Policy responses for Israel - HSRM


Policy responses for Israel

1.4 Monitoring and surveillance

At the beginning of the outbreak in Israel, when most of the cases were imported, the MoH monitored and investigated each diagnosed case. Each known infected individual received a unique number and and all details of movement and places s/he frequented were published in the media and the MoH website. All individuals who were in touch with someone who had been infected, or were in the same places as an infected person, were asked to self-quarantine for 14 days (see section 1.3 Isolation and quarantine). Epidemiological case investigations are performed according to the accepted protocol.

As the number of cases increased and reached a point where individual epidemiological investigations were no longer possible, the MoH started using big data and technological means to improve and speed up investigations (as of March 25). Routes of diagnosed individuals are no longer shared, and instead known locations are shared on the MoH's website. The MoH reaches out to individuals who have been in touch with infected persons via SMS and alerts them to self-isolate.

On March 18, bypassing parliamentary approval, the government approved regulations for collecting data and geolocation of mobile phones of infected individuals. Emergency measures to allow Shin Bet, Israel’s security agency, to repurpose its mass surveillance protocols for COVID-19 contact tracing. Locations from the previous 14 days are analysed (automatically) and those who were in the vicinity of the infected person are notified and required to go into self-quarantine.

In addition, alternatively the MoH developed an open-sourced voluntary mobile app called "Hamagen" (Shield in Hebrew) which cross-references the locations of individuals and known infected people. The application compares the locations of the owner of the mobile phone with data pulled from MoH servers. In the case of a match, the application notifies the owner of the phone and requests him/her to self-quarantine. The application also presents a link to fill in the self-quarantine report of the MoH. All personal data is saved only locally on the device and is not shared with the MoH. The Public Health Physicians Association issued a letter discouraging the use of this technology, due to methodological problems, which are both epidemiological and technical in nature.

"Clalit", the biggest health plan, has developed a big-data analysis tool based on seasonal-influenza data that identifies persons at high-risk of severe symptoms and alerts them. This is a novel algorithm and its accuracy is yet unknown.

Digital tracing of COVID-19 confirmed cases to continue

The Emergency measures of involuntary digital tracing of geolocation data have been criticized by civil rights groups. Following a number of petitions from advocacy organizations, Israel’s High Court of Justice announced that Shin Bet’s surveillance program would be frozen on March 21, 2020 if the government did not seek parliamentary (the Knesset) oversight. On May 5, the government requested the High Court to continue allowing digital monitoring to identify people who were in contact with COVID-19 patients (and quarantine them). The Israeli parliament has allowed the 'Shin-Bet' (Israel's security agency) to continue monitoring citizens for 3 more weeks, until May 26, 2020. (https://www.haaretz.co.il/health/corona/1.8821029).

Involuntary tracing no longer in effect:
As of the 11th of June, the temporary decree allowing the Shin-Bet to track COVID-19 patients is no longer in effect. The Knesset (parliament) and Israel's high court informed the government that if the Shin-Bet is to continue tracking of COVID-19 patients, a law should be passed in the Knesset. (https://www.globes.co.il/news/article.aspx?did=1001331923)

20.6.20 - Increased epidemiological investigations
The spread of COVID-19, has increased significantly since late May 2020 reaching levels similar to those of the first outbreak in March-April 2020. MoH has attempted to avoid a second lock-down, and have recruited additional workforce for conducting epidemiological investigations in order to speed up the process of locating and identifying individuals that were in touch with positive-diagnosed COVID-19 individuals and isolate them immediately. The Minister of Health has allocated a specific budget to contract 300 additional workers to help the epidemiological nurses shorten investigation times.

22.6.20 – new website with live epidemiological information about COVID-19
The MoH has launched a new online dashboard tool updated 3 times a day with epidemiological data on COVID-19 in Israel: https://datadashboard.health.gov.il/COVID-19/. The dashboard contains detailed data such as number of daily and total new cases, active cases, number of daily tests, number of cases by location, age, gender, by hospital and other important characteristics. Prior to this dashboard, this data was published daily via online platforms (MoH Telegram, 22.06.2020 ; https://datadashboard.health.gov.il/COVID-19/) 

24.6.2020 - Back to involuntary tracing plans
The Government approved the promotion of legislation that allows involuntary cellular surveillance of COVID-19 patients, despite opposition from the Shin Bet (secret service) head.

1.7.2020: The Knesset (Parliament) passed a temporary bill allowing the Shin Bet (secret service) to use technological means to involuntarily track COVID-19 patients, whenever the number of daily new cases is above 200. The law becomes void on the 22nd of July (https://www.haaretz.co.il/health/corona/1.8963386).

5.07.2020 – meanwhile, about 30,000 people were already told to quarantine following close encounters with confirmed COVID-19 patients. The information came from the “Shin Bet” tracking system. (https://www.haaretz.co.il/health/corona/.premium-1.8969925

Recruitment of the army to support COVID-19 testing and contact tracing:
On July, 30, the MoH appointed the army to take part in the control of COVID-19’s spread. It will have responsibilities to support testing and contact tracing schemes.

Involuntary contact tracing will continue to be implemented until morbidity is negligible

Following the High Court ruling on 01.03.2021 on reducing the use of GSS (General Security Service) satellite cellular tracing, the Ministerial Committee on GSS Affairs decided to continue operating cellular tracing in the current format until March 13, and then to activate it only in the case that a COVID-19 infected individual does not cooperate with epidemiological investigations. According to the Minister of Intelligence, the use of GSS tools will cease completely when the level of morbidity is negligible.

New study about the accuracy of cellular tracing

According to the study, there may be a deviation of up to 2000 meters between the reported location and the actual location of the person being traced. The study dispels the fear that using cellular information may infringe on user privacy as the calls are not necessarily made using the antenna closest to the user, thus making it very difficult to verify people's locations accurately.

Electronic bracelets pilot

On March 1, 2021, a program pilot was launched to supervise home isolation for citizens returning from abroad as an alternative to isolation in Home Front Command's dedicated hotels. Returnees from abroad will be given the option to stay in these hotels, or to receive a tracing kit - if they choose home isolation. The kit includes an electronic bracelet, a dedicated smartphone and a tag. The MoH is operating the pilot through an external private company which will receive an alert in cases of isolation violations. Police will be alerted whenever isolation has been violated. Those who are interested in home isolation will have to deposit NIS 1,500 for the kit.