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Israel's Virus Response Success and Combating Loneliness


Blog #1:

Although it’s too early to draw any conclusions, the limited impact of COVID-19 on Israel compared to the rest of the world is quite curious. Especially considering that Israel did not have a smooth time implementing measures to deal with the virus, as documented in the following article by the Times of Israel’s David Horovitz. Horovitz concludes that Israel’s success (may it continue) is due to a good strategy that was eventually embraced by the public. I don’t deny that there’s truth to that. But on the other hand, there are many extremely intelligent people implementing policies in other countries that unfortunately, haven’t been so successful. Maybe it has to do with this verse from Deuteronomy 11:12: “It is a land which the L-RD your G-d looks after, on which the L-RD your G-d always keeps His eye, from year’s beginning to year’s end.”    

It’s not over, and uncertainty abounds, but Israel’s COVID-19 stats are stunning

Are we younger, more hygienic, less kissy? No. We have great doctors and nurses, but so do other countries. And we’ve made many mistakes. So how has Israel kept a lid on the virus?

The economy is in tatters. An unemployment rate that was below 4% last month is now above 25%. Businesses that looked solid just a few weeks ago may never recover. Promised loans and grants have proved hard to obtain or inadequate, been delayed, or not come through at all.

Lockdown and reopening policies have been inconsistent and illogical. IKEA is doing a roaring trade, but bereaved families were barred from military cemeteries on Memorial Day. We were allowed to run 500 meters from our home, but not to walk 500 meters from our home… unless we were on the way to the shops. Restaurants were allowed to make deliveries, but not to have customers come and pick up takeout food, although some cafes were permitted to sell food and drink to passersby. Supermarkets never closed, even though social distancing rules were not always upheld; open-air food markets have not yet been allowed to re-open, even though they promised to impose social distancing.

We had days and days of screw-ups at the airport. Passengers boarded flights knowing they were carrying COVID-19. Arrivals strolled straight through Ben Gurion and into taxis home, without so much as having their temperatures checked. Prime ministerial pledges that all arrivals were being sent to state-overseen quarantine facilities were disproved time and again.

In the early weeks of the crisis, major failures of communication and minor instances of obstinance and stupidity contributed to disproportionately high contagion rates in ultra-Orthodox areas — notably the densely populated, 200,000-strong city of Bnei Brak and several Jerusalem neighborhoods. Communication was less than perfect in the Arab sector and in East Jerusalem, too, where Israel was also slow to set up adequate testing facilities.

There were turf wars between our would-be COVID-19 czar, Defense Minister Naftali Bennett, on one side, and our actual COVID-19 czar, Prime Minister Benjamin Netanyahu, the Health Ministry and most everybody else, on the other. Foul-ups and shortages and arguments afflicted the entire testing process. Our health minister caught the virus amid reports — strenuously denied — that he’d been breaching his own ministry’s guidelines.

And yet…

And yet, just look at the numbers — the horrifying, heartbreaking death tolls around the world.

As of this writing, Israel, population 9.2 million people, has suffered 219 fatalities in the coronavirus pandemic. Of the nearly 16,000 confirmed cases, more than half have now recovered. Fewer than 100 Israelis are currently on ventilators.

Compare those figures to other countries.

By the Worldometers count, based on approximately the same stats, Israel has 25 fatalities per million citizens — which puts us at about 50th in the world, and better than the global average. (With many countries providing less reliable statistics, furthermore, Israel’s global ranking is actually almost certainly considerably better.) Certainly not peerless, but striking nonetheless.

Sweden, which chose a radically less interventionist approach, has about 10 times as many deaths as Israel — about 2,500 — in a population only slightly larger than ours at 10 million. Belgium, population 11 million, has over 7,500 fatalities – 34 times as many as Israel. Britain, with a population six times ours, has buried 26,000 victims. Spain, with five times our population, has 24,000 dead. Italy, population 60 million, has a death toll closing in on 28,000. The United States, with 36 times our population, has almost 300 times as many dead.

Austria and Germany, ahead of Israel in their moves back toward a more normal routine, also have markedly higher death tolls: Austria, with over 8.5 million people, has almost 600 dead; Germany, with some 80 million, has 6,500.

Compare Israel’s numbers to other Jewish communities. In Britain, with a Jewish population of 350,000 at most, there are well over 300 confirmed deaths in the community. In the United States, with a similar-sized community to Israel’s, the most conservative estimate puts the death toll among Jews deep into four figures. (An estimated 2 million Jews live in New York State, which has a population of some 20 million. The death toll in New York State is over 23,000 — which would suggest some 2,300 Jewish fatalities, even before taking into account strong indications that the Jewish community has been disproportionately heavily hit.)

Israel’s relative success, as reflected in such comparative statistics, indeed, is prompting growing calls for Israel to reverse the norm by which Diaspora Jewry rushes to help it at times of emergency, and to urgently reach out with effective assistance to a Diaspora in pandemic crisis.

There is so much the experts have yet to understand about COVID-19. They think it doesn’t mutate, but they’re not completely sure. They think children are at radically lower risk, but there are concerns here too. Can you be infected a second time, after you’ve beaten it? Is it susceptible to climate change? Does it peak at 40 days and gradually disappear by 70, whatever lockdown measures you take to try to thwart it?

