Israel was reduced to a handful of daily COVID cases. It is now around 11,000. What happened?

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Just a few months ago, Israel was a world leader in vaccinating its people and seemed to be getting a grip on the virus that causes COVID-19, struggling to reduce its daily number of cases to double digits – and at times, close to zero.

But any potential celebration was short-lived, as the most contagious delta variant gained ground and spread rapidly, to the point where the most recent daily case count in Israel was around 11,000 – a level never seen since January.

According to some Israeli scientists, this setback provides lessons for countries like Canada, as we enter a fourth wave, to remain cautious and not let their guard down – to avoid some of the mistakes their country has made. committed.

“This is a very clear warning sign to the rest of the world,” said Dr Ran Balicer, chief innovation officer at Clalit Health Services (CHS), in a recent interview with Science magazine.

“If it can happen here, it can probably happen anywhere. “

While Israel was often at the top of the Oxford University’s Our World in Data vaccine population list, it now tops another category: It has the world’s highest seven-day moving average. new daily cases of coronavirus per million people.

Daily check-in

On Tuesday, Israel’s health ministry reported that the country had set a new daily record for diagnosed coronavirus cases of nearly 11,000, which comes as the delta variant increases across much of the world.

There have been 716 people nationwide hospitalized and in serious condition with complications from COVID-19, including 159 on ventilators, The Times of Israel reported.

Health workers wearing protective gear are shown in the coronavirus ward at Shaare Zedek Medical Center in Jerusalem on Tuesday. Israel’s health ministry reported that the country has set a new daily record for diagnosed coronavirus cases of nearly 11,000, as the most contagious delta variant takes hold. (Maya Alleruzzo / The Associated Press)

And while Israel went several weeks in May without deaths, more than 550 people died from COVID-19 in August, including more than 100 of them in the past five days, the Times reported.

“It seems that some mistakes were made when we thought we won the war, and now we understand that we only won the battle. The war is still here, and we have to go on and explain and push everyone to stand. get vaccinated, “Israeli coronavirus czar Professor Salman Zarka said in a recent interview with The Times.

Meanwhile, Israeli health officials reported what appeared to be waning vaccine effectiveness, including among those who had been doubly vaccinated. Data showed that among severe cases admitted to hospital, around 60% of patients were fully vaccinated people, although most were over 60 years of age or had underlying health conditions.

Collective immunity is considered to have been reached

“Many public health professionals believe that what happened in Israel was a demonstration of popular immunity or herd immunity. [But the] delta, with its higher infectious rate, coupled with waning immunity, proved us wrong, ”said Dr Eyal Leshem, clinical associate professor of internal medicine and infectious diseases at the Sackler School of Medicine at the University of Tel Aviv, in an interview. with CBC News.

In May, as herd immunity was reportedly established and cases declined to double digits, with few deaths, Israel began to ease its public health restrictions. Businesses and schools were back to normal.

Then, in early June, capacity limits in stores and restaurants were lifted, as well as for indoor and outdoor gatherings. Israelis also no longer needed proof of vaccination to enter various locations.

In mid-June, the requirements for indoor masks were lifted.

Yifat Kahana takes a swab sample for a COVID-19 antigen test kit from her 10-year-old daughter, Ariel, before the first day of school at their home in Moshav Talmey Yafe, Israel. (Tsafrir Abayov / The Associated Press)

“The government … has decided that we shouldn’t impose restrictions; we will rely on vaccines for protection. But then we realized that it is very difficult to stop infections with the delta variant,” said Cyrille Cohen, head of the immunotherapy laboratory at Bar-Ilan University and a member of the Israeli Ministry of Health’s advisory committee for clinical trials of COVID-19 vaccines.

“What we should have done is maintain some restrictions – for example, wearing the mask indoors,” he said.

As the number of cases in the country rose rapidly again, the government turned the tide. Mandatory masks and his green pass regime were once again mandatory to enter indoor public spaces.

Between January and March, Israel had been very proactive and innovative, explained Nadav Davidovich, director of the School of Public Health at Ben-Gurion University in the Negev. “And then we got a lot more passive.”

A large number still unvaccinated

Israel has so far fully immunized about 62% of its population. But that still leaves a significant number of people unvaccinated, said Dr. Isaac Bogoch, an infectious disease physician and member of the Ontario COVID-19 Vaccine Task Force.

“You have a million unvaccinated people, plus a very contagious delta variant, as well as opportunities for transmission of the virus,” he said. “So you can’t be surprised that there is a big increase in cases.”

The most edifying account for Canada might be the observation that the infection rate was found to be higher among those vaccinated in January than among those vaccinated in April, Leshem said.

“Simply put: this protection against infection wanes over time.”

These results were seen in people who were doubly vaccinated, regardless of their age or if they were immunocompromised, he said.

Leshem said this development, along with fears that an increase in serious infections could overwhelm the healthcare system, prompted Israel to become the first country to launch a recall campaign, with a third dose targeted at people aged 60 and over. years and older. Boosters are now accessible to everyone from the age of 30.

A man receives a third dose of Pfizer-BioNTech COVID-19 vaccine in Tel Aviv, Israel. Booster shots are now available to everyone in the country aged 30 or over. (Oded Balilty / The Associated Press)

So far, the results of the recall campaign suggest that the third dose is likely effective both in preventing infection and in reducing the number of serious infections and hospitalizations, Leshem said.

“So what we are seeing on the ground in COVID services – in my hospital and other hospitals – is that while the number of cases continues to increase, we have seen a stabilization of the number of severe cases. “, did he declare. “The most plausible reason is that this elderly population that has been boosted is more protected against serious infections, hospitalization and death.”

The disease continues to grow, Leshem said, and Israel is still seeing more and more cases every day – “but at a slower rate.”

According to Cohen, the lesson that countries like Canada can learn from Israel’s experience is that the focus needs to be maintained on populations most at risk.

“As the number of infections increases, you really want to make sure that this population is optimally protected,” he said.

Limit gatherings

In terms of policy, governments must maintain some level of restriction, such as limiting gatherings, Cohen said.

“I was in favor of having… tighter restrictions like a month and a half ago. It was actually my personal advice when officials asked me here so we wouldn’t end up in this situation,” Cohen said. “They decided against it.”

To Canadians and Canadian lawmakers, his advice is to open up gradually – and as there is a steady increase in cases, don’t wait to act. “Because the higher the increase, the harder it is to stop with simple measures.”

He also advises people to continue to hide indoors and use rapid tests for vulnerable people attending family gatherings.

And his message to Canadians who were vaccinated over six months ago: “You are vulnerable. You are more vulnerable than you were three months ago, especially when faced with the delta variant.

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