Ran Balicer

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

The real battle lies ahead

Other countries that had initial success in containing coronavirus but lifted restrictions too soon have seen renewed outbreaks. Israel must not become complacent.

Israel has "crushed the curve." That is the term that describes a handful of countries that have managed to get the current pandemic under control, despite its exponential growth. One of the characteristics of infectious disease is exponential spread growth in two directions -- when uncontrolled, it spreads quickly, but under closely controlled conditions, it can disappear quickly, as well.

The fact that only 30 new cases were discovered on Tuesday is a sign that as of 10 days ago, community transmission was at near zero, and that the virus is exponentially, and rapidly, being suppressed in Israel.

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The assumption that we can expect this trend to continue gave decision-makers the confidence to ease restrictions starting after Passover and continue with additional ones the week after, as more information became available. The goal is to allow a return to "routine, with restrictions," with the remaining regulations to be re-evaluated and adjusted at predefined stages.

The process of risk management that has taken place since Passover is based on the working assumption that the eased restrictions will lead to a higher rate of infectious conditions, causing renewed spread of the virus in the next few weeks and months.

The expectation and hope is that the bugger zone created thus far allows us at withstand at least two weeks of uncertainly about the effects of each stage of easements. If we can reach a steady average of new cases per day, the economy could be rehabilitated gradually by the time winter comes.

Other countries that took the necessary steps relatively late and saw a dramatic rise in infection now face a situation in which the daily infection and death numbers require them to choose between bad and terrible options -- continuing with stringent restrictions for many weeks to come, wrecking their economies, or lifting the shutdowns, which will keep the daily death toll at its current rate for weeks or months to come.

For Israel, it would be excellent news if the current number of new cases remains steady. For the US and some of Europe, as well as more and more countries in South America, the numbers could lead to ongoing catastrophes for their society, economy, and humanity.

But as we are hitting "restart" for our economy and our social ties, we must not take things too lightly. It's important that we constantly remind ourselves that it's not over yet. Countries more disciplined than we are like Japan (particularly its northern island, Hokkaido) and Singapore, which eased its shutdown too soon, have found themselves seeing another exponential outbreak and have reinstated restrictions. Their economies and societies will have difficulty handling another blow.

So we must use the next few weeks for three main purposes: The first, to put the economy back on track as far as the global recession allows.

The second, to adjust the economy and people's behavior in public to the conditions that will prevent the spread of the virus -- including the Purple Tag for businesses and people taking responsibility for maintaining social distancing, washing their hands, and wearing masks.  

The third, and most critical, to prepare for the next corona outbreak.

These preparations must include strengthening medical institutions through additional personnel and equipment while at the same time outfitting ourselves for and drilling national systems that will be tested in the next outbreak: a system of epidemiological tracing, from the moment the virus is suspected until potential carriers can be quarantined; a system of support for at-risk populations, including the elderly who live at home and younger people who are in danger according to models; and a system that meets the differential needs of "red areas," which see concentrated outbreaks.

We don't necessarily have the time to finish all the preparations. We cannot become complacent, not as individuals, whether it has to do with cautious behavior in public or quarantining ourselves at the first suspicion of infection, and not as a nation, when it comes to taking advantage of the precious time we have to get ready for the next stage of this unfolding event. The first part might be over, but the real battle lies ahead. 

 

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