Photo Credit: Screenshot from a World Health Organization (WHO) video
Dr. Manfred Green

With virtually every country in the world impacted and more than 137,000 dead, it appears that the novel coronavirus is not slowing down anytime soon, according to renowned epidemiologist and director of University of Haifa’s international master’s program in public health, Dr. Manfred Green, who provided his breakdown of the latest developments surrounding this pandemic, including what will come next.

Where are we now?

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An increase in 500,000 cases worldwide – 1,800,000 total

The spread is not over – For example, while Italy has managed to control the spread, both Turkey and the UK are still grappling with a large number of new cases

But…there are success stories:

“While news surrounding the coronavirus remains grim, there are examples of countries that successfully combated the disease. China essentially managed to stop the epidemic. How did they do that? They had a total lockdown for weeks, sophisticated monitoring of movement for those who tested positive, sealed their borders and implemented widespread testing and isolation.

“Today, China is reducing its lockdown and slowly going back to work. Borders remain sealed as they’re preparing for a possibility of another outbreak. For now, they seem to be controlling it pretty well.”

Why early action is necessary – a look at New York state vs. Israel:

“Using New York as a benchmark may seem a little bit extreme, but the two cases demonstrate why implementing restrictions early on is critical. New York (whose population is double the size of Israel) has seen some 214,000 cases and 11,600 deaths, compared to Israel’s 12,600 cases and 140 deaths.”

Why?

“Some factors are beyond our control. For example, take New York State’s population itself – it has far more people over the age of 65 than Israel. 20% of New York’s population is over 65, while Israel only has 11% of its population in that age bracket.

However, it appears that the New York leadership was still very much in denial in early March. On March 2, Mayor Bill de Blasio tweeted that ‘people should ignore the virus and go on with their lives – get out of town despite the coronavirus.’ Granted, he most likely had experts advising him to issue these statements, but the damage caused by this misinformation to the public is not deniable.

DeBlasio was not alone. Other officials like New York City Health Commissioner Oxiris Barbot who remarked on Feb. 2: “There is no reason not to take the subway, not to take the bus, not to go out to your favorite restaurant, and certainly not to miss the [St. Patrick’s Day] parade next Sunday.’”

Meanwhile, in Israel….

Israel took action early. Israel introduced travel restrictions and social isolation much earlier. How?

Jan. 26: Israel advises against non-essential travel to China, four days later all flights to China are suspended

Feb. 17: Israel extends the ban to Thailand, Hong Kong, Macau, Singapore and a week later adds Korea and Japan

Feb. 26: Situation in Italy flares up and Israel issues a travel warning and also cautioned against any international travel

March 9: Israel declares a mandatory 14-day quarantine for anyone arriving from overseas

While Israel’s steps were much more extreme – they were easier to execute. We’re a much smaller country, with a more centralized government. It may well be easier to do it here. Essentially, though, it appears that the early and relatively heavy-handed intervention policy in Israel was effective.”

What comes next?

Israel is succeeding in “flattening the curve” and the health system is coping very well. While there are many patients, the health care system is not overwhelmed. However, the lockdown will be in place until we control the number of new cases.

And then?

“The lockdown will be gradually lifted, with monitoring still in place.

Then, there seem to be three options on the table: 1) Stop the lockdown and let the pandemic take its course – not a good option! 2) Slow the pandemic to a manageable level – which is what many countries are doing; and 3) Eliminate the virus totally – a dream yet to be realized.

Israel, then, must also increase testing for antibodies and increase the role of immune globulin (passive antibodies from those recovered from Covid-19) to ensure future treatment and prevention.

But, ultimately, this nightmare will be over once we have a viable vaccine.”

What does return to normalcy look like?

A gradual return to work – where a segment of the population is allowed to re-enter the workforce. Or shift work – some people are told to work in alternating shifts where one week they work and the next they stay at home

Intermittent lockdowns – If new cases pop up, we may be under lockdown again

Protection of elderly and chronically ill – Would be ideal to keep them separate from the general population, but this will be nearly impossible to execute and would increase their feelings of loneliness and isolation

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