By David Horovitz, TOI
[…] As of this writing, Israel, population 9.2 million people, has suffered 219 fatalities in the coronavirus pandemic. Of the nearly 16,000 confirmed cases, more than half have now recovered. Fewer than 100 Israelis are currently on ventilators.
Compare those figures to other countries.
By the Worldometers count, based on approximately the same stats, Israel has 25 fatalities per million citizens — which puts us at about 50th in the world, and better than the global average. (With many countries providing less reliable statistics, furthermore, Israel’s global ranking is actually almost certainly considerably better.) Certainly not peerless, but striking nonetheless.
Sweden, which chose a radically less interventionist approach, has about 10 times as many deaths as Israel — about 2,500 — in a population only slightly larger than ours at 10 million. Belgium, population 11 million, has over 7,500 fatalities – 34 times as many as Israel. Britain, with a population six times ours, has buried 26,000 victims. Spain, with five times our population, has 24,000 dead. Italy, population 60 million, has a death toll closing in on 28,000. The United States, with 36 times our population, has almost 300 times as many dead.
Austria and Germany, ahead of Israel in their moves back toward a more normal routine, also have markedly higher death tolls: Austria, with over 8.5 million people, has almost 600 dead; Germany, with some 80 million, has 6,500.
Compare Israel’s numbers to other Jewish communities. In Britain, with a Jewish population of 350,000 at most, there are well over 300 confirmed deaths in the community. In the United States, with a similar-sized community to Israel’s, the most conservative estimate puts the death toll among Jews deep into four figures. (An estimated 2 million Jews live in New York State, which has a population of some 20 million. The death toll in New York State is over 23,000 — which would suggest some 2,300 Jewish fatalities, even before taking into account strong indications that the Jewish community has been disproportionately heavily hit.)
Israel’s relative success, as reflected in such comparative statistics, indeed, is prompting growing calls for Israel to reverse the norm by which Diaspora Jewry rushes to help it at times of emergency, and to urgently reach out with effective assistance to a Diaspora in pandemic crisis.
There is so much the experts have yet to understand about COVID-19. They think it doesn’t mutate, but they’re not completely sure. They think children are at radically lower risk, but there are concerns here too. Can you be infected a second time, after you’ve beaten it? Is it susceptible to climate change? Does it peak at 40 days and gradually disappear by 70, whatever lockdown measures you take to try to thwart it?
Is it emphatically not airborne, or might it just possibly be, under certain circumstances? Is the likelihood of contagion from mucus droplets on solid surfaces marginal, or significant?
How is it simultaneously so radically contagious — spreading like wildfire among the elderly and those with preexisting conditions — and yet evidently not always so radically contagious? There are major outbreaks in innumerable elderly care facilities, and shockingly high death tolls, but most residents of the same facilities, elderly and vulnerable, are unscathed.
How many of us are actually carrying the virus, cheerfully asymptomatic?
In the specifically Israeli context, are our numbers so low because we’re not reporting them properly? That seems highly unlikely.
Because we’re not a huggy, kissy nation? But we are.
Are we doing so relatively well because we’re a relatively young population? Are our hygiene norms notably better than those in other, worse-hit countries? Are our wonderful healthcare professionals, in our perennially underfunded healthcare system, uniquely outstanding?
People chat and drink outside a bar, April 8, 2020, in Stockholm, Sweden, which is pursuing liberal policies to fight the coronavirus pandemic, even though there has been a sharp spike in deaths. (AP Photo/Andres Kudacki)
If the flow of tourism was a factor in the high contagion rates in the likes of Italy, Spain and the UK, then how come we didn’t get more heavily battered for the same reason?
If population density is a major factor, then how come Sweden, all 174,000 square miles of it, is suffering so much more than tiny Israel, 8,550 square miles? And if Bnei Brak, with its large ultra-Orthodox families and its high contagion rates, was identified as an epicenter, how is it that a lockdown, confining large numbers of known carriers to a closed area, proved able to reduce the danger rather than incubating it?
Prime Minister Benjamin Netanyahu and Director General of the Ministry of Health Moshe Bar Siman-Tov hold a press conference about the coronavirus COVID-19, at the Ministry of Health in Jerusalem, on March 4, 2020. (Olivier Fitoussi/Flash90)
Amid profound concerns at the economic meltdown, at the impact of the restrictions on people’s mental health, at the shunting aside of all kinds of other medical imperatives, at the “collateral damage” of lives and livelihoods ruined, Moshe Bar Siman-Tov, the Health Ministry’s director general, was asked in a TV interview a few days ago whether Israel hadn’t overreacted. Wasn’t his, and the prime minister’s, talk of “tens of thousands” of Israeli fatalities if we didn’t heed the rules and batten down “an exaggeration”?
