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Prof. Eyal Leshem

Proffesor Eyal Leshem is the director of the Center for Travel Medicine and Tropical Diseases at the Sheba Medical Center.

Spike in infections does not mandate shutdown

Reliable, up-to-date information is the most valuable tool for the government to use when evaluating the risks of certain activities, and it should weigh other options -- guidelines, capsules -- before jumping the gun and closing down business and leisure sectors.  

It has been 10 days since large public gatherings were banned and restrictions on restaurants, gyms, and public pools were reinstated. On one hand, we are starting to see stabilization and maybe even drop in the number of new confirmed coronavirus cases. On the other, the number of hospitalized corona patients and patients in serious condition continues to rise.

On Monday, the isolated coronavirus treatment unit at Sheba Medical Center was 90% full, and other hospitals are reporting that the number of hospitalized corona patients is still going up. We know that there is a lag of a week to two weeks from the time the spread of the virus slows to the time we see a drop in the number of serious cases. What is the most important thing to do right now?

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First, and most crucial, is to collect reliable, updated information about the number of confirmed cases, the places where they contracted the virus, and in what circumstances. Information about the circumstances of infection will help locate the hotspots such as parties and public events that led to a lot of infections in the current wave. In addition, collecting reliable information will make it possible to identify activities that carry a low risk of spreading the virus, and permit them.

It is likely that activity in open air, such as hiking and possibly even the use of public pools, if instructions about masks and social distancing are followed, are low-risk. There is still not enough reliable information about the risks of dining in enclosed restaurants or using gyms, and we must remember that a lack of information does not mean that these are low-risk activities -- it means that epidemiological research must be improved.

Secondly, we must keep close tabs on the number of hospitalized corona patients, their condition, and how their illness progresses. That will allow the healthcare system to direct patients in serious condition or patients whose condition is at risk of worsening to hospitals with fewer cases, and compare the number of seriously ill patients and patients on ventilators to the number we saw in the first wave.

We need to remember that the biggest concern is about a rapid rise in the number of serious cases. As long as the number of patients and their condition is carefully monitored at the national level, we will be able to take preventative steps in time.

At this stage, we are seeing the spread of the virus slow down, with fewer new cases, and know that the number of hospitalized corona patients is expected to rise, but the situation does not mandate more stringent restrictions or a full shutdown.

The country's leadership has to weigh every case of upping localized restrictions: the information needed to identify high-risk activities is epidemiological and measures the number of cases contracted during the activity in question, as well as information about the economic harm entailed by banning certain activities. Options to stopping activities should be considered: issuing special public health guidelines for it, a "capsule" approach to reduce the number of people participating in said activity, work from home, or holding activities in the open rather than in enclosed spaces. The government should decide on additional restriction only when it is clear that stopping a certain high-risk activity, and the economic harm doing so would cause, justify that step.

The public has a responsibility to follow the Health Ministry's instructions and understand that sometimes, they need to take greater caution when people's lives are weighing in the balance.

Coronavirus is expected to affect our lives for the next few months and years. It does major harm to those who contract it and causes broader social and financial harm to hundreds of thousands more. We are all responsible for protecting at-risk populations. 

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