This week, as part of the fifth corona wave, Israel reached the point in time where the dubious record of the number of infected was broken again, when in one day 11,978 positive people were diagnosed with the virus. Unfortunately, this is probably only a temporary peak, as the current wave of omicrons is expected by experts to lead the country to 30,000 infected a day as early as next week, and in two weeks to 600 to 800 critically ill patients.
The corona is constantly teaching us new things. We have not yet managed to internalize the policy of inclusion of the dead and the counting of the hard patients of the fourth wave, and we have already received a new variant, much more contagious though also easier, with a new policy known as "inclusion of contagious". Now, the elderly and vaccine-suppressed are called upon to shut themselves up at home and take care of themselves, with the public seeing this as a sign of a mood in which "it remains only to pray."
The public itself finds it difficult to understand the new policy, under which, despite the growing morbidity, senior health officials release restrictions to those entering from abroad and do not restrict gatherings, arguing that in large numbers these preventive measures are no longer useful.
Those who can not afford the relief are the medical staffs in the hospitals, who are preparing for another impossible load, under conditions of constant lack of means and equipment.
"Between the fourth and fifth waves, no beds or Acmo devices were added to the hospitals, we promised a hundred intensive care beds to the hospitals and we did not receive them," says Prof. Hezi Levy, the veteran director of Barzilai Hospital in Ashkelon and who until about six months ago And outlined the policy of handling the second and third waves. "I suppose we will come and raise a red flag if we need to, in order to increase the ability to care for the citizens of Israel.
Patients must be seriously discussed.
"Closure is one of the tools to deal with the situation and I hope we will not have to be there, because it will also be problematic in terms of enforcement, and will cause very severe effects."
Policy under pressure
In Brazil, the last corona ward was closed less than a month ago, and since then individual patients who have been hospitalized in isolation in one of the other wards have been treated intermittently.
This week the number of hospitalized corona patients rose to ten, including two children.
"All the internal wards here are 130 percent full, I have no place to match in the corridors," warns Levy. "There are also winter illnesses - flu and more. "Internally ill, and I do not know where to put them. The staff is already tired and worn out."
Get off the automatic isolations.
A class in the days of Corona,
At the beginning of the week, the hospital directors had a difficult conversation with Minister Horowitz and the director general of the Ministry of Health, Prof. Nachman Ash, in which they flooded the difficulties ahead of the expected wave of hospitalizations, alongside a wave of influenza - which also burdens the hospitals. That if there are tens of thousands verified a day - some will come to the hospital, but we hope there will not be much serious illness.
These two years are the first time that Corona and winter illnesses have been dealt with at the same time.
"As the director general of the Ministry of Health, I prepared the system for the flu issue and then, to my joy, it did not break out, because people were vaccinated. Now there is no vaccination and there is the flu."
In previous waves, hospital administrators broadcast stably, but this time everyone in the health care system already knows that the price of heavy loads is a deterioration in the quality of care to the point of reducing other services in the hospital.
"We will fight to provide services but unfortunately I am not sure we will meet the task. Not just us, all the hospitals."
On the current policy, where the threat of closure is no longer on the agenda and the public feeling is that all restrictions have been removed as part of the containment of infection, Levy says: "Once we talk about tens of thousands of people infected with the virus, Can I cut a chain and interrogate thousands of people? It's not real. Nor is there enough PCR to run after everyone. We may find ourselves in a de facto quarantine.
"We are currently on probation. Let people not rest even if they talk about not a serious illness. I still call on people to get vaccinated and avoid gatherings without masks. Mutual guarantee is the key to preventing these difficult scenarios that people are afraid of but place the responsibility on the government. "To act in accordance with the guidelines, and the public must understand and cooperate. It is impossible to depend on a loss of confidence in the government."
Sense of Paul gas in neutral
The loss of public trust in government decisions leads quite a few citizens to the feeling that vaccines are no longer the ultimate solution.
Adva Lotan heads the "Madat" organization, which has set itself the goal of promoting public health, especially in the field of access to information about vaccines.
She is also a member of the Ministry of Health's advisory committee on corona vaccines, and she says now, on the eve of the fifth wave, she recognizes a lack of trust and lack of public cooperation.
The infection will continue.
Levin, Photo: Yossi Zeliger
"We are at a significant low. The current government has not really acted to restore the public's low confidence, and the marked lack of response to the children's vaccine and the booster vaccine indicates this very well. The information system has started to do a better job but it is still not enough."
In a week in which the public began to wonder if the government's strategy is mass infection and herd immunity, Lotan says that "it is no wonder that social networks laughed and said 'we will have success'. To this period of the Fifth Wave, but what could have been dealt with in the period of calm, now seems dramatic.
