Nathan Jeffay is the health and science correspondent for The Times of Israel
Scientists simply don’t have the equipment to wait for how Israel’s sixth wave of coronavirus will develop, according to a senior government adviser.
Epidemiologist Professor Ran Balicer, chair of Israel’s national team of qualified advisers on the country’s reaction to COVID-19, told The Times of Israel that doctors don’t know what degree of serious illness to expect, as erratic testing patterns mean knowledge has disappeared. limited use.
This is problematic because the new BA. 5 variant accounts for about a portion of the new cases in Israel. Experts say it’s too early to realize that the ability of this variant can cause serious illness.
Balicer and other doctors are well aware that a large number of infections go unreported, which he says makes it unlikely to know what percentage of COVID-19 cases currently lead to serious illness. This is partly due to the widespread availability of reliable home tests that lead many other people to self-diagnose and self-isolate, without reporting the results. This, in turn, undermines the ability to analyze how strongly the new wave will affect hospitals.
“In each and every new wave and in each and every new variant, there is an era of very broad uncertainty about the fundamental characteristics of the new variant and therefore the effect of a wave that follows,” Balicer said. The Times of Israel. ” This is really prolonged now compared to past waves due to the lack of reliable knowledge about actual infection rates.
“Today, many infections go unreported. [Institutional] controls are less available than before and needs for the time of control are less transparent to other people. Many other people are inflamed and do not pass an institutional check, simply a home antigen test. It is very difficult to know what percentage of other people with COVID-19 are hospitalized and to compare rates of severe illness with previous variants. All of this makes it very difficult to anticipate how this new momentum might develop.
This effect is exacerbated by the fact that other people have very variable degrees of immunity, have gained other amounts of vaccines, and have already been infected with several variants, making it even more difficult to anticipate the effect of a new epidemic on society. .
Balicer spoke in a large-scale interview, conducted when the average number of new cases, based on a weekly moving average, reached 9,800, up from less than 2,000 a month ago. The number of severe cases has more than doubled in the past two weeks to 285.
Balicer said the buildup in some cases is not a surprise, given the decline in immunity, a new variant and the tendency to close windows in reaction to the summer heat.
“COVID-19 and some other infectious diseases are characterized by patterns of surges and oscillations,” Balicer said. “The existing accumulation can be attributed to several points coming together. One is gradually reducing immunity to the Omicron surge we saw earlier this year and the frequent decline in immunity beyond vaccination campaigns. We also have the emergence of new strains, in this case BA. 5, which is possibly a contributing factor.
“It’s too early to say what the characteristics of BA. 5 are in terms of avoiding immunity compared to past vaccines and diseases; it still lasts indefinitely, but can contribute to the spread of the virus. The third thing is summer and the tendency of other people to spend time in air-conditioned rooms with the windows closed, which means lack of ventilation. It can also have an effect on the number of cases. We’ve noticed a building at this time of year around the pandemic, perhaps partly for that reason.
Israel’s winter coronavirus wave, which ruled in late 2021 and early 2022, caused widespread infection, and it is unclear whether the immunity of recovered patients will keep them at this level of the new wave.
Balicer said that in many cases, the virus will be able to break the immunity acquired in the winter wave. However, the disease can be relieved particularly due to residual immunity.
“Lately, the population in Israel enjoys long-term residual coverage from previous vaccination campaigns, which are 3 doses for adults and 4 for high-risk [groups]. There is also increased immunity for many newly inflamed people,” he said.
“While it turns out that coverage against infection lasts only a few months before declining massively, coverage against serious illness lasts, at least in part, for many months. And so, while we’re seeing a backlog of severe cases right now and while it’s completely imaginable that the numbers will rise further, our knowledge suggests that residual coverage continues to exist. The prospect of a severe infection wave is now very real, but it can be partially hampered through residual immunity of the population.
Despite considerations about the existing wave, Balicer said there are no plans to offer a fifth dose of the vaccine, even to seniors or at-risk populations. In fact, decisions to introduce new doses of vaccines are a balance between imaginable protective dangers and urgency, and Balicer said there is simply no sense of urgency at this time.
“We were asked if we would take a fifth dose, and that advice was not made at this level due to the lack of evidence on efficacy and protection in this express context,” he said. “We feel quite uncomfortable making such decisions unless they are dealing with a nearby public health emergency. In the past, decisions were made in Israel on the basis of partial evidence that later turned out to be correct in retrospect and justified as scientifically accurate. You make decisions with an existing lack of knowledge when the choice of watchful waiting is obviously and dramatically worse, and that’s not the case now.
An update that may be in the masks of card considerations: the reintroduction of the mandatory mask indoors is being discussed among decision makers.
“There are discussions among experts who are advising the Ministry of Health on the desirability of a mask mandate,” Balicer said. of a user facing the threat of severe COVID-19 entering a room and asking others to wear masks, regardless of their non-public preference. The public’s willingness to conform may be greater if there is a mask order.
Asked if other people could simply conclude that “residual immunity” would mean that the existing wave is milder than the winter wave and that, through extension, the fitness formula would possibly not be overcome, Balicer said, “It makes intuitive sense, however, we can’t be sure at this point. There are still open questions related to the rates of serious illness caused by BA. 5 and its ability to evade beyond immunity.
“Therefore, we still want to monitor in depth the evolution of serious disease rates in the coming days and weeks. And, while it may not be overwhelming [the physical care system], the burden of severe cases from the Omicron wave in early 2022 was peak and painful. , and we deserve to aim not to repeat it.
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