Category: Covid-19

After a while the stories all become so similar that they blur together.

Covid-19 infection rates rise. The Health Ministry (or coronavirus czar, or NSC head, or even the prime minister) plan measures to stop the spread of the disease. The measures are announced or briefed to the public. It becomes clear that these measures are unacceptable to the Haredi community. The Coronavirus Cabinet is delayed until a compromise is worked out. The committee eventually meets and votes to do something else instead, but from tomorrow or the day after.

Overnight, it becomes clear that the compromise measures are also unacceptable to the Haredi community. More negotiations happen. The meeting is delayed again. Another compromise is agreed and voted on, but without the list of towns it will apply to; they’ll decide that tomorrow. But then it becomes clear that it affects the towns with the highest rates of infection, and those are mostly Haredi. So it’s unacceptable again… and meanwhile, Covid-19 infection rates rise.

We’ve been through this cycle over and over again. Three times the adoption of the Gamzu Plan was delayed after objections from the Haredi parties, for example.

And here we are again. The coronavirus cabinet voted last Thursday night to effectively lock down ‘red towns’ starting from Monday… but they didn’t vote on which towns. Over the weekend, the sharp rise in infections in Bnei Brak and other Haredi areas led to the huge Haredi political backlash I wrote about yesterday.

So the vote on the lockdown towns was delayed, then cancelled, and instead the coronavirus cabinet voted to impose a curfew on 40 towns from Monday night. No shops or entertainment after 7pm, no travelling more than 500m from the house, educational institutions closed… the works.

This was less of a compromise and more of a capitulation, because a curfew on coronavirus hotspots was previously being planned in addition to local lockdowns. But it’s better than nothing.

Except, yup, they didn’t decide which towns. And so, today, the coronavirus cabinet was due to meet to vote on which towns to curfew.

And, of course, the meeting was delayed because of pressure from Haredi parties. The curfew includes nighttime closure of educational facilities, which includes yeshivot. Senior Haredi rabbis have instructed their communities to ignore any such closures.

(There are also some weird rumours out there, like that instead of the obvious towns to curfew – the red zones! – the list might include Eilat, which is a full-on green zone. Though Eilat might be green because the people getting infected there are internal tourists who live in other cities.)

So the curfew won’t start tonight. It’s now planned to come into effect tomorrow, Tuesday night. And there still isn’t a list of which towns will be curfewed — the coronavirus cabinet is debating that now, supposedly.

And you can already predict what will happen if the ‘wrong’ towns are on the list….

Meanwhile, Israel’s test test positivity for the last six days is a worrying 9%. Every day of delay is a day where cases grow exponentially.

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.

As I sounded the alarm over Israel’s sharp increase in daily coronavirus cases last week, I made a rather gloomy prediction:

I don’t see how Haredi yeshivot can possibly be able to function safely while virus cases are high without making things much worse. But I also see little political possibility that the government, relying on Haredi votes at Cabinet and in the Knesset, will take the necessary action.

Hopefully, ministers stick to the Gamzu Plan and impose targeted measures on the hotspots today or tomorrow. But I think more likely is doing little and opting for a country-wide lockdown later, once things are worse.

The next day, Friday, the Coronavirus Cabinet met and decided to impose a de-facto lockdown on the most serious virus hotspots. Residents of these towns would be forbidden from leaving except for essential needs and emergencies, shops and educational institutions would be closed, visitors would be banned and a 500-metre rule would be in effect for anyone out of the house.

Another thing happened, too. The full list of Red Zones was published and it included, as expected, the Haredi city of Bnei Brak.

The local lockdown was due to come into effect only after a second meeting of the Coronavirus Cabinet which would decide which of the red zones it would apply to, with the suggestion that it would only fall on the 8-10 towns with both a high Traffic Light score and a lot of people. A bit last-minute, but that’s how things always are here.

And then today it all fell apart.

The mayors of Bnei Brak, Beitar Illit, Elad and Immanuel, four Haredi towns, wrote a letter to Benjamin Netanyahu, formally announcing that they would withdraw cooperation with the national government if their cities were locked down. The letter also hinted strongly that the Haredi public, and their political parties, might be done with Netanyahu for good if he proceeded with the plan.

(The Haredi parties used to be a swing bloc in Israel. Since they refused to support Tzipi Livni in 2008, triggering an election, they have essentially transformed into a part of the Israeli Right, supporting Netanyahu and Likud even when excluded from the coalition by Naftali Bennett and Yair Lapid in 2013. It is the Haredi parties as much as anyone that have kept Netanyahu in power.)

