As soon as they learned of Covid-19 and the dangers it posed to Israel as well as the rest of the world, top staff members at Sheba Medical Center faced a key question related to their mission.
The medical center already knew it would need “every doctor we can get and every nurse we can get” to fight the novel coronavirus, Dr. Eyal Zimlichman, its chief medical and chief innovation officer, told The Jewish Week. “But what about innovation staff, data scientists and engineers? How essential are they?
“And it took us about seven minutes to get to an understanding that innovation is not only essential, but critical, if we’re going to try to win this war against the virus.”
As it turned out, that understanding became not only crucial for Sheba, the largest hospital in the Middle East and, according to a 2019 article in Newsweek, one of the 10 best in the world, but for other Israeli hospitals, too. Israeli hospitals large and small have become partners in the past few months with their country’s high-tech sector and the Israel Defense Forces in developing new technology that would allow them to treat coronavirus patients while keeping their own staff safe.
Sheba was chosen — in light of its scope, location and nature — by Israel’s Ministry of Health to house the country’s first coronavirus patients. A 2,000-bed medical center in Ramat Gan’s Tel Hashomer neighborhood, close to Tel Aviv, Sheba took root in 1948 as Israel’s first military hospital. It remains a government-run hospital today, and its 150-acre campus is home to such national institutions as the Israel Center for Disease Control, the equivalent of the CDC in the United States.
The first coronavirus patients included only the 11 Israeli citizens who had flown home from Japan near the end of February after being quarantined on the Diamond Princess cruise ship, where they were passengers. But the number of active cases in Israel climbed, eventually reaching a high of 10,000, and other hospitals began taking patients, as well. They included Hadassah Medical Center, the largest hospital in Jerusalem and one of the centers designated to receive coronavirus patients. Hadassah had already made headlines in mid-February when one of its infectious-disease specialists, Dr. Ran Nir-Paz, was asked by the government to fly to Japan to treat Israelis from the Diamond Princess.
Forecasts presented at the end of March to Prime Minister Benjamin Netanyahu reportedly warned that as many as 40,000 Israelis would die should the government do nothing, and that 10,000 would die under the rosiest of scenarios.
But nothing even close to those scenarios took place. From the end of February to May 20, the number of confirmed cases in Israel totaled 16,667 patients, of whom 13,504 recovered and 279 died. Throughout that time period, the number of new cases per day ranged from one to 20 throughout the entire country, said Dr. Yoram Weiss, director of Hadassah’s Ein Kerem Hospital, who spoke at a May 20 webinar sponsored by the Jewish Council for Public Affairs. Medical centers had already discharged most of their cases, he said.
(Israel’s health minister warned on Sunday that a new lockdown was possible given a sharp spike in cases, mainly at schools. Prime Minister Benjamin Netanyahu, in a nationally televised address on Sunday, urged Israelis to “continue adhering to the rules” of social distancing in order to avert another lockdown. At Sunday’s cabinet meeting, Netanyahu stressed that the economy “has to remain open,” according to The Times of Israel.)
Doctors and other observers interviewed by The Jewish Week credited the government, which took early and decisive action to limit the virus’ spread; Israeli scientists, engineers and high-tech professionals; and the commitment among Israelis in general.
Yossi Klein Halevi, an Israeli-American author and a senior fellow at the Shalom Hartman Institute, said Israel’s leaders did two things right from the outset: They took the virus seriously and they drastically curtailed traffic from the outside world. The latter, he noted, was only possible because Israel is a small country, with one international airport, and because Israelis have been in semi-quarantine for years, albeit for security reasons.
“We’re a population used to dealing with sudden emergencies,” Halevi said. “What that means is that once you impress on Israelis that it’s a life-or-death situation, we’re generally able to follow the rules.”
As for innovations, Sheba adopted what it calls a military-like strategy to fight the disease. Helmed by Dr. Yitshak Kreiss, a former brigadier general and a former surgeon general in the IDF, the hospital made rapid-fire assessments based on shared input; acted immediately while planning for every scenario; and kept information flowing on key data points, such as expected patient loads, the availability of beds and the quantity of medical supplies.
“It’s imbedded in our DNA to be prepared, to drill, to practice, to have enough supplies,” said Yoel Har-Even, director of the hospital’s international division and a retired IDF colonel. The ethic is to act rather than ask questions, he added during a recent podcast. “If you know what to do, don’t ask others. Just do what you have to do and plan for the future.”
Over at Hadassah, Dr. Nir-Paz said in a Zoom call with The Jewish Week that he attributes the ethic not to the military, but to what he called the Israeli spirit. “When you’re committed to something, you’re committed all the way. There’s no other choice.”
Whatever the source of that ethic, it propelled the country’s major hospitals to pioneer a host of new high-tech systems in such areas as telemedicine, robotics and contact screening. Zimlichman and other Sheba staff members described some of the innovations at their hospital during a private webinar for American donors and friends of the medical center that the Jewish Week was allowed to join.
EarlySense: a monitor placed under the mattress that continuously measures the patient’s heart rate, respiratory rate and motion. The device uses an algorithm to predict if the patient’s health is about to deteriorate.
TytoCare: a device with special adaptors that allows doctors to examine a patient’s throat, heart and lungs while sitting in a different room.
Contact screening: a system developed by AnyVision, a surveillance and facial-recognition company, that connects with 600 video cameras throughout the hospital to track contact between patients and staff members, as well as monitor who is and isn’t wearing a mask and who needs to go into quarantine.
Healthcare command posts: software systems that connect all the data related to various patients, including vital signs and ventilator measurements, and allows it to be seen from a remote command post.
Robotic assistants: technology developed before the advent of Covid-19, but put to use during the pandemic to enable doctors and nurses to treat their patients from afar.
Even some of Israel’s regional hospitals have made what could be lasting contributions. At the Galilee Medical Center, a teaching hospital serving 600,000 Israelis in the Western Galilee, an oral and facial surgeon teamed up with researchers from the Technion and the Ministry of Defense to create an anti-viral sticker that enhances surgical masks, adding an extra layer of protection. Pilot trials of the sticker are now being conducted at GMC and five other hospitals around the country, said Dr. Tsvi Sheleg, the center’s deputy director-general.
Meanwhile, Israeli scientists and physicians are involved in research regarding potential tests, treatment protocols and vaccines to defeat the virus. Hadassah’s Yoram Weiss said in late May that his hospital was working on 17 different clinical trials. One of many trials at Sheba involves testing a sensor chip created by the Israeli start-up NanoScent to see if a simple nasal breath test could identify Covid-19 — technology that could be used to screen people en masse at stores, airports and border entry points.
At the Weizmann Institute of Science in Rehovot, more than 50 projects were underway by the end of April. Researchers have developed an epidemiological model showing how it might be possible to suppress the coronavirus while allowing for “sustainable, albeit reduced, economic activity,” a magazine published by the institute recently reported. The model suggests five days of lockdown, followed by two days of work, every week. Another model suggests that people can work in two-week cycles — four days at work, followed by 10 days at home.
As Israel reopens its economy in a measured way, one of the country’s healthcare reporters, Michal Halperin, offered an assessment, while acknowledging that much about the virus is still a mystery. “I don’t think it’s a mistake,” she said of the reopening. “But you’ll have to ask me in a few weeks and we’ll see.”