Is it emphatically not airborne, or might it just possibly be, under certain circumstances? Is the likelihood of contagion from mucus droplets on solid surfaces marginal, or significant? How is it simultaneously so radically contagious — spreading like wildfire among the elderly and those with preexisting conditions — and yet evidently not always so radically contagious? There are major outbreaks in innumerable elderly care facilities, and shockingly high death tolls, but most residents of the same facilities, elderly and vulnerable, are unscathed.

How many of us are actually carrying the virus, cheerfully asymptomatic? In the specifically Israeli context, are our numbers so low because we’re not reporting them properly? That seems highly unlikely.

Because we’re not a huggy, kissy nation? But we are. Are we doing so relatively well because we’re a relatively young population? Are our hygiene norms notably better than those in other, worse-hit countries? Are our wonderful healthcare professionals, in our perennially underfunded healthcare system, uniquely outstanding?

If the flow of tourism was a factor in the high contagion rates in the likes of Italy, Spain and the UK, then how come we didn’t get more heavily battered for the same reason? If population density is a major factor, then how come Sweden, all 174,000 square miles of it, is suffering so much more than tiny Israel, 8,550 square miles? 

And if Bnei Brak, with its large ultra-Orthodox families and its high contagion rates, was identified as an epicenter, how is it that a lockdown, confining large numbers of known carriers to a closed area, proved able to reduce the danger rather than incubating it?

Amid profound concerns at the economic meltdown, at the impact of the restrictions on people’s mental health, at the shunting aside of all kinds of other medical imperatives, at the “collateral damage” of lives and livelihoods ruined, Moshe Bar Siman-Tov, the Health Ministry’s director general, was asked in a TV interview a few days ago whether Israel hadn’t overreacted. Wasn’t his, and the prime minister’s, talk of “tens of thousands” of Israeli fatalities if we didn’t heed the rules and batten down “an exaggeration”?

Characteristically unruffled, he replied that “We have a very simple check. We were at a rate where the number of new patients was doubling every three days… There was a single day when the number of seriously ill patients rose by 50%. If that trend had continued, today we’d have over 600,000 people [sick], over 10,000 on ventilators, and many thousands who would have died.”

Pressed again: Bar Siman-Tov made one of the comparisons I cited above: “I don’t think so,” he said. “There are enough control groups — look at Belgium.”

Israel has just marked its Memorial Day and its Independence Day. This is always a surreal time, as we transition from the depths of grief for our fallen soldiers and victims of terrorism — men, women and children who lost their lives in the defense of this country and/or amid the hostility to this country — to the heights of celebration. This year, it was doubly so — our sorrow and our joy physically constrained.

But all those numbers above underline that, turning 72 in these nightmare circumstances, Israel has at least wary cause for encouragement. They were not always perfectly executed, but the decisions Israel’s leaders and authorities made, and that its citizens generally heeded, were designed to maximize the defense against a mysterious virus that disproportionately targeted the elderly — our parents, our pioneers. For now, the numbers and the comparisons suggest, that strategy has been remarkably effective.


Blog #2:

Studies have long noted the detrimental physical effects of loneliness. Due to shelter-in-place orders and social distancing, many of us may find ourselves in a position of feeling lonely (even if we’re quarantining with other people). In the following article, Dr. Steven Cole offers five tips for combating feelings of loneliness during these difficult times.

Advice on Combating Loneliness – From a Leading Expert

Loneliness is killing us – literally.

It’s long been recognized that feeling lonely is bad for our health. Dr. Julianne Hold-Lunstadt, a professor of neuroscience and psychology at Brigham Young University, has studied loneliness for years. “We’re social beings,” she’s explained, “and our bodies respond when we lack the proximity to others.” She estimates that feeling loneliness harms our health as much as smoking 15 cigarettes a day. One study found that feeling lonely increases the risk of dying early by a whopping 26%.

Feeling lonely isn’t necessarily the same thing as being alone. “Loneliness is a state of social hunger,” explains Dr. Steven Cole, Professor of Medicine and Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles, School of Medicine. People can be lonely even when they’re surrounded by others, if they feel little or no connection. Conversely, some people who live alone might feel secure and not lonely at all. “Loneliness is about a person's dissatisfaction with the social contact they’re getting,” Dr. Cole explains. “Essentially it boils down to: Do you have a set of people who have your back, and a group of trusted others you can turn to in a time of need?”

In an exclusive interview, by Dr. Yvette Alt Miller, Dr. Cole shared his urgent advice about what people can do to alleviate loneliness, as millions of people face fear and uncertainty as well as social isolation in the coronavirus pandemic.

Dr. Cole has a long history of studying loneliness, and what he’s found has shocked him and the scientific establishment. As well as making us feel sad and cut off, feelings of loneliness actually change the way our cells behave: feeling lonely and isolated weakens the responses of our immune system at a cellular level, making us more vulnerable to viral infections. Lonely people also experience more inflammation than others.

