COVID: Cases rise, but Israel has least deadly month since it all began

Experts skeptical at Netanyahu’s suggestion to start giving a third dose of the vaccine to people over 50.

Two women wearing masks walking through Machane Yehuda in Jersualem (photo credit: MARC ISRAEL SELLEM)
Two women wearing masks walking through Machane Yehuda in Jersualem
(photo credit: MARC ISRAEL SELLEM)
Some 307 new coronavirus cases were identified on Wednesday, according to a Thursday update by the Health Ministry. The figure marks the highest number in over two months and according to health officials and experts might rise further next week, up to 500 or 600. However, serious morbidity remains limited and June was the month with the lowest number of COVID victims since the beginning of the pandemic: Only six people succumbed to the virus.
“I think that we are entering a new phase in which we have a very high vaccination rate and the vaccine is quite effective against the new variant, but at the same time the new variant is very infectious and there is ongoing community transmission,” 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.
Around two weeks after the new outbreaks began in several Israeli schools, active cases continue to increase: the country now has some 2,000 active cases compared to fewer than 200 in the first fortnight of June.
Davidovitch said that next week the committee is going to convene to discuss whether to reintroduce new measures against the outbreaks, starting from the reintroduction of the green pass. Until a few weeks ago, the green pass granted access to specific venues and activities for individuals fully vaccinated or recovered, as well as to children too young to be inoculated who’d had a negative PCR test less than 72 hours earlier.  
Some 0.6% of the 60,000 tests processed on Wednesday returned a positive result. While the rate remains low – at the peak of the pandemic it was over 10% – it still marks an increase compared to a positive rate of between not more than 0.2% that Israel boasted for several weeks in May and at the beginning of June.
While the number of daily cases in the past two weeks has progressively climbed – from 10-20 to several dozen, then over 100, over 200 and on Wednesday surpassing 300 for the first time since April – the number of serious patients has so far increased only slightly, reaching 27 on Thursday; on June 19, at its lowest, it stood at 21.
According to Davidovitch, the new cases may rise next week to 500 or 600 cases, but the most crucial question will be to see what happens with the number of serious patients and deaths.
The current outbreak in morbidity presents different features from those in the past: almost half of the new cases are schoolchildren – about 550 of whom are aged 12-15 – and over 800 of those infected are fully vaccinated.
In both cases, the virus carriers are significantly less likely to develop severe symptoms – at least based on how the disease behaved in the past.
The number of inoculated people should not surprise, the professor stressed.

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“Because most Israelis are vaccinated and the protection offered by the vaccine is about 90% there going to be cases among the vaccinated,” he said, adding that the efficacy of the vaccine is also determined by its ability to protect from serious symptoms, and most people who develop them are not jabbed.  
However, since there is a physiological gap in time between the increase in morbidity and the increase in serious morbidity, health experts and officials believe that it is going to be crucial to observe what happens in the next days.
Asked when we can be fairly sure that serious morbidity will not increase significantly, Davidovitch said, in another two or three weeks.
“Thanks to the vaccines, the chance of returning to the severe number of patients of the epidemic peak (more than 1,000 hospitalized), i.e. the risk of the health system collapsing, is low,” Prof. Eran Segal, a computational biologist at the Weizmann Institute, wrote on Twitter Thursday.
“To put it simply: for the same number of identified cases there will be fewer seriously ill,” he said, adding that before the vaccines, about 2.2% of the verified patients became seriously ill after about four days, while now the situation is much better.
All experts and health officials agree that increasing the vaccination rate in Israel is crucial to prevent further deterioration.
After months of just a few thousands shots administered per day, the campaign has regained speed, with almost 20,000 shots per day on Tuesday and Wednesday, about half of them to children aged 12-15. So far, some 90,000 have been jabbed, out of a population of 550,000.
However the vaccines Israel has – some 1.4 million doses - are going to expire at the end of July. For this reason, every effort is being carried out to make sure that those who are not inoculated receive their first shot by July 10.
“I think it is a shame that we did not close the deal with the Palestinians many weeks ago,” Davidovitch remarked. “The Health Ministry wanted to do it and now we need to vaccinate as quickly as possible.
“If we are not going to use all of them, it’s better to have a deal with another country, I know that there are some discussions with the UK,” he added. “But I’m not worried that we will remain without vaccines because Pfizer is very interested to have Israel continuing its campaign since we are a model country for them.”
According to Channel 12, an attempt by Israeli authorities to ask the pharmaceutical company to extend the expiration date of the vaccines was rejected.
Meanwhile, Thursday, opposition leader Benjamin Netanyahu released a statement addressed to Health Minister Nitzan Horowitz asking him to start vaccinating the population over 50 years old with a third booster in August, claiming that top experts have told him to do so. Before his statement however, no prominent health expert in Israel had come out publicly with this suggestion.
“The topic deserves further analysis, but probably such a move would be more relevant for those over 80,” Davidovitch said, explaining that there are preliminary indications that the protection to older individuals offered by the vaccine declines faster.
“However, it is under investigation, it will need to be discussed further,” he noted.
“I think it is a bit premature to determine if a third dose is already needed,” Prof. Cyrille Cohen, the head of the immunology lab at Bar-Ilan University said. “We need to gather more data about the current infection and to determine to what extent the vaccine is protecting from symptomatic disease caused by the delta variant – which is the dominant strain now in Israel.”
Cohen explained that based on data from abroad, the mRNA vaccine efficacy lasts months and that it appears that the Pfizer BioNtech vaccine awards some 88% protection against symptomatic disease and 96% protection from hospitalization.
“Some recent data also show that mRNA vaccines may induce long lived immune response,”Cohen further said. “Also, we do not have experience with repetitive injections and thus, if we are to plan a third dose, it would be better if it were to include an update with the new variants.”