Despite concerns over the fast-spreading Omicron coronavirus variant, the morbidity situation in Israel seems to be under control. The Health Ministry reported on Wednesday morning that of the 106,585 Israelis it screened for the virus in the past 24 hours, 673 (0.70%) tested positive. The reproduction rate, which inched up to as much as 1.09 in recent weeks has decreased to 1.01.

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There are 6,429 active cases in the country with 122 patients hospitalized. Of those, 84 are in serious condition. 

Israel has reported 1,352,067 cases, including 8,224 deaths, since the outbreak of the pandemic last year. On Wednesday, no COVID deaths were reported. 

Thus far, 4,135,124 Israelis have been fully vaccinated, 5,798,867 received two shots and 6,422,632 got one jab. 

Meanwhile, the head of vaccine alliance Gavi, which is leading a United Nations-backed push to get COVID-19 vaccines to developing countries, said that he's seen early signs that rich countries are beginning to withhold donations out of fears about Omicron– warning any new hoarding could lead to "Inequity 2.0."

Gavi chief executive Dr. Seth Berkley took stock of the nearly two-year fight against the pandemic as the alliance released the latest update to its supply forecast for COVID-19 vaccines that it has repeatedly downscaled, largely because of export bans and vaccine hoarding by some producer countries that critics say it should have foreseen.

"With the Omicron variant, what we've seen is panic in many countries that has led acceleration of boosters both to the numbers of people getting them, but also the timeline for getting them," Berkley told The Associated Press in an interview late Tuesday at his home outside Geneva.

He was referring to extra doses given in rich countries to a broad swath of people – not just those at highest risk of contracting severe COVID-19.

The Geneva-based public-private partnership has been the lead manager of the UN-backed COVAX program that initially sought to get coronavirus vaccines to all countries but was pivoted after wealthier countries, and even some poorer ones, started striking their own deals to get jabs.

That locked down much of tight supplies and prompted vast inequality in access to jabs. Of the roughly 10 billion doses that have been delivered worldwide, the vast majority have gone to rich countries. COVAX has delivered just over 700 million.

"We also are beginning to see donors not wanting to donate their doses as fast as they might have because of the uncertainty now of where we are," Berkley said, declining to specify. "Of course, our long-term concern is, if it turns out that new variant vaccines are required, that there may be an 'Inequity 2.0' where we see wealthy countries hoard those vaccines once again, like we saw at the beginning of the pandemic."

While Omicron's transmissibility, severity and resistance to vaccines aren't yet fully clear, the new variant could require revisions to existing vaccines or even production of new ones. Berkley says a COVID-19 vaccine from Novavax, which relies on a common technology in flu vaccines and has shown efficacy against variants, could be set to win emergency-use approval within "days" from the World Health Organization.

In recent weeks, global production of COVID-19 vaccines has taken off and supply is less of a problem than it once was. Now, a challenge is making sure countries can take in vaccines that sometimes require storage in very cold temperatures or are delivered in batches that need to be used at the same time once opened.

Wastage is a risk. Berkley said some is inevitable and insisted less than 1% of COVAX vaccines have gone to waste.

While he said it's understandable, if potentially short-sighted, that politicians would want to serve their own people first with vaccines, one leading critic of Gavi's handling of COVAX says a lot of the trouble can be pinned on wealthy-country governments who didn't ensure steady sharing of vaccines. Now, an influx of vaccines in some developing countries could present problems.

"Since high-income country governments hoarded vaccine and didn't allow ... distribution ... to be paced, now we're at this end-of-year dump, basically, and lo and behold, surprise, surprise, fragile health systems -- some of them are having real difficultly accommodating it," said Kate Elder, senior vaccines policy adviser at Médecins Sans Frontières, or Doctors Without Borders, which provides medical care around the world.

Gavi manages COVAX along with the Center for Epidemic Preparedness Innovations and UN health agency WHO, while UNICEF handles distribution of shots into arms.

Berkley said Gavi expects to have delivered between 800 million and 1 billion doses by the end of this year to the poorest developing countries, which he says was in line with targets. Where the alliance faced slippage in deliveries was with wealthier "self-financing countries" that were originally expected to get jabs through COVAX but didn't use it as foreseen – many opting for direct deals with manufacturers.

