By the end of the fourth wave of the Corona, and with the discovery in Israel of the new subspecies of the Delta strain, known as the AY4.2 variant, there are already those who are talking about a fifth wave and preparing for it. Only in recent days has Prime Minister Naftali Bennett announced: “We are creating a NIS 10 billion economic and medical safety net for future corona waves that could happen in another month, another six months or not at all.”
Is it possible to minimize the intensity of the following waves and is there a way to prevent them from coming? “I do not know when the next wave will come, it really is to be a prophet,” says Prof. Galia Rahav, head of the infectious diseases unit at Sheba Medical Center in Tel Hashomer. “We are not sure that the level of immunity really drops after six months.
“After the second vaccine it happened, but maybe after the third vaccine the level of immunity will stay high for a longer period? It could very well be, so I really do not know how to indicate a date for the next wave. I also do not know if there will be new variants or not, how many more people will be vaccinated “If we did treat children, etc., there are a lot of missing people in this equation, so I can not say that this coming February, for example, there will be a fifth wave. I do not know.”
What can still be done to possibly delay the arrival of the wave?
“First, the vaccination rate needs to be raised. We still have people who are not fully vaccinated, which is critical. The more vaccinated the population is, the more preventable outbreaks will be in the future. Another critical thing is to do very strict airport monitoring of anyone coming from abroad. If there is a higher morbidity in the area from which the tourist comes, then it is worth doing a PCR test not only on landing, but also after five days. As we know, the sky will open on November 1, and more emphasis needs to be placed on that now. “
What else would you recommend doing?
“Now that the morbidity has dropped sharply, it is also possible to do epidemiological investigations properly. When there are ten thousand infected a day, it is not possible to do epidemiological investigations, but when there are few cases – it is time to put a lot of budgets and people to do epidemiological investigations to stop the spread. “This is critical. These investigations will also be able to guide us if such and such restrictions need to be imposed.”
Prof. Rahav points out that the continuation of the procedure of wearing masks indoors is also necessary. This is important, she says, even in very crowded gatherings and certainly for people who are vaccinated. “We do not know what will happen with the flu this coming winter, and with all sorts of other respiratory viruses that have behaved very strangely this year,” she says. “There was no flu at all, RSV – which is also a problematic virus – was, but not in its normal period. The masks are important to Corona, but are also important to prevent more viruses from causing us problems.”
Prof. Galia Rahav (Photo: Yossi Aloni, Flash 90)
Dr. Bibiana Hazan, director of the Infectious Diseases Unit at the Valley Medical Center in Afula of the Clalit Group, also supports the continued wearing of masks for prevention: “Today there is a feeling of an end-of-track party, The book, in cinemas, at events. Also, in a little while winter, people may be with the flu, feel unwell, have a runny nose and fever. So they will not come to work or school, but will do a corona test. And of course those who have not been vaccinated yet, it is worth getting vaccinated and also receiving the third dose. “
Regarding huge performances and multi-participant events, Prof. Rahav says: “I have to be practical. It’s very nice to come and say no, but I think not to do – there is no reason. .
What about educational institutions?
“We need involvement and caring and especially the responsibility of the parent population. If everyone can really be trusted, which unfortunately we do not see so much, and if everyone really has a responsibility not to send sick children to school or kindergarten and also do the quick tests and report them – I think Because it will be possible to continue the green classrooms. “
According to Dr. Khuzima Khamaisi, District Infectious Disease Specialist and Director of the Corona Chamal in the Northern District of Clalit Health Services, educational institutions are the weak link. “Children at a young age have difficulty adhering to the rules, which is understandable. On the other hand, children’s vaccines are expected to be approved soon,” she says.
“In the meantime, I would recommend that all adult staff members in the education system adhere to the procedures, and that children should also be involved in a friendly manner. Explain to them how to transmit the virus so that they better understand what is meant by hygiene and masks. “Take care of ventilation, and leave a window open, even if it’s in the winter.”
The least difficult things
Following the FDA’s recommendation to vaccinate children aged 5-11, the issue is currently being examined in Israel as well, and may also affect the next wave. “Prevention of the next wave has two layers: one prevention with the help of vaccines, and the other – all kinds of tools that are non-pharmacological actions,” says Dr. Tal Brosh, director of the Infectious Diseases Unit at Assuta Ashdod Hospital, which coordinates the epidemiology team at the Ministry of Health. One of the leaders of the Corona Vaccine Advisory Committee.
“Vaccine is the main thing that prevents disease. Will the vaccine prevent the next waves? I believe it will not be possible to prevent the world or eradicate the virus from the earth through vaccination. But if the population is vaccinated, then when people are exposed to the next wave, the disease will be less complicated and less Adhesions, and this will reduce the wave and also repel it and make it clinically easier.
“The second tier is things we do to prevent infection, and it is very difficult to hold on to them for a long time. It is against human nature to tell people not to get close to each other, not to enjoy and not to do. It is very difficult to do so over time, especially between waves.” Do not gather. “
What can be done in this regard?
“One should try to stick with the things that are least difficult and harmful to people. Closing schools and moving to distance learning is a very destructive thing for society and children, and should be avoided unless there is really no choice. On the other hand, one should wear a mask indoors and outdoors. “It may be unpleasant and annoying and pollute the environment, but it is one of the last things to give up. Of course, the most essential element here is a vaccine, including the children’s vaccine.”
“The next wave will come if there is a new mutation that is either more contagious, difficult and violent than the previous one or is ‘successful’ in that it bypasses the vaccine,” says Dr. Hazan. The next difficult mutation is more likely to come from abroad. Therefore, to avoid a fifth wave, it is necessary, of course, that all people who come from abroad undergo a PCR test and be in isolation until the result is obtained.
“I would also recommend what happens elsewhere: that whoever enters the country will do a test not only on landing, but also another test on the third or fifth day of his landing, because the fact that I am negative on the day of landing does not mean that I am negative; this can be the incubation period. “A positive test should be done in the laboratory to see if there are new strains. It is very important to detect the entry of a new strain early.”
“I less like the phrase ‘waves’, because since the virus was discovered, we have been living with it with ups and downs in the number of verified,” Khamaisi concludes. “The phrase ‘waves’ conveys to people between us without Corona, which is not true. We constantly need to be prepared, and the professional preparation is that we will understand how the disease is transmitted as a basis, and then we will also understand how to avoid it and actually strengthen preventive medicine.
“That is, if in the case of the corona there is a ‘drop transfer’ – then masks in a closed space, hygiene and physical distance are the basis for avoiding the spread and prevalence of the disease more significantly. These things are known, but not internalized enough. Wearing masks indoors. “