Israel’s lessons for COVID’s next stage – analysis

Israel has been one of the world leaders in vaccination efforts, a success that should show the way forward for many countries being assured that vaccines may help them return to “normal” during the pandemic. This is particularly true in the US, where the CDC has warned of a “pandemic of the unvaccinated” and experts are quoted saying that the “unvaccinated are the greatest threat to pandemic recovery.”

The tendency in the US to assign blame and find scapegoats is amplified by major media, which argue the pandemic is “spiraling out of control due to unvaccinated people.” Israel has a lesson here and it is a cautionary tale: Large numbers of vaccinated people are testing positive, apparently due to the new “Delta variant” that has impacted much of the world.

Prime Minister Naftali Bennett has said that “the scientific facts are clear: Those who get vaccinated get infected less; those who get vaccinated are less contagious. If you don’t get vaccinated, you put yourself and your loved ones in danger, especially the elderly.” On July 20, The Jerusalem Post reported that of the 143 hospitalized patients, 58% were fully vaccinated, 3% were partially vaccinated, and 39% were not vaccinated at all.

Israel is still very much trying to struggle with what to do next in an uncertain era. This is because the simplistic analysis that media have tried to shoehorn the pandemic into, quoting some experts, has sometimes been misleading.

There is no magic “return to normal.” Countries discover that just when they think cases are going down, they find them going up. Various measures, from social distancing to masks and lockdowns, have not always been effective. There are many cases to learn from, whether the experience of Australia – where a tough border policy initially appeared to enable “normal” life – to Sweden, where the choice not to lock down was slammed by outsiders but turned out to work fine. Big data tells us that the number of cases per million in Sweden, for instance, is not vastly different from Israel, where there were lockdowns.

 
THE US has lurched from one extreme to another during the pandemic. The new zeal against the “unvaccinated” has sought to heap blame on a swath of the country where vaccination rates are slightly lower among adults for the spread of Covid. There are also calls for vaccine mandates in the military and angry articles asserting that unvaccinated areas are to blame for the spread of the Delta variant.

“Delta variant surges in US amid lagging vaccination,” reads one headline. One commentator, who is not a medical expert, has said on CNN that “we are going to move from a world of incentives to disincentives… This is no longer people just hurting themselves. It’s people incubating deadlier forms of the virus, more infectious forms of the virus, and exposing others to harm, especially children.”

In this line of argument, “vaccinated America” has “had enough” of the unvaccinated. “This was the week that vaccinated America started to get really fed up,” says Brian Stelter on CNN. He says there is a major divide in the US and that is why there is talk of “mandates,” apparently related to vaccines and masks.

Israel was able to achieve an impressive rollout of vaccinates – and not only to vaccinate much of the adult population, particularly the elderly who were vulnerable to Covid’s first waves, but also to achieve impressive vaccination levels in the military, where 83% were vaccinated by March and there were zero deaths.

Yet today in the Jewish state, despite all this and without being able to blame the “unvaccinated” – who make up only a small number of people – there is a rise in Covid cases beyond 1,000 a day to even 2,000, which is a lot for such a small country.

 
DESPITE MAJOR American media claiming that the rise in cases is primarily in states with low vaccination levels, in fact there are large numbers of cases in many states across the political and vaccination spectrum. This is because the US doesn’t want to have a healthy media discussion, with actual experts, about what is going on.

Some media in the US prefer a simple conclusion, blaming unvaccinated areas for why the pandemic isn’t over, and concluding that “in the United States, this pandemic could be almost over.” There’s no evidence it could be over, because with the exception of China, where there are almost no cases, most of the world is seeing the pandemic continue. Countries with the highest vaccination rates, including the UK, Israel and the US, continue to have rising cases. High profile cases of vaccinated people getting Covid are beginning to break through into media, with cases like the UK’s health secretary. This has led to discussion about what these “breakthrough” cases are.