Gavi expects to have 1.4 billion doses available by the end of his year. It had originally set a goal to deliver 2 billion doses by the end of 2021.

Berkley said Gavi expects another 800 million doses in the first quarter of next year, but not all of those are confirmed. Questions remain about supplies from manufacturers, regulatory approvals, and dose donations that are "somewhat more unpredictable." Places like the United States and the European Union have been key donors.

As it has been forced to adapt and revise its strategies, donations from countries like "Team Europe" have grown increasingly important to COVAX – which was never planned to be a donation mechanism.

"In fact, we didn't even have donations in the original framework and way of working," Berkley said. "That only occurred because of the vaccine hoarding that was occurring in wealthy countries and because of the fact that we had export bans."

Critics say Gavi misjudged national self-interest and wrongly bet on trying to supply the whole world through a vast new program whose long-term impact is questionable. They say focus should have been on strengthening existing vaccine distribution systems, like one through WHO's Americas regional body PAHO (Pan American Health Organization).

"Hindsight is 20/20 but there have been a tremendous number of shortcomings in the COVAX facility, probably many of them which could have been anticipated (by) understanding the environment and how countries with means were going to respond to this pandemic," said MSF's Elder.

In related news, Pfizer pharmaceutical giant said on Tuesday that its antiviral COVID-19 pill showed near 90% efficacy in preventing hospitalizations and deaths in high-risk patients, and recent lab data suggests the drug retains its effectiveness against Omicron. 

The drugmaker said last month that the oral medicine was around 89% effective in preventing hospitalizations or deaths when compared to placebo, based on interim results in around 1,200 people. Data from its final analysis of the trial disclosed on Tuesday includes an additional 1,000 people.

Nobody in the trial who received the Pfizer treatment died, compared with 12 deaths among placebo recipients.

The Pfizer pills are taken with the older antiviral ritonavir every 12 hours for five days beginning shortly after the onset of symptoms. If authorized, the treatment will be sold as Paxlovid.

"It's a stunning outcome," Pfizer Chief Scientific Officer Mikael Dolsten said in an interview. "We're talking about a staggering number of lives saved and hospitalizations prevented. And of course, if you deploy this quickly after infection, we are likely to reduce transmission dramatically."

Pfizer also released early data from a second study suggesting that the treatment reduced hospitalizations by around 70% in a smaller trial of standard-risk adults, including some higher-risk vaccinated people.

It said those results showed a positive trend but were not statistically significant. They are following the results and plan to release data from the final 20% of participants in the 1,100-patient trial. The trial did not show that the drug alleviated symptoms of COVID-19 in that population.

Dolsten said he expects authorization for use in high-risk individuals from the Food and Drug Administration and other regulatory agencies soon. He does not believe an FDA advisory panel meeting will be needed.

"We're in very advanced regulatory dialogues with both Europe and the UK, and we have dialogues with most of the major regulatory agencies globally," he said.

Pfizer submitted data to the FDA last month, asking for emergency use authorization of the drug.

"These are very exciting results," said Dr. Paul Sax, a professor at Harvard Medical School, adding that the FDA should try to accelerate the authorization process as much as possible, noting there are very limited treatment options for high-risk people outside of the hospital.

There are currently no oral antiviral treatments for COVID-9 authorized in the United States.

Analysts on average forecast 2022 revenue of more than $24 billion from the pill, which would more than make up for any decline in vaccine sales after 2021.

Rival Merck & Co has asked for authorization for its antiviral pill molnupiravir. But that drug only reduced hospitalizations and deaths in its clinical trial of high-risk patients by around 30%.

Some scientists have also raised safety concerns about the potential for birth defects from the Merck drug, as well as worries that it could cause the virus to mutate.

Pfizer's treatment works differently. It is part of a class of drugs called protease inhibitors currently used to treat HIV, hepatitis C, and other viruses.

Recent laboratory testing showed that activity against the protease of the Omicron variant is as "good as basically any SARS-COV-2 variant of concern," Dolsten said.

The company has said it can have 180,000 treatment courses ready to ship this year and plans to produce at least 80 million more in 2022.

