Prof. Hagai Levine

Dr. Hagai Levine is chairman of the Israeli Association of Public Health Physicians and an epidemiologist at Hebrew University’s Braun School of Public Health.

Despite the vaccinations, proceed with caution

Safety guidelines need to be simple and easy to implement, so as not to create a disconnect between the stated policy and reality on the ground.

 

The epidemiology of the coronavirus in Israel and across the globe should teach the decision-makers a lesson in humility. Politicians issued baseless promises, only to realize shortly after that infection rates were again on the rise, forcing them to explain why they are imposing another lockdown after vowing the previous one would be the last.

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Today the situation is different, as most of the at-risk population has already been fully vaccinated. Has the time come to open the economy and return to real life, without the need for safety precautions?

The truth is that caution is imperative. We are still in the midst of a global pandemic.  From a public health perspective, the probability of a dramatic spike in the number of serious cases beyond the health system's capacity is exceedingly low. On the individual level, however, each and every one of us is at risk of contracting a disease that could be damaging, even in the young and healthy.  In accordance with Aaron Antonovsky's salutogenic approach, it's better to avoid a black and white approach to disease, and rather focus on finding solutions conducive to a healthier life, in the broader sense.

Decisions about reopening the economy must be based on epidemiological considerations, not political ones, even during an election season. The risk of infection is high in closed spaces, in areas with high infection rates, in large gatherings with numerous personal interactions, and in activities involving singing, kissing, speaking and eating. The risk of serious illness is greater in the elderly, those with chronic conditions and the unvaccinated.

To identify the appearance of new variants in time, we must methodically perform full genetic sequencing on those returning from abroad, in outbreak zones and in cases of infection among vaccinated individuals. We cannot allow the failed political management of preventing the spread of the coronavirus at Ben Gurion Airport and the borders, which led to Israelis being stripped of their basic civil right to return home, to be replaced by total neglect. We still need an e epidemiological unit at Ben Gurion Airport, along with effective testing and quarantine measures for at-risk people re-entering the country, based on professional criteria. We should also stop our addiction to news reports about the calculated reproduction rate, which is neither accurate nor relevant in the vaccine era. Instead, we need to track actual infection measurements: hospitalization and serious cases, based on distributions of risk levels, population and region.

There is a misconception that people are selfish by nature and that therefore only forceful means will prevent people from putting themselves and others at risk during a crisis. Research and experience tell us that most people are fundamentally decent and care for others. Hence, if we give them logical and consistent recommendations and set a personal example, the public, for the most part, will quickly abide by health guidelines. If people aren't given clear directives now, we could see a complete breakdown, the first signs of which we saw on Purim. The recommendations need to be simple and easy to implement, so as not to create a disconnect between the stated policy and reality on the ground.

Our test is to learn to live with the virus and restore our control over our lives and health. It is time for kids of all ages to return to school, for adults to return to work in all sectors, and to reinstate leisure, sports and cultural activities. But, even if we are vaccinated, we must continue practicing caution on the individual level and observing public health guidelines.

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