Ran Balicer

Prof. Ran Balicer is a member of the Israeli Health Ministry's pandemic response team.

On the verge of losing control

Given the current daily rate of infection, and the fact that the percentage of seriously ill among older patients has not changed, Israel's health care system could be maxed out by August.

For a month now, Israel has been experiencing a new outbreak of coronavirus that is highly unusual when compared to the rest of the world. Since the beginning of June, the daily number of new confirmed cases has risen from 1000 to about 1,000.

A small part of that increase can be attributed to the increase in the number of corona tests being carried out, but the vast majority is the result of community spread. It is happening in every community in all sectors of the population, especially among young people. Many factors might be involved in the spread, but public gatherings, including weddings and other celebrations, are a key element in community spread, and we must not wait a single day longer to restrict them.

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Currently, Israel is seeing a higher number of people test positive per day than any European country, including nations much larger than us that were badly hit by the virus. Britain, for example, a country of 66 million that is running over 100,000 tests per day, saw fewer new cases on Saturday than Israel. In terms of confirmed cases per 1 million people, Israel is second only to the United States.

Some might ask what, exactly, the problem is, since the rise in the number of cases does not go along with a corresponding number of serious cases, right? Sadly, that is incorrect. Among the older citizens who contract the virus, the rate of serious cases has not changed, and one out of every seven people age 60 and over who contract coronavirus will become seriously ill. The older population follows public health regulations more carefully, and older people make up a smaller percentage of new cases than they did in the first wave, but the virus continues to worm its way through, infecting many dozens of elderly each day.

The math for the numbers of seriously ill corona patients we can expect to see in the next few weeks is very clear. If nothing changes unexpectedly, 2% of new cases in the past two weeks, or 10-20 individuals, will become seriously ill within two weeks, and require two to three weeks of hospitalization. Within a few weeks, therefore, we could see 200 corona patients hospitalized in serious condition, in intensive care that requires close care by a large staff wearing clumsy protective gear that must be changed frequently. That isn't a number that will bring down the healthcare system, but it certainly comprises a major burden on the system, which is already stretched to the limit.

When the infection rate reaches thousands per day, or if the virus makes its way to the elderly population, it will bring us closer to the limits of what the nation's health care system can provide. Given the current rate of spread, these are extremely viable scenarios. If we don't make significant changes to how we handle it, and even if the number of seriously ill remains under what I mentioned above, we could find ourselves maxed out by the end of August.

If that happens, what options do we have? The system of epidemiological research and quarantine cannot cope with such a high rate of infection, even if there were enough personnel.

At the end of the day, we must not wait for the authorities to declare restrictions. We all need to safeguard our lives. The keep to stopping the spread of the virus requires all of us – young and old – to keep our distance from anyone outside our nuclear families. Wearing masks in public, washing and sanitizing our hand, and staying at home if any symptom appears will also help check the rate of infection.

The entire population has to follow the rules, but the at-risk population – the elderly and those who suffer from chronic or serious illnesses – must do so even more stringently. The danger of contracting the virus is now at its apex, and people who spread it might be completely asymptomatic. This is the time to avoid any risk, limit social contact, and totally avoid crowded placed. As for the younger folks – if not for your own sake, then at least think about your parents and grandparents, and do everything possible to behave responsibly and avoid infection. Keep your distance, wash your hands, wear masks, and stay healthy.

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