The Cost of Uncertainty

When the current lockdown started, right before Rosh Hashana, two things were clear: 

  1. The goal of the lockdown, as stated by Health Minister Yuli Edelstein, was not to lower infection rates. It was simply to stop the infection rates from continuing to rise at an astronomical rate.
  2. Many Israelis found the uncertainty about the lockdown, and the way it was announced at the last minute, to be one of the hardest parts about the lockdown.

Therefore, it was perhaps surprising when the cabinet voted this morning to tighten the lockdown restrictions. After all, a last-minute set of extra restrictions was part of what had caused emotional and financial hardship to the public in the first place. It’s even more surprising when one finds out that the new restrictions were against the recommendations of Health Minister Yuli Edelstein and Coronavirus “Czar” Roni Gamzu, both of whom believe that these new strictures will only be marginally beneficial, and are therefore not worth the economic cost.

Perhaps the restrictions become less surprising when one looks at reports that the primary topic that was discussed during the cabinet meeting was the anti-Netanyahu protests. According to Netanyahu, he wanted to shut down the protests, and was advised by Attorney General Avichai Mandelblit that he could only legally do so if there was a tight national lockdown. But Mandelblit denies this. Bibi blamed the protests for being the cause of mass public non-compliance of Coronavirus regulations, as if there were no mass weddings, large prayer services, nightclubs, and restaurants that were regularly flouting the rules. Also, Shas MK Arye Deri was refusing to close indoor prayer services (which some health experts want closed) unless protests were shut down.

A tight national lockdown provides a means of shutting down both protests and prayer services, even though the government is now already speaking about having special exceptions for prayer services on Yom Kippur. Also, it seems like a person might still be allowed to attend a protest, if it’s in 20 person capsules with everyone two meters apart and wearing masks, and is within a kilometer of their house. Except that the entire point of a protest is people gathering together en masse to express a political opinion. Once protests are limited to those within a 1km range and can’t gather a large crowd, they lose their political power.

But, because we live in a Kafkaesque political climate, the fact that the cabinet voted on something has very little bearing on whether that thing actually becomes law. The Knesset is already talking about refusing to vote the cabinet’s new regulations into effect. Meanwhile, the Israeli public is left with the same uncertainty. 

This uncertainty amplifies the economic cost of the lockdown: In interviews with restaurant owners in Haaretz recently, many of the restaurant owners complained that the hardest part of the situation was the uncertainty and constantly shifting guidelines, which made it nearly impossible for them to plan.

The uncertainty also amplifies the emotional impact, and undermines trust in the government (the theory being that if it knew what it was doing or had a plan, things would be less last minute), which leads to non-compliance of the guidelines -thereby necessitating the need for even stricter rules, which are again announced at the last minute. It becomes a vicious cycle.

Red Zones Don’t Work in a Country the Size of New Jersey

Last week, I wanted a day of outside fun, so I went to the beach in Tel Aviv. A few years ago, when a family friend passed away, I paid a shiva call in Bnei Brak.

The great thing about living in a country the size of New Jersey, is that it’s relatively easy to travel between cities — and people often do so in the rhythm of their daily lives, whether for work, to see family, or just to check out a cool exhibit.

This means that imposing strict restrictions on cities labelled “red zones” is pretty meaningless, unless you prevent people from those zones from travelling to other cities. Closing a mall in a city is meaningless in a country where it wouldn’t be that strange to travel to a mall in a neighboring city on a Friday because the mall there is the only one with your favorite clothing shop, or when you might live in Israel’s central area, but commute daily to a job in Haifa.

That was the logic behind the proposed lockdown of the country’s “reddest” cities.

Prof. Gamzu’s traffic light plan called for decreasing restrictions in “green” and “yellow” zones, which have low Coronavirus rates. The easing of restrictions in some areas would be compensated for by increasing restrictions in red zones, and having a proper lockdown of the reddest zones, to make sure that people there didn’t travel to – and potentially infect people in – other zones.

Now, the government has taken local lockdowns off the table. But the other parts of the plan are being implemented. This means that the easing of restrictions is starting, without all of the accompanying balancing measures that were supposed to be in place.

Given that, pre-Gamzu, daily life in Israel was almost back to normal, with the exception of large gatherings, such as weddings (which were still taking place illegally) and the indoor capacity at restaurants, there is a real question about the cost of easing restrictions in yellow and green zones, relative to the risk. But that risk is manifold when green and yellow zones might include people who technically live in red zones, but now come to green zones for a date night or to buy their kid a pair of new shoes. Easing restrictions in some areas only works if you can ensure that, statistically, the population in those areas is unlikely to have Covid-19, but you can’t ensure that if there is a constant flow of population into and out of the area.

They are talking about curfews for some of the reddest cities. That’s as if, at the start of the virus, Israel sealed off travel from Italy — unless people from Italy were travelling into Tel Aviv in the morning and then taking a late night flight back, without sleeping in Israel. Except that it’s much easier to drive for an hour within a country than it is to fly between countries.

