ICU monitor
ICU monitor iStock

Israel is currently operating in “coronavirus mode.” Or is it? Maybe the government, or parts of it, is. Some politicians are; others are placing other considerations at the forefront. But does the general population really comprehend the scope of the crisis we’re in? Probably not. Not yet.

As of Tuesday, 1,656 people have tested positive for coronavirus here, with 31 in serious condition. So far, only one person is confirmed to have died from coronavirus. Given these figures, the average Israeli might (though shouldn’t) be forgiven for concluding that it isn’t really as bad as all that, and not much worse than seasonal flu. Would it really be so terrible if we had a hundred thousand people infected? Or a million?

On the other hand, what we do see already is the shutdown of the economy. No one knows yet what the ramifications will be, though it seems pretty certain that the downturn will be the worst the country has seen in the last 35 years. So, when the average Israeli puts the two issues on either side of the scale, which one wins out in importance?

But all this is an illusion – a dangerous illusion. So far, there are “just” 31 people in serious condition in our hospitals. There are enough ICU beds to go around, enough ventilators, and enough critical care staff to provide the best that Western medicine can offer. Even when a patient is in critical condition, there are still enough life support machines to pull them back from the brink. That’s probably why the mortality rate from coronavirus that we’re currently seeing is so low. It’s still worse than the rate from influenza, but it’s not shocking most people as disastrous or unprecedented.

The real extent of the crisis will only be seen when we reach a stage where we don’t have enough critical care beds for coronavirus patients in serious condition. This is what’s already happening in Italy and Spain, and that’s why the mortality rates there have increased dramatically. If someone in serious condition is provided with assisted respiration then he has a good chance of recovering, especially if he’s still young, but even if he is older. However, if such a person is left untreated, his chances of surviving – even if he’s still young – drop significantly, and for an elderly patient, it’s virtually a death sentence.

There are currently 31 patients in serious condition in Israel’s hospitals. If the rate of increase in the number of patients continues as it has until now, within ten days there will be 310 patients in serious condition, and in less than two weeks we could reach crisis point in the hospital system. When ICU wards run out of ventilators, doctors have to start making life-and-death decisions regarding who gets treated and who is, effectively, left to die. This is what’s already happening in Italy, where there are 12.5 critical care beds per 100,000 residents, and in Spain where there are just 9.7 beds per 100,000. (By contrast, in Germany there are almost 30 beds per 100,000 residents, and a much lower mortality rate – so far.)

The Health Ministry recently ordered another 1,000 ventilators to add to its pre-existing stock of around 3,200, and it estimates that this translates to a figure of 40 ventilators per 100,000 people. However, if the numbers of those infected increases dramatically, as has been seen in several countries across the world, nobody knows if that will be enough.

There is a growing consensus that the only way to avoid turning into the next Italy, with tens and then hundreds of deaths per day, is to slow down the rate of contagion using drastic measures. This can only be achieved by means of much tighter restrictions than we have seen until now, as well as by testing far greater numbers of people, including those who are asymptomatic, in order to isolate them from the community.

It won’t be easy – in fact, it could make our lives virtually intolerable. But the kind of “shutdown” we’re in now, where people are still on the streets, in the parks, and on the beach, just isn’t going to make a significant difference once the progress of the virus ramps up, as has happened across the world. Bear in mind that in China, people were in total lockdown for two whole months before the tide turned, and it’s by no means certain that coronavirus has actually been stopped entirely in its tracks there either. So the question is, are we prepared to go all the way to stop coronavirus – before it’s too late?