Dolsten said Pfizer is looking to expand that output further as new variants could push the need for antivirals substantially higher. Current vaccines appear to be less effective at preventing infection with Omicron.

Pfizer, which makes one of the leading COVID-19 vaccines with German partner BioNTech, has agreed to allow generic manufacturers to supply versions of the drug to 95 low- and middle-income countries through a licensing agreement with international public health group Medicines Patent Pool. However, Dolsten said that for next year he expects the drug will be mainly produced by Pfizer.

The MPP told Reuters in a statement, that it will be "well into next year" before pills produced by generic manufacturers under its licenses will be ready for use."

The US government has already secured 10 million courses of the Pfizer treatment for $5.29 billion.

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Meantime, the Sheba Medical Center in Ramat Gan will conduct the world's first study on a fourth vaccine dose against COVID-19, Kan pubcaster reported on Tuesday night.

About 200 volunteers will participate in the study. Their level of antibodies against the virus will be checked before and after receiving the fourth dose.

The study will be supervised by Professor Gili Regev-Yochay, director of Sheba's Infectious Disease Epidemiology Unit, with the backing of the Health Ministry.

The study is going forward "so that data can be based on [the participants] when we come to decide on a fourth dose. At the moment, no one knows and there is no data on this from the world," a senior ministry official was quoted as saying in the report.

The ministry's vaccination committee decided against recommending a fourth COVID vaccine to the general public on Sunday night, including those who are immunocompromised.

Concerns are on the rise in Israel and around the world as Omicron threatens to become the dominant strain globally, although a study from South Africa – where the variant was first detected – indicates that the heavily mutated strain is milder in symptoms than the Delta variant.

However, the study also found that the Omicron is more resistant to the two-dose Pfizer vaccine at 33% efficacy. 

Researchers said that the vaccine offers 70% efficacy against severe Omicron illness, which they called "very good protection."

i24NEWS contributed to this report. 

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Over 2,000 new cases of the coronavirus were confirmed in Israel, Monday. According to Health Ministry data released Tuesday morning, 2,279 of the 72,423 people who tested for the virus were found to be positive, for an infection rate of 3.2%.  Monday's infection rate was the highest recorded in Israel since Oct. 15, when Israel saw 2,115 new infections, in a sign the government was likely to impose a period of so-called "tightened restraint" that would see the government reimpose restrictions on movement aimed at reining in the spread of the virus.

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Israel currently has 18,651 active cases, 344 of which are serious. Of those in serious condition, 130 are on ventilators. So far, 3,004 people have died.

Deputy Health Ministry Director Itamar Grotto said the high number of infections was a sign Israel was moving toward a third lockdown in an interview with Army Radio, Tuesday.

"We hope this was a one-time anomaly. It will take two to three months until we see the impact of the vaccines. We mustn't become complacent. The first days of vaccination [Dec. 20] will be chaotic, but I believe that in time it will work out."

At a government meeting last week, Health Minister Yuli Edelstein said the goal of the government's efforts to stop the spread of the virus was to get to a reproduction rate of 1 and to have fewer than 1,000 people diagnosed with COVID19 per day.

"When the reproduction rate reached 1.32 or alternatively when there are 2,500 new diagnosed [cases] a day we will enter the "tightened restraint" restrictions for a period of three weeks.

Meanwhile, Prime Minister Benjamin Netanyahu entered quarantine on Monday after coming in close contact with a coronavirus carrier. He will remain in isolation until Friday.

Speaking to i24NEWS, Aaron Klein, strategic advisor to Netanyahu, said Israel would soon "be in a phenomenal position with regard to the fight against corona."

On regional matters, despite US President Donald Trump departing the White House come January 20, Klein said he believed that time was not an issue and that there would be additional peace deals announced with Arab states.

While the Trump administration brokered four historic normalization deals between Israel and Arab states, Klein said, "I think that what we're seeing now is an outpouring of willingness from Arab countries and Muslim countries from around the world to orient themselves toward Israel; to open diplomatic relations."

