Israel Demonstrates Why Relying On Covid Vaccines Alone Doesn't Work

Israelis were led to believe the crisis was over when the country began injecting its citizens with the 5 million doses of Covid vaccine it purchased. 

But the government failed to reckon with the spread of Covid variants just as many people stopped quarantining or taking other precautions like wearing masks. The British variant now accounts for 80% of the country's infections even as its citizens, especially the young, believe they have no need to worry. JL

Noga Tarnopolsky reports in New York Magazine:

60% of Israel’s population has received at least one shot. (But) while Israel races ahead on putting shots in arms, the country is seeing a spike in cases, with 74 out of every 100,000 Israelis testing positive, compared to 40 out of every 100,000 Americans. "The Israeli government didn’t listen to the experts who explained that it couldn’t protect an entire population by vaccinating." As grandparents and ambulance drivers got vaccinated, younger, less cautious Israelis flouted caution just as the highly infectious British mutation of the virus wafted into the country. "We put all our eggs in one basket: vaccines.”

On December 9, a big bright yellow DHL jet loaded with Pfizer’s coronavirus vaccine landed in Israel, where it was welcomed by Prime Minister Benjamin Netanyahu in a dramatic photo op at Ben Gurion airport. Days later he became the first person in the country to be vaccinated, live on television, followed by millions of Israelis. Since then, Israel has given at least one jab to more than half its population, earning the title of most vaccinated country on Earth. By comparison, the United States has vaccinated about 10 percent of its population.

While Israel races ahead on putting shots in arms, the country is also seeing a spike in cases, with almost 74 out of every 100,000 Israelis testing positive for the virus, compared to about 40 out of every 100,000 Americans. On Thursday, the death toll in Israel crossed 5,000.

When asked about the seemingly contradictory puzzle, Galia Rahav, the head of the infectious-disease unit at Tel Aviv’s Sheba Medical Center, sighed, chuckled, and said: “This is Israel. We have to be extreme in everything.”

A small, prosperous country with a long-established universal health-care system, Israel has administered over 5 million doses of the Pfizer vaccine in about six weeks. Once the vaccines arrived, responsibility for their distribution and administration was handed to Israel’s four venerable and experienced health-management organizations. “No other country has been as efficient about inoculating its population,” Rahav said. Netanyahu, the face of the campaign, is pushing for 90 percent of Israelis over the age of 50 to be vaccinated by mid-February. Almost 60 percent of Israel’s population has received at least one shot, which confers partial immunity, and slightly more than half have received the second shot for full vaccination. Among people vaccinated, COVID-19 cases and hospitalizations have fallen dramatically, according to the Ministry of Health.

Rahav attributes the soaring rate of infection in the general population to the weariness of Israelis — on their third or fourth lockdown, depending on how you count — with having their children at home, restrictions limiting them to 1,000 yards from their homes, and of the “politicization” of the ever-shifting rules of confinement.

Like many other countries, Israel launched its vaccination campaign with the two most vulnerable sectors: frontline medical workers and citizens over the age of 65. In January, as jubilant grandparents and ambulance drivers got vaccinated, and slowly stopped falling ill, younger and less cautious Israelis flouted caution — turning themselves into spreaders just as the highly infectious British mutation of the virus wafted into the country.

Netanyahu ably steered Israel through the first wave of the pandemic, closing Israel’s schools, businesses, and borders and ordering a strict curfew that kept people to within 90 feet of their homes. On May 26, the day he all but declared the five-month-old pandemic over, only 281 Israelis had died from COVID-19. Netanyahu reopened schools, shops, restaurants, amusement parks, swimming pools, and even cable cars. “We want to make your lives better,” he said. “To make it possible for you to go out, return to normalcy, get a cup of coffee, enjoy a beer … so first of all, have fun.”

Netanyahu’s exuberant statement came after an extraordinary few days in Israeli history. On May 17, Netanyahu, Israel’s longest-serving prime minister, managed to cobble together a government that would ensure his hold on power for a further 18 months. (A coalition of bitter rivals, it lasted only seven months.) On May 24, he stood before the Jerusalem District Court as Defendant No. 1 in a complex corruption case in which he was charged with bribery, fraud, and breach of trust, becoming Israel’s first incumbent prime minister to be put on trial. Two days later, he told Israelis to go out and have fun. Almost immediately, driven by the shambolic reopening of schools, positive cases began to spike.

“Netanyahu dropped the ball,” a senior official involved in the first lockdown told Intelligencer. “From April to July, no progress was made … Nothing was put into place, no framework for testing, no nationwide contact-tracing system, it was as if the crisis were over. Netanyahu was busy trying to put a government together and staying out of jail.”

