For our sake: Fighting Covid-19
This is how a group of leading Israeli scientists and I have gathered at the Weitzman Institute for Science in Rehovot, working tirelessly to prepare a clear, plain-language scientific publication about the Covid-19 pandemic.
The core mission of our organization, “Le-Ma’anhem” (For Your Sake), is to provide the public with a comprehensive medical and professional response to the Covid-19 pandemic. Our network of experts, called “physicians on reserve”, already includes more than one-hundred senior physicians in all areas of medicine, and it continues to expand. We remain up to date with current research and the most innovative approaches, and we learn from the most experienced professionals in diverse fields of medicine by collaborating with large institutions in Israel and around the world.
Since the onset of the pandemic, we have found ourselves in uncharted territory. The symptoms of the disease were revealed slowly – respiratory tract problems, fever, respiratory difficulties. As time went by, we learned more, and we especially realized that all of us must adjust our daily lives in order to stop the spread of the disease.
Last summer, I discussed this issue with Professor Eli Waxman of the Weitzman Institute, who, among other things, heads the government’s coronavirus experts advisory team. I resolved to launch a project to promote compliance with the Covid-19 prevention guidelines, through respectful, non-inflammatory discourse, that would gain public support and help stop the spread of the virus.
To begin with, I enlisted my long-time friend Professor Gabi Barbash, a former Director General of the Department of Health, who now heads the “Bench to Bedside” project at the Weizman Institute. The Weitzman Institute responded enthusiastically to our proposal for collaboration and provided their best and brightest to create the joint publication. Professors Barbash and Waxman were joined by Prof. Israel Bar-Yosef, Prof. Daniel Zajman, and Prof. Yosef Nir. Many physicians, members of the “physicians on reserve” initiatives, immediately joined as well, including Prof. Joseph Press, the president of Le-Ma’anhem, and dr. Benny Davidson, Le-Ma’anhem’s director of Professional Team.
We knew that the public had many questions about the virus, the paths of transmission, the risks of the disease, and protective measures. We also knew that the public often had inaccurate information from unreliable sources, and we had to keep in mind that much about the virus remains unknown. For example, early on in the pandemic, many predicted that it would end when summer arrived, but this belief was refuted when infection rates rose despite the warmer weather. In addition, various groups took the view that developing “herd immunity”, while protecting at-risk populations only, would prevent severe illness and stop the spread of the virus. This, of course, is a very dangerous notion that can cost lives: contracting the disease does not guarantee immunity, and even younger people who are not at-risk may become severely ill or suffer long-term harm. These types of ideas may lead to the collapse of the entire health care system. And on top of all that, there were those who claim that this dangerous pandemic was “fictitious”.
In light of these issues, we believed that clearer information about Covid-19 and its risks would lead to better compliance with the Covid-19 prevention guidelines. We therefore decided to create a publication that responds to frequently asked questions according to reliable data, scientific information, and advanced models that have accumulated since the pandemic began.
The publication is very informative about the virus and sheds light on the reasons behind the various prevention guidelines. For example, it indicates that the disease is dangerous for everyone and for all age groups: although older people are at a higher risk for complications and death, there are 20 deaths for every 100,000 patients in the 20-50 age group; and one in every twenty patients in the 45-65 age group will suffer severe illness that may include multi-system damage to the heart, the brain, the lungs and the kidneys and require intensive care. Moreover, we have found that one-fifth of Covid-19 patients continue to suffer symptoms for many months after the virus is no longer detected in their bodies. These symptoms include fatigue, weakness, shortness of breath, limitations on physical activities, and memory and concentration problems.
The publication is also instructive about the pathways of transmission. The virus’s main pathway of transmission is through droplets that are exhaled from the mouth and nose while we breath, speak, sneeze, and even sing. These droplets contain viruses that can be inhaled into another person’s respiratory system. Although large droplets remain in the air for a short time and within a distance of two meters only, smaller droplets remain in the air for longer periods and may remain in enclosed spaces for many hours. For this reason, the risk of infection is greatest in enclosed spaces with other people present, and lowest outdoors. In any event, the best way to reduce the risk of inhaling virus-carrying droplets is to wear a mask, maintain a distance of two meters from others, and refrain from gatherings - especially in enclosed spaces. Enclosed spaces must be thoroughly ventilated at least three times per hour.
Importantly, the publication indicates that asymptomatic patients are no less infectious than symptomatic patients, and some of them are “super-spreaders”, who are patients that infect tens or even hundreds of others even though they have no symptoms. Teenagers and children over the age of ten transmit the virus in the same way as adults.
Those who have encountered a confirmed patient are required to self-isolate and be tested for Covid-19, in order to prevent further transmission in case they had contracted the virus from the confirmed patient. Doing so prevents about 75% of transmissions!
Anyone who has been in contact with a confirmed patient is required to self-isolate for ten to fourteen days, because this is the period during which they may be infectious, whether or not they experience any symptoms. Of note, Covid-19 patients are already infectious before the onset of symptoms and continue to be infectious after they are symptom-free, because they begin to excrete the virus from their respiratory tract two days before the onset of symptoms and continue to excrete it after their symptoms resolve.
Nineteen senior physicians have signed this publication. They are the heads of hospitals and hospital departments, specialists and experts, who have seen the harm caused by the pandemic over the past year and understand the importance of public awareness and education.
I am privileged that senior members of the Israeli medical community, many of them my good friends, have joined me in this special initiative whose worthy goal is to save human lives.
I conclude by noting that as of the time of writing, we do not have vaccines yet. Nonetheless, the scientific forecast for the end of the pandemic remains as before, and it appears that the pandemic will remain with us until mid-2021. I therefore entreat everyone again: please comply with the prevention guidelines, maintain distance, wear masks, and avoid gatherings. For the sake of all of us.
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