Back in April the Centers for Disease Control and Prevention (CDC) in the US said that “evidence suggests vaccinated people don’t spread Covid-19.” Articles put up headlines such as “yes, vaccines block most transmission of Covid-19,” as The National Geographic wrote. That was the situation in Israel as well: The number of new cases declined dramatically as the vaccine rollout increased.

Then, cases began to grow again in June. By July there were thousands a day. This is alleged to be due to the spread of the Delta variant, which has tragically and coincidentally come along just as everything was returning to “normal.” Now articles are explaining “why vaccinated people are getting breakthrough infections.” Mask guidelines have been reversed. The CDC agrees and has also reversed the indoor mask guidance. This has been surprising for some, and articles have asked “why are vaccinated people still testing positive for Covid-19,” as Fortune wondered.

Others point out that vaccines weren’t going to reduce new cases to zero and that if you have a highly vaccinated public, then some of those who are infected will be vaccinated. But this still leaves an elephant in the room when it comes to Israel’s experience.

According to NBC, “CDC Director Rochelle Walensky said recent studies had shown that those vaccinated individuals who do become infected with Covid have just as much viral load as the unvaccinated, making it possible for them to spread the virus to others. Based on that finding, Walensky said the CDC is also recommending that all school children wear masks in the fall.”

As usual in the US, they are concerned that “messaging” might lead people to do something that is not in their best interest. This is why America also issued misleading mask guidance early in the pandemic when they claimed there were shortages of masks. People were told not to wear masks so that there wouldn’t be a shortage. 

Now the question is about vaccination rates. “Within the administration, there had been concern that a focus on mask use could take away a key incentive for people to get vaccinated, which they believe was a factor for many people in choosing to get the shot,” says NBC.

THE US has made another odd decision as well, which is worth quoting in full from the NBC report: “Just how widespread infections among the vaccinated are in the US is unknown. The CDC said in May it would stop monitoring the number of infections in vaccinated people aside from cases where a fully vaccinated person was hospitalized or died. Walensky said on Monday the agency has been tracking specific groups for breakthrough infections and would be reporting that data soon.

“The limited data so far has left doctors saying they feel they are flying blind in trying to assess the risk the new variant poses to their patients and relying on data out of other countries like Israel, where researchers released data last week showing the Pfizer-BioNTech vaccine was just 39% effective against preventing infection from the delta variant and 91% effective at preventing severe disease.”

America, which has the resources to track big data such as infections and spread among vaccinated people, appears to have dropped the ball when it comes to gathering important information early on during the vaccination effort. In essence, this dovetailed with the rise of the Delta variant, such that when people needed this information about how it was spreading among all sectors of the population, some information was not forthcoming.

Israel, which has tried to reduce politicizing the pandemic, is reporting how many cases there are a day and apparently how many are among vaccinated people, because Israel wants to know what to do next.

 
CHANGING MASS narratives about the pandemic have left many wondering what might come next. This is because when it began in January 2020, it was largely blamed on a “wet market” selling exotic, live animals, a theory later dismissed. Talk of a “lab leak” was banned on social media for a year.

Later, confusing information about masks presented a challenge for the public. While the WHO praised China for its mask mandates in Wuhan in February 2020, it waited until June to provide guidance for the rest of the world. It also waited weeks to declare a pandemic, appearing to affirm that the spread had been contained in China by February 25.

What followed in March were guidelines in Western countries asserting that “two weeks” would “slow the spread.” In fact, that’s not what happened. While the world struggled with changing regulations and strategies, including talk of “herd immunity” in the UK and a zero-case goal in New Zealand, vaccine programs eventually kicked into gear in the fall of 2020, in record time.

Israel was among the first to put in place mass vaccination, pushed by positive government messaging and national health care. By March 2021 this had become a major success. By July, however, the pattern of success in reducing cases had changed.