As a Jerusalemite, I was recently looking into going to an outdoor concert overlooking the Old City walls. The Old City is a designated red zone, but there’s nothing to stop someone from the Old City from going to a concert in a different part of the city.

Now they’re talking about a national lockdown over the holidays, which is likely to have a much greater national emotional and economic impact than localized red zone lockdowns.

But nothing’s been confirmed. The government spoke about local lockdowns, but then cancelled the vote about local lockdowns on the day the vote was supposed to take place, 24 hours before the lockdowns would have started. The government spoke about closing schools in red zones, but only made a final decision the day before schools were set to open.

The constant state of uncertainty, and the last minute-ness of the decisionmaking, only increases the economic and emotional impact of whatever decisions the government will finally make. How can you know how much inventory to order when you might be shut down in 2 weeks? But how can you not order inventory when you might not get shut down, and then you’ll need to feed customers? How can you make plans with family when you know that you might all have to stay home? But how can you not make plans to spend the first night of the year with your grandma?

Even if there’s no lockdown, people constantly have to plan as if maybe there will be a lockdown. But if there is a lockdown, it will still be a huge emotional and economic disappointment for many people, who still have reason to hope there won’t be a lockdown. Worse of all, the constant last-minute waffling makes it clear that the government has no plan, decreasing public confidence, which leads to less compliance of the guidelines, which leads to more cases -which starts the cycle all over again.

New Jersey and Wales
Editor’s note: For British readers, New Jersey is 1.09 times the size of Wales

Of Masks and Meters

Yesterday, Israel decided to scrap limits on the percentage of the workforce that could be in the office. Instead, each company will be in charge of appointing a person in charge of ensuring the employees maintain masks and two meters’ distance (where possible), and that 50 person meetings don’t occur unless absolutely necessary.

This is reminiscent of Israel’s earlier coronavirus strategy: open everything up, tell people to maintain masks and two meters’ distance, and hope for the best.

That strategy didn’t work, for two key reasons:

Lack of Compliance

In late May, with coronavirus numbers in only the dozens daily, the Israeli government was quick to take a victory lap, hailing itself for how its own policies had beaten the virus. PM Benjamin Netanyahu urged everyone to go out and have a beer. Politicians said that vigilance was still necessary, and that people should adhere to mask and distancing guidelines to prevent the coronavirus from re-surging. But the louder voice, which was internalized by the Israeli public, was that the virus had gone away; it was safe to go out again.

Israel did not engage in any sort of mass public campaign to educate the public about the possibility of a second wave, the reason behind mask-wearing, the importance of distancing, or how to wear masks properly. To do any of that would have taken away from its self-promotional message of victory.

There is no reason to think that compliance would be better this time around. Despite the spike in coronavirus cases, the lack of compliance with masks and meters is evident to anyone who enters a shop or walks down a public street. Why would the public change its behavior if it hasn’t even been informed about why changing its behavior matters?

Masks and Meters Can Only Do So Much

The virus is spread in two  primary ways: 

  1. Droplets, which are spread through speech, coughing, and breathing
  2. Airborne particles

In order to for healthy person to catch the virus, they need to be infected with a certain amount of viral load. If a sick person breathed on you for just a second, you probably wouldn’t receive enough viral load from that to actually catch the virus.

The longer a person speaks, coughs, and breathes in your vicinity, the more viral load they emit through droplets. The mask worn by the sick person provides a physical barrier, stopping those droplets from reaching you. The mask worn by the healthy person also provides a barrier, but a mask’s main purpose is that if someone sick wears it, their mask will help lower the amount of viral load that they give to other people. Additionally, wearing a mask means you’re breathing in and out less of the droplets in the air. This means you’re contributing less viral load to the air if you’re sick, and inhaling less of it if you’re healthy.

If a room is well aerated, that helps shift the droplets and the airborne particles, so that if there is viral load in the room, it will be transported out of the room sooner rather than later.

While masks reduce the viral load emitted by a sick person at any given moment, they don’t get rid of it completely. Similarly, masks reduce – but don’t eliminate – the amount of viral load ingested by a healthy person.

The longer you stay in the room with someone sick, the more viral load you get from them. That’s because they emit a certain amount of virus each minute, which adds up, and you’re near them. That’s why the Ministry of Health’s official quarantine guidelines apply to people who are within two meters of a sick person inside for 15 minutes.

If you spend the entire day in an office with a sick person, even if you’re both two meters apart and wearing masks, by the end of the day there’s likely to be a lot of viral load in the air, both through particles and droplets — and this could be enough to overcome the distance of masks and meters that lie between you.

It remains a mystery why the government thinks that a tactic that failed and helped create the second wave would  be effective at keeping case numbers down when we are still in the middle of that second wave.