Category: Covid-19

Coronavirus vaccination programmes are starting all over the world, following the approval of the Pfizer-BioNTech vaccine; Moderna’s vaccine is also likely to be approved within days.

Mass vaccination programmes are complicated logistical feats. The right amount of vaccine needs to be delivered to the right places at the right times, stored (the Pfizer vaccine needs to be kept at -70C, a crazy low temperature) and injected into people. That also means health systems need syringes, needles and nurses to do the actual injecting.

It also means deciding who gets vaccinated first. For the next few months, vaccine supplies are going to be limited as every country scrambles to buy up what they can.

Personally, I’d love to get my vaccine right now. But at the individual level, a vaccine wouldn’t change my life very much.

We know that vaccines protect against coronavirus disease – CoViD-19. But it’s possible that vaccinated people can still catch, carry and transmit the actual virus to other people, without experiencing any disease symptoms.

There’s good reason to think that vaccines DO reduce coronavirus infection and transmission, too, but that hasn’t been properly studied yet, and the reduction is likely to be less than the claimed 95% effectiveness these vaccines show at preventing disease.

So how long will it be before I can benefit from the vaccine, if it might be months before I get my turn for a jab?

Actually, the benefits will come a lot faster. Because Covid-19 is so much more risky for older people, a little vaccination goes a long way.

(The following methodology and analysis is based on Harry Lambert’s article in the New Statesman which applied it to the UK)

Three thousand Israelis have died from Covid-19. Of the casualties, 54% were over 80 years old. 80% were over 70, and 93% were over the age of 60.

This is even more striking when considering the size of each age cohort. Israel’s young population means that the over-60s only represent 16% of the total population.

Let’s assume the vaccine is 95% effective at preventing death from Covid-19. In reality it might be higher than this, because it seems like the 5% vaccinated people who do get Covid-19 have less severe symptoms, but it’s a reasonable assumption.

With just the 51,000 over-90s vaccinated, which is around 0.5% of Israel’s population, the total risk of fatalities from Covid-19 drops a huge 19%.

Expanding vaccination to all over-80s would only require 273k people to be vaccinated, but would more than half the fatality risk of the virus.

By the time we’ve vaccinated all over-70s, we’ll be up to 76% lower fatality risk with just 735,000 people vaccinated.

For those people who are into 80-20 principles, the graph suggests that when Israel has vaccinated the most vulnerable 20% of people, the fatality risk will be reduced by 80%.

Alongside this drop in fatality should also be a drop in serious cases and hospitalisations, reducing strain on the health system as a whole.

Adding on all over-60s drops the fatality risk by 88%; adding in under-50s brings us to a 93% decrease with a quarter of the whole population vaccinated.

But from then on, vaccinating all the under-50s, which is the remaining three quarters of the population (6.8 million people), only moves the fatality risk from 93% to the maximum of 95%. And even this is misleading; we might be able to get close to 95% by targeting vaccines at vulnerable under-50s with known conditions.

So the most devastating phase of the Covid-19 pandemic is nearly over. But what comes next?

Does Israel reopen rapidly once all the over-60s are vaccinated? Reducing the risk by 93% is huge, but with unmitigated virus spread, the remaining 7% might still represent many thousands of deaths.

Equally, maintaining restrictions after mass vaccination seems crazy; isn’t the whole point that we want to get back to normal life?

My best guess is that it’s somewhere in the middle. Once the most vulnerable part of the population has been vaccinated, we’ll be able to take many more steps back towards normal life, while maintaining some restrictions.

What I’m less sure about is how that works. It’s tempting to just allow massive coronavirus spread in, say, under-40s as a path to herd immunity once all over-60s are protected. That approach could lead to thousands of deaths… but maybe they’d be in the ballpark range of annual flu, or a little higher.

Or perhaps we keep a constant level of restrictions until the whole population is vaccinated, including the 75% of us that are under 50, and hope that the vaccine also significantly reduces the risk of spreading the infection. This is a longer path back to normality, but a safer one. There’s good reason to think a vaccine will give better, stronger immunity than an asymptomatic virus case, so this is a more durable path too.

