A new study found that while medical centers in Israel worked in an emergency format, the death rate dropped • "When there is less workload - few are exposed to hospital infections"
A new study conducted by an Israeli group of researchers found that during the first closure in Israel, when hospitals worked in an emergency format, overall mortality rates were significantly lower compared to routine holidays without holidays.
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The Israeli researchers assumed that as in other countries overseas, during the first closure period there would be an increase in the total number of deaths, along with a reduction in the number of medical services and hospital activities, and to their surprise they found the opposite to be true.
The researchers had good reason to believe that the closure would contribute to an increase in the overall mortality rate.
First, because some patients chose not to resort to life-saving medical treatments as a routine during this period, and their health condition rapidly deteriorated to mortality.
Numerous studies have shown that elderly populations in many states (e.g., New York) have refrained from seeking medical treatment during the first closure due to fear of being infected in Corona hospitals.
Second, during this period other new diseases are not detected and may cause more mortality.
Third, once there is a new disease like corona, the new mortality data are added to the existing mortality data every year in the population, so it is expected that in any case there will be an increase in overall mortality.
The study, recently published on the medrxiv website, preceded peer review.
The researchers compiled all the reports of mortality from all over Israel recorded in the Ministry of Health between January 2000 and May 2020, including holidays, weekends and the first closure period, and divided them according to weeks.
Among other things, a comparison was made between the weekly mortality rates during the first corona closure, compared with the weekly mortality rates during the weeks without holidays.
The conclusions of the article were unequivocal: "The average weekly mortality rates were significantly lower during the weeks of the first closure compared to weeks without holiday vacations."
What can explain this finding?
Although the health services operated in the first closure in a very limited format, the heavy burden that exists on weekdays on the Israeli health system was almost non-existent.
In a routine situation, according to the scientific article, the average occupancy of hospital beds is about 94% throughout the year, with an average of only 2.2 beds per 1,000 people.
For comparison, the average occupancy rate of hospital beds in OECD countries is 77% and the occupancy rate in the United States is 64%.
In addition, in Israel there are fewer doctors and fewer nurses on average per 1,000 people compared to the OECD average.
This burden contributes to an increase in the number of deaths associated with secondary infection - infection acquired due to hospitalization.
The Israeli Ministry of Health also recently reported in this context that in Israel there are between 6,000-4,000 deaths caused by secondary infection.
"When there are fewer congestion in medical centers, such as during the first corona closure, fewer patients may have been exposed to hospital infections and then there are fewer deaths that could be caused, resulting in lower mortality rates - a possible explanation for the phenomenon," the researchers said this week.
"In the same breath, our research reveals the importance of strengthening other treatment options, such as home hospitalizations and community medical services, that will ultimately lead to the least burdens on hospitals."
And what about the second closure?
Although the scientific article did not address this, the researchers noted this week: "It is difficult to compare the first and second closures at such an early stage. The starting point of the two closures in terms of morbidity is different. However, unlike the first closure, there are hospitals since the beginning of the second closure. "In which elective surgeries continue to be conducted as usual and in general, private medical services operate as a routine. In our opinion, hospital loads will not decrease. As a result, it can be assumed at present that there may not be a decrease in overall mortality similar to the first closure."
The researchers come from the Hebrew University (Roni Reznik, Daniel Klinger and Dan Ofer) and Ben-Gurion University (Yoav Comey), with the entire study led by Prof. Michal Liniel from the Institute of Life Sciences at the Hebrew University, and Prof. Eitan Bechmet from the Department of Computer Science at Ben-Gurion University.