“The human brain treats loneliness as a state of unsafety,” Dr. Cole explains. Loneliness “turns on a set of cellular and molecular defenses that might have made great sense thousands of years ago when the things we feared were something that was going to bite us or stab us – but that equation isn’t serving us so well now.”

Even more damaging, experiencing loneliness can trigger physical changes that make it harder to reach out and connect with others, thereby dooming some lonely people to years of loneliness. Feeling lonely can make us more suspicious of others and make us see others as a threat. That in turns makes it harder to connect with others and exacerbates the feeling of being lonely and out of touch.

How can we break this destructive cycle? Surprisingly, some common approaches have been found to have only limited success in battling feelings of loneliness. Putting people together with others does not address the deeper feelings of alienation and lack of trust that underlie loneliness. Even psychotherapy has been found to have only limited effects on treating the root causes of loneliness.

A series of recent experiments has shown that giving to others is one of the keyways to break the cycle of loneliness. Today, as millions of people experience lockdowns and insecurity, these findings are more important than ever before.

“We were studying other adversities,” explains Dr. Cole of a series of research papers he wrote with colleagues. He and his colleagues spoke with people facing intense loneliness and other extreme hardships, including poverty, war and life-threatening disease. “We started looking at people who were doing well even when they were in this threat system,” he explains. The researchers made a startling discovery: “People who have a strong sense of purpose or meaning in their lives seemed surprisingly well protected. It’s not like they didn’t feel some objective sense of threat, but it wasn’t registering in their brains” in the same harmful ways that loneliness did. Hopeful, optimistic people – even when they faced grave problems – were “connected to something greater than themselves and their own personal well-being”.

Dr. Sonja Lyubomirsky, a psychologist at the University of California, Riverside, built on these findings. She led a team that decided to see if encouraging lonely people to perform acts of kindness to others could help foster that sense of connecting to something greater than themselves – and if that would help alleviate the crushing burden of feeling cut off that lonely people reported.

Her results, reported in February 2020, just before the pandemic shut down much of the world, were startling. She asked people who described themselves as lonely to perform simple activities to help other people, such as running errands for them or helping them solve a problem with their computers. After doing even these small, mundane acts of kindness, people described themselves as feeling significantly less lonely.

Their blood cells also showed a decrease in the inflammatory responses that are typically associated with loneliness. “When it comes to the pursuit of happiness, popular culture encourages a focus on oneself,” Dr. Lyubomirsky concluded. “By contrast, substantial evidence suggests that what consistently makes people happy is focusing… on others.”

Forcing ourselves to look beyond our own needs and focus on the needs of other people as well is a key way to fight feelings of loneliness and despair.

Dr. Cole lists five central ways we can refocus our attention to others and help alleviate the loneliness and worry that many of us are feeling right now in this perilous time.

  1. Volunteer.

Volunteering isn’t always easy when people are living under lockdown, but Dr. Cole explains that it’s a crucial first step to connecting with others in a meaningful way. “If you start working with others around some common purpose, then you start to learn that at least a few other people in the world see the world the way you do, and that there are some people you can trust.” He recommends signing up for political or social campaigns, or for any cause that reminds us of goals outside our own immediate well-being. Volunteering alongside others – even just discussing goals with them – “is surprisingly effective at buffering people against the adverse impacts of loneliness.”

  1. Perform Acts of Kindness.

Reach out to help others in any way you can. Call up a neighbor or friend to check up on them. Run an errand for someone else if you are able to. Volunteer to tutor someone in an area in which you have expertise. “One activity that’s surprisingly impactful,” Dr. Cole explains – and which is possible to perform even in the confines of being stuck at home during a lockdown – is “getting older people to write some form of letter or create a video for the next generation, explaining ‘this is what I’ve learned in my life, and this is what I think matters, and this is what I wish I’d known when I was younger.’” By focusing in this way on the well-being of other people, we can remind ourselves that we are still important, valuable people who have much to contribute to the world.

  1. Connect.

As hard as it might feel, pick up the phone and call other people. “Don’t focus on the news; focus on your neighbor and what she’s doing,” Dr. Cole urges. Sign up for Zoom chats if you can. A keyway to combat loneliness is to “give yourself reasons to get up and get dressed, because people are counting on you.” It’s not always easy but remaining engaged with other people is an important tool in the arsenal to fight loneliness and stress.

  1. Go Outside.

Spending time outdoors “reminds you that the sun rose today, and the birds are still chirping – this can work surprisingly well in connecting you with what’s enduring and true” in the world. In addition, numerous studies have linked spending time in the sun to a range of health benefits from having more regular sleep cycles to producing higher levels of serotonin, the hormone our brains produce that’s linked to feelings of calm and well-being. Making time to get outside each day, even briefly, can lift our moods and help us focus on things other than ourselves.

  1. Take a Class.

This is a great time to sign up for an online class and spend time acquiring new skills or knowledge. In addition to taking our mind off our own personal circumstances and the news, learning new things and broadening our minds is empowering. “The process of learning new stuff and becoming stronger and more capable – that's a great neurobiological antidote to the free-floating anxiety of the pandemic era.”