COVID-19 Israel and New Rochelle - History

COVID-19 Israel and New Rochelle - History

As of tomorrow morning a curfew will be imposed on the citizens of Israel. Individuals will only be alowed to leave their houses for limited reasons such as buying food and medicine and goint to work that is defined as essential.

As I write this piece from the very center of Tel Aviv, the streets are nearly deserted, the bars and clubs are dark, as are the coffee shops. On most days (depending on the weather) planes destined for Ben Gurion Airport fly directly over the city on final approach. One often sees a convoy of planes lining the skies. But these days, hours pass between the arrival of one plane and the next, at an airport that handled 25 million passengers last year.

Yesterday, 6,000 miles away, my four-year-old grandson completed his 14 days of mandatory quarantine — just in time to find his city (New Rochelle) closed in ways very similar to the shutdowns of Tel Aviv. These past few weeks have felt like a slow-motion car crash; one in which we are still unsure how severe the damage will be.

Israel began taking the Coronavirus very seriously on January 30th, when it banned entry into the country of all non-residents coming from China, and forced residents returning from China to enter into quarantine. Those restrictions were extended shortly afterward to all of East Asia.

The US followed suit, banning entry from China on February 4th, but never took any action on flights from the rest of Asia. I remember being on-air at i24News on February 6th during President Donald Trump’s triumphal speech, after his acquittal by the Senate, saying he should not be wasting time on this [his impeachment trial]. Rather, he should be devoting his time to telling the nation how the US is preparing to defeat the Corona virus.

Back in Israel, more and more countries were added to the list of nations from which visitors required quarantine. A friend cut short his ski trip in Italy. One day I saw him in the park, the next day he was told he had to be in quarantine. The rollout of additional countries was haphazard.

Aliya Nussbaum, (originally from Hawaii and San Diego, currently a student at IDC, the Herzliya Interdisciplinary College) was en route back from Europe to attend a ceremony in which her brother participated, scheduled for March 4th. As she landed, Aliya received text messages from friends suggesting she not return home at this time, since a quarantine had been imposed on all those returning from Austria. But, it was too late. She had already landed back in Israel.

Upon arriving home, Aliya received no instructions. She was eventually contacted and told she had to remain in quarantine for 14 days. Regarding quarantine, she confided: “I can't say it was easy. When it’s beautiful outside, it’s hard. But as more and more people enter quarantine you feel you are not so alone.” Aliya came out of quarantine this morning, as most of the country entered a national quarantine.

Meanwhile, 6,000 miles away, in the place where I grew up, my 4 year old grandson was forced to remain quarantined. The disease began to spread from some source — unknown to this day — which infected a member of the Jewish community, who tested positive for the Coronavirus. Regrettably, by the time existence of the disease was discovered, the man and his children had interacted with dozens of people; many of whom tested positive for the disease. My grandson’s school, Westchester Day School, (which both I and my daughter attended) closed. Many other Jewish schools in the area shut down, as well.

The sudden closings caught the school administrations and faculties by surprise. Nevertheless, they are all trying their best to improvise. Rabbi Joshua Lookstein, WDS Principal said: “We have been moving ahead with distance-learning via Zoom’s synchronized conference calls — it reconnects students and teachers.” Lookstein went on to say about the online interactions: “The teacher’s tone and demeanor are more important than their subjects”.

Unfortunately, what WDS has implemented became the norm in Israel this week, and is quickly becoming the norm for much of the United States, as schools have been forced to shutter for a yet-to-be-determined length of time.

As of Thursday afternoon, Israel has identified529 residents who have tested positive for COVID-19:

Thankfully,at the time of this writing there have been no deaths in Israel. The Israelis convalescing at home are all being monitored using a system developed by Datos designed specifically to oversee patients with COVID-19. According to Uri Bettesh, CEO of Datos Health, they were able to implement their monitoring system with all of Israel's HMO’s and the Health Ministry. Every one of Israel’s at-home patients is being monitored via the Datos system. According to Betttesh, starting today, their system will also be deployed by Rochester Regional Health. However, implementing Datos’ solution in America's fractured health system will be a challenge.

Israel's economy has been slowly grinding to a halt, and our connections to the world dwindle — as El Al who two months ago operated over 80 flights daily, has now cut back to four flights per day; and whose international airport welcomed flights from 149 airlines, most of which have suspended their flights.

