Texas and Israel have used different strategies to fight COVID-19, and unsurprisingly, have had different outcomes. Below is a brief description of these strategies and outcomes.
Israel’s aggressive approach to COVID-19 appears to have been successful, as the number of new cases is decreasing with most occurring concentrated in certain areas.[1] As of May 15, 2020, Israel had 16,589 confirmed cases, and 266 deaths, translating to a known infection rate of 0.18 percent and a death rate of 1.6 percent.[2] Lockdown restrictions are being lifted and the economy is opening,[3] and this past week preschool and cheder children returned to school. Although the infection rate is decreasing, ultra-Orthodox Jewish communities in Israel are still experiencing a disproportionately high number of cases (the same goes for Hasidic neighborhoods in the United States).[4] This could result from crowded conditions in these neighborhoods and their choice to rely on the protection of God rather than government restrictions. However, despite these exceptions, Israel still persists in its low infection and death rate compared to the United States.2
As of May 15, 2020, Texas has had 45,169 cases of coronavirus and 1,256 deaths, translating to a known infection rate of 0.15 percent and a death rate of 2.78 percent,[5] and the number of new coronavirus cases has not yet begun to decrease. In fact, on May 13, 2020, Texas reported 1,355 new cases, the second-highest increase in cases since testing began.[6] Lifting lockdown restrictions such as the stay-at-home order and opening up different businesses, restaurants, retail, and so on could be contributing to the absence of any steady decline in cases. And unlike Israel, which closed its borders on March 9, 2020, Texas
did not initiate closed borders barring interstate travel. Another possible factor is the decentralization of health services in the United States and, likewise, Texas.[7] State governments are only responsible for COVID-19 actions within their borders, focusing all efforts on their own citizens, which means for the fifty states, there could be fifty different responses to defeating COVID-19. Israel health services are more centralized due to the nature of their government, so supplies are quickly distributed nationwide to areas that have been hit hardest, naturally leading to a better organized response overall.
The Prime Minister of Israel, Benjamin Netanyahu, declared a goal of testing 30,000 people daily for the coronavirus, a steep goal when compared to Israel’s highest daily testing record of 13,342.[8] The Israeli Secret Intelligence Service, Mossad, was able to procure coronavirus tests and other supplies from an unknown source,[9] but though more tests were then administered, Israel still fell short of its goal. Aside from testing for the active virus, serological testing for antibodies present in the body due to a recovery from or exposure to coronavirus is also key. The plasma in the blood of those who have survived the virus could be used to eradicate the virus in those who are infected,[10] and would also help to determine whether or not Israelis have developed “herd immunity”, meaning that enough people in a community have become immune to a disease that it stops the spread.[11]
To date, Israel has only been administering tests to determine if the virus is active in a patient's system, but recently there have been positive developments in antibody tests. In about 10 days, these serological tests will soon be administered nationwide to 100,000 people in order to estimate the national infection rate, including both diagnosed and asymptomatic cases of coronavirus.[12]
Texas has currently tested less than two percent of its population and its testing rate is ranked low in comparison to other U.S. states. In “The Governor’s Report to Open Texas”, Governor Abbott said that “Texas has maximized testing capacity to perform 15,000 – 20,000 tests a day”, and similar to Israel, announced a goal of reaching 30,000 coronavirus tests per day in the near future, as well as increasing accessibility to tests.[13]
Apart from testing for the active virus, Texas has also been investigating antibody testing, and has been collaborating with the CDC as well as other federal health authorities to stay on top of further developments. The demand for these tests grows as stay-at-home orders are lifted. This past week, the medical provider Total Primary Care became the first provider in Texas to offer these serological tests, which are approved by the U.S. Food and Drug Administration.[14]
Both Israel and Texas are at different points in terms of widespread antibody testing, but there remains a great amount of needed progress, and therefore opportunity for collaboration. On April 16, 2020, Senators Ted Cruz and Chris Coons announced their plan to push a bill that would strengthen partnerships between companies looking to treat COVID-19 in Texas and Israel, saying that “Israel is not only our friend and ally, but also a global leader in medicine”, and that “it is in the interest of all Americans, Israelis, and the rest of the world that we work together to fight COVID-19.” They will press for a $12 million appropriation for this join effort in the CARES 2 bill.[15]