To add even more pressure on Netanyahu, the Rabbinic leadership of Bnei Brak organised a visit tonight by Defence Minister and “Alternate Prime Minister” Benny Gantz. In theory, of course, Netanyahu is supposed to hand over the premiership to Gantz in just over a year anyway, but this visit sent the current PM into reverse.

Netanyahu cancelled this afternoon’s Coronavirus Cabinet meeting where the lockdowns were due to be voted into effect. Instead, he invited the heads of the Haredi parties in for a private meeting, with Prof. Gamzu in attendance. The meeting just ended, and Netanyahu announced that he was “considering alternatives” to the local lockdowns.

What alternatives? The answer is, again, predictable: a total national lockdown for Rosh Hashanah, the Jewish New Year which starts in two weeks. This is reportedly what Shas leader Arye Deri is supporting.

A national lockdown helps the Haredi community feel less singled out, of course. But it’s also MUCH harder to police than a targeted closure of a couple of cities. The Haredi leaders probably calculate (probably accurately) that the police are less likely to break up huge indoor prayer services in Bnei Brak if they’re busy stopping people from driving on highways in Beer Sheva.

Waiting until things get worse is not a strategy. The level of infection is now so high that it is crossing into nursing homes and other vulnerable populations. Deri’s New Year lockdown means a two week delay, which could cost hundreds of lives.

If all of this sounds familiar, it’s pretty much what I predicted on Thursday. I still hope I’m wrong, and the Government will stick to the original plan, but it doesn’t look like it. Gamzu is now briefing the media that he might resign, which makes sense because cancelling local mitigation and slapping in a national lockdown is precisely the opposite of his plan.

If there’s a national lockdown in two weeks, a lot of the public will blame those Haredi leaders who spent months blocking all attempts to stop the virus in their neighbourhoods.

Yesterday, 3075 coronavirus cases were identified in Israel, a record number. The previous record, the day before, was 2250 daily cases.

That works out to 32.6 new coronavirus cases per 100k residents yesterday, which is the highest in the world (excluding microstates).

Bnei Brak alone reported over 250 cases yesterday. If Bnei Brak was a country, it would have been the 61st-worst in the world yesterday, with more cases than Belgium, Greece, Norway or Ireland.

This rise isn’t just down to testing. Testing is high: at least 34,000 tests were processed yesterday, which is a lot. But the positivity on those tests is 9.4%, which is worryingly high too, especially given the high number of tests. I don’t think Israel has had such a high positivity on a day where more than 25k tests were processed before.

So this is new and this is bad. If we had seen these numbers on Monday instead of Wednesday, I don’t think the schools would have reopened on Tuesday.

Where are the new cases? Everywhere, to a degree, but the most notable increase is in Haredi towns. Bnei Brak, Modiin Ilit and Beit Shemesh, in particular, are seeing numbers surge.

Haredi towns were the biggest virus hotspots for the whole second wave until the beginning of August, when cases began to drop, replaced by a rise in cases in Arab towns. The new wave of infections in Arab communities was blamed on mass Eid al-Adha celebrations, but the drop in Haredi communities was just put down to better rule-following.

But something else happened at the start of August: The Haredi yeshiva (religious school) system began its three-week summer break following the 9 Av fast-day.

That break ended two weeks ago. The reopening happened despite the case numbers in Haredi towns: dropping, but still very high. Unlike the question of the broader school year, there was no serious discussion about delaying the reopening of Haredi yeshivot.

Two weeks later (which is just about the right amount of time it takes for the virus to spread widely), Haredi communities are suffering a renewed outbreak. Yesterday, it was reported that 800 cases in the last week were Yeshiva students, and that was before yesterday’s numbers were taken into account.

Perhaps this is why R Haim Kanievsky, one of the most senior leaders of the non-Hassidic Ashkenazi Haredim, is now calling for Yeshiva students not to get tested at all because it could lead to yeshiva closures or even a full shutdown. This call came, presumably, because they were seeing the rise in cases for themselves.

I don’t have an answer here or words of encouragement. Until this new surge, cases were stable and hospitals were finally beginning to ease off a little from last week’s peak.

I don’t see how Haredi yeshivot can possibly be able to function safely while virus cases are high without making things much worse. But I also see little political possibility that the government, relying on Haredi votes at Cabinet and in the Knesset, will take the necessary action.

