Professor Ronni Gamzu, the manager of Israel's national COVID-19 project ("Magen Israel"), visiting the Home Front Command, credit: Wikimedia
Israel’s project manager in the fight against the pandemic outlined his strategy on Tuesday at a special foreign press briefing at his headquarter at the health ministry.
Professor Ronni Gamzu, a physician, hospital director and former director-general of the health ministry, is the right person for the new post as national project manager of Israel’s anti-coronavirus strategy but faces political challenges from a government which has tended to politicise the response and to frighten the public.
Without knowing in advance what decision powers he would be given and whether the health ministry would agree to confer competencies to him, he accepted the task offered to him by Prime-Minister Netanyahu at end July, relying on his energy, experience and outreach to all stakeholders.
By that time, Israel was hit by a surge of confirmed new cases reaching 1,500 – 2,000 per day. Since the first wave, the number of confirmed cases has increased six-fold from 16,000 to 96,000 (18 August). On the positive side, case mortality in Israel is among the lowest in the world. The coronavirus has claimed around 700 lives until now.
His task is to lead a new emergency coronavirus authority, to streamline the testing and contact tracing system and ensure an effective coordination between all authorities involved in the fight against the pandemic. Until his appointment, decisions had been taken in an ad hoc way, which confused the public and made it lose trust in the government.
“Around February, at the start of the first wave, Israel took the right measures,” he explained at the press briefing (18 August).
“But after the lockdown restrictions were lifted, there was a push for a return to normal and to allow almost all economic activities again. Maybe it went too fast and wasn’t done in the right way. Since late May we have a second wave which has mostly hit younger people in all Israel.”
The reproduction number (R), the number of new cases infected by one person, is now around 1. “It’s a kind of accomplishment since it has been above 1 and gone down to 0.9. But it’s not enough if we want to ‘normalise’ life in Israel. My target is 0.8,” he said.
What caused the surge in new cases in Israel was probably the premature opening of the schools which remained open until the end of July. Professor Gamzu says diplomatically that there is a dispute about the opening and fears their reopening in September if it is not done in the right way.
On Thursday, he will propose the government to divide the pupils into two groups. Pupils above the age of 12 have almost the same infection rate as adults. For them he proposes remote learning and one day per week in the schools with precautions. For the younger group, a return to school is possible in the form of capsules (smaller groups).
During his first weeks as project manager, he has been travelling all around the country. Compared to other countries, a relatively big share of the population – Jewish Orthodox and Arab families – lives in crowded households, where they have been infected. A number of municipalities and neighbourhoods have been marked “red” and local lockdowns have been reinforced to prevent the spread of the virus.
He underlines that local lockdowns cannot be managed centrally and must be enforced in close cooperation with the local communities that know the situation best. They will also be given the support of the Home Front of Israel’s Defence Forces. “Establishing an effective infrastructure isn’t a medical task but a logistical issue and in Israel it’s the army which is best in doing it.”
“We have managed to protect elderly people in nursing homes,” he says. “So far only 10 % of all infected people are above the age of 60. The situation in the hospitals and community health care is under control. About 800 people are hospitalized, about half of them with mild and moderate symptoms and the other half with severe symptoms.”
His strategy includes three action points: restoring people’s trust in the measures to fight the pandemic, building up an effective infrastructure, and cutting the transmission chain by intensive testing, contact tracing and quarantining of infected persons.
Contact tracing is crucial for containing the spread of the coronavirus but in most countries during the first wave it was hardly in place because of the high infection rate. What is the situation now?
He admits that contact tracing was not working in Israel and that it will take a few weeks to put a system in place. “Israel has a civilian app but it’s not mandatory and most people don’t download it in fear of ‘big brother´. We are using another app while respecting data protection rules as in the EU but most tracing will be manual.”
Professor Gamzu advocates a different strategy than the one applied during the first wave when most of the economy was closed down. The lockdown resulted in mass unemployment – still around 20 % – and an economic recession which might shrink the GDP by two-digit figures this year.
“Lockdowns cannot be excluded but I’m doing my best to avoid a new lockdown. We know from other countries that lockdowns spell economic and social disasters. I’m trying to explain to everyone that we need to combat COVID-19 without a lockdown. That’s my strategy – to keep Israel away from a new lockdown.”
As long as the rate of those testing positive is below 3 %, there is no community transmission, he says. The coming weeks with the opening of the schools and the Jewish high holiday season in September will be crucial. “Everything depends on what will happen until then.”
Israel is in the middle of a unique experiment in reducing the infection figures without a lockdown. If Professor Gamzu would have the authority to decide by himself, he might succeed but he has already been overruled by the government on issues where it interfered to approve requests from the ultra-orthodox parties to bend the rules that all other citizens have to comply with.