Tourists who have received three shots of the Pfizer coronavirus vaccine should be able to enter Israel from “orange” countries without isolation, beginning right after the High Holy Days, according to COVID-19 chief Prof. Salman Zarka.
The third person to head the country’s “Magen Israel” program in the last year, Zarka told The Jerusalem Post that the professionals in the Health Ministry agree that “what is allowed for Israelis we will also allow for foreigners.”
Zarka, who took over as coronavirus commissioner from Prof. Nachman Ash in July, has been only about one month in his new role. But already he has learned the balance between health and politics.
He spoke to the Post on the day that schools opened, as cases were surging and expected to continue to rise, but said that he does not expect to lockdown, and that Israel – like the rest of the world – would have to learn to live alongside coronavirus.
Earlier this week, the ministry changed the definition of a “vaccinated person” to someone who has been vaccinated with two doses of the Pfizer coronavirus vaccine within the last six months, a person who has received three doses of the vaccine – the booster at least one week prior, a person who has recovered from the virus within the last six months, or someone who recovered more than six months ago but received at least one vaccine dose.
With this shift came an updated travel outline: Vaccinated individuals returning from orange countries who meet the above criteria have to isolate only until the receipt of a negative coronavirus test result or up to 24 hours, whichever comes first.
The majority of the world is orange, including Greece, Cyprus, the United States, France, Spain, Portugal, Thailand and Italy.
But the Health Ministry’s new protocol does not pertain to anyone who meets the criteria but did not receive his or her shots inside the country.
“It should be emphasized that any traveler who was vaccinated outside Israel, no matter when, where, with what and how many times, is subject to quarantine of at least seven days – except for arrivals from the nine low-risk countries,” a message disseminated by the Government Press Office explained. “That applies for Israelis as well. No serological test will waive this requirement.”
But Zarka told the Post that it is the Health Ministry’s intention to “complete this process” and enable people who have had three shots of the Pfizer vaccine abroad to enter Israel without quarantine, too.
“If someone comes from the US and he has three doses of the Pfizer vaccine, according to our protocols – and we will soon update our policy – it would be very logical that this person has to take a PCR test on arrival, wait up to 24 hours, and then, if the test is negative, he can leave isolation,” Zarka said.
The protocol would also eventually apply to those who receive a Moderna booster.
The company announced late Thursday night that it had initiated the submission to the US Food and Drug Administration for the evaluation of a booster dose of its COVID-19 vaccine and that it expects to submit data to the European Medicines Agency and other regulatory authorities in the coming days.
But Zarka said he could not guarantee the policy shift, because travel protocols are often based on “agreements between countries and not professional logic.”
He said that “it could be that the Foreign Ministry, with a certain country, they don’t agree to allow us to enter, so we won’t agree to let them come in. Or they require us to isolate, so the Foreign Ministry will also require them to enter isolation.”
Zarka admitted that until this week the Health Ministry was not even sure of its own policy and how best to define a vaccinated person, as research started to show that antibodies wane over time. It also felt that it could not tie travel to booster shots without enabling anyone who wants or needs a third shot to get one.
The ministry only this week reorganized itself around the definition of who is vaccinated, Zarka said, “and now we will also pass it along to other countries. “Probably by the end of the holidays, we will be secure enough in our policy to open it up to the wider public.”
He said that Israel has been in close consultation with the United Arab Emirates, the United States and Japan, among other countries.
ZARKA IS A graduate of the Technion-Israel Institute of Science Medical School. He is the first Druze to head an Israeli hospital – Ziv Medical Center in Safed. He is also one of the few Druze or Arabs in the top echelon of the Health Ministry.
He serves as a clinical associate professor in Bar-Ilan University’s Faculty of Medicine in Safed and a senior lecturer in the faculties of social sciences and health Sciences as well as the department of military medicine at the Hebrew University.
In addition to his medical degree, he holds a master’s degree in epidemiology and public health from Hebrew U. and is a graduate of the Institute for National Security Studies. He also spent 25 years in the Israel Defense Forces Medical Corps, including as commander of the IDF’s Medical Services Center and as head of the Health Division. He established a military hospital on the Syrian border as part of a special humanitarian operation by Israel.
In 2019, he lit a torch at the country’s Independence Day ceremony.
Zarka was raised in an Arabic-speaking family in Peki’in, in the Upper Galilee. Today, he lives with his wife in Usfiya on Mount Carmel. He has three children. His oldest son just graduated from the IDF, another son just entered the military, and “my princess,” he said, began 10th grade on Wednesday.
On the day that Zarka spoke to the Post, nearly 11,000 new coronavirus cases were diagnosed, and the prediction was a continued spike. But he said this was not cause for alarm.
