Israel’s rising number of coronavirus cases isn’t causing the expected level of increase in hospitalizations, giving reassurance to those who fear a healthcare system collapse, according to some leading doctors.
In September, the number of active confirmed cases jumped from 20,699 to 31,263.
But the number of hospitalized patients at any given time has only risen from 878 to 926. The number of seriously ill COVID-19 patients at any one time has increased from 438 to 478.
One of the reasons those numbers are keeping steady has been the daily deaths of seriously ill patients, but these too have remained similar to the previous month so far, at around 12-15 per day.
Some hospital chiefs have reportedly given stark warnings to the government.
In a Zoom conference call on Wednesday with Health Minister Yuli Edelstein, the government’s coronavirus czar Prof. Ronni Gamzu and other officials, hospital directors said their crews were “collapsing” under the strain of rising numbers of sick, according to quotes from the closed meeting reported by Channel 12.
But some senior doctors suggest this kind of talk is political posturing designed to force the government to take the needs of the health system seriously.
“The discussion about the situation in hospitals is plagued by politics and interests,” Dr. Yoram Maaravi of Hadassah Medical Center told The Times of Israel.
He said hospitalization levels bode well. “Generally, we would expect more people to be hospitalized because you have more spread of the virus, but you don’t see a big rise,” he commented.
At Jerusalem’s Shaare Zedek Medical Center, hospital president Prof. Jonathan Halevy took a two-week view, commenting: “So we climbed from around 410 to 470 serious cases in the last two weeks; I’m not worried.”
“My prediction is we won’t be overwhelmed, but we can’t guarantee it,” he said.
Maaravi, a senior geriatrician, said that the main reason that hospitalizations are being kept in check is that new coronavirus cases are mostly young healthy people and the elderly are being protected.
“The government is [doing] better at protecting the vulnerable elderly in nursing homes,” he said. “This is one of the main reasons for fewer hospitalized people.”
Halevy, a member of a Health Ministry public information team, suggested another reason: Israel’s efficient health maintenance organizations, that care for people in their homes. “This has to do with the wonderful community medicine,” he said, adding that this efficiency is unique to Israel.
One of the major fears among doctors is that the the upcoming Jewish High Holidays will trigger a rise in the average age of people with the virus, potentially promoting a rise in hospitalizations.
There are also questions as to whether hospitalizations will increase even if the age profile of infected people remains young.
Avi Weissman, deputy director of Rambam Health Care Campus in Haifa, said during a Wednesday briefing: “We have two children newly admitted with coronavirus, and we see a bit of a decrease in the age of people being hospitalized and a worsening in their condition.”
Rambam is one of several hospitals opening new facilities, having just launched an intensive care facility, which already has 10 patients. But it hasn’t opened its large emergency hospital in a specially-designed underground car park.
Weissman referred to the increase in hospitalizations as a “slow drip.”
Small hospitals warn of “compromised care”
While big hospitals like Rambam and Hadassah can still absorb a significant rise in patients, some smaller hospitals are concerned that more coronavirus patients could harm their ability to care for other patients.
“It’s possible we’ll need to take over another department or another medical team, as numbers are going up,” said Margarita Mashavi, head of internal medicine at Wolfson Medical Center in Holon, where the COVID-19 patient count has jumped to 43, after around a month-and-a-half at an average of 32.
Expressing concerns that some of the patients diagnosed in September could yet deteriorate, and the effect of the latest spike will still be felt, she said: “If this happens there will be fewer doctors in other departments.”
At the Galilee Medical Center in Nahariya, the prospect of a further rise in cases is already reducing the space available for general care.
“We have six internal medicine wards in the hospital and only three of them are functioning as internal medicine wards,” spokesman Gal Zaid told The Times of Israel, explaining that one has been turned into a coronavirus ward, and two others are in the process of being converted.
Zaid said northern Israel is in worse shape than the rest of the country, as cases are growing faster, particularly in Arab-majority communities, and there is less healthcare provision.
“We have three coronavirus wards, and the first two are almost full with 60 people between them. Yesterday we opened a third, where there are already six people and only 35 beds,” Zaid said. ‘If in another week this third ward fills up, we’ll have reached a kind of red line, and it’s very possible we won’t have a place to put other sick people.”
Header: Israeli police seen at the entrance to the neighborhood of Ramot in Jerusalem, as Israel enforces a nightly curfew in coronavirus hotspots, September 9, 2020. (Yonatan Sindel/Flash90)