Despite the fact that things in Israel are liable to get worse before they get better, there is a sense (perhaps false) that things are under control, at least to some extent. However, I worry about my family in the USA, where a failure of national leadership has allowed the situation to get out of control.

We have entered into a very uncertain time. As the head of tourism for Jerusalem, Ilanit Melchior told me: “The world is looking for hope that there will be a future.” Amen to that.




Coronavirus ‘Patient Zero’ And New Rochelle Both Recovering From Early Dark Days

NEW ROCHELLE, N.Y. (CBSNewYork) – The effects of the pandemic have touched all our lives over the past 70 days, and now the lawyer famous as “patient zero” and his community are looking to the future.

After 10 tough weeks, New Rochelle is standing strong, and one family especially so, reports CBS2’s Tony Aiello.

“I’m thankful to be alive, to be honest with you,” said Lawrence Garbuz on Monday morning. “It’s been quite a journey.”

Lawrence and Adina Garbuz spoke to The Today Show about his early March plunge into the pandemic spotlight.

The lawyer was labeled “patient zero” for the outbreak at Young Israel of New Rochelle at a time when confirmed cases were few and focused in Westchester County’s second-largest city.

CORONAVIRUS: NY Health Dept. | NY Call 1-(888)-364-3065 | NYC Health Dept. | NYC Call 311, Text COVID to 692692 | NJ COVID-19 Info Hub | NJ Call 1-(800)-222-1222 or 211, Text NJCOVID to 898211 | CT Health Dept. | CT Call 211 | Centers for Disease Control and Prevention

“Just think about it, New Rochelle has more than double the cases of New York City,” said Gov. Andrew Cuomo on March 19.

Garbuz’s late February movements were retraced on network news, and a tabloid declared his hometown “New Roch-Hell.”

Resident John Lanser heard from a concerned family.

“I got a lot of phone calls and emails, you know, ‘Is everything okay down there?'”, he said. “It seemed like it was a major thing that a lot of my family was afraid.”

“Really have not been focused on the media frenzy as one of the first patients to get it,” said Garbuz. “I’ve been focused on getting better.”

CORONAVIRUS PANDEMIC

Garbuz spent two weeks in ICU and says his family is key as he struggles to complete his recovery.

“I think that I appreciate life a lot more,” he said. “Every day is an absolute gift that God has given every one of us to enjoy, we need to appreciate family and friends, and live life.”

New Rochelle is recovering too.

“The residents and city officials and employees handled it very well in the beginning,” said New Rochelle City Manager Chuck Strome. “We were the focus of this national thing and it was horrible. I think a lot of folks watched what we did and copied that.”

Tough calls such as closing houses of worship and smart moves including food aid and increased testing were among the struggles of spring that now are giving way to hope as summer approaches.


Vaccinations and COVID-19 – Data for Israel

Our World in Data presents the data and research to make progress against the world’s largest problems.
This data presentation is part of our work on the Coronavirus Pandemic.

Many thanks to Hagai Rossman, Eran Segal and colleagues for providing official data on Israeli vaccinations, confirmed cases and hospitalizations.

Israel has conducted the fastest campaign to vaccinate its population against COVID-19 so far. The world is now watching how the pandemic in the country evolves to assess whether vaccinations are having the intended effect, and how effective they might be in preventing infection, severe disease and death.

To answer the question of how the vaccination campaign impacts the evolution of COVID-19 requires a thorough analysis based on an epidemiological model. All we can do here is to present some relevant data to track what is happening. Note that the changes in case rates, hospitalizations and deaths cannot be solely attributed to the impact of vaccination.

To be able to track the development of the pandemic in Israel, we show the data on vaccinations, confirmed cases, hospitalizations, ICU admissions, and deaths in the following charts. The data presented below comes from multiple sources:


Israeli real-world data on Pfizer vaccine shows high Covid protection

The Pfizer/BioNTech vaccine appears to give high protection against asymptomatic Covid-19, according to data from Israel – a finding that will boost hopes that mass vaccination can stop the spread of the virus.

The top line of the real-world results, issued by the Israeli ministry of health and the companies but not yet peer-reviewed by scientists, is efficacy of 97% against disease and death and 94% against infection without symptoms.