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Representatives from different museums across Israel have come together to create a national network for sharing best practices on how museums, galleries, and heritage sites can welcome their visitors with special needs and disabilities. Earlier this month, the representatives attended the first-ever National Forum on Accessibility and Inclusiveness in Museums. The virtual event, which took place earlier this month, was held under the auspices of the Israel Council of Museums.

The first meeting focused on how COVID-19 has impacted access to museums. Keynote speaker Beth Ziebarth, director of access for the Smithsonian Museums, shared how her team had incorporated accessibility in the reopening of museums.

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"As museums begin to reopen during the 'new normal' created by the pandemic, my hope is that we build on the progress in accessibility we have achieved in the past decades, rather than retreat from those efforts," said Ziebarth. "It's more important than ever to invite self-advocates and families of children with disabilities to be part of the planning and protocols being put into place as we reopen our doors."

Caroline Smith of London's National Gallery and co-chair of the UK SEND Network addressed how museums could best provide what families need from cultural institutions during the pandemic.

Museum representatives from Jerusalem, London, and Washington noted that with the usual forms of communication – touch, hands-on experiences, facial expressions – being curbed due to health regulations, these sectors of the population are unable to engage as well as they otherwise would be.

The forum was initiated by the Tower of David Museum, one of the first museums in Israel to run programs for children with special needs.

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Museum director Eilat Lieber said that "through imaginative programming over the last few years, the museum has brought new and diverse audiences into the world of culture and heritage and has established a forum to share like ideas among all cultural institutions in Jerusalem. We look forward to expanding this forum together with ICOM in order to make inclusivity a standard in all museums in Israel."

Reprinted with permission from JNS.org

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The government convened on Thursday to decide whether to impose new coronavirus restrictions over the Hanukkah holiday. During the meeting, Health Minister Yuli Edelstein said the operation to vaccinate Israel's citizens would kick off on Dec. 27.

Ministers were set to discuss a proposal that would forbid Israelis from staying at other people's homes from 5:30 p.m. until midnight starting Thursday evening, the first night of Hanukkah. Violating the ban would constitute a criminal offense and would incur a 500 shekel ($154) fine, according to the proposal, which would make an exemption for, among other things, those providing or receiving an essential product or service, providing or receiving medical treatment, helping someone in need or distress. Exemptions would also be made for minors staying with a parent who lives outside of their home.

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According to the Health Ministry, the purpose of the restriction was to prevent people from gathering in closed spaces.

Finance Minister Israel Katz blasted the Health Ministry's proposal, saying the move was equivalent to "bringing back a lockdown through the backdoor."

The ministers were also set to authorize the conditions for entering a phase of what coronavirus chief Nachman Ash has called "tightened restraint," according to which the government would reimpose a series of coronavirus constrictions if the number of new daily cases tops 2,000 and the rate of reproduction reaches 1.3.

The meeting comes as 1,828 of the 73,146 Israelis who tested for the coronavirus, Wednesday, were found to be carrying the virus, for an infection rate of 2.6%. Israel currently has 5,716 active cases, 318 of which are serious. Of those in serious condition, 100 are on ventilators. So far, 2,934 people have died.

The ministers were also set to authorize mandating Israelis either enter into quarantine upon entering Israel or take two coronavirus tests. Meanwhile, shopping malls across the country opened their doors to customers on Wednesday, after receiving approval from the cabinet on Tuesday night.

Despite efforts by the Health Ministry to designate the United Arab Emirates a "red" country following the spike in recent infections and growing interest from Israelis interested in visiting the Gulf state, Following pressure from the Foreign Ministry, the United Arab Emirates will continue to be designated as "green" for the coming three weeks at least.

On Wednesday, Prime Minister Benjamin said he plans to be the first Israeli to receive Pfizer's coronavirus vaccine to encourage others to be inoculated.

Netanyahu made the remarks at a ceremony marking the arrival of the first shipment of the pharmaceutical giant's vaccines at Ben-Gurion International Airport.

In a statement, Netanyahu and Health Minister Yuli Edelstein announced Israel's healthcare providers would begin vaccinating people on Dec. 27.

He emphasized, "I believe in this vaccine. I expect it to receive the necessary approvals in the coming days, and I want Israel's citizens to be vaccinated. And to that end, I want to set an example, and I intend to be the first in Israel to be inoculated with this vaccine."

