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Israel redefining immunization as third dose of vaccine becomes widely available

A fully vaccinated person has received two doses or three?

A high ranking Israeli health official has admitted the country is having second thoughts about what it means to be fully vaccinated against COVID-19 as cases mount nationwide and the third dose of vaccine is being made available for whoever wants to take it.

“We are updating our definition of what it means to be vaccinated,” said the Health Ministry's Coronavirus Commissioner Salman Zarka Sunday during a press conference alongside Director-General Nachman Ash and Public Health Services head Dr Sharon Alroy-Preis as well as Health Minister Nitzan Horowitz himself.

Effective October 1, only those who have received the second dose within the last five months, who have received a third booster shot, who have recovered within the last six months or who have recovered and received one-shot will be eligible for the Green Pass.

The third coronavirus vaccine shot is available for anyone who has been fully inoculated for at least five months, Horowitz said. “There is some improvement in morbidity, but it is too early to talk about the end of the fourth wave,” he added.

Horowitz also pointed out “there is room for optimism, but we have no certainty that the slowdown will continue.”

“We value life above all, but do not forget that restrictions and closures have very severe consequences,” he went on.

Those who have received the booster, or have recently been vaccinated, will be exempt from isolation upon arriving from abroad. Two million Israelis have received the additional injection.

According to the ministry, those who have received a booster are 10 times more protected from infection and serious symptoms compared with those who have had two doses, Alroy-Preis highlighted.

Currently, all travellers from abroad are required to quarantine for a minimum of seven days, unless they come from a very limited group of countries.

Under the new rules, effective as of next Friday, those who are either vaccinated within the previous five months or who were vaccinated earlier and received a booster, will be exempt from isolation if they return from all other countries, except those labelled as “red” – Brazil, Bulgaria, Mexico and Turkey.

“This is a very important message: We are not imposing restrictions for the sake of restrictions,” Horowitz said. “The moment we see that the efficacy of vaccination is very high, we can loosen the requirement of isolation for those who come from abroad.”

Over the past week, more than 100,000 shots were administered per day on weekdays, mostly boosters, but also first and second doses.

Days before returning to schools, some 34,000 of the active cases are schoolchildren, while around 90,000 people were kept in isolation after being exposed to a verified patient.

Hundreds of healthcare workers gathered in front of the Health Ministry in Jerusalem Sunday to protest against a lack of funding. Seven public hospitals, including Jerusalem’s Shaare Zedek Medical Center and Hadassah-University Medical Center, stopped receiving coronavirus patients last Monday and have been operating in emergency mode since Wednesday, only admitting patients in need of life-saving treatment, because of a prolonged financial crisis.
So-called public hospitals are independent organizations that rely mostly on donations, as opposed to facilities directly owned and funded by the state or the health funds.

Officials from the Health and Finance ministries said they have been monitoring the crisis closely and are committed to resolving it quickly, but so far have failed to deliver any solution.

Earlier his month an Israeli scientist had claimed COVID-19 could be treated for less than the US $ 1 a day by using ivermectin, a drug both the FDA and WHO have cautioned against. The study appeared on the MedRxiv health-research sharing site. It has not yet been peer-reviewed.

Ivermectin, a drug used to fight parasites in third-world countries, could help reduce the length of infection for people who contract coronavirus for less than $1 a day, according to recent research by Sheba Medical Center in Tel Hashomer.

Prof. Eli Schwartz, founder of the Center for Travel Medicine and Tropical Disease at Sheba, conducted a randomized, controlled, double-blinded trial from May 15, 2020, through the end of January 2021 to evaluate the effectiveness of ivermectin in reducing viral shedding among nonhospitalized patients with mild to moderate COVID-19.

Ivermectin has been approved by the US Food and Drug Administration since 1987. The drug’s discoverers were awarded the 2015 Nobel Prize in medicine for its treatment of onchocerciasis, a disease caused by infection with a parasitic roundworm.

Over the years, it has been used for other indications, including scabies and head lice. Moreover, in the last decade, several clinical studies have started to show its antiviral activity against viruses ranging from HIV and the flu to Zika and West Nile.

