When the Covid-19 virus began to spread across the world in February, Israel seemed ahead of the curve.
It was one of the first countries to close its borders to arrivals from China and then other early infected countries, and one of the first to send citizens returning from abroad in to self-quarantine and closely track its first cases of infection.
But in recent days, there has been a feeling among medical professionals in Israel that the authorities may have dropped the ball on the way.
As of Wednesday, five Israelis had died from complications due to the virus, all in the space of the previous five days. 2,369 people tested positive, with hundreds added daily. 39 were in a severe condition, one of them critical.
“At this point, it is still manageable,” one hospital chief executive says. “There isn’t an unbearable strain on the health system and we are ready for a surge in coronavirus cases. But we’re in the dark about if and when the surge will come.” At the beginning of this week, the rate of new cases being confirmed was doubling every day.
Criticism of Israel’s response has been focused on three areas. First is the belated gearing up of testing facilities due to a shortage of kits, but also because of senior Health Ministry officials’s belief that testing asymptomatic cases was a waste of time.
“There needed to be much more widespread testing, of both vulnerable groups and geographic samples,” says a senior lung specialist. “Now, as a result, we’re like soldiers being sent in to battle without intelligence.”
The other two main criticisms are more related to organisational politics. The slowness with which a lockdown was imposed — it finally came into nearly full effect only on Wednesday evening — was the result of an ongoing disagreement between the finance and health ministries.
“We had a half-hearted closure for the last week,” said one minister. “It had the effect [of] bringing the economy almost to a standstill, but people continued going outside and spreading the virus anyway.”
But perhaps at the root of the problem was the absence of a clear director of Israel’s response to the virus — someone who can focus on the coronavirus response without political and legal distractions but with power to adjudicate between the different ministries — other than Benjamin Netanyahu.
Instead, under him there is a health minister who has mainly been concerned with keeping synagogues open despite data that shows they are a main hub of infections, a finance minister who is about to retire from politics and a defence minister who controls most logistical resources but is deeply distrusted by Mr Netanyahu.
The main problem for the next fortnight is that while Israel’s public health service is highly trained and has the benefit of the latest medical technology, it is also one of the most understaffed and overcrowded in the OECD.
“We’ve spent the last three weeks doing everything to cobble together new ventilators,” said one veteran hospital department head. “But all that means is that there are now 3,300 in Israel, instead of just 3,000. That’s a finite number and if the number of patients needing them overtakes that, we’ll be doing triage and deciding who we have to let go, just like in Italy.
“People here still have this belief that we’re Israeli and special and therefore the rules that apply elsewhere don’t apply here. I want to believe that as well, but it’s not a way to plan a health system and we’re about to find out next week.”