Israel is the first country to have vaccinated more than half its population, which it has done with the collaboration of Pfizer/BioNTech and an agreement to monitor the results. As of Wednesday, about 55% of its 9 million population had been given at least one dose of the Pfizer vaccine, according to health ministry data, and 43% had received a second dose, which in Israel takes place three weeks after the first.

Last month a paper from Israel’s largest health provider, published in the New England Journal of Medicine, said the vaccine appeared to have 94% efficacy against symptomatic illness and 92% against severe disease.

The companies declined to release the finer details of the results, on the grounds that they will be published in a peer-reviewed journal in due course. But Pfizer said the data confirmed the 95% efficacy it had found in its phase 3 trials of the vaccine, called BNT162b2, and pointed to the role the vaccine could play in stopping the virus spreading.

“The findings which suggest that the vaccine may also provide protection against asymptomatic Sars-CoV-2 infections are particularly meaningful as we look to disrupt the spread of the virus around the globe,” said Luis Jodar, the chief medical officer at Pfizer Vaccines.

“Altogether, these data are critical to understanding the role of vaccination in combating the pandemic and provide hope to other countries dealing with this devastating disease, which has now afflicted the world for more than a year.”

Uğur Şahin, the chief executive of BioNTech, said: “The real-world data reported from Israel demonstrate that BNT162b2 is exceptionally effective in fighting Sars-CoV-2. Our vaccine has been effective in preventing Covid-19 cases, as well as profoundly reducing the rate of Covid-19-related severe diseases, hospitalisations and deaths.”

He said the findings were also important because the data was generated at a time when the Sars-CoV-2 variant B117 – known as the UK or Kent variant because of where it emerged – was the dominant strain. B117, which is highly transmissible, was responsible for 80% of tested cases in Israel during the study period. It now accounts for about 98% of cases in the UK and is also common around the world.

However, the data shed no light on the effects of the vaccine against variants that have emerged in South Africa and Brazil, because there have been few cases of either in Israel.

Prof Yeheskel Levy, the director of the Israeli health ministry, said the impact of vaccination had been profound. “Incidence rates in the fully vaccinated population have massively dropped compared to the unvaccinated population, showing a marked decline in hospitalised cases due to Covid-19,” he said.

“This clearly demonstrates the power of the Covid-19 vaccine to fight this virus and encourages us to continue even more intensively with our vaccination campaign. We aim to achieve even higher uptake in people of all ages, which gives us hope of regaining normal economic and social function in the not-so-distant future.”


New inhalable COVID treatment in Israel showing ‘dramatic results’

There is good news on the COVID front that involves a cure for people who already have come down with the disease in Israel, and doctors there have reported pretty dramatic results. Mercer Island MD Dr. Gordon Cohen joined Seattle’s Morning News to discuss what it entails.

“The good news out of Israel is that they had 30 patients who had moderate to severe COVID-19, and they were given a treatment developed in Tel Aviv as part of a phase one trial, … meant to treat a component of the disease that we talked about, which is the cytokine storm. This is the body’s reaction to the virus, and it’s this overwhelming immunological response that causes the flooding of the lungs and the inflammation of all the organ systems that often leads to death,” he said.

“So in this case, they deliver an inhaled protein — the CD 24 protein to the lungs — and they found that it really attenuated dramatically the cytokine storm that occurs, and in fact, they cured basically 30 out of 30 patients, and 29 out of 30 of them within just a couple of days. So it was a pretty dramatic response.”

Not only is the treatment inhalable, but it appears at the outset to have fewer side effects than other COVID treatments.

“It’s inhaled once a day for a few minutes at a time, and they do it for five days, and it directly targets the lungs, which is really the site of the cytokine storm. It really differs from other treatments — which we’re giving to the whole body, we’re giving systemically — and have a lot of side effects. This doesn’t really have many side effects associated with it, it appears,” Dr. Cohen said.


Experts Predict When And How Often We'll Need COVID-19 Vaccine Boosters

After an incredibly fast push to develop vaccines, followed up by a rocky initial rollout, the COVID-19 pandemic in the United States is at a hopeful point. Vaccination rates are climbing, while cases and deaths have dropped to their lowest point in nearly a year. The Pfizer, Moderna and Johnson & Johnson COVID-19 vaccines are working — and not just against the initial strain of the virus. The vaccines are holding up well against emerging variants so far.

