From Israel: “Vaccinate Children before Omicron Becomes Dominant”

French Economist Cécile Philippe interviews Executive Director of Kohelet Policy Forum, Meir Rubin

December 23, 2021

CP: What is the current situation in Israel?

MR: The government has done the following: vaccinate 5-to-11-year-olds in schools, tighten border controls (for example, the U.K. is rated “red” as of December 17th), install HEPA filters in schools, use sewage testing for early detection of Omicron and conduct pooled PCR tests in many schools on a weekly basis. And we already have a nationwide mask mandate in all enclosed spaces. Vaccine passports are required in many places, and third doses are available to everybody 12 and up. As of now, we are in a Delta wave, but we may still be able to delay Omicron for a few precious weeks.

CP: How do you make yourself heard by politicians?

MR: I make myself useful. I have managed a think tank for 10 years. We happened to be lucky on the issue of pandemics: in 2019, we created a national security team and picked this as the issue to work on. With our eyes focused on this issue, we could not miss what happened in Wuhan, and we were quick in providing information and advice to the government. With data missing on excess mortality, something that was needed to develop effective policies, one of our top researchers, Ariel Karlinski, created such a powerful tool that it is now used by the Financial Times, The Economist, the World Health Organization and many others. They all use Karlinski’s work as the basis of their reporting. It is a bit like France’s Covid tracker guy, Guillaume Rozier, who earned a Légion d’honneur award for his amazing work. My institute has 200 people in Jerusalem, and we have the tools and research capacity to be very reactive and to help decision-makers. This does not mean that it always works, but we have established a constructive dialogue.

CP: Again, Israel is the first to implement new measures in the face of Omicron. What is the strategy?

MR: We are in a Delta wave, and the idea is really to keep Omicron under control until we at least have time to vaccinate kids. Time is key. That is why, on November 24th, when I saw news of a weird new variant in South Africa, I immediately warned the authorities. On the 25th, as new features of this new variant were observed, specific PCR tests that can recognise Omicron were delivered for control at the borders. Things then proceeded as before, with the difference that, when a test came up positive, the sample would be re-tested with kits able to recognise a peculiarity on the spike gene. This meant that, within 24 hours, Israel was able to screen for 100% of Omicron. On the 26th, Israel was the first country to put a third of Africa on a red list (eight countries) and, 24 hours later, we put 50 African countries on the red list because we understood that Omicron probably circulates widely there, and we saw that the rate of growth in South Africa was so fast (doubling in two days) that it must already be widespread. On the 28th, we understood that we probably had some suspected cases, and we already had a few confirmed cases on the border that were supposed to be in quarantine. We used our security services to locate the missing persons and were able to free those who were wrongly quarantined. On the 29th, new restrictions on gatherings were enacted: no more than 50 people in an enclosed space unless everybody is fully vaccinated or has been tested within the last 24 hours, and we banned entry to all foreigners. Only Israelis are allowed to enter Israel, and they all need to isolate, whether fully vaccinated or not, at least for three days, or get a negative test

result after landing in addition to a negative test no more than 72 hours before boarding. Anybody arriving from a red-listed country goes to a government facility for quarantine.

CP: Is Israel not reacting too harshly? It is said that Omicron could be milder.

MR: I do not think it is reacting too harshly. I do not even think that what is in place will keep Omicron at bay. We already know it is circulating within the community. Again, the strategy is to get as many people as possible to get protection before the new variant hits. We need time so that people can get their booster shots and kids can get vaccinated as well. As for Omicron being milder, this has yet to been seen. Because so far it really is more contagious. We saw that in Scotland it took just two weeks from the day the first Omicron case was detected for it to become dominant. The numbers double in about two to three days. The same in the Canadian province of Ontario or in Denmark. All of this while countries are in Delta waves with very high numbers. Still, Omicron is taking over. We cannot let that happen and do nothing, especially since double vaccination does not stop Omicron. Transmission beats mortality by a long shot. If Omicron transmission increases by a factor of two, a decrease in mortality of 50% is almost negligible considering the harm it causes.

CP: Vaccinating kids is a contentious issue in France. The French paediatric society is even urging the authorities to consider natural immunity for kids. What do you think?

MR: The protection of kids has been completely overlooked. At least one in five kids in Israel has got infected with Covid during the various waves. I see this as a major failure. We will suffer for years from this failure. I hope we are going to learn our lesson. We know, of course, that when kids get contaminated, they can contaminate their families. Large households have a Omicron attack rate three times greater than Delta. It is a serious problem, as Israel has one of the highest number of kids per family in the developed world, averaging around three. Then kids can get sick. We saw that Delta was worse than Alpha, and Omicron may be even worse for kids. It is not getting milder for that population, if at all. The U.K. has reported 192 new hospital admissions in the last seven days for children 0 to 5 years old. We know that 0-to-1-year-old children in South Africa were the hardest hit by the Omicron wave. And finally, there is long Covid. Everyone can understand that getting long Covid for kids is a much more serious matter than it is for adults, who can make their own choices. Our data on long Covid in kids are poor, but medical centres had to open in order to take care of them. The issue cannot be ignored.

CP: what lessons shall we learn from this long battle?

MR: The most important lesson we have learned through all the waves is that the countries that tried to protect their people from the outset have been winners. It is a very simple message. It means infections have to be stopped by all means possible, and we need to use the mix of measures we have today in the most efficient way. We definitely need to vaccinate as many people as possible, but we also know that vaccines are not enough. Green passes are actually becoming an obsolete tool as public health policy. We need masking, HEPA filters in all public places, ventilation, etc. If we decide that we do not accept anyone being infected with a deadly virus, then we will be able to control the worst variants. We have not seen the worst yet, I believe. We are at war over our kids’ safety, against a deadly virus. Let us do our best and win.