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• Posted February 4, 2021

Israel Leads World in COVID Vaccinations, But Challenges Remain

Israel has become the world leader in COVID-19 vaccine rollouts, inoculating millions of its citizens against the coronavirus in a matter of weeks.

But the nation is still under a full lockdown and likely will remain so for a while longer, given the highly infectious nature of new COVID-19 variants out of the United Kingdom, South Africa and Brazil, said Dr. Ran Balicer, chair of Israel's COVID-19 National Experts Team.

"In this race the virus wins, especially given the fact that when you have like we do over 50% of your new cases caused by the British variant, which is obviously more infective and therefore disseminates more quickly," Balicer said during a recent HD Live! interview.

Israel has administered more than 55 doses for every 100 people in the nation, according to Bloomberg News, compared to 10 doses per 100 citizens in the United States and 15 per 100 in the United Kingdom.

The Israeli rollout has been helped by several factors, said Balicer, who works as director of the Clalit Research Institute at Clalit Health Services in Israel.

"Israel only has 9 million people, and it's a fairly condensed country geographically, so the amount of logistical and other complications are vastly different" from the United States and other countries, Balicer said.

Israel also has universal health care, with every person covered by one of four different HMOs, of which Clalit is one, Balicer said.

"These organizations are very strong in terms of logistics and personnel," Balicer said. "They are focused on care within the community setting, not just within hospitals. There are plenty of trained staff that's used to doing outreach to the entire population. There's no issues of different tiers of insurance."

Unfortunately, Israel's success with its vaccine rollout has also run head-on into the emergence of new COVID-19 variants that spread more easily between people.

Because of those variants, a full nationwide lockdown that's been underway for nearly three weeks now will likely continue for at least the near future, Balicer stressed.

The goal of a lockdown is to bring the infection rate, or "R-naught," below 1. That means that for every infected person, the virus is spreading to fewer than one additional person.

"In the previous strain, after three weeks of lockdown we've seen an R of 0.7 and a clear massive decline in the number of new cases daily," Balicer said. "Right now [with the new variants], the number is close to 0.95 despite a full lockdown. The numbers are stable, in the high thousands, and there doesn't seem to be a way, without the actual impact of the vaccines acting as an epidemiological barrier, to reduce the numbers of new cases per day."

So even if Israel gets 90% of its population age 50 and over vaccinated, Balicer estimates that severe COVID-19 cases will decline by only 75% to 80%, which could continue to strain health care resources.

"This is why the virus always wins, and you always have to keep the virus at bay while vaccinating," Balicer said.

Balicer predicts that the Israeli government will agree upon a gradual, not sudden, reopening of the country, so that the infection rate can be controlled until more people can become vaccinated.

"We will begin with opening only partial parts of retail and only part of the education system," Balicer said. "We will try to keep the virus dissemination rates at bay for at least a few more weeks if not more, and we'll gradually increase as the vaccines begin to have their indirect effect and reduce transmission, we'll be able to add in more and more easement of restrictions in more and more parts of culture, retail, etc."

More information

The Israel Ministry of Health has more about the novel coronavirus.

SOURCE: Feb. 2, 2021, HD Live! interview with Ran Balicer, MD, MPH, director, Clalit Research Institute, Clalit Health Services, Israel