Israel’s blanket 14-day self-quarantine requirement on everyone arriving from abroad is likely to remain in force for longer than the scheduled two weeks, a top physician has predicted, adding that the virus is unlikely to disappear in the summer months.

Most of Israel’s coronavirus restrictions are open-ended, but Prime Minister Benjamin Netanyahu and his ministers have put the new quarantine rules in place for 14 days. Prof. Allon Moses, director of the Department of Clinical Microbiology and Infectious Diseases at Hadassah Medical Center, told The Times of Israel: “There’s a good chance they will go beyond this.”

The new restrictions came as US President Donald Trump appeared to mock concern about coronavirus. He tweeted on Monday: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”

Netanyahu, often in agreement with Trump, is taking a totally different attitude to the coronavirus. He insisted in Sunday’s cabinet meeting that it represents a “global pandemic, even if this has not been declared officially.” Across the Israeli government, there is a conviction that the coronavirus is in a different league from the flu.

Moses said that the reason Israel is unleashing measures now that it never used against even the most harmful strains of flu, such as swine flu during the 2009 pandemic, is that COVID-19 has caught humanity off-guard. People have some immunity against flu even if they haven’t been vaccinated, but are completely undefended against the new virus, he said.

Moses said that in view of this, “… if we want to keep up the small numbers [of cases], we have to be extreme in our measures. This restriction on all returning Israelis and any tourists who arrive is important and I support it.”

Netanyahu announced on Monday evening: “After a day of complex discussions, we have made a decision. Whoever arrives in Israel from abroad will enter quarantine for 14 days. This is a difficult decision but it is essential to maintaining public health, which takes precedence over everything.”

Moses wouldn’t predict how long the restriction will end up lasting, but said that it will take time to get the virus under control, and cast doubt on the theory that the summer heat will end its spread.

He said: “One possibility is that the disease will wane by itself when the summer comes and seasons change. This happened with SARS in 2003, but this option is unlikely now because there are so many sick people [around the world].”

Moses believes it is more realistic that Israel will maintain strict isolation rules for people who may be carrying the virus until two full weeks pass without anyone becoming infected, at which point the crisis will be concluded. A third possibility, he said, is that the virus won’t be contained until a vaccine is available.

“This is not the flu,” he stressed. “The flu is a different disease, and a lot of the population has previous antibodies and is immune. We have been dealing with the flu for 100 years, so the population of the globe has immunity to the flu, even if it’s a different strain. Coronavirus is different and therefore the measures have to be more extreme.”

Immune system researcher Tomer Hertz thinks that coronavirus’s high death rate is the main factor that sets it apart from swine flu. “The main difference between swine flu and this is case mortality rate, which is calculated by the number of deaths compared to the number of infections,” he said.

According to his calculations around 0.1% of people with the flu, including swine flu, die as a result of catching it, but for the coronavirus estimates are upwards of 0.6% — and he predicts the figure will end up being around 1%. Some 10% of people suffering from coronavirus are hospitalized, which is a high percentage for an infectious disease, he said.

Middle East Respiratory Syndrome, also known as camel flu or MERS, and Severe Acute Respiratory Syndrome (SARS) are “more lethal but certainly not as infectious.”

Comparing coronavirus to flu and the other respiratory syndromes explains the government’s current hard line, said Hertz, who is head of microbiology, immunology and genetics at Ben-Gurion University of the Negev. If not controlled, coronavirus could paralyze Israel’s health system in a way that didn’t happen as a result of swine flu or any other health crisis, he warned.

“Even with 10% of the people with corona needing medical treatment, there might not be enough beds,” said Hertz. “Hospital wards in Israel right now are at about 80% capacity and there are not a lot of free beds.”

He cautioned that the fight against the coronavirus just got significantly harder, as officials announced on Sunday that they had found the virus in a man who had not been abroad or knowingly come into contact with any other infected person, the first such case in Israel since the outbreak.

“Once you have community spread it’s very difficult to know where the virus is,” said Hertz.

“It’s the first sign of community spread, which is the next phase, during which we don’t have a tally of quarantine and we don’t know who is where. Very quickly you may be in a situation where you have many undocumented cases walking around and infecting others.”

Header: Hadassah Ein Kerem Hospital, Jerusalem