Is the coronavirus Delta wave in Israel really abating?

After the long period of the Jewish holidays, Sunday marked the beginning of the first full working week in over a month. Israeli children were back in their classrooms and adults to their normal schedule, without repeated days off in the middle of the week.

The new beginning also marked a moment of truth in terms of how the country is doing and dealing with the coronavirus pandemic.

The past few days have borne increasingly encouraging data, prompting health officials to express some optimism just days after they had sounded the alarm about a new increase in serious patients and the overload on Israeli hospitals.

However, the upcoming week or two will be crucial to understand where the country is really going, by looking at how data changes as the number of daily tests performed becomes more consistent, and even more so how the full reopening of schools is going to affect the trends, as several experts said.

“Several elements are very encouraging,” said Prof. Cyrille Cohen head of the immunotherapy laboratory at Bar-Ilan University.

“The positivity rate has been steadily decreasing for a few weeks, it stood at 6-7% and now is down to around 2.7%,” he added, referring to the percentage of coronavirus tests returning a positive result, which, as he noted “is less influenced by the number of tests, contrary to what happens with the daily cases themselves.”

On weekdays in the second half of August and the very beginning of September, the number of tests performed every day was consistently around 150,000. After the holiday period began, it fluctuated between 55,000 and 185,000 with as many as over 10,000 cases and as little as 2,400 infected people identified.

On Saturday then only 1,709 new cases were identified according to the Sunday report by the Health Ministry, marking the lowest number since the end of July.

“The figure of patients in serious conditions – which is even more objective – is also declining,” Cohen remarked. “We were at over 700 and now we are at 580. The daily number of people developing serious symptoms is going down as well.”

“The situation is complex but we can see that the trend is undoubtedly improving,” said Prof. Nadav Davidovitch, director of Ben-Gurion University of the Negev’s School of Public Health, an epidemiologist and a member of the expert committee advising the ministry on the crisis.

Davidovitch also highlighted that the R, or reproduction rate, has been dropping – currently standing at 0.74.

The rate measures how many people each virus carrier infects on average and it mirrors the situation of around ten days earlier. Davidovitch explained that several other elements besides the number of daily cases is taken into account to calculate it, therefore it can be considered a reliable sign that morbidity is declining.

“At the Sheba Medical Center we are definitely seeing a reduction in hospitalizations and in severe patients,” said Prof. Eyal Leshem, the director of the Center for Travel Medicine and Tropical Diseases at the hospital. “I would also add that nearly all people hospitalized are not vaccinated.”

The three experts said that no doubt remains about the efficacy of the third shot in curbing morbidity and serious infections.

“We now can say for sure that the booster represents a very important factor,” said Davidovitch. “The main challenge is to convince people, especially young people and members of the Arab community, to get vaccinated. We now see clearly that the vaccine covers the Delta variant as well as it did with previous variants and that the main problem has been the waning of immunity after a certain period of time.”

Davidovitch, Cohen and Leshem said that the upcoming days will still be critical, especially in terms of monitoring how the full reopening of the education system will impact the situation and whether it will lead to an increase in daily cases.

“It is possible,” Leshem remarked.

“If we look at current data, we can see that in the past month about a third of the infections have occurred among children ages 0-9, and around 53-55% of the cases were registered among people 0-19,” Cohen said. “I’m not overly concerned because these populations usually are not at risk but on the other hand, a high number of cases could create a rise in pediatric patients. It is a possibility.”

“I think we need two more weeks to assess what the impact of schools will be,” Cohen noted.

“I believe cases will increase but not in a dramatic way,” said Davidovitch, noting that the lower level of morbidity compared to the beginning of the school year on September 1 will probably help limit infections.

“In the coming weeks, I also hope that vaccination for children ages 5-11 will be authorized,” he said.

Leshem also said that inoculation for this cohort will be a very important tool against the virus.

Asked about whether it is possible to say that Israel is really leaving the fourth wave behind, he responded that “looking at the data objectively we do see a decline, it is not about an interpretation.”

“I think that there is cause for optimism but I want to be cautious,” Cohen remarked. “It is true that the holidays cause many gatherings among families or in synagogues, but on the other hand this period represents a sort of voluntary lockdown when children often don’t go to school and parents don’t go to work. The real test is coming now.”

If the positive trends were confirmed, would it mean that the government strategy paid off and Israel managed to leave the new wave behind without any major restrictions?

“It is a little complicated,” Cohen said. “On the one hand, I don’t believe in lockdowns as a solution, on the other, I think we should ask ourselves whether we could have done better. Let us not forget that around 1,300 people lost their lives to the virus between August and September. Maybe with just minimal further measures, such as a limit on the largest gatherings, or better enforcement, we could have had a better outcome without a major impact on the economy.”