Characteristically unruffled, he replied that “We have a very simple check. We were at a rate where the number of new patients was doubling every three days… There was a single day when the number of seriously ill patients rose by 50%. If that trend had continued, today we’d have over 600,000 people [sick], over 10,000 on ventilators, and many thousands who would have died.”
Pressed again: Bar Siman-Tov made one of the comparisons I cited above: “I don’t think so,” he said. “There are enough control groups — look at Belgium.”
Soldiers at the Kiryat Shaul Military Cemetery on Memorial Day, Yom Hazikaron, April 28, 2020. (Avshalom Sassoni/Flash90)
Israel has just marked its Memorial Day and its Independence Day. This is always a surreal time, as we transition from the depths of grief for our fallen soldiers and victims of terrorism — men, women and children who lost their lives in the defense of this country and/or amid the hostility to this country — to the heights of celebration. This year, it was doubly so — our sorrow and our joy physically constrained.
But all those numbers above underline that, turning 72 in these nightmare circumstances, Israel has at least wary cause for encouragement. They were not always perfectly executed, but the decisions Israel’s leaders and authorities made, and that its citizens generally heeded, were designed to maximize the defense against a mysterious virus that disproportionately targeted the elderly — our parents, our pioneers. For now, the numbers and the comparisons suggest, that strategy has been remarkably effective.
@ Shmuel Mohalever:
“his fatalism” I thought of the same word before I saw your post. The Swedes do seem to be fatalistic and matter-of-fact about death. There is a recent book about decluttering (the author is an elderly – older than 80 – Swedish woman).
The book’s title? “The Gentle Art of Swedish Death Cleaning: how to free yourself and your family from a lifetime of clutter”.
Death Cleaning is a direct translation of the Swedish term. That’s what you do when you feel it’s time, so to speak, and you want to be nice and not burden your family with going through your stuff.
“Sweden: Elderly should not be prioritized for intensive care in a crisis
Michael Lord12 April 2020
An official document that was obtained by the Swedish press from the Karolinska University Hospital system in Stockholm reveals that the institution wants its doctors to deprioritize care for elderly patients if an emergency arises during the coronavirus (COVID-19) outbreak.
The Karolinska University Hospital system is the second-largest in Sweden.
The document, which was issued to the hospital’s doctors, is based on guidelines drawn up by Sweden’s National Board of Health and Welfare on how to deal with situations that might arise where there are more patients than there are spaces in Sweden’s Intensive Care Units (ICUs) as a result of the pandemic. The document has been reproduced in a report by Aftonbladet.
The document’s guidelines advise medical personnel not to admit patients over the age of 80 into intensive care when there are limited spaces during a crisis. They further recommend that those over 70 who are experiencing “significant organ failure” in more than one organ should not be admitted, as well as those over 60 who have failure in more than two organs. This would impact those with heart, lung, and/or kidney disease.
The hospital also advised that those who fit into any of these categories who are already in intensive care should be removed from it if a crisis situation arises, in order to make space for others with a better chance of survival. The same would hold true for those who experience organ failure while they are undergoing treatment in an ICU.
Moreover, the document suggests that patients should be evaluated according to their “biological age” rather than their actual, chronological age — i.e., a patient who is already in poor health could be evaluated as being biologically older than his or her birthday suggests, and vice-versa. A doctor who wished to remain anonymous told Aftonbladet that determining a patient’s biological age can be difficult.
While these directives are based on guidelines issued by Sweden’s National Board of Health and Welfare, the original guidelines are not based on specific age groups, and state that evaluations for intensive care should take a patient’s biological age rather than his actual age into account. The Karolinska Hospital’s public relations department has confirmed that this is what the hospital will be following if a crisis arises.” From a website called “voiceof europe.cpm”
“Swedish Document Reveals Elderly Coronavirus Patients Will Not Be Prioritised For Intensive Care
Chris Tomlinson11 Apr 2020
Paramedics with protective gas masks help to transport a patient on April 6, 2020 in Stockholm, during the novel coronavirus Covid-19 pandemic. (Photo by Jonathan NACKSTRAND / AFP) (Photo by JONATHAN NACKSTRAND/AFP via Getty Images)
JONATHAN NACKSTRAND/AFP via Getty Images
2:13
A document from the Karolinska University Hospital in Stockholm has revealed that Wuhan coronavirus patients over 80 and those over 60 with multiple organ failure will not be given priority for intensive care.
The document confirms prior reports that Swedish authorities were looking to prioritise certain groups of people for intensive care who are more likely to survive severe cases of the Chinese virus if or when hospital capacities are overwhelmed.
Along with patients over the age of 80, those 60 to 70 who have multiple organ failures will also be moved out of intensive care. The document states that any patients in those categories that experience organ failure while in an ICU could also be taken out of intensive care, as well, Aftonbladet reports.
