On Friday, after nearly two harrowing months, Shaare Zedek Medical Center in Jerusalem closed its coronavirus wards. To learn more, The Jewish Press spoke with its president, Professor Yonaton HaLevy.
The Jewish Press: How did you manage to close your emergency corona units?
HaLevy: To be fair to other hospitals in Israel, nearly all of them are closing up their corona units now that the rate of infection has gradually lessened.
Along with the Sheba Medical Center in Ramat Gan, which borders Bnei Brak, Shaare Zedek was called upon to deal with the highest number of patients – probably because of the large charedi population in the Holy City since charedi communities were the most affected.
Over the last week, from 125 hospitalizations, we are down to 34. Five out of our six units have been closed. I believe one reason for our success was the preparedness of our medical team, which has a lot of experience dealing with mass disasters.
At the height of the epidemic – a period of three weeks – we had 400 cases, which we were able to absorb without being overwhelmed. Nevertheless, 33 of the patients died – mostly people in their late 80s and 90s, one in his 60s, and two in their mid 50s.
What’s the treatment for patients who require hospitalization?
There is no definite treatment. We were partners in several different tests, but none proved particularly effective – not the anti-malarial medicine, not erythromycin, not hydroxychloroquine, and not remdesivir.
The only medicine that seems potentially hopeful is remdesivir, which we used in limited clinical trials. The drug limits the duration of the virus and the length of hospitalization, but there is no proof at this point that it decreases mortality.
The treatment we provided was mainly supportive: Tylenol for fever and oxygen if the saturation dropped below 93 percent – whether with a small nasal tube or other respiratory aids like a respirator if needed.
Fluids were administered, but antibiotics only in cases where there was a secondary infection. Generally, the immunology system of patients with no previous medical complications can deal with the Covid-19 virus on its own.
Out of 100 patients, 85 percent have either no symptoms or very minor symptoms with no need of hospitalization. An additional 10 percent need to be admitted, and five percent arrive in critical condition with the infection mainly centered in the lungs, but also sometimes in the liver and kidneys.
These are the patients isolated in the special corona intensive care units. As has been widely reported, elderly people are the most endangered by the virus, but younger people can also be stricken with, of course, a far greater chance of recovery.
Other factors such as high blood pressure, diabetes, lung conditions, excessive smoking, and obesity can make people more vulnerable.
Did doctors and nurses become infected?
Yes, we had about 30 members of our staff infected, but at Shaare Zedek the virus was not contracted in the corona departments where the medical staff communicated with patients via special cameras and microphones. It was contracted outside of the hospital in interactions with other people in their communities or people arriving in Israel from around the world.
How did you deal with family members who couldn’t visit patients confined in isolation units?
The doctors and nurses were absolutely outstanding in their concern for the patients and their families. For example, in one instance, a woman told me that when her elderly mother was dying, the Arab physician who headed one of the corona units telephoned her and told her that he was with her mother and that he had called in two Jewish nurses to recite Shema Yisrael and vidui.
We initiated a policy whereby one of the family members would be contacted each day by the presiding doctor and a social worker assigned to the case. Social workers worked around the clock in a special center where they could be approached at all hours.
We have heard warnings that next winter might bring an even greater corona epidemic. Is Shaare Zedek taking precautions to deal with this possibility?
Why talk about next winter, which is far away? The possibility of a second wave of the virus occurring even now is an ongoing threat.
For that reason, we have not dismantled the partitions we built in the isolation wards. People shouldn’t think that because quarantine restrictions are easing that the virus has disappeared. Caution remains the order of the day.