The drug is also highly unexpensive. A study published in the peer-reviewed American Journal of Therapeutics showed that the cost of ivermectin for other treatments in Bangladesh is around $0.60 to $1.80 for a five-day course. It costs up to $10 a day in Israel, Schwartz said.

In Schwartz’s study, some 89 eligible volunteers over the age of 18 who were diagnosed with coronavirus and staying in state-run COVID-19 hotels were divided into two groups: 50% received ivermectin, and 50% received a placebo, according to their weight. They were given the pills for three days in a row, an hour before a meal.

The volunteers were tested using a standard nasopharyngeal swab PCR test to evaluate whether there was a reduction in viral load by the sixth day – the third day after termination of the treatment. They were swabbed every two days.

Nearly 72% of volunteers treated with ivermectin tested negative for the virus by day six. In contrast, only 50% of those who received the placebo tested negative.

The study also found that only 13% of ivermectin patients were infectious after six days, compared with 50% of the placebo group – almost four times as many. “Our study shows first and foremost that ivermectin has antiviral activity,” Schwartz said. “It also shows that there is almost a 100% chance that a person will be noninfectious in four to six days, which could lead to shortening isolation time for these people. This could have a huge economic and social impact.”

Schwartz said other similar studies – though not all of them conducted to the same double-blind and placebo standards as his – also showed a favourable impact of ivermectin treatment.

“Another recent review found that ivermectin reduced deaths by 75%,” the report said.

BUT IVERMECTIN is not without controversy, and hence, despite the high levels of coronavirus worldwide, neither the FDA nor the World Health Organization has been willing to approve it for use in the fight against the virus.

Prof. Ya’acov Nahmias, a Hebrew University of Jerusalem researcher, has questioned the safety of the drug. “Ivermectin is a chemical therapeutic agent, and it has significant risks associated with it,” he said in a previous interview. “We should be very cautious about using this type of medication to treat a viral disease that the vast majority of the public is going to recover from even without this treatment.”

During Schwartz’s study, there was not any signal of significant side effects among ivermectin users.

Only five patients were referred to hospitals, with four of them being in the placebo arm. One ivermectin patient went to the hospital complaining of shortness of breath on the day of recruitment. He continued with the ivermectin treatment and was sent back to the hotel a day later in good condition.

The FDA said on its website it “received multiple reports of patients who have required medical support and been hospitalized after self-medicating with ivermectin.”

The “FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans,” it said. “Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea. Ivermectin is not an antiviral (a drug for treating viruses). Taking large doses of this drug is dangerous and can cause serious harm.”

The World Health Organization has also recommended against using the drug except in clinical trials.

But Schwartz said he was very disappointed that the WHO did not support any trial to determine whether the drug could be viable.

Last month, Oxford University announced a large trial on ivermectin effectiveness.

Schwartz said he became interested in exploring ivermectin about a year ago, “when everyone was looking for a new drug” to treat COVID-19, and a lot of effort was being put into evaluating hydroxychloroquine, so he decided to join the effort.

“Since ivermectin was on my shelf, since we are using it for tropical diseases, and there were hints it might work, I decided to go for it,” he said.

Researchers in other places worldwide began looking into the drug at around the same time. But when they started to see positive results, no one wanted to publish them, Schwartz said.

“There is a lot of opposition,” he said. “We tried to publish it, and it was kicked away by three journals. No one even wanted to hear about it. You have to ask how come when the world is suffering.”

“This drug will not bring any big economic profits,” and so Big Pharma doesn’t want to deal with it, he said.

“Developing new medications can take years; therefore, identifying existing drugs that can be re-purposed against COVID-19 [and] that already have an established safety profile through decades of use could play a critical role in suppressing or even ending the SARS-CoV-2 pandemic,” wrote the researchers in the American Journal of Therapeutics. “Using re-purposed medications may be especially important because it could take months, possibly years, for much of the world’s population to get vaccinated, particularly among low- to middle-income populations.”

(Source: The Jerusalem Post)