The concept of “biological age”, which can be assessed as either higher or lower than a patient’s chronological age, is also mentioned in the document as a potential guideline. But a doctor who spoke to the newspaper stated it was difficult for medical practitioners to use the concept in practice.
“It is not chronological age but biological age that applies in assessing patients for intensive care. The medical priority is always based on the patient’s prognosis to cope with intensive care and to recover,” a spokesman from the Karolinska University Hospital told the paper.
In late March, Dr Thomas Lindén, of the National Board of Health and Welfare, said that hospitals could give priority to illegal migrants over elderly Swedes infected with coronavirus, saying that nationality was not an essential factor.” From Breitbart
Another reaon for the very high death rate from coronavirus in Sweden is that their hospitals practice “triage” by excluding elderly sick people from care in favor of younger people who (supposedly) have a better chance to live. According to articles in both Breitbart and Sputnik, internal documents leaked from one of Sweden’s main hospitals provide “guidelines” for who will receive intensive care and who will be denied it. Those over 80 and those over 60 with multiple organ failure” will not only permitted to die but will be “sent home” to receive only “palliative” care. The following is from an article in Front Page magazine: “There’s more on the triage front. Last week the Swedish daily Aftonbladet got hold of an internal government document indicating that sometime this week the hospital beds in Stockholm will be full. What will the powers that be do to address this challenge? The document is a masterpiece of euphemism, but the bottom line is clear enough. Older people infected with COVID-19 won’t be given full-fledged hospital care but, upon presenting themselves at the offices of their primary-care physicians, will be sent back home or to retirement home-type facilities, where they’ll be given palliative care. In other words, they’ll basically be allowed to die. (Which makes one wonder how sincere Tegnell was when he expressed regret last Thursday that Swedish authorities had failed to protect residents of retirement homes from infection.)
On last Thursday’s Swedish evening news, an ICU doctor from the Karolinska Hospital was interviewed about this new throw-grandma-under-the-bus policy. I was struck by what I couldn’t help interpreting as his fatalism. Beginning this week, he said matter-of-factly, patients who formerly would’ve been put in intensive care for weeks will be denied treatment. Would the unlucky patients be winnowed out by age, he was asked? Oh, no, no, no, he said. The main criterion, he explained, will be “biological age.” He was certain, he added, that many parents and grandparents who don’t have many years left anyway will gladly sacrifice their lives for their grandchildren. He and the other two people onscreen discussed this topic as if they were talking about train schedules.”
@ Shmuel Mohalever:
I am wondering whether this ”flattening the curve” would be only temporary. When lockdowns are lifted and all those people come out in the open there might be another wave of infections, so in the long run the death rates will tend to be about the same everywhere.
There is a video of 2 doctors from California who said that when you lock yourself in like that, your immunity actually WEAKENS.
The virus has already mutated more than 30 (thirty) times – who are the author’s “experts”?
Sweden’s high death rate from coronavirus has been attributed to its policy of allowing most business, including bars and restaurants, to remain open. But there is evidence that it is other “mistakes” by the Swedish government that may actually account for the high death rate. In particular it has instructed the nurses in nursing homes to fail to obseve routine safety precautions to avoid infecting patients and themselves. They are instructed not to war face masks or gloves when caring for patients. They have been issued soap, but not any other hand sanitizers. They have been advised to stay home if they feel sick, but to return to work as soon as they feel better. As a result betwween one-third and one-half of all Swedish coronavirus-related deaths have occurred in nursing homes. This from a Guardian article dated April 9th.
“How did Australia flatten its coronavirus curve?
Australia closes beaches amid coronavirus
(CNN) — When it comes to the coronavirus, South Australia ought to now be considered among the safest places in the world. That was the message from one of the country’s leading public health officials this week, as much of Australia began the slow process of easing restrictions.
That many Australians now find themselves in such an enviable position would have been unthinkable only a month ago, during which time nationwide daily infection rates reached into triple figures. But on Friday, the entire country reported just 16 new cases, a sharp decline from a peak of 460 new infections on March 28.
Australian Prime Minister Scott Morrison said Friday the National Cabinet will meet on May 8 to consider easing lockdown measures, bringing forward the discussion from the week beginning May 11.
“Australians have earned an early mark,” Morrison said. “We need to restart our economy, we need to restart our society.”
In some states, the curve has completely flattened: Queensland hasn’t reported any new cases since Monday, and South Australia has seen no new infections for more than a week.
“No more cases in South Australia. This is a landmark for us,” South Australia Chief Public Health Officer Nicola Spurrier said with a big smile during a press briefing on Wednesday.
The southern state of 1.6 million people, home to the country’s fifth most populous city Adelaide, has reported 438 confirmed Covid-19 cases, with only 14 remaining active cases and four deaths, according to the SA government.
“I think many people are surprised in Australia at how well we have done. Really, when you look across all the states and territories, this is the safest place to be in the world, perhaps other than New Zealand,” she said.
