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As more COVID rules are lifted, Israel is in stable condition but not yet at the endemic stage

Israel is scrapping some of the last remaining coronavirus regulations. As of Saturday, Israeli and foreign travelers will no longer need to be tested for COVID-19 to enter the country.

From Tuesday, face masks will no longer be required on international flights and will only be mandatory in medical centers and senior living facilities. These changes paint a picture of a country in exit mode from the pandemic mindset.

In a Times of Israel Q&A on the current situation, leading epidemiologist Prof. Michael Juwel said that Israel is enjoying a well-deserved rest and is responding appropriately in political terms, but there is a fine line between stability and complacency.

After all, the virus continues to circulate across much of the world, meaning cases, including new variants, are likely to reach Israel. Currently, immunity to infection is high, but that will change, he stressed.

“The emergence of a new variant that has an evolutionary advantage is probably a matter of when, not if, and could lead to spikes in infection,” he said. According to his analysis, however, Israel can withstand such spikes without falling into crisis mode.

Gemstone started the pandemic as a senior health official in England and has since moved to Israel’s Bar Ilan University, working on prominent research projects on the coronavirus and vaccines.

A worker at a coronavirus testing facility in Israel. (Olivier Fitoussi/Flash90)

How do you assess the current situation in Israel?

We are in a stable situation where all restrictions are pretty much gone and restrictions related to air travel are about to end.

But not only are we in a stable place, we’re also in a potentially complacent place.

It’s easy to forget that while cases in Israel are few, the virus continues to circulate internationally and re-imports will continue. In parts of the world we have many ongoing transmissions and suboptimal vaccinations, which not only means high case numbers, but also creates a breeding ground for new variants.

Can we start using the word endemic to describe where we are in relation to the coronavirus?

I don’t think we’re at a point where we can say COVID-19 is endemic yet. We are not at a stage where there are only small fluctuations and we know what to expect – in fact there could well be spikes in infection. So I wouldn’t start using the word endemic.

dr Michael Gem, Professor of Epidemiology and Public Health at Bar Ilan University

Many people consider Omicron, which spread so quickly and infected so many, to be the last of the worrisome variants. Is that right?

No – or rather, we cannot know. Many people don’t know, but since Omicron there are many new variants. We haven’t heard much about them. This is partly because the news has been so heavily dominated by events in Ukraine and the coronavirus has faded into the background in public consciousness.

But that’s mostly because none of the newer variants had an evolutionary advantage over Omicron, meaning they didn’t spread and become dominant faster. The emergence of a new variant that has an evolutionary advantage is likely a matter of when, not if, and could lead to spikes in infection.

Does this mean it’s only a matter of time before we’re back in full-blown pandemic mode, with hospitals overwhelmed and talk of lockdowns?

no We’ve gotten much better at changing our way of life to adapt to different COVID scenarios without feeling like we’re in deep crisis. Second, we have high levels of immunity, both to many people who get infected and recover, and to vaccines.

While this does not necessarily prevent people from becoming infected, it has a very powerful effect in preventing it from worsening into a serious illness. Even in the thick of Omicron, hospitals have not been overrun. So we’ve both gotten much better at handling cases, and immunity means that, assuming future variants cause similar diseases, we can also handle a relatively large number of cases.

What’s the thinking behind relaxing international travel rules when importing new variants is still a concern?

The government’s guiding principle seems to be that those who want vaccines have received them and if there are more imports then we’re probably fine. The cost of preventing all transmission at all costs with travel-related restrictions and prudent domestic policies has very little appeal, so we accept peaks and troughs of transmission but believe there is enough immunity in the population – through vaccination and recovery – to survive prevent this crisis.

Illustrative Image: Travelers wearing protective face masks arrive at Ben Gurion Airport on Sunday, November 28, 2021, shortly after Israel denied entry to foreigners to crack down on a new variant of the coronavirus. (AP Photo/Ariel Shalit)

There are reports of people becoming reinfected just two or three months after recovering from Omicron. Does this mean that the immunity is very short-lived?

It’s possible to get infected again relatively soon after recovery, but that doesn’t mean the body isn’t protecting us. Cases of COVID-19 shortly after recovery tend to be mild, as the effect of recovery still provides strong protection against serious illness.

Do you expect more vaccine doses to be distributed?

Yes, at some point, maybe in a few months, we will see immunity dropping as more time has passed since vaccinations and since the very large number of Israelis who have had Omicron have recovered.

More doses of vaccine are likely to be given, but it’s not clear if all of them will be given. Because relatively high levels of protection from serious disease appear to persist long after immunity to infection has worn off, further booster shots may only be given to elderly or vulnerable populations.

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