In recent weeks we have seen a steady improvement in most European countries in containing further coronavirus outbreaks, after a long period of lockdown and essential restrictions. Now, after the heavy toll exacted by COVID-19, France, Spain, Italy, and other countries are taking careful, highly scrupulous steps to ease the lockdown.
Thanks to the disease's lesser impact, Israel has had the privilege of acting otherwise. In light of the rapid, exponential decrease in the number of cases, it swiftly – some say too swiftly – began to lift restrictions to restore the country's economic productivity and social stability. One of the recent decisions taken as part of these steps – reopening the education system – is almost unparalleled in other countries struck by the disease. We thus have no point of comparison or way of knowing whether the number of cases can be contained in crowded classes of over 30 pupils, in "real life" conditions wherein masks are not consistently worn.
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The last few days have thus provided troubling evidence. At least two clusters of over 10 new cases of infected pupils and teachers (one cluster involving many dozens) are a major warning sign reminding us that high outside temperatures and hypotheses regarding low infection rates in children cannot deter the spread of the virus.
The decision to reopen schools was a calculated risk, assuming we should implement a trial-and-error strategy. Errors are permissible, and risks should indeed be taken, as long as we have a broad and significant "safety margin" between the present rate of infection and one that threatens the health system with overload. This safety margin allows for significant maneuvering and risk-taking, yet still requires good judgment to reduce the danger of overflow.
It is therefore unnecessary at this stage to close down all the elementary and secondary schools, excluding those that are in imminent danger or where new cases have been found. The Health Ministry should ensure that swift contact tracing and widespread testing be performed for every new cluster to effectively break the chain of infection. However, if in the next few days outbreaks continue to occur in educational facilities, we will have no choice but to revoke the schools' "purple badge" and shift to a different mode of activity less conducive to mass infection.
Mass outbreaks are not extraordinary with coronavirus. According to mounting evidence in studies from Israel and abroad, the disease tends to spread in particular events of mass infection in unprotected groups, rather than steadily progressing from one person to another. In a famous outbreak, 53 (out of 61) singers present at a single choir gathering in Washington State were infected by one "super-spreader." Two have since died of the disease.
The evidence shows that with coronavirus, any large gathering is like a barrel of gunpowder waiting for a match. We've been lucky so far, but at some point a super-spreader with no mask will enter a crowd, setting off an outbreak that will force us to implement social distancing restrictions more stringent than we would like. Such events can be easily prevented: everyone should take personal responsibility, avoiding crowds, wearing masks, and staying at home when feeling any suspicious symptom, especially a fever, coughing, or impaired smell or taste – a typical sign of coronavirus. Symptomatic individuals should contact their HMO to be tested.
The rise in infections – assuming this trend will continue – will again increase the risk to the elderly and the chronically ill, who should again exercise good judgment to prevent infection by avoiding large groups and close contact. However, a combination of a national effort to break chains of infection and the assumption of minimal personal responsibility for reasonable behavior will allow Israel to get back to normal without disturbances or delay. At the moment Israel enjoys relatively optimal conditions to succeed – and success is entirely in our hands.
