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I am exempt - and want to breathe

Site Staff 2.11.2021

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The Law:

The law clearly states that anyone with “significant difficulty” covering their mouth and nose, whether physical or psychological (mental), is exempt from wearing a mask.

 

Text from the law:

 צו בריאות העם (נגיף הקורונה החדש) (בידוד בית והוראות שונות) (הוראת שעה), תש”ף-2020
Source: https://www.nevo.co.il/law_html/law01/502_230.htm#Seif10 (section 3ה) Download a PDF of the law
 

The Ministry of Health’s own site: https://www.gov.il/he/departments/general/pwd_exemption_mask_corona 

 

No Certificate Required:

The law does not require any certificate, document, or other proof of one’s inability to wear a mask. All that is required is for the individual to say that he is exempt. The Minister of Health, Nitzan Horowitz was asked to explain this point in the Knesset on 28/7/21. 

He answered:
“Indeed, the law has defined an exception that a person due to mental, intellectual or medical disabilities significantly has difficulty wearing a mask, or is prevented from doing so due to his disability that is supposed to cover the mouth and nose, he will be exempt from the mask obligation. The thing is, the law does not define how this exception is made in practice, simply giving an exemption.

Therefore, the wording of the regulation – I can tell you this clearly – does not impose an obligation to present a certificate for the purpose of the exemption and therefore the same person can also verbally claim his right to explain the situation. We will refine this situation among law enforcement agencies so that they know. If you want, you can also ask for a note from a doctor or a letter, if you want, but it is not mandatory.”
The video of the Minister’s statement:

When asked to put on you mask you don’t have to explain why, simply say “אני פטור על פי חוק יש לי קושי משמעותי”

The Ministry of Health’s response to The Association for Civil Rights:

The response clarifies that no documents need be presented: 
“as can be seen, the language of the regulation does not establish how an exemption should be proven, and whoever requests an exemption can show that they meet the necessary criteria in the way that they choose – whether by showing an approval or in some other manner. It must be said that the regulation does not specify any limits on the type of approval and does not require presentation of  a medical document or personal information.”
The Court Upholds:

This policy was upheld in court when a customer was refused service for not covering her nose. The customer explained that she was exempt for medical reasons, and the store still refused to serve her. She sued the store, and was awarded compensation, the judgment acknowledged the law and awarded the customer compensation. 
“as stated, there is no legal obligation to present a medical certificate, and it was sufficient for the plaintiff to state that she suffers from a medical disability that makes it significantly difficult for her to wear a mask.”
 

Egged’s Policy:

The policy of not requiring proof of a “significant difficulty” to not wear a mask is not limited to stores but includes all enclosed areas including transportation. Egged’s policy explicitly states that:
“ In addition to the general duty to wear a mask, it is possible to exempt persons who have difficulties in wearing a mask. If a passenger says that he cannot wear a mask because of his disability, it is uncomfortable for him, etc., do not ask questions and it is absolutely prohibited from demanding that he present a certificate or any other proof of the disability, and shall be allowed to receive service without a mask.” 

How masks can cause “significant difficulty”:
Reduced oxygen intake

“SpO2 decreases after the first hour.”

 https://pubmed.ncbi.nlm.nih.gov/18500410/ 

“N95 masks are estimated to reduce oxygen intake by anywhere from 5 percent to 20 percent. That’s significant, even for a healthy person”

https://news.stanford.edu/2020/04/14/stanford-researchers-reengineer-covid-19-face-masks/ 

“Ventilation, cardiopulmonary exercise capacity and comfort are reduced by surgical masks” 

https://link.springer.com/article/10.1007/s00392-020-01704-y 

 

Headaches:

“81% of masked healthcare workers developed headaches”

https://headachejournal.onlinelibrary.wiley.com/doi/epdf/10.1111/head.13811 

https://mediatum.ub.tum.de/doc/602557/602557.pdf 

 

Mask-Induced Exhaustion Syndrome (MIES) 

https://www.mdpi.com/1660-4601/18/8/4344/htm#B37-ijerph-18-04344  

 

Increased risk of infection:

https://www.nature.com/articles/s41598-018-32008-x.pdf 

“result in increased risk of infection”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/  

 

Skin rashes:

“The incidence of adverse skin reactions to the N95 mask was 95.1%”

 https://pubmed.ncbi.nlm.nih.gov/32541493/ 

 

Are Face Masks Effective? The Evidence.


