Doctors at Israel's largest hospital report a surgein critical coronavirus cases in recent weeks despite a month-long lockdown and an exceptionally fast vaccination programme.
In an underground Covid-19 ward at Sheba Medical Centre, near Tel Aviv, the head of intensive care noticed alarming changes among her patients.
“The patients are younger and the disease is more violent,” Dr Yael Haviv-Yadid said.
“I think that this wave is very difficult for us, because we thought it would be easier and it’s not.”
About 120 people with Covid-19 are being treated at Sheba in specialist wards, including one for children and another for psychiatric patients.
In the coronavirus intensive care unit, medics are concealed behind masks and face shields with name tags on their white protective suits.
Others sit behind a screen in an observation room, surrounded by the sound of beeping from computers monitoring the patients.
Only a dozen patients are in the underground ward; spare beds lie empty because there are not enough staff to handle the specialist equipment required.
On Sunday, three coronavirus patients died at Sheba, adding to a nationwide toll of more than 4,800 in a population of nine million. About 30 per cent of Israel's Covid-19 deaths happened within the past month.
In the same period, a third of the population received their first coronavirus vaccine. The country has been under lockdown since late December, with the vast majority of schools shut and residents required to stay at home but for a few exceptions.
While rule-breaking may play a part in the high infection rate, with 9.3 per cent out of 88,503 of the latest tests in one day returning positive, Dr Haviv-Yadid noted that new and more transmissible coronavirus variants are a key factor.
“Last time, when we saw 10 friends come together and one was sick, maybe one and another one would become sick as well,” she said.
Today, almost all would contract coronavirus, she said.
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While some virus variants may be more infectious, Dr Howard Amital, head of Sheba’s research centre for autoimmune diseases, said there is no clear evidence that they alone cause more severe cases.
“I think we have more critically ill people in hospital because we have a higher number of infected subjects in the country,” said Dr Amital, who also leads one of the hospital’s internal medicine departments.
But Dr Michael Halberthal at Rambam Health Care Campus, a hospital in Haifa serving northern Israel, disagrees. He said doctors in Rambam have seen the proportion of serious or critical coronavirus patients treble.
“Twenty per cent of the patients were considered serious or critical patients; now about 60 per cent to 70 per cent of the hospital has patients in serious or critical condition,” said Dr Michael Halberthal, the hospital’s general director.
“What changed is the rate of infection – it increased dramatically – and the second thing is the acuteness of the patients. The patients are much sicker.”
The pandemic is having a dire impact on the mental health of medical staff, Dr Halberthal said, with 11 physicians who treated Covid-19 patients at his hospital now undergoing treatment for post-traumatic stress disorder.
“When we have terrorist attacks and wars, there is lots of heroism. There’s no heroism in dealing with Covid-19,” he said.
“You work very hard and lots of people die in really tough circumstances.”
Doctors and nurses are under similar strain at Sheba, where they take breaks from the intensive care unit in a converted car park fitted with chairs and games.
"I think that the most difficult thing now is the young who die," Dr Haviv-Yadid said.
“When you come to a family with lots of kids and say that the father is not going to come back home … nothing makes you ready for that.”
Dr Amital described high levels of fear and anxiety among patients and their families, whose visits are restricted because of the health risks.
“Being a corona patient is facing, on the one hand, some kind of severe illness, while you’re quite isolated,” he said.
“All those who try to ignore the existence of the virus need to face it, because being sick is not a picnic,” Dr Amital said.
Doctors at Sheba and Rambam noticed a slight decrease in coronavirus patients being admitted in recent days, although Dr Halberthal said he urgently needed more staff at his hospital in Haifa.
Some Israeli hospitals have hit capacity, according to official data, and Prime Minister Benjamin Netanyahu on Sunday described the health system as “stretched to the maximum”.
While the government struggles to curb infections, it has grounded international flights until February 8 and extended the nationwide lockdown until Friday.
Dr Haviv-Yadid saw the shutdown as having little effect, predicting “nothing will change” unless authorities invest more in educating the public about the consequences of their actions during the pandemic.
“They don’t understand what it means. That someone dies for a stupid reason, because he didn’t wear a mask,” she said.
Dr Haviv-Yadid urged Israelis not to take unnecessary risks, with just weeks to go until the vast majority of adults are set to be vaccinated against coronavirus.
“They survived this horrible year, and now they die one second before vaccination.”
