Balicer: Local Covid outbreaks don't need policy change

Ran Balicer / Photo: Eyal Izhar, Globes

Prof. Ran Balicer, head of Israel's advisory panel on Covid-19, says recent outbreaks in Binyamina and Modi'in were apparently of the Delta variant.

Is the coronavirus making a comeback in Israel? No, but it never really left. In the possible scenarios for the end-of-coronavirus period, the experts described one in which herd immunity would be incomplete and children would not be vaccinated, resulting in sporadic local outbreaks. Israel has gained control of the pandemic with surprising success, but infiltration of the disease from overseas now appears to have the potential to cause such outbreaks. Covid-19 is still with us, although another large wave of the disease does not seem likely.

The main vector for the disease at present is schools, as children and teenagers are infected overseas, or are infected by parents returning from overseas, resulting in the disease spreading in their schools. If such outbreaks continue, it might change the balance of utility of vaccinating teenagers, and the Ministry of Health, which has said that vaccinating them is worthwhile but not urgent, may change its stance. Vaccinated teenagers will not have to be isolated in the summer vacation, and that might prove an incentive for a more rapid vaccination process. In the two weeks since vaccination was approved for 12-16 year-olds, 2,500-3,000 have been vaccinated daily. The capacity is a little higher than that.

Prof. Ran Balicer, head of the panel of experts advising the government on Covid-19, said via Twitter today that the outbreaks seen recently in Israel - in Binyamina, where 45 people were infected, and in Modi'in, where 20 people were infected - were probably caused by the Delta variant. This is the variant that originated in India, where it spread widely, and is now the cause of a further outbreak in the UK, where the patient numbers have been rising for a month. This variant is believed to be 1.5 times more infectious than the British variant, which was the most common variant in Israel's last outbreak. It is not yet known whether it is more violent.

Balicer stresses that in Israel a higher proportion of the population has received two doses of vaccine than in the UK, and that the Pfizer vaccine, the one used in Israel, has been shown in laboratory tests to be effective in two doses against the Delta variant.

"As long as the outbreaks remain local and contained, and Ben Gurion Airport is well managed and isolation instructions are observed, no change in policy will be required. It is certainly possible that the 85% of adults who have been vaccinated here will continue to protect against spreading of the disease between communities," Balicer writes.

Even in the UK, where only 60% of the population has been vaccinated, the new wave has not caused a substantial rise in mortality, probably because the rates of vaccination among the elderly and people at risk are higher. The risk has switched from deaths among old people and flooding of the hospitals with patients to a spread of the disease among young people, and the effects of "long-Covid". Yesterday, for example, a British study was published showing differences in brain tissue between Covid-19 patients and those who had not had the disease, and also versus previous brain scans of those patients, indicating that Covid-19 can cause loss of brain tissue.

In the event of a large outbreak, "the decisions will be complicated," says Balicer, because of the change in the pattern of morbidity in a population that is mostly vaccinated, and because it is not yet clear what preventative measures should be introduced if the impact is mainly on children and teenagers, in the absence of full knowledge of the consequences of the disease for them. "What is the price of morbidity in children and when will intervention be justified? At what stage will a blanket recommendation be required to vaccinate adolescents, aged 12-16?" Balicer asks.

The answers to these questions are currently being formulated, on the basis of study of the experience of other countries in which the Delta variant has started to spread, and further examination of the situation in Israel.

Published by Globes, Israel business news - en.globes.co.il - on June 20, 2021

© Copyright of Globes Publisher Itonut (1983) Ltd. 2021

Ran Balicer / Photo: Eyal Izhar, Globes
Ran Balicer / Photo: Eyal Izhar, Globes
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