How to prevent future lockdowns in Israel

Iam a math nerd who watches the numbers of new COVID-19 cases in Israel every day. When the corona crisis began in mid-March, we instituted tough restrictions. Daily cases peaked at close to 800 on April 1, and decreased sharply and stabilized at around 20 per day in May.

After an overzealous relaxing of restrictions, the numbers crept up steadily starting in late May to a mid-July total of almost 2,000 new cases per day. Starting in late May, when the numbers increased, I watched with annoyance, and by late June with exasperation, as the government encouraged masks but did little else. It had squandered the hard-fought coronavirus gains at the cost of around a million lost jobs.

Had we restricted indoor gatherings to 20 people in mid-June, we may have peaked around 400 new cases a day and would be facing a much easier summer and fall. Our government, caught in wishful thinking and politics, failed us.

We can take advantage of the incredible lessons we have learned to choose only the most high-impact restrictions. We can help businesses adapt their business models or use their assets to solve problems caused by the pandemic. Moreover, we need to be nimble, adapting restrictions rapidly when numbers inch upward.

We need a solution to avoid future lockdowns while balancing economic damage until a safe and effective vaccine is available. The solution has three steps: 1) decrease cases 2) stabilize restrictions and 3) monitor and pivot.

My key metric is new daily corona cases. Restrictions should be prioritized based on how much the interventions decrease corona transmission vs. economic and quality-of-life costs. When you tighten restrictions, there is a lag of two to three weeks until you see the number of new daily cases go down.

Likewise, when cases start to tick upward, you should immediately tighten restrictions as you are already two to three weeks behind. Current policies – like mandated masks in closed public spaces, lockdown for hot spots, school protocols and social distancing, coronavirus hotels, extensive testing, contact tracing, and at-risk and elderly individuals taking added precautions – should continue.

PHASE 1: DECREASE NEW DAILY CASES Use strict restrictions to shrink to 100 new cases per day.

• Limit gatherings to 10 people indoors, 20 outdoors.

• Only allow fully in-person school/ camp indoors for special needs and through grade 3, and outdoors through grade 6. Ganim (kindergarten and below) are not significant disease vectors and should not be closed.

• Bars and restaurants open for takeout or delivery only, plus outdoor seating for restaurants.

• Gyms closed; slightly limit occupancy at nature reserves, beaches and pools.

• If new cases per day fail to decrease after three weeks, restrict further.

PHASE 2:

FIND A LIVABLE BALANCE

• After reducing to 100 new daily cases, slowly release restrictions.

• Limit gatherings to 50 outdoors and 20 indoors.

• School,camp through grade 3 open full-time; open older elementary, middle and high schools slowly with more restrictions for in-person learning.

• The goal is to find the minimum level of restrictions which will lead to a stable number of new daily cases. This may change over time and adaptations must be made.

PHASE 3: MONITOR AND PIVOT

TRANSPARENTLY

• Monitor new daily cases constantly.

• If new daily cases doubles compared to the lowest phase 2 weekly average, immediately revert to phase 1 regulations. If we can act before new daily cases double, less tightening is required.

• Be fully transparent with the public about what level of cases will cause added restrictions so businesses can plan.

• Follow through without politics. As the “Start-Up Nation,” we must be creative. Businesses should be encouraged to adapt or reinvent their business, for example, restaurants bringing food to a different city or town every day on a schedule.

Just like tour guides are being hired at a discount to give Israeli students tours in English as a living English lesson, event halls can rent space to schools for proper distancing and food vendors can therefore serve food more safely. The government can offer grants for out-of-work businesses to create public goods, like musicians offering virtual concerts for seniors and actors offering acting virtual group acting lessons to at-risk individuals stuck at home or in bidud (quarantine).

Outdoor activities cause limited viral transmission and improve mental health and therefore should be encouraged where possible. Telehealth, like video and telephone appointments, should be available for physician visits, mental health, chronic disease check-ins and current and former COVID-19 patient check-ins.

Finally, we need to rebuild our national unity and understanding of Am Yisrael chai – we are one people and must do our part to help each other.

Israel was a world leader in the coronavirus pandemic, until we saw daily new cases double to 50 a day and did nothing, until there were 1,000 new daily cases and it was too late. Regaining and retaining Israel’s control over the coronavirus is crucial for both our economy and for unemployed Israelis. The key is to act quickly when things just begin to worsen, as we did brilliantly in March but failed to do in June.

This plan is based on an article by Tomás Pueyo on medium.com, and informed by research from Israel about where coronavirus transmission occurred before and after our initial lockdown.

The writer is a healthcare actuary (i.e., math person) who immigrated to Israel in 2019 from South Florida with her husband and four young children.