The coronavirus isn’t going away. It probably never will. But a little vaccination goes a long way to reducing the risk. Vaccinating just half a percent of Israel’s population should cut the fatality risk significantly, and just 3% will half it. There’s a lot to be hopeful about right now.

As Israel slowly exits its second lockdown, there hasn’t really been time to take stock of how bad things got.

One of the common claims of the conspiracy theorists and deniers is that the coronavirus isn’t really killing anyone, or at least not nearly as many people as the official figures claim. These people say that hospitals are deliberately inflating death tolls, blaming every respiratory or elderly death on the virus even when there is no test, no proof and no connection. People can check Karen Ann Ulmer, P.C. if they need some help with estate planning. During this pandemic, the rise and fall in the real estate market is being noted often not only in here but in the global market too. You can check here to know about the many benefits that the real estate has, especially now, when the market is not stable.

I’ve heard many Israeli sceptics saying that there are no excess deaths; no more people passed away than normal, so perhaps the numbers are all fake?

The data released by the Central Bureau of Statistics shows a grimmer picture.

The CBS reports on all deaths by calendar week. I looked at week 38 to week 43, six weeks that cover 14 September—25 October this year, the latest data that the CBS has published. I also looked at the same six weeks back to 2014.

As you can see, this year stands out sharply, with about 1350 more deaths than we might expect, excess deaths of around 28%.

If we compare these figures with the reported Covid-19 deaths as published by the Health Ministry, we find that they’re actually very close.

The Health Ministry reported 1278 Covid-19 deaths in the 42 days from 14 September to 25 October.

This suggests, again, that the hospitals and healthcare system is doing an accurate job when it comes to coronavirus casualties. In many other countries, excess deaths have been far higher than the official death toll.

But equally, it should squash the lies of the conspiracy theorists.

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I’ve been distracted with the US election these last couple of weeks.

What would you want me to write about next? I can do more about the domestic politics of the virus response, or some general roundups on international news and vaccine development, or even go WAY off-base and talk US politics that isn’t Coronavirus-related.

Leave your thoughts or suggestions in the comments.

Israel’s government appeared to have learnt the key lesson of the country’s second coronavirus wave: open things slowly. Slowly enough to see the impact of each decision in the hope that infection rates keep dropping, and slowly enough to stop or reverse any relaxation of the rules before things spiral out of control again and a third lockdown becomes necessary.

Or at least, that’s the plan. But it’s already running into trouble over the reopening of the education system, starting, in theory, with pre-schools, kindergartens and daycare for 0-6-year-olds.

More than just pre-schools

Did I say starting with pre-schools? That’s not quite right, actually.

• Students at Hesder Yeshivot for post-school national religious students returned to their studies a week ago, right after the Sukkot festival, at the height of the full national lockdown.
• National-religious boarding schools for teenagers, the pnimiot and ulpanot, reopened this week. In theory, students at these schools will be restricted to “capsules”, but given that they’re also allowed to spend every other weekend at home, the capsule situation is
• Haredi Yeshivot will return later this week, also with a capsule deal — which worked out so well last time.

So even officially, a lot more educational institutions are opening, with many teenagers going back to school in person.

And that’s just what’s legally open.

R Kanievsky, the spiritual leader of much of Israel’s non-Hassidic Ashkenazi Haredi community, ordered that schools for younger children – well, for younger boys, anyway – the Talmud Torah schools, should open despite the law. Yesterday, many did.

This morning, some girls’ schools also began opening illegally, too. These illegal school reopenings are not limited to R Kanievsky’s community; many Hassidic schools are also open.

Some Haredi schools took things even further, celebrating the illegal reopenings with parties and bouncy castles, like this one from the Red Zone city, Elad, today.