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Knesset Coronavirus Committee Chairwoman MK Yifat Shasha-Biton lashed out at the Health Ministry for failing to send a senior representative to a meeting on setting out a framework for reopening gyms and authorizing sports activities, cultural events, as well as informal education.

Speaking out on the closure of gyms and the ban on sports activities, Shasha-Biton said, "The Health Ministry must bravely show up and present its opinion and its policies on such an important issue. The ministry is disrespecting the Knesset committee and the citizens and neglecting the health of Israel's citizens and hundreds of thousands of people, among them IDF veterans with disabilities and people with disabilities in general – people [who require] medical rehabilitation, and pensioners. This is what helps them maintain their health at this stage in their lives. This is the source of physical and mental wellbeing for many people," she said.

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As for the Health Ministry's decision not to send a senior official to the meeting, she said, "This is all done through the narrow view of the field of health seen only through the eyes of the coronavirus." She said the ministry had demonstrated "a lack of courage or ability to correctly handle the crisis in its entirety, alongside, of course, the prevention of the spread of the virus. Instead of coming to the committee and seeing how we can maintain people's health, Dr.  Sharon Alroy-Preis and other senior officials sit and think about how they can shut down the State of Israel again. That is not looking out for public health. We expect an official to come and look all the people who came here in the eye."

She said that "by not coming to the committee [meeting], the Health Ministry's senior management has disrespected people with disabilities."

According to Shasha-Biton, the Knesset committee would demand sports centers for people with disabilities be designated as vital operations.

Boaz Herman, who heads ILAN – The Israel Association for Children With Disabilities, said, "When we assess the benefit of restrictions compared to the heavy price people with disabilities pay for stopping physical activity, the necessary decision is as clear as daylight.

"We demand the Health Ministry make substantive decisions based on infection data and not harm the public. Halting physical activity, certainly for people with physical disabilities, is disastrous and has consequences on their physical and mental state, and the facts prove there is no justification for it. ILAN will fight for people with disabilities to be able to continue their daily routine in the field of rehabilitative sports," he said.

The Knesset committee's meeting came as the Health Ministry released updated data on the status of the outbreak, Monday. According to the ministry's findings, 1,251 of the 38,363 people who tested for COVID-19 on Sunday were found to be carrying the virus, for an infection rate of 3.3.%.

There are currently 13,158 active cases in Israel, of them, 342 are serious. Eight-eight of those in serious condition are on ventilators. Israel has recorded 345,661 infections since the outbreak of the pandemic. So far, 2,917 people have died.

Officials from the National Coronavirus Knowledge and Information Center said the increase in verified cases of the virus was continuing to intensify, with "over 1,300 infected on average each week, alongside an increase in the rate of positive tests, despite the increase in recent testing each week."

In a report published Monday, officials identified an increase in the number of patients in serious condition in recent days, findings they said, "appeared to be consistently on the rise."

There are currently 28 Israeli cities designated as "red" and 37 as "orange" according to the government's traffic light system for designating public health restrictions for local authorities based on the number of new coronavirus cases and percentage of positive test results.

The so-called coronavirus cabinet was set to convene Monday afternoon to decide on the next steps for tackling the outbreak.

A meeting on Sunday saw the cabinet approve a 48-hour extension for the pilot program for reopening malls and museums. During Sunday's meeting, Health Ministry officials called for drastic measures, among them the closure of schools, not including preschools, in "red" and "orange" cities, the closure of malls and open-air markets across the country, and requiring all new arrivals from Serbia and Turkey enter into quarantine.

According to coronavirus chief Nachman Ash, Israel would be better off allowing people to leave the country and imposing harsh restrictions on their return than shutting down air travel completely.

As for the vaccine deliveries set to begin to arrive in the country by the end of the month, Prime Minister Benjamin Netanyahu went back on his stated intention of establishing a ministerial committee to determine policies for their distribution, opting to side with Health Minister Yuli Edelstein's position that only qualified experts be tasked with the decision-making process.

"There is a professional committee that was established and is handling the issue of vaccines and the manner of their distribution. Political figures should be kept away from it, as is the case around the world. This is an entirely professional committee," he said.

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