CP: What brought the Wuhan outbreak to your attention so early on, when most of the world remained unaware of the danger?
MR: It was no coincidence. At the time, I was deeply immersed in the study of possible threats the Israeli nation-state might have to deal with in the future. Because pandemics were identified as one of those threats, I – from the start – was able to jump on the situation and advise public figures, members of the Parliament, and ministers. I believe, thanks to our awareness about the issue, we were able to implement what remains one of the pillars of our strategy against COVID-19: border control. Israel was actually the first country to close its borders. It proved to be a very effective strategy, but then we had a breach in our home-based isolation system for positive cases. We thus faced an increase in cases during the summer of 2020.
CP: Israel is now facing another increase in cases. Is this troublesome? And how does Israel plan to deal with it?
MR: On the 22nd of July there were over 1,100 new cases. Compared to our peak in mid-January 2021 of more than 8,000 daily cases, this is still low. But it is troublesome because we are facing the Delta variant. While our testing capacities are top-notch, we are now running near full capacity, with some 90,000 tests administered every day. We are starting to see delays in the results. It might become hard to keep up with the rapid pace of new infections while the country has fully opened up again. Even though indoor masking has been made compulsory again after briefly being dropped as a requirement for two weeks, there is no limit whatsoever on any activity except for events of over 100 people, which require a vaccine passport or a negative test in some circumstances.
CP: Vaccine passports are the subject of intense debate in France. What is the situation in your country?
MR: We have made limited use of this measure. Vaccine passports are broadly supported by the public other than a small group of anti-vaxxers. Under this measure, only people who are fully vaccinated, recovered from the disease, or who have tested negative in the previous 72 hours may attend events with more than 100 people. You must show your status through an app or demonstrate a negative test result at the door. The police enforce this with penalties of hefty fines. Although this was suspended for a short time while Israel had fewer than ten cases a day per million people, it was reinstated because of the current situation.
CP: Does that mean vaccines are not enough to overcome the current situation?
MR: Absolutely. Vaccines have always been a very important tool to fight the virus and save lives and health, but certainly not the only tool as we see infections building again in Israel, despite our high vaccination rate. Winning against the virus is a combination of strategy and tactics. On the tactical front, Israel is pretty good. On testing capacities, contact tracing, isolation, border control, and vaccination, Israel has done a very good job. As I mentioned before, we are able to test around 9% of the population each week [in France the average is 2%, 6% maximum], we have teams of contact tracers, nearly 3,000 people, who are able to trace from 7 to 12 contacts per positive case [2.5 in France], and isolation is organized at home and supervised either by calls or police visits, and we control borders, however not well enough. Our main issue is our strategy.
CP: What strategy is Israel pursuing?
MR: While Israel was able to hit almost zero cases twice during the health crisis, first in May 2020 and then in June 2021, it was not able to keep its advantage due to a lack of political determination in deciding which numbers are the right numbers to follow in order to keep up with testing, tracing, and isolation. We continue to let the virus spread again and again due to a lack of proper border controls.
CP: Why is it so important to control borders?
MR: It is the one thing you cannot go without. That was the first advice I gave public authorities back in January 2020. I stand by it because if you import the virus, you’ll deplete your early investment. You need to be very determined about this issue. We know it is feasible, as Israel went hard several times on border controls, and we know it is not that difficult to implement, as Israel only has two airports and five lanes. However, the rules have to be thought out carefully. The outbreak we are facing now was imported because we relaxed border controls. We definitely need to control the border sufficiently.
CP: Is there an alternative?
MR: This is an argument I am fighting against, the argument that remains focused on hospital beds, with the belief that if hospitals still have capacity we can go on with our normal lives. Vaccines are efficient, they’ve bought us time – we still have very few hospitalized cases. According to data published by the Ministry of Health, new hospitalized cases are currently 3% to 4% of confirmed cases and so far we only have 89 people in ICUs, but the numbers are rising fast, and we have over 18 new ICU cases per day. It gives us the misleading impression that we have weeks to spare and there is no need to act quickly.
Anything that grows exponentially should be kept as close to zero as possible. If you aim for elimination, in the worst case you will have a small number of outbreaks. But if you aim for containment you are almost guaranteed to lose control. Israeli tactics – of which vaccines are only one tool – used in the service of elimination would allow us to get out of the current crisis in a sustainable way.
Meir Rubin serves as Executive Director of the Kohelet Policy Forum, a non-profit organization that strives “to secure Israel’s future as the nation-state of the Jewish people, to strengthen representative democracy, and to broaden individual liberty and free-market principles in Israel.” Meir graduated from the Hebrew University in Law and Economics and became interested in the pandemic as soon as he heard about the Wuhan outbreak at the end of 2019. While Israel is a country that many eyes look to for a better understanding of the power of vaccination, it has recently faced an increase in cases, showing that risk management is an incremental process of many tools coming together as one. Vaccines are necessary, but not sufficient.
Cécile Philippe is President of the Institut économique Molinari, a French think tank that has shown a keen interest in the economics of the health crisis. It recently published The Zero COVID strategy toward protecting people and economies more effectively: https://www.institutmolinari.org/2021/04/03/the-zero-covid-strategy-protects-people-and-economies-more-effectively/.
Translated and edited for clarity from L’Express article “Vu d’Israël : “Les vaccins sont un outil très important, mais ne peuvent suffire” published on 07/28/2021.