Scientific evidence that shows masks don’t prevent viral transmission:
“Evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission”

https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article#r39

“CDC Study Finds Overwhelming Majority Of People Getting Coronavirus Wore Masks” https://thefederalist.com/2020/10/12/cdc-study-finds-overwhelming-majority-of-people-getting-coronavirus-wore-masks/

First RCT concludes: “mask-wearing ‘not statistically significant”

https://www.israelnationalnews.com/News/News.aspx/291576

47 studies that don’t support mass masking

47 studies confirm ineffectiveness of masks for COVID and 32 more confirm their negative health effects

“none of the studies established a conclusive relationship between the use of masks/respirators and protection from influenza infection.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/

https://apps.who.int/iris/bitstream/handle/10665/329439/WHO-WHE-IHM-GIP-2019.1-eng.pdf?fbclid=IwAR3zlFmLcryeqTqACfGjc8FX54ngMo0rep2o570B_c3GV1fVlE2ux7zGYGA (page 31)
The Ministry of Health knew that all of this is true, see their summary before requiring masks:
MOH FOI Response Letter 22 NOV 2021

The Letter
American Frontline Doctors Article

Print your own stickers and spread the word (nylon works best) click here to download
For more information or to get stickers in your area contact: anipatur2022@gmail.com

For more information on how the corona response is causing “significant difficulties” while being ineffective see:
www.covil.co.il

www.americasfrontlinedoctors.org

www.pecc.org.il

www.swprs.org/covid19-facts/

Alert: Severe Concerns Regarding the Reliability and Legality of Data from Israel in light of the Planned Discussion on the Administration of COVID-19 Vaccines to Children Aged 5-11

Alert: Severe Concerns Regarding the Reliability and Legality of Data from Israel in light of the Planned Discussion on the Administration of COVID-19 Vaccines to Children Aged 5-11

The Israeli Professional Ethics Front 24.10.2021

October 21st, 2021.

Addressed to:

US Food and Drug Administration (FDA)

Dear Sir/Madam,

Re: Alert: Severe Concerns Regarding the Reliability and Legality of Data from Israel in light of the Planned Discussion on the Administration of COVID-19 Vaccines to Children Aged 5-11

It is with great concern that we, the members of the Israeli Professional Ethics Front, are writing this letter to you. The Professional Ethics Front is an independent Israeli group of physicians, lawyers, scientists and researchers, who have come together to address the many ethical issues that have surfaced as a result of the COVID-19 crisis in the Israeli society. The purpose of our letter is to provide you with important information towards the upcoming FDA discussion on the topic of administration of the COVID-19 vaccines to children aged 5-11.

We are aware that the state of Israel is perceived as “the world laboratory” regarding the safety and efficacy of the Pfizer-BioNTech COVID-19 vaccine, as reflected by statements made by Dr. Albert Bourla, Dr. Anthony Fauci, and other senior figures in leading health authorities throughout the world. It is therefore our understanding that the data and information coming from Israel play a crucial role in critical decision-making processes in regards to COVID-19 vaccination policies. We thus see it of utmost importance to convey a message of warning and raise our major concerns regarding potential flaws in the reliability of the Israeli data with respect to the Pfizer-BioNTech COVID-19 vaccine, as well as many significant legal and ethical violations that accompany the data collection processes. We believe that the significant failures underlying the Israeli database, which have been brought to our attention by numerous testimonies, impair its reliability and legality to such an extent that it should not be used for making any critical decisions regarding the COVID-19 vaccines.