 
WHAT ISRAEL now knows is that while hospitalizations are relatively low and deaths have been reduced to near-zero, the overall number of spreading infections, assumed to be of the Delta variant, is growing. This is not good news for those who gambled on stopping the spread.

It’s also confusing because the public initially wanted to protect the elderly by using vaccines. But now it appears that not only may booster shots be in order, but also vaccines for children. This leaves some adults wary and skeptical. While in the US the media war about vaccines boils down to political crusades, now informed by toxic messaging of health mandates, a more reasoned discussion might ask about where this is all going.

Vaccine producers so far have not produced a patch that deals with Delta, similar to how tech companies create patches against vulnerabilities. Delta may also only be the latest incarnation of a changing geography of pandemic.

This is because we are now largely entering a new phase. The first phase was the initial crisis, the second was the vaccination phase, but the third is the one in which spread continues and variants emerge that somehow prevent the return to “normal.”

Some have argued for a while that the pandemic should be seen like the flu, and that given the vaccines’ ability to reduce symptoms, overall spread can be discounted. This appears to be what Singapore is saying. Count the hospitalizations, as we do with more serious illnesses, but not every case. For many countries that are case counting, like Australia, that won’t happen yet.

 
A MORE serious discussion is lacking. Why is the world still playing catch up with basic coordinated measures and data sharing? Claiming that this is a “pandemic of the unvaccinated” in the US is more about trying to coerce people into being vaccinated, than having a larger discussion about how to plan strategically in a time of pandemic. For instance, “normal” life may not be possible if we have to be fearful of new “variants” all the time.

Coordinating strategies to identify variants and rapidly test their particular threats might be better. For instance, why was it not known that Delta would infect and spread among vaccinated people? Why is there so little discussion of a vaccine booster that particularly targets Delta? What is the next “Delta” – the next variant that will appear, maybe next year – to set everything back again?

In previous eras, governments seeking to deal with a crisis have coordinated their activities better. Whether it was the space race of the 1960s or the Manhattan Project, or the Second World War – when whole factories were used to produce bomber aircraft –  the use of the nation’s best and brightest to deal with a national or global crisis was normal. So where are the best and brightest today – and where are the national and international efforts to systematically coordinate Covid responses?

At every turn, this pandemic has taken people and countries by surprise. Countries are labeled “green” one week and “red” the next for travel. Basic information on masking was confusing in the first months. While some countries mandate masks for children, others do not. Much of this appears based on attempted prevention, not necessarily lab-driven studies based on big data.

Even questions about something as simple as “how many vaccinated people got Covid yesterday?” lack basic answers in some places. These basic questions are replaced by shouted responses such as, “when everyone is vaccinated, then those who get Covid will be vaccinated, so what?” Well, it might matter if your measure for opening borders is the numbers of cases and the vaccination rates, to know things like “how many people are vaccinated and positive, and are they transmitting it among each other?”

 
OTHER MYSTERIES persist. There are vaccines being rolled out across the world, some of whose efficacy against Delta are apparently unknown. That leaves countries grasping for answers, seeking what they perceive as the best vaccines. This shouldn’t be the case. National coordination and preparing for the future should mean systematically testing vaccines against variants, transmission and serious cases – to see what is happening, not just to postulate.

Instead of these kinds of responses, we continue to see chaos. Countries sometimes talk of vaccine passports or cards as a method of entry to venues, and then sometimes scrap the idea. Mask mandates for indoors come and go. When we read, many months after Delta appeared, that “the limited data so far has left doctors saying they feel they are flying blind in trying to assess the risk the new variant poses to their patient,” this is disturbing. Why wasn’t their national Covid center established to coordinate responses? What happens next year when there is yet another new issue that comes along?

Major media appear to prefer click-bait stories about these crises, such as depicting India as falling apart due to Delta in the spring, rather than trying to learn from this information. People prefer to be told to blame the “unvaccinated” – without asking about why a new variant might be uniquely placed to do what the old Covid variant was less lethal at doing.