We Israelis thought we had Covid-19 beat. We thought we had herd immunity thanks to the world’s most successful vaccination campaign.
On April 18, Israel canceled facemasks outdoors and reopened schools fully. On June 1, we lifted most pandemic restrictions and on June 15, stopped requiring masks indoors. We eagerly anticipated international tourists arriving July 1.
Now, the highly contagious Delta variant from India is causing what many believe is a fourth wave of Covid-19. Our faces are once again masked indoors. We don’t know when and how tourism will resume.
While vaccinations appear to be keeping new infections mild, the numbers are rising in Israel and across the world.
In Israel, Delta accounts for some 90% of cases diagnosed in July. On July 20 alone, about 1,400 new infections were reported.
“It has started to create an environment of despair,” says Dr. Manfred Green, director of the University of Haifa’s international master’s program in global health leadership, previous head of the IDF Public Health Branch and founding director of the Israel Center for Disease Control.
Road map
We all need to change our thinking and draw a road map for living with Covid, Green tells ISRAEL21c.
“In the long run, if we achieve very high vaccination rates globally, we are likely to see the SARS-CoV-2 virus become much less of a public health problem, as happened with the Spanish flu of 1918,” says Green.
“For now, we have to accept that we will always be dealing with pandemics, and we cannot keep stopping the world. In a sense, it’s like accepting there will always be some road accidents but we don’t stop driving. However, we do try and minimize the impact.”
What’s different about this virus?
Viruses will be around “as long as humans share the same space with them,” Green says.
We have come to accept the likelihood of annual flu outbreaks. Yet we don’t take any precautions other than encouraging people to get inoculated even though the flu vaccine is only 40-50% effective.
However, the novel SARS-CoV-2 coronavirus stands out due to several problematic features, Green says.
It has changed from the start of the pandemic and continues to mutate. It spreads easily and has not been confined to one season as with respiratory viruses such as influenza. It’s particularly dangerous for the elderly. And it can cause “long Covid” — persistent symptoms for a prolonged period — in as many as one in three cases.
Prevention is key
Green points out that no disease except smallpox has ever been completely eradicated, and the dream of eradicating Covid in a year or two is impossible.
“In addition, viral diseases frequently are difficult to treat. So far, the world hasn’t been very successful in developing effective specific medications for Covid-19. The best approach is preventing viral diseases with vaccines,” says Green.
Israel vaccinated more citizens more quickly than any other country. We began vaccinating ages 12-15 in June, and pioneered giving booster shots to vulnerable populations such as transplant recipients and cancer patients.
The handful of Covid-19 vaccines developed in record time — some more effective than others, notes Green — are changing the nature of the pandemic. Booster doses and more targeted vaccines soon to come “will certainly be more protective,” he adds.
“Initially, all we could do was slow down transmission so we wouldn’t overwhelm the health services,” Green says.
“Now that we have vaccines, death rates have dropped dramatically as the populations in many high-income countries are vaccinated. Even if the vaccines are only partially effective against the Delta variant, the disease will be much milder.”
He urges high-income countries to assist less well-off countries in accessing vaccines. “We will not control the pandemic if large populations in the world are not vaccinated.”
Practical steps
Green and many other experts agree that to live our lives as normally as possible, we should continue masking and social distancing indoors for the foreseeable future.
“It’s very low cost and can be effective in reducing the spread of the disease, particularly to vulnerable populations,” he says.
“The vaccination is not 100% effective, so as long as there is a high circulation of the virus, we need to protect the vulnerable.”
On a policy level, Green urges countries to invest generously and continuously in preparing for future infectious disease outbreaks.
This includes investing in infrastructure upgrades like better ventilation and air-filtration systems in schools and event halls. It also includes simply making sure there’s an adequate supply of facemasks and other PPE so nobody is caught short.
“We also need funding for epidemiology research and infectious disease epidemiologists,” says Green. “Very few people got into the field for lack of funding.”