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A Year of COVID-19: What did we learn and what can we expect?

25. 3. 2021 by Friends of Assuta

Prof. Shuki Shemer and Dr. Roy Barnea

A MIXED TREND

Unlocking the economy, the NY variant, a population tired of lockdowns and a few encouraging signs from around the world: One year of COVID-19: What did we learn and what can we expect?

  1. The SARS-CoV2 virus, or in short, the Coronavirus, dramatically changed routine life all around the world. In Israel, over 730 thousand people contracted the virus and around 5,800 died. Worldwide, over 114 million people took ill and almost 2.5 died of the virus which caused global uncertainty and deep concerns about a possible collapse of health systems.

The pandemic in Israel, as defined by the number of hospitalized patients and those in critical condition, is currently on the decline. Last week, the number of tests significantly increased, and yet, the number of new cases did not change and even declined on some  days, as compared to the same days in the previous week. In addition, the remarkable vaccination operation reduced the number of the critically ill patients, especially those over the age of 60. Since this age group was the main population affected by the virus, this new data probably attests to the significant effect of the vaccination.

  1. This week we learned about the many violations of the pandemic restrictions due to celebrations on the holiday of Purim. Large gatherings in violation of the guidelines of the Ministry of Health were held in several venues, especially in Tel Aviv and Jerusalem. The effects of these huge gatherings and massive dance parties will be apparent only in two or three weeks. This massive unruliness on Purim is also due to the fact that the general public is tired of the multiple restrictions and lockdowns and has also lost trust in the instructions issued by the authorities.

In anticipation of Passover and the Seder night, a different kind of approach might be considered, instead of imposing limitations. If the public is expected to obey the rules, especially in light of the huge number of the people already vaccinated, innovative solutions must be provided that will enable a normal life routine. Such solutions can also be of help in the national effort of vaccinating the population.

  1. This week the government authorized the next phase of opening the economy, including resuming frontal teaching in schools for grades 8-10, opening restaurants and coffee shops, hotels, conventions and event venues for those with a green pass, and re-opening the skies, limited to 3,000 returning-citizens to Israel per day. These steps join prior steps that began opening the market and partially opening the education system two weeks ago.

Opening the economy and gradually returning to a normal life is a correct and important step, but there is a chance that it will lead to a renewed rise in Coronavirus cases. Opening the sky and the airport is of special concern and makes it necessary to come up with a meticulous and strictly enforced plan to prevent the entrance of sick people carrying a variety of the virus variants. It is important to monitor the distribution of the pandemic in Israel, while paying special attention to areas and towns with growing numbers of COVID-19 cases.

  1. Many countries around the world, including those in which the vaccination rate is still low, register a steep decline in new cases of the virus. Simultaneously, many European countries started lifting limitations this past week and are gradually opening the economy.

The decline may be attributed to a combination of the effects of the vaccine, seasonal effects on the dispersion rate of the virus and the possibility that the threshold needed for herd immunity is getting closer. We need to keep monitoring the situation in order to track the spread of the pandemic, while continuing with protective measures, such as social distancing and masks.

The FDA granted an emergency authorization for the Johnson & Johnson Company’s COVID-19 vaccination to be used on people aged 18 and above, and administered as one shot dosage. This vaccine’s technology is based on the use of the virus’s DNA (as opposed to the Pfizer and Moderna vaccines that are based on the mRNA molecule).

So far, more than 20 million people have been vaccinated in the UK. Australia and Canada authorized the AstraZeneca vaccine and in counties like Japan and the Philippines, the vaccination operation will be launched soon.

  1. In a survey conducted in Italy, a low concentration of antibodies was identified in overweight (BMI over 30) vaccinated people, as opposed to vaccinated people with normal or below-average weight. However, it is important to remember that the immunological system is complex and comprised of many elements (including T cells ), and a decline in antibody numbers does not necessarily indicate a decline in the effectiveness of the vaccine.

Another article published this week reports that people who recover from the virus probably have immunity for at least three months. In Israel, the Ministry of Health authorized only one dose of the vaccine for people who recovered from Corona, to be administered at least three months after their recovery.

  1. Several scientific articles published in the last weeks emphasized the importance of keeping the schools open, as a first and foremost priority. While the benefit of closing schools to reduce morbidity is questionable, the education system has a very important role in shaping the “next generation” in a wide variety of areas, such as education, society and economy, bridging gaps and reducing inequality.

It is therefore very important to refrain from closing the education system as much as possible, while closely adhering to the rules for  appropriate capsules, social distancing, wearing masks, spending as much time as possible outside in the open air and vaccinating the educational staff. It may be advisable to consider collective testing in order to identify hidden morbidity in schools.

  1. Viruses are apt to evolve and create new variants, with levels of contagion and aggression which must be studied. Recently, we have news about a New York variant, when three members of one local family contracted the virus. This must be studied in depth, with an extended epidemiological investigation and prevention of the import of these mutations in the future.

However, an article published this week in the medical journal Lancet, reports that the British variant, which is a dominant factor in new cases of Coronavirus in Israel these days, doesn’t increase the chances of severe morbidity and Coronavirus complications in children and young people. A report by the British Ministry of Education also claims that the variant did not lead to more severe morbidity in children.

 

Prof. Shuki Shemer is chairman of Assuta Medical Centers and former General Manager of the Ministry of Health. Dr. Roy Barnea is a senior researcher at the Assuta Institute for the Research of Health Services

tguvot@maariv.co.il

 

 

 

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