“The percentage of new cases is going up mostly because we are looking for more cases,” the commissioner explained. “We asked parents to test their children, and somewhere between 10% and 20% in some places will be positive. Those numbers will cause the daily count to go up.”
On Tuesday, parents were requested to administer rapid antigen tests at home before sending their kids to school. Students that tested positive were supposed to get a PCR test at their health fund to confirm the results and be recorded in the national data system.
Zarka said that while the number of cases might rise, the level of vaccination should go up, too. The Health Ministry inoculated hundreds of students in yeshivot on Wednesday, and was expected to provide shots at schools across Israel through Rosh Hashanah.
Specifically in the Arab sector, where vaccination has been markedly lower among young people than in the rest of the country, Zarka said he expects a surge.
“I am already hearing from municipalities that they want vaccines because they are in red areas and 70% of students are not vaccinated and they have to learn from a distance,” he said. “The Arabs don’t have holidays and will learn all month, so we will have time to inoculate them.”
Will Israel lock down if Zarka’s predictions prove incorrect?
“I have not said the word ‘lockdown’ in a long time,” Zarka said. “I do not think we will lock down.”
But he admitted that he wants the government to enact additional restrictions this month while schools open, to better manage the spread of the virus.
“If we want kids in school, then we may need to shut down some other events, like soccer games or culture,” he said.
Zarka and the rest of the Health Ministry professionals brought their recommendations to the previous coronavirus cabinet meeting, but they were met there by deaf ears. The government does not want to have to pay benefits to businesses it asks to scale back and therefore refuses to enact restrictions.
“I don’t agree, and this is one of the conflicts we have,” Zarka said. “But we live in a democratic country, and the people who make the final decisions are the government and not Salman Zarka or any other epidemiologist.”
He said that the Health and Religious Affairs ministries have aligned on a High Holy Day plan that includes pushing for outdoor prayer. He worked with municipalities to provide prayer tents to make services more comfortable, and said he has been in close touch with haredi (ultra-Orthodox) leaders about getting more people vaccinated with a third shot before Monday evening to ensure maximum protection.
Zarka also recommended that parents screen their unvaccinated children before hosting meals with grandmother and grandfather, to help keep everyone safe.
THERE HAS recently been an increase in verbal violence against Health Ministry staff and other doctors, including threats of violence, by anti-vaxxers. Zarka, too, has been the target of some of these threats, but said that he believes “there is a lot of noise around the anti-vaxxers, but it is not real noise.”
Until a few weeks ago, some 1.1 million eligible Israelis remained unvaccinated. But he said that number is down to around 890,000 due to programs to reach out and get people the jab.
“When we started to check who are the people who did not vaccinate, we learned that many of them are people that we have not managed to communicate with: Bedouin, people of lower socioeconomic status, people from the former Soviet Union, from Ethiopia and development communities. It is not really these people that have an ideology against vaccination,” Zarka explained.
The Health Ministry rolled out a program to bring vaccination to people’s homes in some of these communities, and that has already led to promising results.
A survey published Wednesday by the Israel Democracy Institute showed that nearly one-fourth of unvaccinated Israelis simply have not gotten around to getting their shots.
“If people do not want to vaccinate for ideological reasons, I am not angry with them,” Zarka said, noting there are plenty of stories of people who have chosen not to get inoculated and then wound up on their deathbed regretting the decision. “What is not OK is for them to force their opinions on the rest of the public or to threaten violence.”
Either way, he said that ultimately the country and the world will need to learn to live alongside the virus because “there is no other choice.”
“We saw that vaccines are not a magical solution,” Zarka said. “We all see that although we celebrated our victory two months ago, the virus has a mind of its own. There are new variants. The vaccines do not give an answer for life, and sometimes we need to get a booster.”
Moreover, there are plenty of countries that do not have vaccines or that have “less good” vaccines, he said. Therefore, unless Israel would shut its borders – “and it won’t shut its borders,” Zarka said – then as Israelis travel around the world, the virus will go with them, and people will continue to infect and be infected.
“The headline that reads ‘Let’s finish with this virus’ is an impossibility,” according to Zarka. But people also cannot live under lockdown, because it is bad for the economy and health.
“We need to understand that the virus is here and will continue to be here, that there will always be another wave,” Zarka said.
As such, the basic principles will continue to apply: mask wearing, social distancing, good hygiene and vaccination. The third shot, he said, could last a year or it could only be six months – “we just don’t know.
“I know it sounds limiting, but it should not be that hard when we know we are dealing with a fatal virus that causes severe health damage,” Zarka said. “You cannot live as if nothing is happening.... This is our new way of life.”