What will the Delta Covid-19 variant do to Israel's herd immunity?

By Zev Chafets

In his inaugural speech to the Israeli parliament, Prime Minister Naftali Bennett addressed an impressively detailed list of the challenges his ruling coalition faces. Only one issue went unmentioned: the fight against Covid 19. As far as the prime minister and the public were concerned, the pandemic was over, the virus vanquished by Israel’s world-leading vaccination campaign.

That belief lasted a week. In mid-June, new and alarming cases of the virus began to sprout up. The Delta variant of the virus was responsible, experts said. It was being imported by Israelis returning from abroad. A large percentage of those infected were children.

Ever since Israel began its remarkable vaccine roll-out, its progress has been a focus of international interest. Many Israeli experts now believe that the country has reached herd immunity; and yet that hasn’t dispensed with the need for a policy response to the surge in Delta variant cases.

While expert opinion was split on how to respond, Bennett decided against imposing stringent measures. “Vaccinations instead of lockdowns,” he ordered. “We know the vaccine works.” Indeed, there are hundreds of new cases daily but no rise in the most important statistics – the rates of hospitalization and mortality. But there are two significant holes in Israel’s protective umbrella: unvaccinated adolescents and international travelers.

Until June, children between the ages of 12 and 15 years were not eligible for vaccination. When that ban was lifted, a significant number of parents, who themselves had been vaccinated, were unwilling to allow their kids to get the jab. Their hesitancy would appear to be unfounded; upwards of 2 million kids in the US have been vaccinated without significant problems.

While the children mostly experience Covid as a mild flu, leaving children unvaccinated poses a broader problem. “The fact that Israel has achieved herd immunity is not relevant to children,” says Sigal Regev Rosenberg, the head Kupat Holim Meuhedet, one of Israel’s highly efficient HMOs. “Kids interact mostly with other kids. They are a herd of their own.” As long as this herd goes unvaccinated, it will be almost impossible to resume normal schooling since teachers and school personnel (some of whom are themselves not vaccinated) do not want to be exposed to unvaccinated children.

To deal with this problem, Israel’s health maintenance organisations have launched a national campaign whose goal is to reach at least 60 per cent adolescent vaccinations before the start of the school year. Bennett, a parent of four young children, has made himself the focus of his effort. “I know how much you want to relax this summer,” he is saying to teenagers. “We don’t want to impose restrictions on parties, trips or anything. Talk to your parents and go get vaccinated.”

It is a carrot and a stick and it appears to be working. Since Bennett's appeal, the HMOs are now meeting and exceeding their goals for adolescent vaccination.

The situation at Ben Gurion Airport — Israel’s main point of international exit and entry — is a harder problem. Almost all incoming tourism has been halted for at least a month. Israelis are not permitted to visit highly contagious countries (currently including Argentina, Brazil, Russia, South Africa, India and Brazil) and face a hefty fine if they are caught cheating. All Israeli travellers, regardless of where they arrive from, have to take multiple Covid tests and must isolate for two weeks if they test positive. Many complain this is overkill.

The problem is enforcing these rules. Bennett has appointed an airport czar to restore law and order, though many Israelis are determined to crawl through all available loopholes. There is a limit to how much Israel can enforce the rules in a chaotic, understaffed airport, especially when international tourists begin to arrive.

To deal with the influx, a small terminal has now been designated for arrivals from especially infectious countries, special testing areas outside the terminals will relieve crowd pressure at peak hours; and the government has announced an emergency effort to establish an efficient in-house laboratory that can provide on-the-spot testing results.

But this is not just a technical issue. Both the US and Europe have struggled with porous borders for years. Even countries with a zero-Covid policy such as Australia have found the toughest border controls are not foolproof. For all its success in the vaccination rollout, and for all the efficiency and security of Ben Gurion, Israel will likely encounter the same issues.

Bennett’s approach of expanding vaccinations to younger members of the population while continuing with vigorous testing and border restrictions will no doubt be watched closely by other countries. If his vaccination push and border strictures succeed, Bennett’s speeches can remain largely virus free.