Hopefully, ministers stick to the Gamzu Plan and impose targeted measures on the hotspots today or tomorrow. But I think more likely is doing little and opting for a country-wide lockdown later, once things are worse.

There’s been a LOT of confusion over how long mandatory quarantine (aka self-isolation or בידוד, “Bidud“) lasts in Israel. I probably get a few messages a week asking me about it, and it’s a popular topic on Secret Jerusalem too.

Basically, there are two categories of quarantine in Israel, as there are in many other countries:

Infection quarantine

People who have tested positive for Covid-19 are in infection quarantine. These people have or recently had Covid-19. They must self-isolate for:

• (Ten days from the onset of their symptoms,
• OR ten days from their first positive test if they have no symptoms)
• AND three days from the end of their symptoms if they had symptoms

So, for example,

• someone with a positive test and no symptoms has to self-isolate for ten days from the test date.
• someone with a positive test, a cough and a fever that goes away after five days has to self-isolate for ten days.
• someone with a positive test, a cough and a fever that lingers two weeks has to stay in quarantine for 17 days.

It isn’t necessary to have a negative virus test to get out of quarantine, and Israel doesn’t even administer tests to people who are already known cases.

Exposure quarantine

Anyone who has not tested positive for Covid-19 but is still in quarantine is in exposure quarantine. These people were in suspected contact with someone else who had Covid-19.

The precise rules for who has to go into exposure quarantine are complicated. It includes people who were in close contact with a confirmed case, but the definition of ‘close contact’ is unclear; the Ministry of Health says it means being within two metres of an infected person for 15 minutes. In practice, though, people who were in the same shop or room as a case are sometimes sent to quarantine, too.

Exposure quarantine rules in schools are also applied differently. And then there are people who are sent into self-isolation by the General Security Service’s phone tracing. Basically, it’s all a great big mess.

Travellers who arrive from abroad are considered to have been exposed in transit unless they came from a ‘green country’. So travel quarantine is just a special case of exposure quarantine.

People in exposure quarantine must self-isolate for 14 days from the exposure. If the person tests positive for the virus, then they move over into infection quarantine rules (above). If not, out in 14 days.

Why is infection quarantine shorter than exposure? That seems backwards but it actually makes sense and is the international standard. It’s because exposure quarantine includes four days of hypothetical incubation period to develop the virus, plus the ten days of hypothetical asymptomatic infection.

On the other hand, once someone actually tests positive for the virus, they’re probably not infectious for very long. In fact, for mild or asymptomatic cases, it seems like people are at their most infectious in the first few days. Ten is already on the safe side.

In reality, though, many Israelis will spend less time in exposure quarantine anyway, because often the exposure was a week ago or even more. I know lots of people who were in exposure quarantine for just two or three days by the time they found out about it.

Did I say two categories? Well, there’s sort of a third one too:

Symptom Quarantine…?

You wake up in the morning with a cough and a temperature. You call your doctor who tells you to get a coronavirus test and writes you a referral. The next testing slot is tomorrow afternoon.

In this case, where there is no known contact with a confirmed case, the law says are supposed to be in quarantine from the time you get the doctor’s referral for a coronavirus test until the test results are returned. This is likely to be a day or two assuming the test is negative. Despite this, the major HMOs are telling people with symptoms to remain self-isolated in this case even with a negative test, until 48 hours from the end of your symptom

But… the form for notifying the Ministry of Health about entering quarantine doesn’t include having symptoms alone as an option; that form is only for people who’ve been near a confirmed case. And it seems like the legal requirement for quarantine doesn’t kick in until the sick person gets referred by their doctor for a test. So a person with symptoms is under no legal obligations at all to see a doctor; they can go around infecting people. I hope I’ve misunderstood this, and will correct it if I have. I suspect that a lot of Israel’s infection chains are caused by people with symptoms like this.

There are a couple of other cases where I’m not sure what happens.

Imagine a traveller arrives in Israel on Monday morning, develops a fever on Monday afternoon and gets a coronavirus test which tests positive. Then say the fever goes away within a couple of days. Does the traveller get to leave quarantine after ten days like a ‘normal’ infected person? Or do they have to stay for the full two weeks as a ‘traveller’? I assume the former, but I don’t know for sure.

One thing I’m asked a lot is if I’ve heard that travel quarantine will be shortened. I see no real prospect of the 14-day exposure quarantine being shortened any time soon. It’s a global standard based on incubation times, and there’s no indication that the government plans on shortening it. That said, as more countries join the Green List with no quarantine requirements, perhaps it doesn’t matter very much.