'Bad testing policy, lack of leadership, danger of irreparable damage'

The Knesset coronavirus task force heavily criticized the state's management of the coronavirus crisis on Tuesday and rolled out a set of recommendations to help Israelis emerge from the current challenge.

Among the commission’s recommendations, which are divided into categories - policy, health system functionality, second-wave preparation, exit strategy, local authorities and economy - are making changes to the country’s testing policies and establishing a national crisis-management body.

“Continuing with the current policy could lead to a situation where the long-term damage to the economy will equally lead to loss of life,” commission chairman Ofer Shelah (Yesh Atid) said in a press briefing Tuesday.

He said that while the commission "has no doubt" that the government made decisions that have helped ensure Israel maintains a lower number of sick, critically ill or deceased patients compared to other countries, an overall strategy was lacking and "the commission believes that costly errors" were made in the decision-making process, which did not take into account the social and economic impact.

 

The commission met for nearly 29 hours with 73 relevant leaders from across the health and other related fields. Its recommendations were approved by a vote of six to zero.

"The committee's impression is that a significant part of the policy is formulated based on a strangled system,” the report stated.

For example, the commission said that it is difficult to determine whether the Health Ministry’s decision to limit the number of coronavirus screenings conducted per day was due to a medical philosophy or because “there were simply not enough test kits and our laboratories were not prepared."

The report also noted that there were contradictory statements made regarding the effectiveness of the use of masks and it questioned whether this was because until late March there were not sufficient masks in Israel to require a country-wide protection policy.

It points out that the Health Ministry admitted to the committee that it was aware of the threat of coronavirus to Israel as early as January 20 but made no efforts to procure additional ventilators until mid March and that no new ventilators entered the country between January 20 and March 26. 

"The Health Ministry did not know, when it appeared before the committee, to give any estimate of the rate of infection or the main parameters of the spread of the disease,” according to the report. 

It is further detailed that the focus on the number of ventilators is misleading, since the machine alone cannot save a patient, but a team of qualified medical professionals are needed to monitor and treat an intubated patient - and the country is also short on those caregivers. 

Moreover, the report points out that decisions were made in a limited forum - by the prime minister, Health and Finance ministry officials and that despite the existence of well-known emergency protocols being established by the Defense Ministry, no similar protocol was established to manage coronavirus.

"There is no operator appointed to act as ‘chief of staff’ for this event,” Shelah said at Tuesday's press briefing. He said that there was no “Coronavirus Cabinet” established in the government, headed by the prime minister and with the participation of relevant ministers, such as Security Cabinet operates in times of emergency.  

“The members of the committee believe that this alone is indicative of an organizational failure,” the report states. “In a multidimensional and deep crisis like this one, decisions should not be made on the fly.”

The report recommends that a crisis-management body be established as soon as possible.

In the realm of testing, the committee believes that testing should not be limited to people who are experiencing disease symptoms, as is currently the case - except for a relatively small number of monitoring tests. Rather, it said, three main groups should be checked regularly, in cycles of one to several days and with a fixed percentage of tests, for at-risk groups: populations at risk (elderly people, people with background illnesses); medical staff; and staff dealing with at-risk populations.

Regarding isolation, the report condemned the Health Ministry for its policy that when “physicians and nurses are admitted to isolation they would be considered 'sick' and would not receive regular wages, even though there is no difference between them and soldiers who were injured during their service."

That policy was overturned on Monday night, when the Knesset voted on the new economic plan.

The commission recommended a differential isolation policy that would not only cover populations at risk, but also geographical risk centers, such as the city of Bnei Brak and other communities, where there are unusually large outbreaks of the disease.

“The peripheral damage from a complete halt to any activity unrelated to coronavirus may eventually be worse even than the plague itself,” the report stated, and Shelah reiterated during the briefing. “The committee recommends a gradual release of the economy that must start as soon as possible, as soon as the end of the Passover holiday.

“The Committee believes that the needs of the economy and society require, immediately after Passover, changes in the prohibition of movement and work,” the report stated. “Even in the absence of an overall ‘exit strategy,’ continuing the current policy could bring us to a situation where the hard and dead numbers will remain low on a world-class level, but the damage to the economy and society will be irreparable, leading in the long run to even loss of life.”

At the same time, according to the report, Israel must prepare for a second wave of infection as soon as possible. The commission's research noted that it is expected that even if coronavirus begins to spread less during the summer months, it is expected to come back in full force next winter.

"It is estimated that a second wave of the Corona will erupt this winter, even though the current crisis has not yet passed,” the report said. “This should be discussed on all levels.”