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With tourists set to return November 1, are Israel’s COVID gains at risk?

Israel is reopening to many foreign tourists on November 1, for the first time since March of last year. But does the move pose a danger to the country’s hard-won coronavirus success?

It comes just as virus rates are dropping. Serious cases have dipped below 300 for the first time in 10 weeks, and the rate of positive test results is at a four-month low.

Vaccinated visitors from overseas will be welcomed back via Ben Gurion Airport, often referred to as Israel’s COVID Achilles’ heel — because it is likely to have been the gateway for the first virus cases and the first cases of new variants, and because of often lackluster enforcement of quarantine and other health procedures for arrivals.

All arrivals must undergo tests prior to flying to Israel and upon arrival. And all incoming tourists will need to quarantine until they receive a negative test result.

But the regulations are far from perfect — some arrivals may get false negatives, others may be too early in the disease to register as positive but become contagious later, and yet others may fail to quarantine properly.

Experts say that as long as the pandemic persists, tourism will bring with it a virus risk.

“We shouldn’t test too much the immunity we’ve built up here,” Prof. Gabi Barbash, a former director-general of the Health Ministry, told The Times of Israel.

He didn’t reject the idea of welcoming some tourists, but said he fears that the scale of the reopening — accepting visitors from all countries — is too big.

“I’m not in a position to say [it’s] wrong or right but I’m worried,” he stated. “The concern is that you are going to import patients who are apparently immune, but not actually immune.”

Barbash is particularly concerned about Russia, where daily COVID deaths have just hit a new high, especially as he doubts the reliability of the Russian Sputnik V vaccine. Israel has decided to recognize the vaccine from November 15, despite it not having the stamp of approval of the World Health Organization, in an apparent diplomatic gesture to Russia.

In all other countries, Israel will only accept those vaccinated with Pfizer, Moderna, AstraZeneca, Johnson & Johnson, Sinovac and Sinopharm.

In contrast to Barbash, Prof. Eyal Leshem, an infectious disease specialist at Sheba Medical Center, is not particularly worried.

“The airport is not a weak spot today, and hasn’t been a weak spot since we reached high vaccine coverage,” he told The Times of Israel.

Leshem said the coronavirus is transmitted at Israel’s malls, schools, restaurants, concerts and elsewhere. Incoming flights are one of many virus vectors, but unless the percentage of arrivals who are infected and go undetected gets high, it won’t significantly affect virus rates, he believes.

“Because we have community transmission anyway, foreign cases don’t affect the epidemiological situation. If tourists infected enter on top of hundreds of cases in Israel, it doesn’t change the situation in Israel.”

“Most countries have been much more permissive than Israel. There’s no need to keep on hitting the travel industry. We can accept the risk based on the assumption that there is still some community transmission in Israel, and arrivals from abroad will just add to this slightly.”

Leshem said that prior to widespread vaccination, there was a logic to keeping tourists out — as a single COVID-positive foreigner was liable to infect many others. But the risk is much lower now that inoculation has reduced transmission rates.

“The airport was an Achilles’ heel, for example in March 2020 when we weren’t ready for treatment and didn’t have vaccines, and flights arrived packed with people with COVID who weren’t quarantined,” said Leshem. “But now we’re a year and a half later.”

Barbash argued that Israel’s immunity is still in a delicate state and that therefore a more stringent airport policy may still be wise. And he said vigilance was especially important as the airport would be the likely arrival route for any new variants, which he is keen to keep out.

Leshem thinks that attempts to keep out the next variant are a losing battle.

He said experience has shown that unless countries completely seal their borders to stop even their citizens from leaving and returning, variants will arrive.

“The assumption is that when there is a new variant it will enter the country, unless you completely shut down the border,” Leshem said.

“New variants will enter Israel as previous variants have, which makes the big airport discussion a little bit futile.”

Source: Nathan Jeffay – TOI