Israel’s hurried exit from the first lockdown, with no plan to guide the nation through the pandemic’s next phases, was widely panned. Jerusalem’s elite Gymnasia Rehavia was shuttered soon after reopening, when scores of teachers and students became sick. For reasons no one can now explain, Ben Gurion Airport never began to test arrivals for COVID-19. A summer of mass weddings, desert raves and in-person summer schools provoked a sharp uptick in the rate of infections, bringing Israel to its second lockdown in September, just in time to keep families apart during Rosh Hashanah, the Jewish New Year.

Around that time, Netanyahu took personal charge of Israel’s vaccine-procurement effort, speaking with Pfizer CEO Albert Bourla 17 times and offering him a deal impossible to turn down: Israel would pay top dollar for the vaccines (about $31 per dose) and — skirting privacy laws — turn the anonymized but detailed data collected by its health-care network over to the company, an invaluable service.

But as Israel boasts of its abundance of vaccines, the inequity of its situation stands out: Until last week, it did not distribute vaccines to the Palestinian Authority, the semi-autonomous government of the West Bank. This week, the Authority began a vaccination campaign with 7,000 doses of the Moderna and Pfizer vaccines from Israel and 10,000 Sputnik V doses donated by Russia. The Palestinian government expects to receive more than 2 million additional doses of the Oxford-AstraZeneca vaccines by next month, as part of the World Health Organization’s COVAX global-sharing initiative.

Naftali Bennett, the former defense minister who coordinated much of the nation’s initial virus response and is now running to replace Netanyahu, accused the government of adopting a strategy that, in his words, can be summed up as, “We’re not going to manage the crisis in this country, we’re going to put all our eggs in the one basket: vaccines,” he told Intelligencer.

“Israel’s entire strategy relies on the hope that no variant will escape the vaccine,” he continued. “If a mutation that can bypass the vaccine appears tomorrow, we’re in trouble.” 

On Thursday, at a cabinet meeting convened to debate the future of a partial, fraying lockdown, which is scheduled to end on Sunday, Netanyahu acknowledged that “the British mutation is running amok in Israel,” driving 80 percent of Israel’s recent COVID-19 fatalities.

Health experts, who have grown accustomed to being ignored by the government, oppose lifting the lockdown, imperfect as it is. The government’s COVID czar, Nachman Ash, warned that “if we leave this lockdown with the figures as they are, we will need another lockdown in two weeks.”

The advent of the British strain has been a game-changer for Israel. “The vaccines are a big success,” Ayman Seif, Israel’s deputy corona czar in charge of anti-COVID measures in the Arab community, told Intelligencer. “We began to see their effects, but it is not enough to curb the rise in contagion brought by the mutation.”

Netanyahu dubbed the mission to vaccinate the nation “Operation Getting Back to Life,” and promised Israelis they’d be COVID-free by late March, which is, coincidentally, when they will head to the polls in what is shaping up to be a tight race. On Thursday, he tweeted out that among those ages 60 and over, he said, referring to a group that has almost universally received the second dose of vaccine, “there has been a 26 percent decrease in the critical-care hospitalizations.”

While true, the numbers don’t seem as unequivocal as the prime minister indicated. A government study showed that 44 percent of cases diagnosed in Israel between Thursday and Friday were found among citizens younger than 19. Only 6.2 were found in those ages 60 and older. Rahav said that hospital beds left free by the inoculated over-60 population are being filled by the under-50 crowd. “The British variant of the coronavirus brought us to our knees,” she said. Her hospital’s COVID wards remain at capacity, with ever younger patients.

Nadav Eyal, a columnist for the Israeli daily Yediot Ahronot, and the author of Revolt, a book about the uprising against globalization, said: “We’ve gotten to this weird point because the Israeli government didn’t listen to the experts who explained that even going at full speed, it couldn’t protect an entire population by vaccinating, which is always a linear process, while the virus itself kept growing exponentially in the population.”

He says Israeli ministers, who appear to have no idea how the crisis would be managed, “were impacted by the euphoric nature of the vaccination rollout.”

The danger confronts any country that chooses a primarily vaccine-reliant policy before COVID-19 is finally vanquished. With vaccines slowly wending their way to communities around the world while the virus itself runs rampant, Israel’s coronavirus conundrum is unlikely to remain within its borders.

“When historians look back,” Eyal says, “they will see that science and scientists rose to the moment, but politics failed almost everywhere, and made it much worse. In the competition between science and its achievements and the damage done by hollow, corrupt politics, they will say that in the short run, politics inflicted huge damage on society, and cost lives.”