A paramedic from the Magen David Adom, Israel's version of the Red Cross, samples a Palestinian man for coronavirus at a mobile testing station in east Jerusalem on July 5. (Ahmad Gharabli/AFP via Getty Images)

Israel Counters Pandemic’s Second Wave with All-Hands-On-Deck

Police, government and local authorities, together with health funds and doctors, try to coordinate a somewhat disorganized response

The Israeli Knesset’s coronavirus committee approved regulations on Sunday to limit the number of people allowed in private establishments such as bars, event halls and synagogues to 50, effective at 8 a.m. Monday.

The decision – decidedly a step backward – came as more than a thousand new novel coronavirus cases were diagnosed in the prior 24 hours, with 5% of those tested for COVID-19 returning positive results as of Saturday.

Israel is trying to respond to a once-in-a-century health crisis involving individual citizens and many layers of bureaucracy, yet because government guidelines change frequently, there is confusion about what to do.

The police announced that they would step up enforcement starting on Sunday, but at least 210 students out of a total of about 700 at a yeshiva in Bnei Brak, near Tel Aviv, have now caught the novel coronavirus.

Micky Rosenfeld, the national police spokesman for the foreign press, told The Media Line: “Eight special task forces were set up to be specifically involved in implementing health and safety rules and regulations on public transport, public areas and restaurants.”

In addition to acting in public areas, each clearly overworked task force is supposed to make sure that people who return from abroad are in 14-day isolation.

“The emphasis is on activities on modes of transport used by the public… as part of the efforts to prevent the spread of coronavirus…. Over the weekend, police activities continued across the country both day and night,” Rosenfeld stated.

“The aim of the activities is to make sure that health and safety rules and regulations are being kept, including [via] the handing out of fines,” he continued.

“At the same time the police are continuing to explain to the public the importance of the health and safety measures,” he said. “Police have given out over 50,000 fines to people not wearing masks.”

The fines are for NIS 200 (about $58), but will soon be raised to NIS 500 and issued to people with masks but not wearing them properly, for example, by not covering the nose.

With frequent changes on the national level regarding coronavirus guidelines, there has also been confusion among physicians.

“The national government reports almost every day with instructions, but they change too fast and too often,” Dr. Amnon Lahad, chairman of the Department of Family Medicine at the Hebrew University of Jerusalem, told The Media Line.

The national government reports almost every day with instructions, but they change too fast and too often

“In all the government’s teams, there is no [single] person who is really treating people…. The other thing,” he said, “is that when you do not integrate forces with all the people around you, mainly clinicians, not everyone trusts you 100%.”

Lahad is also head of the Jerusalem district for Clalit Health Services, the largest of the country’s four health funds, and chairman of the National Committee for Primary Care, an advisory board to the Health Ministry.

He says that mass gatherings for celebrations and for shiva mourning visitations have been responsible for many of the new infections, adding that the government should have increased its epidemiological capacity to investigate in order to lower the spread.

“I was surprised that we didn’t have the manpower emerge this year [for epidemiological tracing], where, like in many other areas of medicine, we are short of personnel,” he stated.

He notes that although several months have passed, tracing capacity is “not much larger now” than it was at the start of the pandemic.

“There are ways to do this. You can teach vets and medical students and other people – which might not be 100% effective, but it’s better than nothing,” he noted. “We need to start now.”

Prof. Ronit Calderon-Margalit of Hadassah Medical Center and the Hebrew University Braun School of Public Health, agrees, and cites the fact that there are only 27 epidemiological nurses for all of Israel.

“In order to increase the number of investigations, the Ministry of Health should release the second version of Hamagen,” she told The Media Line, referring to an app that cross-references the GPS history of a user’s smartphone with Health Ministry data on confirmed patients.

She adds that combating coronavirus will require multiple levels of responsibility.

“There’s a personal, local and national level to this. On the personal level, people should be very careful and use masks, use sanitizer, refrain from spending time in closed places where the ventilation is poor,” she said.

On the local level, Calderon-Margalit believes local authorities should continue to allow restaurants to seat diners outdoors, while on the national level, the government should limit the size of large gatherings such as weddings, even if held outside, or even ban them altogether.

“Whenever people are dancing together, there’s limited chance of social distancing,” she said, adding that all these steps need to be taken immediately.

“The impact of what we are doing now,” Calderon-Margalit said, “will show in the severity of the coronavirus in about 10 days, so it’s imperative that we take action now in order to avoid a lockdown in two weeks.”

The impact of what we are doing now will show in the severity of the coronavirus in about 10 days, so it’s imperative that we take action now in order to avoid a lockdown in two weeks

Jerusalem Deputy Mayor Fleur Hassan-Nahoum, however, argues that the national response has been clear when it comes to allowing local authorities to exercise their responsibilities regarding the virus.

“We control all the information that is sent out to the public, and the mayor has oversight over enforcement of coronavirus restrictions,” she told The Media Line. “We make decisions in coordination with the Health Ministry and all the relevant bodies.”

In Jerusalem, Hassan-Nahoum is spearheading an effort to make more Arabic-language coronavirus information available.

“I received a few reports saying there was not enough material among the Arab population of Jerusalem, so I specifically asked the mayor to increase the amount of information in Arabic… regarding the dangers of corona and how to prevent it,” she said.

The city of Tel Aviv is also increasing the amount of public service information available in multiple languages, including English, Arabic, Amharic and Tigrinya.

The Tel Aviv-Yafo Municipality is “distributing brochures to residents and business owners, sending messages to residents, hanging posters, announcing guidelines, posting video and outdoor signage, and working with community leaders,” a representative of City Hall told The Media Line.

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