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Israeli COVID-19 Endgame | Science

Israeli COVID-19 Endgame | Science

 


Israel may be switching to the other side of the pandemic, as some countries are currently facing a surge in COVID-19. Last week, 5.5 million new cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were reported worldwide, compared to only 398 in Israel (50,000 in January). Compared to the above). Already, 54% of Israel’s 9.2 million citizens are fully vaccinated, significantly more than most other countries. The country should be optimistic but cautious as the risks of a resurgence continue as regulations continue to be relaxed over the next few months. Therefore, Israel could be an early case study of the positive outcomes of a mass vaccination campaign.

In January 2021, in the face of a third pandemic wave caused by the newly predominant B.1.1.7 variant, Israel carried out a strict four-week blockade in conjunction with rapid mass vaccination. By early February, 38% of the population had been vaccinated at least once (80% over the age of 50) and an additional 7.5% had recorded past infections (believed to provide some protection). ). The risk of recurrence and its expected burden are well hedged due to high vaccine intake and an interim analysis of a large regional cohort showing high vaccine efficacy (> 90%). Was considered to be. Therefore, despite the stagnant incidence (more than 8,000 infections per day), the blockade was lifted.

Beyond expectations, new infections declined sharply for 90 consecutive days, documented infections fell by more than 100-fold, and severely by 50-fold, even though most restrictions were gradually lifted. It has decreased more than that. Some signs suggest that this was primarily caused by vaccination campaigns rather than seasonal or residual blockade effects. The reduction in severe cases was initially apparent in the elderly (the earliest vaccinated group), and after just a few weeks, mostly in the unvaccinated younger age group. By late March, more than 55% of daily COVID-19 mortality occurred in a small (<1.6%) subgroup of unvaccinated adults over the age of 60.

From Israel’s experience, it is difficult to estimate a universally “safe” vaccine intake threshold that allows countries to safely resume their economies. This is because such thresholds are likely to be configuration specific. By mid-April, there was a similar reduction in infections in the UK after a single vaccine campaign, but in Chile and Seychelles, despite relatively high vaccine intake, COVID-19 (48, 39, 67%, respectively). The population of each country has received at least one vaccination).

Israel’s rapid vaccination campaign has benefited from decades of investment in a community-focused universal health care system, including digital health infrastructure. Hundreds of vaccination clinics, led by four public non-profit medical institutions in Israel, have vaccinated up to 2.5% of Israel’s population daily. Their preparation highlights some best practices. Aggressive outreach through call centers and easy-to-use mobile device apps. Electronic health records to promote ingestion at the vaccination site. And provide the vaccine left over at the end of each day to people of all ages so that the dose is not wasted.

Vaccine hesitation has hampered early immunization efforts, especially in the ultra-Orthodox and Arab communities. By setting up vaccination sites in these communities and encouraging respectful discussions between health professionals and community leaders, we were able to increase penetration. Israel’s COVID-19 National Expert Advisory Committee has proposed that Israel consider proactive measures to increase vaccine access to the Palestinian Authority’s population, and Israel has so far been in Israel. We have vaccinated more than 100,000 Palestinian workers in employment.

Israel may not reach herd immunity soon, as nearly 40% of the total population has not yet been vaccinated, most are under 16 years of age, and there are 15% of the vaccinated age group. .. Interference with viral infections by mass vaccination (“indirect defense”) has so far continued to reduce the incidence in all age groups. However, as the remaining non-pharmaceutical interventions (indoor masks, quarantine, and vaccination certificate policies (restricting access to high-risk indoor settings to vaccinated and recovered individuals only)) are gradually removed, COVID -19 The risk of resurrection persists. In the absence of these interventions, outbreaks can be caused by increased vulnerability in areas of low vaccine intake, as well as viral variants that may partially circumvent the protective effect of the vaccine. Even in one of the most vaccinated countries, the pandemic is not over yet and Israel must remain vigilant. The success of its mass vaccination should not be wasted and may serve as a model strategy for other countries.

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