Preparing for the doomsday variant

In confronting the ongoing COVID-19 pandemic, Israel has been moderately successful. Cumulative mortality is well below that of most OECD or G20 countries.

This is around the mid-point of those countries in the Middle East and North Africa for which reliable data exists.

Israel was among the earliest vaccinators in the world and among the first to introduce booster shots—although vaccine coverage is still a little lower than many comparable countries (due to hesitancy, not capacity).

But why raise all of this at PAXsims? Because Israel recently conducted an exercise to examine the challenges that would be posed by a “doomsday” variant of the SARS-CoV-2 virus, one that is more lethal to children yet not affected by current vaccines.

According to Haaretz (paywalled):

Last week, a national exercise code-named Omega was held, to examine how to cope with a fifth wave that would be caused, hypothetically, by the arrival of a new variant that was immune to vaccination.

Prime Minister Naftali Bennett took the possibility seriously and spent eight hours straight in the national management center. The exercise was planned by the special methods branch of the Defense Ministry, and it was led by Maj. Gen. (res.) Yaakov Ayash, formerly head of the IDF’s Operations Directorate.

The method of the simulation recalled a military exercise, which takes the scenario to the extreme to examine the true capability of the system to arrive at and implement decisions.

The fifth wave that was posited in the exercise was a doomsday affair: the penetration of a vaccine-immune variant that strikes hard at children and causes large-scale death among children and teenagers. In the past year, and more decisively under the Bennett government, Israeli strategy has relied on vaccination as the chief response to the virus. Here, then, the carpet was pulled from under the feet of the decision-makers and they were compelled to look for other solutions.

One method that is meant to improve the situation is the purchase of a large quantity of medications against COVID-19, which are now in the final stages of approval in the United States. Prior acquisition of such medications, on the assumption that they will prove effective against the next variant, too, could reduce deaths and perhaps allow the continued partial opening of the economy.

he economic damage from one week of closure is estimated at between 2 billion and 4 billion shekels ($650 million-$1.3 billion). No medicines or vaccinations will be anywhere near as costly.

On the other hand, Bennett leans to hermetically closing Ben-Gurion airport to non-Israelis in the event a new variant appears, and to conducting stringent control and quarantine of returning Israelis.

The exercise turned up other points of weakness: the difficulty of the civilian system to move from routine into emergency mode, the feeble ability of the public information system and holes in the coordination between government ministries. (The National Security Council, on which the Netanyahu government pinned its hopes, is not up to the task.)

One of Israel’s problems – again, contrary to the boasts of the former prime minister – is the absence of an orderly mechanism capable of tracking and analyzing the spread of the virus abroad. Thus, the Foreign Ministry is barely mobilized in the national effort, even though it has representatives in almost every country.

The Guardian provides further details on some of the issues that were explored:

Restrictions on gatherings and movement, quarantine policy, lockdowns, curfews and tourism.

Oversight and warnings issued during the development of a new and dangerous variant, testing vaccine protection, epidemiological investigations, hospital capacity and the carrying out of mass-testing and vaccination programmes.

The legality of local or regional lockdowns and curfews, and other restrictions.

Economic support for the population.

Public security in enforcing quarantine, lockdowns and curfews.

Closing schools in outbreak centres, reducing class sizes and remote learning.

Departure and arrival policy at borders including Ben Gurion airport.

Informing the public and responding to “discourse on the internet”.

You can also find additional details from Reuters and the Jerusalem Post.