After rescinding stay-at-home orders in Israel, people are now able to leave their homes and many have returned to work, although caution in doing so is strongly encouraged. Due to a swift response and a quick lockdown in Israel, the number of COVID-19 cases in Israel has been held to a manageable number, and this has allowed the economy to open up faster than other countries. As mentioned before, elementary schools and private day cares are reopening,[16] as well as hairdressers and cosmeticians.[17]
Currently, as cases have not seen a significant increase since society and the economy reopened, some coronavirus hospital wards have begun to close.[18] Although Israel has seen less protests than some other parts of the world, near the end of April, over 2,000 people gathered in Rabin Square in Tel Aviv to protest some of the policies of Prime Minister Benjamin Netanyahu. But as they stood in the square, they maintained social distancing rules and covered their faces.[19]
In Texas, there has been confusion surrounding restrictions, resulting from incongruent guidelines being set by both state and local governments. Cities such as Dallas, Austin, and San Antonio implemented stricter rules than Governor Greg Abbott. Abbott then pronounced it unlawful for cities to continue enforcing their local orders, as state law supersedes all local government. In “The Governor’s Report to Open Texas”, released April 27, 2020, Governor Abbott announced that some businesses, such as movie theaters, malls, and restaurants, could begin to open at limited capacity. Strict stay-at-home orders were also lifted, although Abbott strongly encouraged citizens to stay home as much as possible and to take every precaution to maintain good health. However, despite the slow reopening of society and the economy, people continue to protest lockdown orders.
There were several different protests before stay-at-home orders were lifted, including a demonstration of several hundred people on the steps of the Texas Capitol building and another in front of the city hall in Frisco. But even after the implementation of the first phase of the Governor’s plan, rallies continue. A Dallas salon owner, who was arrested for opening her business earlier than allowed, traveled to Laredo, Texas to join protestors there as they pushed for the right to reopen all businesses.[20]
All measures taken to slow and stop the spread of the virus are important, but this pandemic cannot end until a vaccine is produced and distributed. Vaccines require time to develop, as they must be tested extensively and then pass evaluations by government agencies. Due to urgent need, many countries are working to fast-track the discovery of an effective
coronavirus vaccine and there is hope that one may exist in the next 12-18 months.[21] Israel has made great progress in researching and developing possible vaccines. Well known for its innovation in technology and medicine, Israel has involved health officials, scientists, doctors, and engineers to accelerate the development of a vaccine. MIGAL, a company located in Galilee, claims to be close to developing the first coronavirus vaccine. In a press release in late February, Israel’s Minister of Science and Technology, Ofir Akunis, said that MIGAL’s vaccine could be ready in a few weeks and available in 90 days, and that he is “confident there will be further rapid progress, enabling us to provide a needed response to the grave global COVID-19 threat”.[22] MIGAL has been focused on a vaccine for infectious bronchitis virus, or IBV, a disease affecting poultry. By chance, they chose to test its effectiveness on the coronavirus caught by poultry, which is similar to the strain ravaging humans. With adjustments, the outcome could be a vaccine suitable for humans.[23]
Texas has not seen this kind of progress in developing a vaccine. However, researchers at the University of Texas at Austin announced a potential breakthrough with antibodies that neutralize the coronavirus, publishing their work in the scientific journal Cell on May 5, 2020.[24] In conjunction with Baylor College of Medicine and the University of Texas MD Anderson Cancer Center, Texas A&M University is researching the possible effectiveness of the tuberculosis vaccine on people already infected by the virus.[25] But in terms of a vaccine, Israel appears to be ahead of Texas if MIGAL’s claims prove true. However, given Texas universities’ breadth of knowledge of infectious diseases, a partnership between the two could prove vital. This also supports the push by Senators Cruz and Coons for medical collaboration with Israel in the aforementioned CARES 2 bill.
Even as numbers of cases and deaths begin to decrease or plateau, fear is still palpable. A second wave of COVID-19 is anticipated in the winter of 2020, while a vaccine could still take at least another year (or years) to develop. Rates of infection will most likely continue to decrease as summer begins in both Texas and Israel, as the virus supposedly struggles to survive in warmer weather. However, as cold weather returns in the fall and winter, it could make a swift, potentially deadlier return. As coronavirus would then coincide with flu season, this second wave could push hospitals farther past capacity than ever before.[26] Serological tests could prove that Israel and Texas are on track to reach “herd immunity” before cold weather returns.[27] But if that is not the case, or if recovery from COVID-19 proves to not guard against a second infection and a vaccine still does not exist, then a second wave could prove deadly. Considering what could happen in the future, collaboration between Israel and Texas could prove to increase testing and accelerate the development of a vaccine.
