COVID-19 Cases Surge In Israel

Looking at the plans being bandied about to handle the coronavirus explosion in Israel, I see this continued emphasis on bringing infection to a stop. I'm curious whether people think this could actually work at this point. Even in Israel, which has conducted a lot of tests, only 30% of cases have been detected (according to serological studies in August).

I don't see how we'll capture the massive spread of cases that must be underway, but completely undetected. The cat, almost inevitably, is out of the bag. So instead of capturing the cat, shouldn't we stop the cat from causing widespread damage?

To use resources effectively I'd focus on:

1) Building more treatment capacity, including building field hospitals and importing health professionals for temporary placement. There are lots of Arabic, English and Russian speaking doctors out there who can treat large swaths of the Israeli public.

2) Protecting the at-risk (if they want to be) - including buying Sonovia masks for them and offering financial support to enable isolation.

3) Regularly test healthcare workers to protect the vulnerable. There are about 70,000 healthcare professionals in the country. Every one could have a weekly test and only require 20% of testing current capacity. Israel could even use the NBA's spit tests and process far more samples.

4) Giving the elderly vaccinations as soon as they pass initial safety and efficacy tests (e.g. in the next few weeks - because the long-term health effects and effects on child-bearing don't matter as much)

5) Actually enforce masks to cut dosing - which seems to impact health outcomes substantially

As of August 23rd (when the last serological survey was done) 318,000 of Israelis had coronavirus antibodies and 819 had died - indicating a death rate of 0.25% (this is far better performance than others have seen and it doesn't even assume a expiration of antibodies). In addition, the average age of death was 81. By protecting the elderly, including selective vaccinations, Israel can bring the 0.25% death rate down substantially. They might even lower it to the range of the flu (according to the CDC), this is between 0.04% and 0.15%). It would still be a major cause of death - but it wouldn't be *the* major cause of death.

The crackdown is expected to cost 35 billion NIS. Israel could literally build entirely new hospitals for that kind of cash. Or to paraphrase one doctor who took a more negative view: what do we tell people with cancer in two years when our gutted economy can no longer afford to treat them?

For those who doubt community immunity, look at Sweden and the NY-area Haredi (ultra-religious) community. Both had terrible outbreaks (with 5% deaths in Sweden because they didn't treat the elderly and 1.4% death rate in NY because nursing homes had to admit corona-positive patients). Both either chose not to enforce a shutdown or could not effectively socially distance. Both have had very few deaths since.

Although the Haredi population numbers are hard to nail down (because they don't generate separate reporting) anecdotal community data indicates a very low death rate. In Sweden, the case is far clearer. Since Sep 1, Sweden have had 3 deaths/million in population. Israel, which still has a low death rate, has had 40 deaths/million.

Israel can get to where Sweden is - but at a far lower cost in lives than that paid by Sweden. Just protect the at-risk (which they and NY aggressively failed to do), enforce masks and build capacity.