But whether those rates will remain low, and whether we are truly inching toward a return to long-term normalcy, is not yet clear. And one possible determining factor is whether Americans are going to have to roll up their sleeves for another COVID-19 shot — or shots — and when.

Will we need to get one regularly, like a flu shot? What will the rollout process for boosters look like in the next year? Here’s what we know so far:

We don’t know how long immunity lasts — and that determines when we need COVID-19 vaccine boosters.

Many experts now believe that immunity against COVID-19 is going to wane with time, but no one really knows when. Nor do researchers know exactly how much a person’s immune response has to dip in order for the vaccines to stop doing their job. So far, research shows the Pfizer and Moderna vaccines offer robust immunity for at least six months, but what happens beyond then isn’t clear yet.

“We’ve had to very openly say from the get-go that we do not know what the durability of the mRNA vaccines or the J&J vaccines are,” Cameron Wolfe, an associate professor of medicine specializing in infectious diseases with Duke University’s School of Medicine, told HuffPost. “We knew great safety data. We knew great efficacy data. We did not know great durability data, because they haven’t been around for that long.”

Experts can try and answer that question in a few ways. The first is to use models to try and formulate a best guess.

“You can project how long it’s going to last by seeing a number of different time points and seeing how much antibody levels — or T-cell function, how good your immune system is at its broadest capacity — how long that lasts,” Wolfe said. “So if I know what it is at baseline ― if I know what it is after you’ve finished the vaccine course, and I know what it is at, say, three and six months ― then I can see how much decline may have taken place and extrapolate that.”

Then there is also real-time data collection. Wolfe, who was a volunteer in the early Phase 3 clinical trials for the Pfizer shot, and others like him continue to enter their results each week, saying whether they’ve developed COVID-19 or not.

“We can then model against those who took a placebo how long it’s expected to last for,” Wolfe explained. “That’s real, hard case data.”

Many experts believe boosters will be necessary soon, but some disagree with that assessment.

If immunity does wane over time, then subsequent COVID-19 shots will be necessary. But experts disagree over when that will take place.

The Centers for Disease Control and Prevention has indicated the agency is planning a year-plus ahead, although the agency doesn’t know for sure if and when any additional shots might be needed.

“What happens if, in a year from now, or 18 months from now, your immunity wanes? That’s really our job is to hope for the best and plan for what might happen if we need further boosters in the future, the way we get flu vaccine boosters every year,” CDC director Rochelle Walensky recently told CNBC.

Wolfe said he’d “be very surprised if it was in 2021. Beyond that, I’d be surprised if it wasn’t in 2022.”

How frequently boosters will be needed after that is also still up in the air. It could be that annual COVID-19 shots become the norm, in much the same way that annual flu shots are recommended.

However, there are experts who do not believe boosters will be necessary at all in the near feature. This is based on the fact that people who got immunized during the initial clinical trials have now been immunized for about 10 months — and they’re doing really well.

“We are not seeing breakthrough infections, even in the setting of surges,” Monica Gandhi, an infectious disease specialist with the University of California San Francisco, told ABC7, arguing that “we may not need booster shots.”

Anthony Fauci, the nation’s top infectious disease expert, acknowledges there’s a chance of this as well, recently telling NBC News that boosters aren’t necessarily a given.

“The bottom line is, we don’t know if or when we will need booster shots,” he said. “But it would be foolish not to prepare for the eventuality that we might need it.”

Variants are a significant factor in all of this.

Emerging variants and their impact on efficacy may just be what determines if subsequent COVID-19 shots are necessary, Wolfe said. That’s because if variants emerge that are able to dodge our current vaccines, people may need a reformulated shot that does a better job of targeting them.

Moderna, for example, is doing preliminary trials to figure out how a booster developed specifically to fight against the COVID-19 variant found in South Africa works against that strain. The company is also monitoring how a booster might work against the strain that emerged from Brazil. Pfizer and Johnson & Johnson are also conducting various booster trials.

The companies are also investigating whether a booster shot of the same formula will do the trick, or if their current vaccines need to be tweaked to better take on the variants. Additionally, the National Institute of Allergy and Infectious Diseases is planning studies to look at what happens if people mix-and-match vaccines — if boosters are, indeed, necessary. For example: Would it be possible for someone who received the Johnson & Johnson shot initially to get a Moderna booster?