[1] The Times of Israel - https://www.timesofisrael.com/the-end-of-exponential-growth-the-decline-in-the-spread-of-coronavirus/
[2] Corona Tracker - https://www.coronatracker.com/country/israel/; infection rate based on total population; death rate based on confirmed cases.
[3] HAARETZ - https://www.haaretz.com/israel-news/coronavirus-israel-news-breaking-tests-deaths-updates-1.8816224
[4] The Times of Israel - https://www.timesofisrael.com/slammed-by-covid-19-ultra-orthodox-jews-try-to-understand-what-god-hath-wrought/
[5] New York Times - https://www.nytimes.com/interactive/2020/us/texas-coronavirus-cases.html
[6] The Texas Tribune - https://www.texastribune.org/2020/05/13/coronavirus-updates-texas/
[7] The Times of Israel - https://www.timesofisrael.com/us-expert-israeli-response-to-coronavirus-crisis-is-right-on-target/
[8] The Times of Israel - https://www.timesofisrael.com/israel-will-soon-be-able-to-test-hundreds-of-thousands-daily-scientist-claims/
[9] New York Times - https://www.nytimes.com/2020/04/12/world/middleeast/coronavirus-israel-mossad.html?campaignId=7JFJX
[10] HAARETZ - https://www.haaretz.com/science-and-health/.premium-plasma-from-covid-19-survivors-helps-patients-whose-condition-is-deteriorating-1.8788154
[11] The Jerusalem Post - https://www.jpost.com/health-science/this-winter-flu-and-coronavirus-will-likely-strike-together-627303
[12] New York Times - https://www.nytimes.com/2020/05/05/world/middleeast/coronavirus-israel-antibody-testing.html
[13] The Governor’s Report to Open Texas - https://gov.texas.gov/uploads/files/organization/opentexas/OpenTexas-Report.pdf
[14] El Paso Inc. - http://www.elpasoinc.com/news/state/total-primary-care-offers-the-first-covid-19-antibody-test-in-texas-approved-by-fda/article_0f3215dc-3a6f-5735-9a35-a9bf560ad3cd.html
[15] U.S. Senator for Texas Ted Cruz - https://www.cruz.senate.gov/?p=press_release&id=5054
[16] HAARETZ - https://www.haaretz.com/israel-news/coronavirus-israel-news-breaking-tests-deaths-updates-1.8816224
[17] HAARETZ - https://www.haaretz.com/israel-news/.premium-israel-eases-coronavirus-restrictions-more-stores-hairdressers-allowed-to-open-1.8796670
[18] HAARETZ - https://www.haaretz.com/israel-news/coronavirus-in-israel-police-breaking-up-holiday-gatherings-met-with-violence-1.8839625
[19] The Atlantic - https://www.theatlantic.com/international/archive/2020/04/protest-demonstration-pandemic-coronavirus-covid19/610381/
[20] LMTonline - https://www.lmtonline.com/local/article/Dallas-salon-owner-Laredo-s-2-home-beauticians-15267545.php
[21] The Times of Israel - https://www.timesofisrael.com/who-says-there-are-7-or-8-top-candidates-for-a-covid-19-vaccine/
[22] The Jerusalem Post - https://www.jpost.com/health-science/israeli-scientists-in-three-weeks-we-will-have-coronavirus-vaccine-619101
[23] The Jerusalem Post - https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three-weeks-we-will-have-coronavirus-vaccine-619101
[24] The University of Texas at Austin College of Natural Sciences - https://cns.utexas.edu/news/antibodies-from-llamas-could-help-in-fight-against-covid-19
[25] The Texas Tribune - https://www.texastribune.org/2020/05/06/coronavirus-deaths-texas-am-tuberculosis-vaccine/
[26] The Jerusalem Post - https://www.jpost.com/health-science/this-winter-flu-and-coronavirus-will-likely-strike-together-627303
[27] New York Times - https://www.nytimes.com/2020/05/05/world/middleeast/coronavirus-israel-antibody-testing.html