This document briefly outlines the main failures that lead to this unfortunate, albeit inevitable, conclusion. We emphasize that we can expand and clarify further, as well as provide references, in relation to each of the failures described below.

Lack of a Public and Transparent Adverse Events Reporting System:

The first prerequisite for granting a permit for use of any new medicinal preparation is the setup of adverse events (AEs) collection systems that would allow appropriate management of risks and generation of alarm signals. All the more so when it concerns a mass vaccination campaign of a first-in-human use of an experimental preparation to the citizens of an entire country, which serves as a global model. Despite the advanced technological systems available to the Israeli HMOs, and contrary to common standards in Western countries, there exists no proper and transparent AEs reporting system in Israel, such as the US VAERS system, that is accessible to the public, and thus no appropriate tracking of AEs occurring after the administration of the COVID-19 vaccine.

Healthcare professionals or citizens in Israel, who wish to submit reports of AEs following vaccination, are unable to do so. As such, there is no possibility for either of these populations to also search through the data, rendering impossible the examination of the reported AEs by other citizens, physicians and independent researchers. Instead, there is only an online AEs reporting form available on the MOH’s website. This form, however, was for many months not useful, since it did not allow the inclusion of personal contact information, the free text field intended to describe the AEs comprised a limited number of characters, and the symptoms list available to choose from was limited as well and included only mild AEs terms.

A petition to the Israeli Supreme Court of Justice has led the Ministry of Health (MOH) to implement the above-mentioned necessary improvements to the form. Unfortunately, the modification of the form was made very late, after the majority of the adult population had already been vaccinated. Furthermore, since the report is not publicized in a transparent manner, the MOH is the only recipient and thus the sole owner of the data and the decision-making authority on the utilization and distribution of it.

Moreover, no tracking and monitoring of even the most sensitive populations, such as pregnant women and the elderly, is taking place. For example, as part of the ‘National Senior Population Protection from the COVID-19 Program’ in Israel, a reporting system was activated in April 2020, which presented detailed reports almost daily on COVID-19 eruptions, hospitalizations, and mortality in nursing homes. However, on December 29th, 2020, the very day the vaccination campaign commenced in nursing homes, the publication of these reports was abruptly discontinued, and has never been resumed since.

2.Severe Impairments in Healthcare Professionals’ Adverse Events Reporting System:

We reveal that physicians and medical teams in Israel encounter great obstacles when attempting to report AEs following Pfizer-BioNTech COVID-19 vaccination to the MOH. We have testimonies of physicians, who attest to the complexity of filling the AEs reports to the MOH, claiming that reporting is almost impractical in the incredibly stressful working conditions of medical teams in Israel during this period. As a result of these tremendous difficulties, there is an immense underreporting of AEs by healthcare professionals in Israel, and AEs are only rarely reported in exceptional cases. The physicians’ testimonies that we have obtained also show that reported AEs are not openly publicized, or made available to the healthcare professionals themselves.

Even more disturbing is the fact that the few reports, which the Israeli MOH does publicize about the AEs observed after receiving the Pfizer-BIONtech COVID-19 vaccine, are not consistent with the testimonies of physicians regarding severe adverse events (SAEs) that they themselves have reported to the MOH. Thus, for example, in a discussion before the Advisory Committee of the FDA on September 17th, 2021, the head of the Israeli Health Services, Dr. Sharon Alroy-Preis, claimed that only one case of myocarditis was observed after the 3rd vaccine dose out of three million people who received the 3rd vaccine dose in Israel. This claim does not reconcile with research findings from all over the world, including findings from Israel, that were published in the medical literature[1],[2], according to which the rate of myocarditis observed after receiving the Pfizer-BioNtech COVID-19 vaccine stands at 1:3,000-6,000. The claim of Dr. Alroy-Preis also stands in contrast to reports given by a handful of brave Israeli doctors about cases of myocarditis and other SAEs observed in close proximity to the Pfizer-BioNtech COVID-19 vaccine.

