Coronavirus: What are the exit strategies Israel is considering?

APRIL 13, 2020 22:28

After weeks of near lockdown, the government will hold a meeting Thursday to consider the next phase: An exit strategy for the State of Israel.

Over recent weeks, the National Security Council (NSC) has been presented with plans by the Finance and Health ministries and teams of academicians, scientists, mathematicians, economists and others – many of which are at odds with one another – and has considered all of these plans. On Thursday, Deputy National Security Adviser Eytan Ben-David will present the prime minister with several alternatives.

There are two opposing viewpoints and several plans in the middle.

The Health Ministry believes that returning to work and daily life can be done only when the country sees around 10 new patients per day. As of Monday, there were still hundreds of new patients being diagnosed with the novel coronavirus every day. The ministry argues that if the country opens too hastily, all its work to reduce infection and “flatten the curve” will be undone.

On the flip side, the Finance Ministry argues that the economy cannot take much more of the current restrictions. More than a million people are out of work and the unemployment rate is 26.1%. The ministry argues that Israel should move fast, or the economy may not be able to rebound.

What are some of the proposals being considered by the NSC that might be presented to Prime Minister Benjamin Netanyahu?

The Finance Ministry: The country will reopen in stages

The Finance Ministry would like to see immediate action after Passover but has a plan that will take around six weeks to be completed.

Stage 1 will begin immediately after Passover, with 50% of the workforce returning. At the same time, as has already been approved, special education centers will resume operations. Preschools would also start up again, with smaller class sizes or children attending in shifts. Public transportation would also be increased to accommodate the additional workers.

Stage 2 would run from May 3 until May 17, at which time another 35% of workers would return, bringing the active workforce up to 85%. Children in grades 1 through 3 would also start school again, though again in smaller classrooms or shifts. Malls and some recreational centers or cafes would be opened, but operated under Health Ministry restrictions.

And finally, in stage 3, which would start on May 18 and end on May 30, the rest of the economy would gradually resume, while the public continues to social distance, maintain good hygiene and wear masks.

Other ideas that the plan offers: Allowing those at lowest risk for fatal infection – people under the age of 65 with no underlying medical conditions – to return to work first, as well as reopening those businesses that contribute the most to the economy, such as hi-tech, large industrial enterprises and the financial industry.

Also, on the table: Only asking teachers under the age of 50 without preexisting medical conditions to return to work, which is around 75% of the country’s educational staff.

Under the Finance Ministry’s plan, older people remain at home indefinitely.

Gertner Institute: Limited and Delayed

The Gertner Institute, which advises the Health Ministry, published an extensive report detailing why it would be difficult to implement any exit strategy under the current circumstances. It recommends that neither preschools nor elementary schools be opened at this phase.

According to the report, the epidemiologic isolation and investigations system has so far failed, and the exit plan should be limited and delayed until the country can ensure the following: The public will adhere to social distancing measures designed to reduce infection; an increase and more rapid testing system will be rolled out followed by immediate isolation of those with which an infected person was in contact; a system for filtering entrance to the country of people from abroad; isolating areas having a high-level of infection with special treatment protocols in those areas; increased intensive-care unit capacity; and a plan to better care for the elderly and at-risk populations.

Bar-Ilan University: Alternating Lockdowns

A team of Bar-Ilan University researchers, led by Baruch Barzel of the Department of Mathematics, has recommended alternating lockdowns.

First, the population will be split into two groups, Barzel told The Jerusalem Post. These groups will then alternate between lockdown and routine activity in weekly succession. At the same time, those who show symptoms of the novel coronavirus – fever, coughing or difficulty breathing – will be isolated.

These two groups of citizens will have little if any interaction, which would already slow the coronavirus spread. It will also isolate the “invisible spreaders” – those who are asymptomatic or who became infected during their active week and don’t show symptoms until further on in the incubation period.

Barzel said that while they are at home during their following inactive week, they will most likely begin to exhibit symptoms, and therefore remain in isolation until fully recovered. If they don’t show symptoms, they are most likely uninfected and can partake in social and professional activities during their active week.

The Weizmann Institute of Science: Intermittent Lockdowns

Another team of researchers, from the Weizmann Institute of Science, has a similar proposal to Bar-Ilan’s, but in their proposal everyone, including children, are back to their normal lives for four days, and then locked down for 10. This, according to the proposal, would allow those who become infected during the open period to become infectious at home.

The plan, led by Prof. Uri Alon, suggests that after several such cycles, the number of infected people will drop dramatically.

“People will hold a 40% position instead of being completely unemployed – an economic and psychological game-changer,” Weizmann explains on its website.

This plan requires longer periods of confinement because the current official estimated range for the coronavirus incubation period ranges from two to 14 days.

Mobileye CEO Amnon Shashua: Risk-based selective quarantine

Under a plan devised by Mobileye CEO Amnon Shashua and Hebrew University computer science professor Shai Shalev-Shwartz, the population is divided into low- and high-risk groups.

People under the age of 67 and without underlying medical conditions, who are at low risk for becoming fatally infected with corona, can return to life as usual while following certain distancing protocols.

Those over 67 or with co-morbidities, who are high-risk, would stay at home and be surgically quarantined – tested as soon as they exhibit coronavirus symptoms. If people test positive, they are quarantined, epidemiological tracking is carried out and all those who they were in contact with are also isolated.

The high-risk population will gradually be released.

Other ideas being considered:

One idea is centering an exit strategy solely around age and risk of complications, keeping the high-risk under lockdown and reducing restrictions on others in stages.

Another idea is to base the exit strategy on geography. “Green areas” – those with a low-level of infection – would exit first, while “red areas” would remain restricted.

A similar principle could be applied to businesses, whereby industries or companies would be labeled green, yellow or red. Green businesses – those whose products are essential to the public – would open first. Yellow ones would open second – those that are not necessary but would benefit from resuming work. And red ones – industries like tourism, which even if they opened, would not have work to do – would open last.

It is likely that the government will only evaluate the first stages of any exit strategy and not consider matters that could become relevant further into the future, such as aviation. In addition, any exit plan will require that the situation be assessed at every stage: It takes around two weeks to determine if any step has led to a spike in infections.