As Israel’s Health Ministry indicates that it will prolong the lockdown, it is time to recognize that they have no exit strategy. Their current approach is a yo-yo, where restrictions go up and down based on the total number of infections. That is crisis management, not a plan.
We should be very clear: COVID-19 is dangerous and deadly. Millions have died worldwide and thousands have already died in Israel. Israel has a case mortality rate of 1%, which is significantly lower than the global rate of 2.9%. The case mortality rate is the chance that someone with COVID dies as a result. Israel’s medical system deserves our gratitude and the Health Ministry has good reason for its cautious approach.
At the same time, they do not seem to weigh all the factors, and their narrow scope sees the blunt lockdown as the best solution. During this time, my children have lost months of education (yes, the teachers union inflexibility only made things worse. Why couldn’t there be some school over the summer?), friends have lost jobs, and many small businesses have already failed because their fixed costs remained while their revenue dried up. Many other businesses are on the brink. The closing of synagogues has disconnected people from religious guidance, inspiration, and community. All these factors are beyond the purview of the Health Ministry.
Regarding mental health, lonely people are deeply suffering and people face desperate economic realities. Anxiety and depression will only get worse with a prolonged lockdown.
But yes, COVID-19 is deadly. Well, that is an oversimplification. If one looks at the statistics, COVID-19 has a high case mortality rate with the elderly population. For example (and I am leaning toward higher estimations, just to be safe), until the age of 20, COVID has a case mortality rate of close to 0% and it rises to 0.2% by the age of 40. For the 40-49 age group, the case mortality rate goes up to 0.4%. The case mortality rate then rises exponentially. Those over 80 have a case mortality rate of over 10%. To put this all into perspective, the estimated case fatality rate of the seasonal flu is 0.2%. For a younger population, the flu is more dangerous than COVID. Certain pre-existing health conditions like cardiovascular disease and diabetes raise the COVID mortality rate as well.
One can see the fatality distribution at Israel’s Ministry of Health Corona website:
In essence, the total number of infections does not matter. Rather, it is the number of infections of high risk individuals that needs to be tracked. To put it differently, 81.5% of Israeli fatalities are above the age of 70, while they represent 5.4% of infections.
Given these realities, here is a proposal for a more targeted approach:
- The country should reopen — schools, malls, restaurants, synagogues, parks, offices, etc.
- There should be an age restriction preventing people at a higher risk from entering these venues. The Health Ministry decides the specific age.
- The previously developed traffic light system should determine the level of restriction for the at-risk population. For example, in a green area, they can enter a mall, but in a red area they cannot.
- People who live with someone at-risk should restrict their activities as well.
- Necessary services like shopping, banking, the post office, etc. should have dedicated times for the at-risk population. Certain recreational activities like beaches should have reserved times for those at risk. Other accommodations at work and school should be made.
- Social distancing rules, masks, hand-washing, etc. should be kept in place.
- Antibody testing should be ramped up so that Israel actually knows its immunity rate. People will have better knowledge of their own risk.
- People who are sick should be isolated.
- Exposed people should be quarantined, but then be tested after the virus incubation period. If the person tests negative, then quarantine should be ended. Israel currently mandates 14 days to see if symptoms develop. This, however, is due to a lack of testing. Someone who tests negative after the virus incubation period is not infected with COVID and does not need to be in quarantine for a full 14 fourteen days.
These are difficult times and we can’t magically make this go away. It is critical that we treat this virus with seriousness. We cannot be cavalier with our own lives or the lives of others. That is a religious and moral obligation. At the same time, being overly cautious can be devastating. And so we must balance.
A more surgical approach to combating COVID will minimize hardship while maintaining safety. Developing herd immunity is the quickest way for life to go back to normal. As non-risk people recover from COVID, herd immunity will build for everyone, and better protect the at-risk population.