"There is no enforcement of the guidelines. Not enough is done even about basic things like wearing masks and keeping distance or decisions to install filters. The general feeling is that even the government has given up. There is a lot of talk and information thrown into the air and it feels like Paul Gas in neutral. "Understand the logic behind what needs to be done. Anyone who does not try to follow closely what is being said, is not at all able to understand what is happening."
According to Lotan, one of the reasons for this gap is the atmosphere that remains after two years of chaos in terms of the information the public receives, the integration of Pike News on the networks, the conduct of the media, and the feeling that the state has no tools to deal with.
"Media bodies are looking for a sensational angle, to show position against position. We see the damage every day and it will have a broad impact in the future as well."
Lotan notes that the stage of drawing conclusions and drawing lessons from previous waves has not been done successfully.
"There are some things I do not see improvement, such as the lack of a clear policy. There are very vague statements about life alongside the epidemic, but there is really no message from the state what it plans to do to protect us. There is a need to change policy and say 'friends - we face a new threat ', What is known today has been known for several weeks and there was enough time to formulate some kind of perception, but it did not happen. I do not think anyone thinks it is possible to stop the wave, but it is possible to try to flatten the curve.
No enforcement.
Lotan, Photo: Niri Gatmon
"Even if it's a less violent disease - it's still corona, and it still has long-term complications and risks. We will not see the same curves as in the Delta but that does not mean the disease has become harmless. Yes we will see the hospitalized and people injured and died from the disease."
Lotan was a member of the Corona Vaccine Advisory Committee and, among other things, was a partner in the decision to give a fourth vaccine.
"The decision was made at the end of December, but the director general of the Ministry of Health decided to approve it only this week." Was right.
I was a little surprised that it took a long time to confirm it, we saw in previous waves what the price of rejection and waiting with a vaccine is. "
Prof. Hagai Levin, chairman of the Association of Public Health Physicians, who has often criticized the government's decisions on the struggle in Corona, believes this time that the measures that are perceived as a strategy according to which "the state has moved to prayers" are correct and proportionate.
"This is not a show of hands, but a transfer of some of the responsibility to the public, and it had to be done from day one," he says, "so we kept saying that closures as a policy are not public health policy. And not because there are cops out there.It is true that there are irresponsible people but most of the public in Israel goes with the recommendations of the Ministry of Health and keeps it healthy.With all the confusion there are clear principles - a sick person does not leave the house.It is true before the corona and true after the corona.
"We did not hide the criticism we had from the beginning of the event in Israel, that the general approach did not sufficiently share and empower the public."
Know how to release
Two weeks before the arrival of the omicron, the prime minister, ministers and all relevant systems practiced a similar scenario of the arrival of a new variant that bypasses vaccines, which has been dubbed the "Omega" exercise.
"It is good that such an exercise was carried out, but instead of Omega came Omicron - which is very contagious and causes easier morbidity," says Prof. Levin, "so the balance and mental and operational flexibility are different.
"We are not good enough at the field level - we lack local solutions. For example, 'health ambassadors' in the field, such as a school nurse or other professional who can be updated with professional knowledge and translate it into his community, whether at school or in one organization or another.
"I'm not sure we will meet the task."
Prof. Levy,
"One of the lessons for me from the epidemic is that every local authority needs a health unit. I get a lot of inquiries from high-tech companies, organizations and municipalities, with concrete questions about how to translate policy guidelines, because the guidelines are difficult to deal with."
Regarding the "zig-zag" in the guidelines, Prof. Levin says: "Obviously it is better to produce stability, but the guidelines have to change all the time depending on the situation. I have the impression that the current rate of error correction is faster. Slow reactions.There is a more open system for criticism and change.And mistakes are still made.For example, we closed the sky too much, and once everything has spread there is no point in it.For example the fact that the isolation and testing policy does not match the omicron and is ineffective.
"The arrays were not closed between waves, but these are temporary arrays and this is the government's mistake. It does not need a Corona commissioner in a school, but a health commissioner in a school. It does not need a 'State Classification Committee' ".
This week has been marked by an epidemic of isolation that has made it difficult for students, parents and workplaces, with more than 110,000 people in isolation, including more than 75,000 students.
At the same time, many stood for hours in long queues for corona tests, and the labs reached the threshold of their capacity.
"We need to prepare for the continued activity of vital bodies," says Levin.
"The combination of morbidity and isolation and austerity policies will cause teams of entire wards in hospitals to be in isolation. In England the ambulance service was shut down not because workers were sick in Corona but because of isolation, and learning to deal with it. And congratulations on setting up the glorious array of tests, but at some point this thing will not be able to hold. Home examinations must be recognized. The plague must be flexible, it must know how to release. An illusion of security is incorrect. "
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