Israel’s Weakened Health Care System Leads to a Near-Total Lockdown
Israel was one of the first countries to respond forcefully to the coronavirus. Many of the steps taken to contain the virus were later adopted by other advanced countries. The regulations are intended to “flatten the curve”—that is, to prevent a spike in the number of cases that could spiral out of control and overwhelm health services, as happened, for example, in Lombardy, Italy.
And on Wednesday, as the Ministry of Health announced that 2,170 people in Israel are sick with COVID-19 and 5 have died from the virus, the country went into an almost total lockdown.
The new restrictions, issued by the government and based on emergency regulations, severely curtail freedom of movement. Israelis are now allowed to walk only within 100 meters (less than 110 yards) of their homes. Only two people are allowed in a car at a time, and only if they are traveling to the grocery store, the pharmacy, an approved place of work or an urgent medical appointment. Public transportation has been reduced by 75 percent, and taxis are limited to one passenger per ride, sitting in the back with the windows open.
Even synagogues have been shut down, since it is now permitted to pray only in an open space. Weddings, funerals and circumcisions can only be held outdoors and with no more than 10 participants, all of whom must stand at least 2 meters (just over 6 feet) from each other. Breaking these restrictions is a criminal offense, entailing a steep fine or a suspended jail sentence.
Israelis have already been in partial lockdown for more than a week. However, numerous experts have stated that if Israel’s health system had been properly prepared for the crisis, these newer, stricter measures might not have been necessary.
Dan Ben-David, head of the Shoresh Institution for Socioeconomic Research and an economist at Tel Aviv University’s Department of Public Policy, has told reporters that, “The fact that Israeli governments have let the country’s health system deteriorate steadily for years left it no choice [but to institute these restrictions] when the pandemic hit.”
“Flattening the curve,” he continued, “is only so urgent because hospital budgets have been severely cut back for years, so that Israel needs to bide more time than it would otherwise have had to,” in order to be ready for what is regarded as an inevitable influx of coronavirus patients.
Speaking on Israel’s Channel 12 news, Jihad Bishara, director of the Infectious Disease Unit at Petah Tikva’s Beilinson Hospital, said that the quarantine rules are so strict because government officials know that our health system cannot withstand coming under any more strain, because it is perennially stretched to the limit.
According to a November 2019 report by the Taub Center, a socioeconomic research institute, in Israel, there are about 2.2 acute-care hospital beds per 1,000 people as compared to an average of 3.6 in countries belonging to the Organization for Economic Cooperation and Development (OECD); in European countries in which, as in Israel, medical services are provided by health funds (such as Belgium, Germany, the Netherlands and Switzerland) the average is 4.1. Even after adjusting for the relatively younger age of the Israeli population, the number of acute-care hospital beds stands at 2.5 per 100,00 population, which does not significantly reduce the gap between Israel and other countries.
After adjusting for age, the share of expenditure on hospitalization in the GDP is 2.1 percent, as compared to 2.3 percent in the OECD countries and 2.8 percent in similar countries.
This situation leads to overworked staff, poor infrastructure, crowded wards and a greater risk of infection.
While it acted quickly as the risk became known, Israel came into the crisis without enough equipment. Israel did not have enough test kids or protective equipment for medical staff. Although Israel quickly engaged in an international attempt to purchase these kits, a Haaretz report revealed that many of the kits that did arrive were the wrong kind. The shortage of tests led to a delay in the “drive-through” testing stations put up by Magen David, and Israel is very far from the goal of 10,000 tests a day, recommended by experts.
Furthermore, it is unlikely that Israel will be able to purchase enough test kits and protective gear on the international market, due to a world-wide shortage and the massive buying by large counties.
“What exactly has the Health Ministry been doing all these years if not preparing for something like this?” a senior health ministry official asked rhetorically in an interview with the Walla news site.
In unexpected emergencies, Israelis are very good at improvising. Israeli teams have brought emergency care to disaster areas throughout the world, from Haiti to Sri Lanka. Last week, workers from Sheba Hospital, not far from Tel Aviv, were able to transform an underground parking lot into an emergency care unit in 72 hours.
But the COVID-19 virus, experts warn, is an ongoing, rapidly worsening crisis that demands preparation. It remains to be seen if we can get through the next few weeks without overwhelming the health system.