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A volunteer with the women's unit of United Hatzalah emergency service prepares a fourth dose of the COVID-19 vaccine for a woman at Clalit Health Services in Mevaseret Zion on Jan. 11.Maya Alleruzzo/The Associated Press

If there was one country that seemed to have its pandemic-response act together, it was Israel.

Israel was the vaccine rollout leader during the COVID-19 onslaught and one of the first countries to introduce a vaccine passport system.

The aggressive vaccination campaign beat back the virus and allowed some semblance of normal life to resume by late last spring, when the numbers of new daily infections, hospital admissions and deaths plummeted.

By June, those numbers went into single digits on some days. The streets were full, and mask use outdoors virtually vanished.

Then came the highly contagious Omicron variant, and Israel now finds itself back on the pandemic front lines.

With a population of 9.4 million, Israel has one of the highest per-capita infection rates in the world. The Coronavirus National Information and Knowledge Center said that in January alone more COVID-19 cases were identified than in all of 2021, when fewer than a million positive tests were recorded.

The hospitals are filling up, and deaths are climbing, though the numbers of new cases and hospitalizations have fallen in recent days. “We are in the middle of a huge, dramatic wave,” Nadav Davidovitch, director of the school of public health at Ben-Gurion University of the Negev, said in an interview. “We are in a very different situation over last year.”

Weekly new hospital admissions

for COVID-19 per million

500

400

U.S.

Israel

300

France

200

Britain

Italy

100

Germany

0

Feb. 3, 2021

June 4

Sept. 12

Feb. 2, 2022

the globe and mail, Source: our world in data

Weekly new hospital admissions

for COVID-19 per million

500

400

U.S.

Israel

300

France

200

Britain

Italy

100

Germany

0

Feb. 3, 2021

June 4

Sept. 12

Feb. 2, 2022

the globe and mail, Source: our world in data

Weekly new hospital admissions for COVID-19 per million

500

400

U.S.

Israel

300

France

200

Britain

Italy

100

Germany

0

Feb. 3, 2021

June 4

Sept. 12

Feb. 2, 2022

the globe and mail, Source: our world in data

The story in the Palestinian territories, where vaccination rates lag those in Israel by a wide margin, is even more grim, relatively speaking. “The infections [in the West Bank and Gaza] are unprecedented,” said Robin Abu Ghazaleh, assistant professor of virology at Palestine Polytechnic University in Hebron. “There are twice as many cases than there were at the worst times in the last two years.”

In response, the Israeli and Palestinian health authorities are urgently trying to ramp up vaccination campaigns. In December Israel began to roll out fourth doses to anyone over 60, medical staff and people with high-risk health conditions. The move came about half a year after the country began administering third doses.

At the same time, hospitals are adding ICU beds – no easy task when thousands of doctors, nurses and other medical staff are off work because they are infected. “The health system is working around the clock, day and night, to safeguard public health,” Prime Minister Naftali Bennett said last week. “We are at the height of the wave and will soon see light at the end of the tunnel.”

Prof. Davidovitch said early results indicate that a fourth dose is “very safe” and research has shown it doubles protection against symptomatic COVID-19 infections and triples protection against severe illness and hospitalization compared with three doses.

Last week, Israel’s vaccine advisory panel recommended a fourth dose for all adults – a world first – which would be administered four or five months after the third dose. The move would have to be approved by Health Ministry Director-General Nachman Ash.

Many countries are closely watching Israel’s response to Omicron and its fourth-dose campaign. Since the start of the pandemic two years ago, Israel’s research into vaccine effectiveness and other efforts to suppress the pandemic, such as testing, have helped guide health policy everywhere.

Australia is considering fourth doses for older people. Hungary, Denmark and Sweden have already decided to roll out fourth doses amid concerns about waning protection. Other countries are bound to follow.

Israel’s early campaign against the pandemic drew worldwide admiration for combining fast procurement of vaccines with a mass vaccination plan.

While the United States, Canada and much of Europe struggled to launch their vaccination programs, Israel administered the first dose of the Pfizer-BioNTech jab to 20 per cent of its eligible population within three weeks of the start of its program in December, 2020. The country taught the world that a determined vaccination effort could bend the pandemic curve down quickly.

Half a year later, two-thirds of eligible Israelis had received at least one dose. Today 70 per cent are fully vaccinated, and 55 per cent have received a booster shot, though many countries have caught up to Israel and a few have surpassed it.

When variants such as Delta triggered a surge in cases, Israel worked fast to administer second doses. New daily cases plunged in the autumn, though the good news would not last. Omicron is efficient at infecting large numbers of vaccinated as well as unvaccinated people, though the symptoms tend to be milder. But the sheer number of infections means hospitals are filling up and deaths increasing.

Israel went from 500 or fewer new cases a day to almost 102,000 on Jan. 25. Weekly new hospital admissions per million are among the highest in the world, and the number of seriously ill people has climbed fast.

The Ministry of Health reported 114 “seriously ill and hospitalized” patients on Jan. 4. The number had climbed to 1,133 by Feb. 1. In the past week, there were 279 deaths, up 14 per cent from the previous week.

“In Israel, we got hit with a combination of pandemic fatigue, some people didn’t go for the third dose, and there was a slow vax rate for children,” Prof. Davidovitch said.

In the West Bank and Gaza, the pandemic appears to be back in full swing.

Prof. Abu Ghazaleh said that, on Jan. 31, 36.5 per cent of tests done in the West Bank came back positive; in Gaza, the figure was an astonishing 48.5 per cent. Less than half of Palestinians in those territories are fully vaccinated. “Our Ministry of Health is struggling to get people vaccinated,” he said. “There is a lot of vaccine hesitancy.”

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