The coronavirus has taught us an important lesson in humility. We learned that some things are hard to predict and that declaring victory too soon certainly isn't a good thing. Therefore, instead of predicting, I will focus on the picture the most recent figures are painting, in the understanding that whatever does happen largely depends on the actions we take and possibly, even more so, on the actions we don't take. A good understanding of the current situation is of course critical in terms of planning the next steps.
It's possible to reach two opposite conclusions about our situation based on the figures from the past few days. On one hand, the number of infections is stable at around 1,500, and the rate of doubling that number is now two weeks, up from one week. In other words, the virus isn't spreading exponentially, certainly not quickly, and supposedly we are trending toward stopping its spread.
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Is this really the case? That without any change, without comprehensive epidemiological inquiries, without increasing the number of tests, and without enough time to see whether the latest restrictions have had the desired effect, we simply got lucky and the virus has stopped in its tracks? This is hard to believe, but we've already said we must focus on the figures and less on public relations and emotions.
This is where we reach the flip side of the figures, those that lead to the opposite conclusion. The number of patients in serious condition is steadily rising, exponentially at a rate that is now doubling every six days. Over the past two weeks, another 300 seriously ill patients were added to the tally, and at the current pace, more than 1,000 such patients will be added in the next two weeks. The prognostications beyond that are even gloomier. It's close to the nightmare scenario we were warned about during the first wave of the pandemic, whereby our healthcare system could collapse in the coming weeks.
How can we reconcile these polar opposite conclusions? There's a simple explanation, which, sadly, indicates that the virus will continue to spread. Apparently we've hit the maximum threshold of new patients we can detect with 25,000 tests per day. As we approach this threshold, the number of new confirmed cases will appear stable on a daily basis. In actuality, however, the pandemic is continuing to spread, which is expressed in the growing number of patients in serious condition – precisely what the figures now show.
According to this scenario, the percentage of seriously ill patients among newly confirmed cases is also expected to rise, and this phenomenon, too, has started to emerge. If this is indeed what's happening, it means the actual number of infected is already in the many thousands and is expected to grow as well. Such a number cannot be accounted for with the number of tests currently being administered. Even a well-oiled, efficient testing body, which we don't have anyway, cannot cover this amount of new cases. It's too late.
Why is the daily threshold of new cases so low? Firstly, because in most cases close contact with a confirmed carrier ends without infection. Hence, ever since we expanded the testing policies to include symptomless people who have been in contact with a confirmed carrier, such as an infected child's classmates, most of the time the results will come back negative.
Secondly, because even if we transition to only testing people showing symptoms, most of the time they will still test negatively for the coronavirus. This is because corona symptoms are not unique and resemble other diseases. In other words, the threshold is low because it's hard to devise a testing policy that yields a positive testing percentage of above 5-10%, which presently allows us to detect about 2,000 infected people per day. Indeed, the percentage of tests with positive results has remained relatively stable recently at around 5%. Even during the first wave of the pandemic, the highest percentage was 8%.
And now, a little optimism and a few words on what can be done. The corona questionnaires on the Weizmann Institute website continue to indicate an increase in the use of masks and an increase in social distancing practices across all age groups, and it's possible that the infection stoppage is real and stems from these factors. Moreover, the definition of who constitutes a seriously ill patient has been expanded recently and it's possible that part of this spike stems from this alteration.
What can be done regardless to avoid a general lockdown? The answer is clear. We need to restrict those activities to which most infections can be traced. The problem is that this information doesn't exist, but can be acquired quickly through a simple idea that we can begin implementing as early as tomorrow.
When anyone is sent for testing because of contact with a confirmed case, the national health funds must document the type of place (synagogue, restaurant, swimming pool, gym, etc.) where the contact occurred. Within days we should have information on about 10,000 contacts, which will tell us where people are most likely to contract the virus and about the percentage of contacts that end in infection, depending on the activity.
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The benefit of having this knowledge is two-fold. It would allow us to restrict only those activities where people are most susceptible to infection, and thus reduce the spread of the virus and the need for a comprehensive lockdown. We could also better prioritize when and who we test and send to quarantine. The train has already left the station, but the destination we reach still depends mostly on us.