Neighboring country New Zealand recently achieved its ambitious goal of “eliminating” the coronavirus, meaning that while the daily infection rate has yet to reach zero, the country is able to track the origins of each new case.
A group of men walk on Bondi Beach on May 01 in Sydney, Australia, following the easing of lockdown measures in response to a decline in coronavirus cases across the state.
A group of men walk on Bondi Beach on May 01 in Sydney, Australia, following the easing of lockdown measures in response to a decline in coronavirus cases across the state.
In total, Australia, which has a population of around 25 million people, has reported 6,762 confirmed cases. Ninety two of those cases have resulted in death, and 5,720 have since recovered, according to the federal health authority.”
These positive “down under” results tend to confirm my belief that fresh air and sunshine are the best propylactics and the best cures for COVID-19. It was sommer in Australia and New Zealand from January to the end of March, while it was winter in the hard-hit countries. Both Australians and New Zealanders are very outdorsie and love to bask in the sun, go on long hikes, etc.
Israelis sang on their balconies both at the end of Memorial Day and Independence Day. The country showed great spirit. There were also famous entertainers who drove from city to city entertaining Israelis from the back of a large truck while they were on their balconies
https://www.youtube.com/watch?v=TBszEQIWens
The lockdowns in many countries seem to have resulted in an eventual decline in the number of cases. But in many countries, this decline only happened after large numbers of infected people either died or became severely ill. A few countries have managed to avoid having a large number of sick people and a large number of deaths without a lockdown. Each country’s experience with the virus has been so different that a clear pattern and a “universal” strategy for containing the disease has not emerged.
The one pattern that has deinitely emerged, however, is that poor medical care or the absence of any medical care to speak of, and underfunded health care systems, have added massively to the death toll in many countries, as well as in the New York metropolitian area. People who have received appropriate treatment for the disease, which seems to be very similar to the treatmeant required for severe or advanced cases of flu, few patients have died. Where patients have been given inadequate or inappropriate treatment, or no treatment at all, as has occurred in many nursing homes, many have died.
Russia has repported a substantial increase in COVID-19 cases in recent days. The nation has been on lockdown since mid- March. This seems to contradict the allegations of the EU that Russia is trying to cover up the spread of coronavirus. Putin has also made several speeches on Russian TV warning his people about how dangerous the virus is, and the need to observe strict social distancing until the epidemic ends. Russia’ Prime Minister, Putin’s second in command, has admitted he has COVID-19.
And yet the over-all Russian case load, proportionate to population, is less than Israel’s, and the proportion of deaths to total cases is less than in Israel and in most other “developed” countries.
Putin attributes this to the fact that the first COVID-19 cases did not occur in Russia until mid-February, which was later than in many other countries. “So we’ve had a head start” in preparing Russia’s hospitals and healthcare system to deal with the virus, Putin claims.
However, the lockdown in force now for more than five weeks, seems to have done nothing to halt the spread of the novel coronavirus in Russia. Possibly, the warnings to Russian hospitals to prepare for the pandemic may have decreased the number of sick people who have died to around 5 per cent.
Not sure if there are any lessons here for Israel and the U.S. but the somewhat unusual Russian experience should be studied.
THis comment summarizes an article in Reuters published today.
The author’s of this report also predict that the psychological stress and financial hardship imposed on Israel’s people by the lockdown will ultimately kill more people than the coronavirus.
Israel’s initial social distancing had already worked before the complete lockdown. See the full report at https://arxiv.org/pdf/2004.10324v1.pdf.
“In theory, authorities can arrest an epidemic by quarantining all the popula- tion for a prolonged period, provided that such quarantine is technically feasible. However, the economic and social price of such quarantine is too much to bear, not to mention its decisively medieval nature. Expected consequences include the destruction of the economy, enormous unemployment, and social and health aspects of quarantine, such as isolation and loneliness, drug abuse, and domestic violence, not to mention hunger and social unrest.
Historically, pandemics tend to attack the group, which is generally per- ceived as low-risk, such as young and healthy, more than elder people, who are usually viewed as vulnerable. For example, during the “Spanish Flu” and the “Swine Flu,” younger and healthier individuals were in greater danger than senior citizens. In contrast, COVID-19 attacks the elderly population much more aggressively than the younger ones, in line with the common flu. (In all pandemics and epidemics, people with pre-existing conditions belong to the high-risk group.) Therefore, the response and pandemic preparedness efforts should not be primarily based on the previously used measures but must be modeled based on the new reality on the ground.” From a study by thee Hebrew University professors, as published in the medical journal arvix. com, and referenced in the Jerusalem Post.
Israel’s social distancing worked. Let us see what happens when everything opens up. Israel is trying to stage the opening up. Still closing down a couple hot spots.