1. Preventing transmission
The section on PREVENTING TRANSMISSION includes information on key public health measures that aim to prevent the further spread of the disease. It details how countries are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak.
1.1 Health communication
Israel responded rapidly to the prevention phase of the pandemic: it closed its borders relatively soon after the outbreak in China and sent passengers coming from risk areas to quarantine. The containment phase included quarantine of diagnosed individuals, but the capacity for testing suspected cases (in order to quarantine them) took longer to develop. The mitigation phase was again implemented with rapid measures, almost on a daily basis, and included social distancing, and a lockdown.
The prevention phase in Israel started during the early stages of the pandemics in China. The Israeli MoH issued official advice on how to reduce the risks of infection with COVID-19, including hand hygiene, respiratory etiquette and social distancing. The advice was disseminated in 10 languages and various levels of complexity, through diverse media and social media platforms. Information was disseminated through various means such as pamphlets, videos, infographics, and culturally adapted to a variety of publics such as the ultra-orthodox and the Bedouins (although the access of these two population to some of the information channels is limited).
In February, the MoH started communicating messages to people coming from risk areas or those who were in touch with diagnosed patients, directing them to self-isolate, and how to behave during the quarantine period. On February 3, the MoH requested cellular companies to send messages to all passengers landing in Israel with instructions regarding COVID-19 and mandating self-isolation of 14 days for all passengers coming from China. On February 27, the same measures were applied to passengers returning from Italy, and the government recommended not to travel to Italy. These measures were expanded as additional risk areas were identified.
Information on outbreak severity, responses and other guidance are available at the MoH website (https://govextra.gov.il/ministry-of-health/corona/corona-virus-en/) in 10 languages at the HPs website, at phone “hot-lines” built by the MoH and the HPs. Information is also conveyed to the public via mass media (national TV and radio news) and social media. There have been briefings, almost on a daily basis, by the Prime Minister, ministers and experts.
Preparedness for/in migrant populations was generally low; there is no reference to migrant communities in Israel‘s pandemic preparedness plan from 2007. It took time and NGOs‘ advocacy efforts to address questions concerning the inclusion of migrant communities in preparedness measures. On March 13, following a meeting with NGOs, the MoH instructed all healthcare providers to ensure that Covid19-related treatment be given to all persons, regardless of insurance or other status. On March 28, the National Security Council stated that there was „no choice“ but to include migrants in Covid19-related measures.
Health information: As with other marginalized groups, there was an initial lack of health information in the relevant languages and minimal outreach efforts; and there were little to no capacities for medical interpretation (including online/telephone interpretation). With pressure from NGOs and collaboration with the Strategic Division and Public Health Services, the Israeli MoH committed to translate all important information into the relevant languages and disseminate to migrant communities via NGOs and employers (letter from 24.3.2020).
The Israeli Ministry of Health has been publishing daily updates on trends incidence, prevalence and case fatality rates of COVID-19, based on positive lab test confirming infected status, including cases in long-term care facilities (LTCF). Yet, figures from these facilities are not published separately.
31.5.2020 – a second COVID-19 outbreak?
Israel was one of the first countries to reopen the entire education system without restrictions except the temporary requirement of wearing face masks.
Between May 26-29, the number of positive diagnosed individuals increased significantly: from an average of 15 new cases per day, to an average of 64 daily cases, with a peak of 115 new cases on May 29th, an increase of 140% of positive cases diagnosed compared to the week before.
Most of the cases were identified in schools, particularly in Jerusalem, but could be an indication of a second outbreak wave.
The MoH mandated the closure of schools where positive cases were diagnosed, but maintained the rest of the educational system operating.
In addition, the MoH renewed its campaigns calling residents to keep physical distance of 2 meters, wear face mask in public spaces and maintain hygiene.
The ‘drive-in’ test stations were rebuilt and reopened full time, and residents with COVID-19 symptoms were called to get tested immediately (including holidays and weekends). Health plans also relaunched campaigns calling their members who feel unwell to be tested at their facilities.
Since the first cases were identified in schools, hundreds of pupils were screened by their health plans. Positive diagnosed pupils and their families were called to self-quarantine for 14 days.
In addition, from May 29th, the health plans’ medical teams regularly contact COVID-19 patients and their families to guide them on how to behave and to send monitoring kits to their homes, which include a thermometer and an oxygen saturation meter. Patients are required to measure themselves and report to the health plan. Each patient/family was assigned a nurse to contact in case of any need.
15.6.20 - New campaign of awareness and call for responsible behavior
Since the third week of May 2020, three weeks after transition measures were put in place, the number of positive diagnosed individuals has risen significantly, including severely ill. On June, 15th, the Ministry of Health launched a campaign raising public awareness for the importance of keeping physical distancing, personal hygiene and the use of masks outside home. The campaign consists of a series of videos of young, healthy people aged 20-50 sharing their COVID-19 experience while urging the public to keep wearing masks and adhering to physical distancing. (daily overview COVID-19, Israel, MoH, 15.06.2020)
We thank Prof. Luigi Migliorini from the World Health Organization, Prof. Nadav Davidovitch from Ben Gurion University, Prof. Avi Israeli from the Hebrew University, Prof. Yoram Weiss CEO of Hadassa Ein Karem hospital and Ari Zwiren, Adam Cutler and Asher Salmon from the Ministry of Health, for the review and constructive comments.