Prime Minister Benjamin Netanyahu told the public last week to “return to normalcy, get a cup of coffee, a glass of beer… have fun” – and that is what most Israelis did.
But that return to normalcy appears to have runneth over, and the cup is apparently no longer half full.
As Israelis declined to comply with social-distancing directives, children returned to school, restaurants opened, and the number of people screened for the novel coronavirus dropped, the country quickly started to see a surge in active cases of SARS-CoV-2.
Over the weekend, Israel crossed a redline: More than 100 people were diagnosed with coronavirus within a 24-hour period. Now, Israelis stand to be locked down again.
Eli Waxman, a professor at the Weizmann Institute of Science who led the team that formulated the National Security Council’s exit strategy proposal that was accepted by the prime minister, said there are three steps to stopping the country’s next closure: Test, trace, isolate.
And it all has to be done within two days.
“The idea is to stop someone who has symptoms, get him tested and get the results,” he told The Jerusalem Post. “If he tests positive, then you go into the contact-tracing phase. You need to identify all of his contacts in the past two weeks, reach out to them and isolate them. Then, you need to test them, too. And you need to do all of this in 48 hours.”
There is little room for error, Waxman said. “You need to have at least 80% efficiency in tracking down all the infected people.”
The two-day period is crucial, he said. “If it is delayed, if it takes five of six days, then most of the carriers have already infected their full potential.”
Contact tracing should be done through a combination of efforts, including optimized human interviews, GPS phone tracking, surveillance-camera records and even credit-card transactions, Waxman said.
In Israel, the HaMagen app, which was developed and endorsed by the Health Ministry and can tell people if they have been in the presence of anyone who has been diagnosed with coronavirus, could play a key role, he said. “The more people who download it, the better.”
The other important aspect is Shin Bet (Israel Security Agency) cellphone tracking of confirmed coronavirus cases, Waxman said. The High Court of Justice recently ruled that the program could not continue unless the government anchored its use in law.
The spy agency was reported to have traced a third of Israel’s coronavirus cases, some 4,089 people, and Waxman said it should be used. But he cautioned that no one technology or system should be seen as a contact-tracing silver bullet.
“There are populations where penetration of cellphones is small, like among the ultra-Orthodox,” he said. “In urban areas, where there are big buildings and malls, you could have a very large number of contacts, which might not be real at all.
“All of the tools should be seen as part of a suite, operating together to do effective tracing.”
At the same time, Waxman noted that the country needs to have enough tests to screen all symptomatic people – up to 10,000 per day.
Israel has substantially dropped its number of daily tests over the last two weeks. On Saturday, the Health Ministry reported conducting less than 2,000 tests.
Contact-tracing protocols and apps have been rolled out all over the world with various degrees of effectiveness. Many countries have looked to South Korea, which conducted its fight against coronavirus by the three principles Waxman described.
South Korea first increased its capacity to test, screening an average of 12,000 people per day, and sometimes up to 20,000, at free drive-in and walk-in facilities. Testing took around 10 minutes, and results were delivered to people’s phones within 24 hours.
The country used a combination of technology and asking people who tested positive to describe their recent movements to trace their contacts. Then the Korea Centers for Disease Control and Prevention could issue alerts about where infected people had been.
Waxman said South Korea has two advantages over Israel: It learned the importance of moving fast from its experience with Middle East Respiratory Syndrome (MERS) in 2015, when the virus killed 36 people, infected 186 and put thousands of citizens into isolation. The outbreak was ultimately traced to a single visitor from overseas.
In addition, South Korea has leveraged some technological tools that “Israel cannot and should not be able to use” because they might infringe on privacy rights, he said.
Nonetheless, Waxman said he does believe Israel could be equally as efficient and effective at contact tracing as the Asian country.
The Health Ministry already accepted this three-step protocol “in principle” in mid-March, including the formation of a regulatory body that would operate independently but under the ministry’s auspices and with access to its resources.
“We could begin operations almost immediately, but the Health Ministry has not yet given authority,” he said.
Waxman said the spike in coronavirus cases is not the sign of a second wave. Rather, the virus never went away.
“When we get back to a functioning society and economy, we will have new outbreaks,” he said. “The question of a second wave is about our ability to suppress these outbreaks fast.”
In the case of stopping the spread of the coronavirus, there is no conflict between the country’s public health, societal or economic interests, Waxman said.
“If we stop the pandemic fast and aggressively, this is the best situation for everyone,” he concluded. “There is one goal: To ensure the community’s safety without any future lockdown.”