And those are just some of the questions that linger about COVID-19 variants what they mean for our collective immunization efforts — and for the pandemic as a whole.

“We know increasingly reassuring information about durability, but the variant question remains open — and a little ominous, I think, as you see what’s happened across the subcontinent, and how we’re getting a rise here in the United States of the Brazilian variant,” Wolfe said.

All of which points to the pressing need to get as many people around the world vaccinated as soon as possible in order to stop the virus from spreading and evolving as it does.

The vaccine manufacturers also play a role.

“Pharmaceutical logistics and how they need to study a new booster, how they need to go into production and whether it’s efficient for them to try and combine those with alternative vaccines” will all play a role in the timing of potential COVID-19 boosters, Wolfe said.

The CEO of Pfizer announced recently that the company was testing whether a booster dose for its vaccine could be combined with a vaccine given to prevent pneumococcal disease.

“Those are company decisions as much as they are medical ones, but they factor in,” Wolfe said.

If a subsequent shot (or shots) are necessary, the process should hopefully be smoother than the initial vaccine rollout was. Some scientists have argued that any adjusted vaccines should not have to go through the same level of scrutiny that the initial vaccines were subject to, in much the same way that a new flu vaccine is updated annually without a long approval process.

But while planning and thinking ahead is important, experts say it is even more critical to focus on the here and now.

“Frankly,” Wolfe said, “we need to understand how to better vaccinate our current population.”

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.


Results

Figure 1. Figure 1. Study Population and Cohort Enrollment Process, December 20, 2020, to February 1, 2021.

The 1,503,216 persons vaccinated before February 1, 2021, were also required to be without a documented SARS-CoV-2 PCR-positive result before the vaccination date. Absolute numbers and percentage changes are shown for each inclusion and exclusion criterion. The exclusion process was gradual and occurred in phases persons could have had more than one reason for exclusion. The same exclusion criteria were applied to the unvaccinated persons for each index date in which they were considered for matching. The chart focuses on the vaccinated population. CHS denotes Clalit Health Services.

Table 1. Table 1. Demographic and Clinical Characteristics of Vaccinated Persons and Unvaccinated Controls at Baseline.

Of 1,503,216 CHS members who were vaccinated, 1,163,534 were eligible for the study and 596,618 were matched to unvaccinated controls ( Figure 1 ). Matched persons were younger than the eligible population overall and had a lower prevalence of chronic conditions because there was a smaller pool of potential unvaccinated matches for older vaccine recipients, owing to high vaccination rates in the older population (Table S2 and Fig. S1). The baseline characteristics of the matched persons are shown in Table 1 . All variables were well balanced between the study groups (Fig. S2). About 0.6% of persons with missing data on smoking status or body-mass index were dropped from the analysis ( Figure 1 ). Data for 44% of the unvaccinated controls and their matched pairs were censored when the controls received the vaccine.


Israel to Provide One Million Covid Vaccine Doses to Palestinians

Israel will provide around one million doses of Covid-19 vaccine to the Palestinian Authority ahead of their expiry, the Israeli prime minister’s office said Friday.

“Israel has signed an agreement with the Palestinian Authority, and will supply approximately one million doses of Pfizer vaccine that is about to expire, and will receive in return the doses that Pfizer is to send to the Palestinian Authority,” Prime Minister Naftali Bennett’s office said in a joint statement with the defence and health ministries.

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How does herd immunity work?

Experts think that with no restrictions in place, someone infected with the original strain of the virus that causes Covid-19, will infect, on average three to four other people.

If it's three, then, in theory, once two-thirds of the population becomes immune to the virus, an infected person will, on average, only pass it to one other person. That's enough for the virus to spread, but not enough for it to grow.

You've eliminated two of those three people from the chain of transmission.

It sounds simple on paper. In reality, though, it's a little more complicated.

The vaccines are not 100% effective, and even when they stop people from getting sick they don't completely block infections in everyone.

That means some vaccinated people might still be able to pass on the virus.

Not everyone with a past Covid infection has strong or long-lasting natural immunity, and newer variants of the virus are more transmissible.

This means we may have to inoculate many more people before we reach that magic threshold.

But it's not all bad news. "I would say that we should not be looking for 'herd immunity' alone as a sign that we can lift all public health measures and get back to 'normal'," Dr Pitt explained.

"Rather we should be looking for consistently low levels of Covid-19 infection".


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