Professor Rafi Beyar, the former General Director of Rambam Health Care Campus, remains deeply committed to quality healthcare. Drawing from his own experience and expertise over the years, he has written an informative and thought-provoking editorial for the daily Israeli business news website "Globes".
A new virus has entered our world and become a reality in our lives. At first, we were afraid—we did not know the enemy—and we were all bewildered by the jumble of facts and speculation that bombarded us daily. We locked ourselves in our homes, but quickly learned that the protection provided was limited, and the virus rapidly reappeared the moment we emerged. We also learned that lockdowns are incredibly destructive to our economy, to our society, and to humanity.
We tried to close off our tiny country from the rest of the world, but here, too, we learned that this was ineffective. The virus found its way here, even without an official visa. We explored draconian electronic monitoring and identification measures, at the expense of our individual liberties and freedom, and we improved and expanded COVID-19 testing measures. But none of these measures were effective in stopping the spread of the coronavirus.
And then came the vaccines, which could replicate our human genetic codes and generate a protein that would cause an immune response in our bodies—molecular genetic science at its best—with very promising results, beyond the expectations of our most optimistic epidemiologists. We thought we had conquered the virus. We celebrated and we were proud that our country was leading the world with our aggressive national vaccination program.
But sadly, the protection of the vaccine did not endure. The virus had a way of overcoming our genius and intelligence through some of the most powerful forces in nature – viral mutation and evolution. As a result, we are now confronting the Delta variant, and undoubtedly, more variants will develop in the future. But just as the coronavirus is evolving, we too are learning, finding treatments, and adapting our vaccines to become more powerful and effective.
Here are the dry statistics for Israel:
From the beginning of the epidemic 18 months ago, as of August 23, 2021, 6,668 people have died due to the coronavirus; this represents 9.3% of the 71,313 total deaths for that time period. Every year, cancer is responsible for 25% of all deaths, and heart disease for 20% – together representing nearly 50% of all deaths. However, cancer and heart disease do not shut down our economy and close our schools.
COVID-19 will Remain with Us
We do not have to live ruled by COVID-19. Eventually the virus will be contained and limited; it will continue to exist alongside of us, just as we have learned to live with cancer and heart disease. We cannot allow the coronavirus to curtail our ability to support our families and ourselves, and to live our lives.
It is becoming increasingly clear that the coronavirus will remain with us, to a greater or lesser extent, for years to come. As the number of people being vaccinated increases, and more information is acquired regarding the means of transmission, we should, over time, see more measured and predictable waves of the virus, similar to our experience with the annual flu. Hopefully, we will see smaller numbers of severely ill people and fewer fluctuations in those numbers. This, in turn will allow us to better prepare for treatment of COVID 19 patients. However, it is simply unrealistic to expect that this virus will soon disappear.
Hence, we need to consider the following basic assumptions as a society that is already contending with challenges to health, education, the economy, and national security:
- COVID-19 will remain with us as one of the causes of morbidity and mortality, primarily among those with complex pre-existing medical conditions and the elderly.
- Having large numbers of people vaccinated will help us deal with the virus, including future strains that may emerge.
- We will not be able to indefinitely suppress our needs—individually or as a society—for human interaction, to gather together, and of course, to earn a living, and to provide for ourselves and our loved ones.
- Our children need a proper education.
- Israel is not, and never was, an isolated island. We are bound economically and socially to the rest of the world. We must not impose restrictions that distance us from other countries, both in our own region and around the world.
- The word “lockdown” needs to disappear from our lexicon. This is an antiquated tool of limited effectiveness, which adversely impacts the nation’s social and economic stability. The logic behind the use of this approach at the outbreak of the pandemic was to give us time to organize and prepare our healthcare system. However, it no longer has a place among the tools now available for combatting the virus.
Strengthening Our Healthcare System
We need to strengthen our healthcare system. Following are the first five steps that I believe must be implemented:
- We must immediately take steps to strengthen our national healthcare system by increasing the number of medical staff in Israel in the short term. In the long term, we need to increase the number of positions for medical and nursing students and expand our medical and nursing schools.
- I applaud the decision to expand the number of positions available and to provide additional resources, as our healthcare system has been starved of desperately needed nurses and doctors for far too long. Adding these additional positions now will help strengthen our healthcare system for the future. Young people entering medical school now will ensure the strength of our healthcare system for decades to come.
- We need to encourage behavior that prevents the spread of infection, including the wearing of masks in crowded locations, avoiding exposure to those already infected, and taking personal responsibility for ourselves and for those around us.
- Israel must develop a strategic, multi-year vaccination program, with an array of tools in its arsenal, and not just the emergency campaigns we see today. The plan must include different types of vaccines, identify the most at-risk populations, and the appropriate time intervals for vaccinations, as determined by expert medical teams in Israel and around the world.
- We must act with utmost responsibility at our airport and at the entry and exit points of our nation. We need to avoid steps that interfere with the freedom of movement of our citizens. Isolating ourselves from the world will not protect us against new strains of the virus. Rapid testing for COVID-19 infections at Israel’s entry and exit terminals, responsible behavior, and uncompromising enforcement of rules on airplane flights are the name of the game. An airplane flight need not lead to exposure to the virus if everyone adheres strictly to the rules.
Just as cancer and heart disease are a part of our lives, we must also learn to live with COVID-19. We will fight the virus with all the tools at the disposal of modern medicine. One day soon, the current COVID-19 epidemic will enter the annals of history and become just another chapter in the thick internal medicine textbooks studied by our medical students.