"צדיק, קפוץ לי" pic.twitter.com/HPBt1gEQND

— ישראל פריי (@freyisrael1) October 19, 2020

So while the government talks about a slow, phased reopening starting only with under-7s, the reality is that large parts of the education sectors are open at all ages.

Ironically, the few remaining Red Zones in Israel (Bnei Brak, Modiin Illit, Elad etc) are the only places in the country where all schools, for all ages, are open. Meanwhile places with very low coronavirus incidence, like Tel Aviv, remain closed.

Schools and coronavirus

The science on schools and coronavirus is not settled. At all. There are vastly differing studies out there, with some papers saying schools are not a source of Covid-19 outbreaks at all, and others suggesting that they’re a major factor.

There is consensus that children, especially those younger than ten, are much less likely to develop symptoms if they catch the coronavirus, and are much less likely to become seriously ill. Because of this, they’re probably at least somewhat less contagious on average because the virus is less likely to make them cough or sneeze.

That’s where the consensus ends, though. Some studies suggest that kids catch the virus at about the same rate as adults, while others say they’re less likely to get it. Some studies claim that children are much less infectious than adults, while others say the difference is marginal.

In Israel, about a third of all coronavirus cases were in the 0-19 age ranges. This means children and teens are under-represented compared to their share of the population, but not by a big amount.

A recently-published study by Israeli researchers looked at infectivity across households in Bnei Brak:

We estimate that the susceptibility of children (under 20 years old) is 43% of the susceptibility of adults.

The infectivity of children was estimated to be 63% relative to that of adults.

This might look like kids and teenagers are a lot less likely to catch and spread the virus.

However, schools themselves are higher-risk environments. Small and often crowded classrooms with 40 students from different households, with exemptions from masking and physical distancing requirements; dining rooms and corridors where different classes mix indoors; lots of physical contact during breaktimes. In particular, classroom learning makes superspreader events more likely.

So even if kids are half as likely to get the virus and two-thirds as likely to spread it, schools themselves could increase their chance of catching it by a couple of orders of magnitude.

Because children are much less likely to be symptomatic, the coronavirus is much less likely to be noticed if it spreads in a school. Some studies that claim school outbreaks themselves are rare, but this isn’t much of a surprise if nobody’s looking for them.

Other studies, though, have found that schools are often a hidden source of infection for adults, with parents getting Covid-19 from asymptomatic kids who were unknowing carriers of the virus. This is hard to detect, so it could happen more often than is known.

Israel has already seen the impact of school reopenings. In late May, when schools first reopened, virus cases shot up, hundreds of schools were shut and students quarantined.

In August, when the Yeshivot returned, virus incidence was already high at around 1500 cases a day. Just ten days later, when the rest of the schools began their year, that had risen to over 3000. Two weeks later, Israel was seeing 5000 cases a day and the government was proposing a full lockdown.

Third lockdown or permanent limbo?

If Israel was only opening education and daycare for under-7s, then that could be a wise move. Indeed, that’s how it’s been presented to the public. The theory is that this can’t possibly be enough to push R above 1, and that the virus will continue to decline.

The reality, though, is that residential yeshivot of all types, which were mostly responsible for the lockdown, are reopening too. The entire Haredi education system in the cities with the highest virus rates is also open, and the government has admitted that it can’t and won’t enforce those closures.

If Covid-19 cases begin to rise again, Israel could find itself stuck in permanent limbo, unable to meet the targets needed for the next stages of reopening, particularly the 500-case target for opening shops and markets.

Alternatively, school outbreaks could go undetected until we start to see increased cases among adults in a month or so. If that happens, a third lockdown is very possible, likely at at around Hannuka time.

And how will the Israeli public react if wider restrictions remain in place for months because, once again, of the Haredi education system?

I end a lot of these pieces by saying I hope I’m wrong, and this one is no exception. I hope that the significant drop in new daily cases continues, that schools of all sorts remain virus-free, and that Israel can move towards a balanced R budget that enables wider reopenings.

I’m not very confident, though. I’m going to spend the next couple of weeks enjoying our new-found freedoms before we lose them again.