the committee’s decision was made known.
The Ministry of Health should have approved the start of the campaign this Thursday, but decided last night to wait for more data from other countries on the evolution of omicron and the protection offered by the third dose. The discussion in the committee of experts that advises the Government to which the New York Times indicates that some scientists consider it premature to administer a fourth dose so often.
For now, in addition, Israel continues to try to convince the nearly four million Israelis (out of a population of just over nine million) who have not yet received the third dose or have already exceeded six months from the second to get vaccinated. with the booster dose, which in Israel did manage to stop the arrival of the fourth wave.
“The failure of the Executive has a lot to do with the distrust of the Israelis,” says Zvika Granot, a professor at the Faculty of Medicine of the Hebrew University of Jerusalem, during a virtual meeting with foreign and local journalists held on Wednesday. “In the first two campaigns, people went en masse to get vaccinated, but since then things have happened: first, the vaccines do not provide the expected immunity; second, the Government has forced people to be vaccinated with measures that violate civil rights, which that generates even more rejection; and third, it has not been transparent about the secondary effects, “says the expert.
Distrust in the Government
According to the teacher, the distrust shown by an important sector of the population would explain the low vaccination rate among Israeli minors. In fact, as of this Wednesday, only 11% of children between 5 and 11 years old have received at least a few doses of the Pfizer vaccine, the only one distributed in Israel. The percentage increases among those between 16 and 19 years old. Of them, 65% have received the first two doses according to data from Clalit, the largest provider of health services in Israel.
“It is logical that parents distrust when there is no certainty about the secondary effects of vaccines in children, especially if the impression is that the government is trying to hide them,” says Zvika Granot in the meeting with the press. The expert in Public Health, Amnon Lahad, specifies the words of his colleague. “Very few children have serious side effects, but this information should be shared whatever it is. I agree that more transparency is needed,” he remarks.
At the other end of the health spectrum is the director of Public Health of the Ministry of Health, Sharon Elroy-Preis, who encourages all her fellow citizens to take their children to be vaccinated “not only to protect their elders but, above all, to protect them. ” The epidemiologist explains that of the more than 500,000 children who tested positive in Israel until the end of November, 200 – most with risk factors – developed serious diseases. Eleven of them died. In one of the cases the doctors did not detect any known risk factors.
However, for Dr. Elroy-Preis, what is worrying is not only the possible deaths that may occur in children or young people as a result of the coronavirus, but also the sequelae that may remain in those who have developed pediatric inflammatory multisystem syndrome (PIMS), a rare condition suffered by some children, both healthy and with previous illnesses, after exposure to the coronavirus.
“We are talking about that in Israel we had 200 cases with PIMS. Even if they overcome the disease, there is a small percentage that develop long-term symptoms, just as it happens in adults (between 10% and 30% end up with problems of memory, concentration, fatigue or joint problems). In Israel we have seen that around 2% of the younger groups may have long-term symptoms. In those over 12 the percentage rises to 4.6% ” explains the researcher. “Even if the estimates were reduced to just 1%, we would be talking about that of the 500,000 children who have tested positive for COVID-19 in the country, 5,000 may develop persistent COVID-19. That’s a lot!” expert.
From SARS-CoV-2, Sharon Elroy-Preis highlights not only the possible lasting effects that it may have on an infected person, but also the little knowledge that exists about a virus that can remain active in the human body for up to six months after it has been produced. the contagion. “That is something very unusual and very specific to COVID-19,” he says.
Finally, the epidemiologist highlights the factor that worries her most: the uncertainty about what may happen in the next 10 years. “There are asymptomatic infections, viruses, that can cause disease after 10 or 20 years. We are talking about meningitis, encephalitis, even cancer. We know what happened with the arrival of AIDS and what it did with the immune system. About COVID-19 it is too early to even have a minimal idea of what might happen, “he concludes.