"Decisions need to be made according to statistics, not according to whims; the raw figures pertaining to the coronavirus aren't accessible to professionals inside the [Health] Ministry and outside it, and they cannot make recommendations about what should be done with them. We can contend with the coronavirus much better," said Prof. Hagai Levine, chairman of the Israeli Association of Public Health Physicians and an epidemiologist at Hebrew University's Braun School of Public Health, in a special discussion via Zoom last Thursday with colleagues from the Israel Medical Association.
Prof. Idit Matot, chairwoman of the Division of Anesthesia, Critical Care and Pain Medicine at Sourasky Medical Center in Tel Aviv, who is also treating coronavirus patients, warned in the discussion that the "Health Ministry lacks sufficient statistics, they don't have enough numbers and they don't care enough about the numbers, and they are led along by fears." Some 50 medical association heads, representing all of the medical fields in Israel, took part in the video summit, whose protocols were obtained by Israel Hayom.
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Levine said in the discussion that the letter sent last week by Health Ministry Director Moshe Bar Siman-Tov to hospital directors, in which he warned them that expanding their non-urgent care activities could be a criminal offense – for which Siman-Tov has already apologized – is a "delusional" statement and that it was unhealthy to "prevent people from engaging in physical activity or receiving medical treatment."
Levine also warned that "something crazy and incredible is happening here," because "cellphone figures alone cannot tell us everything we need to know about contact between people. It doesn't work and is completely pointless; it's like suggesting that coronavirus patients only be treated by robots." Levine lambasted the neglect of the epidemiological studies, which are only being conducted by the Shin Bet security agency instead of public health nurses and doctors.
As Israel Hayom medical correspondent Maytal Yasur Beit-Or first reported, Levine said a greater effort must be made to make the information accessible.
"To understand the rationale of the directives and in order to make evidence-based decisions, we need access to the available figures on patient characteristics in general and particularly those in critical condition, on ventilators, the number of infections per place of residence and more," he wrote to Siman-Tov in a letter last week. On Saturday, Levine said he still hadn't received a response from the Health Ministry.
With that, the medical association heads widely agreed it was critical for the public to continue heeding the Health Ministry's restrictions, which they acknowledged was one of the factors contributing to Israel gaining control of the pandemic as well as the country's relatively low morbidity rates compared to the rest of the world.
Prof. Matot added during the meeting that some of the Health Ministry's decisions were "disconnected from reality, and what's crazy is that some of what's happening stems from the "panic attack' in the ministry."
According to Matot: "There is now a gigantic line of sick people waiting to have surgeries they need, and there's an unimaginable price being paid here… We are learning a great deal about the coronavirus and it is unlike any flu we've ever encountered, [but] there has to be some sort of return to normal and an understanding that it's really not possible to continue separating the medical teams in the corona wards from the staff in the other wards."
In the discussion, Prof. Eyal Leshem, director of the Center for Travel Medicine and Tropical Diseases at Sheba Medical Center, detailed just how difficult and complicated it was to treat critically ill coronavirus patients. According to Leshem, the treatment of some 30 critically ill patients on ventilators at Sheba hospital has effectively already led to the shutdown of two internal medicine wards and the general intensive care department at the hospital.
Leshem also warned that "a situation of 100 critically ill patients on ventilators could shut down the entire rest of the hospital, while 200 such patients would no longer have a good chance of surviving, even if there were enough ventilators."
'Vaccinate for the flu'
"We also must prepare for the very complex situation in which we will need to simultaneously treat hundreds of critically ill patients in need of ventilators," Leshem continued. He also voiced concern that another outbreak of the coronavirus next winter, which, coupled with an outbreak of the seasonal flu, could cause a very high death toll "because we will not be able to handle such a situation."
Leshem advised the Health Ministry to encourage the public to get vaccinated for the flu in October and November of this year, and Prof. Levine cited an urgent need to advance legislation against anti-vaccinators.
The Health Ministry said in a statement: "We publish the figures for the public in a transparent and continuous manner on a variety of platforms. Additionally, the raw data is readily accessible to all via the Health Ministry's website."