One of these physicians, Dr. Yoav Yehezkelli, who was among the founders of the Israeli Outbreak Management Team, wrote on his Facebook page that he personally treated in his clinic a 17-year-old boy, who suffered from myocarditis several days after the 3rd vaccine dose, and he knows of two additional cases among the boy’s classmates. Dr. Yoav Yehezkelli added that he reported the myocarditis case that he treated (and additional SAEs cases) to the MOH through the online reporting system, as well as via personal reports to MOH officials, but his reports were quickly dismissed as having no link to the vaccine, without a thorough examination of the cases. Dr. Yehezkelli also mentioned that he encountered other patients in his clinic, who were hospitalized after suffering from AEs in close proximity to receiving Pfizer-BioNTech COVID-19 vaccines, and the hospital supposedly failed to report said AEs to the MOH. We have affidavits from nine other physicians, who have also treated cases of myocarditis or know of such cases, but have abandoned their attempts at reporting to the MOH having tackled immense difficulty or, alternatively, reported to the MOH and did not get any response. It is statistically improbable that a small cohort of physicians should witness these many COVID-19 vaccine injuries if Dr. Alroy-Preis’s claim was accurate.

3.Data Distortion:

Recently, two serious incidents, in which data presented by the MOH was distorted, have been revealed. Both events occurred in the last month.

The first one was the deletion of thousands of citizens’ responses to a post by the MOH. In response to a MOH post that read “Let’s talk about the adverse events”, and claimed that the vaccine is completely safe and that SAEs are extremely rare, tens of thousands of responses from the public were posted, with many reporting AEs, including SAEs, which they suffered after the vaccine. But instead of examining the responses and addressing them, about half of them were deleted. We have screenshots of the deleted responses.

The second event pertains to backward rewriting of past MOH dashboard data. Based on MOH dashboard data, an analysis[3] conducted by members of the Israeli Public Emergency Council for the Corona Crisis (PECC) demonstrated that the Pfizer-BioNtech COVID-19 3rd vaccine dose effectiveness is much lower than that claimed in the New England journal of Medicine study[4] presented by Dr. Sharon Alroy-Preis to the FDA panel on September 17th, 2021. Within 24 hours of the release of the PECC analysis, the relevant dashboard data history was completely rewritten. The PECC released screenshots of both the original and “rectified” data.

4.Legal and Ethical Violations in Data Collection Processes:

Not only is the data coming from Israel regarding the safety and efficacy of the Pfizer-BioNtech COVID-19 vaccine apparently unreliable, but also the collection method is controversial, and claimed to be neither legal nor ethical. The Pfizer-BioNtech COVID-19 vaccines are administered to the Israeli population without their informed consent, which is required by the GCP chapter of IHC-6 and carried out in other countries. This is a clear violation of the Nuremberg Code Rules, the Patient’s Bill of Rights, and the Israeli MOH directives for clinical trials on humans. Moreover, the Israeli citizens are under tremendous pressure, almost to the point of coercion, to get vaccinated.

“Should the ‘Outbreak Management Team’ decide on a 3rd dose of the vaccine to the immunocompromised patients, it is not clear how many we can vaccinate, and it requires approval of the Helsinki committee (medical trial approval committee) and Pfizer’s approval. We are committed to Pfizer, to vaccinate only by the vaccination regimen established by them”. This is a statement made by Prof. Hezi Levi, former CEO of the Israeli MOH, on July 5th, 2021. The evident conclusion is that the 3rd vaccine dose operation is an experiment requiring approval of the Helsinki Committee in charge of approving human medical experiments in Israel. Such an approval has never been issued. Moreover, according to the statement made by Prof. Hezi Levi, the 3rd vaccine dose operation refers only to the immunocompromised population, and thus is even more unethical in healthy individuals, especially in young healthy individuals, shown to be at a higher risk for myocarditis.

We are deeply concerned with the failure of the Vaccine Safety Committee (VSC) to fulfill its designated role. The VSC is responsible in Israel for vaccine safety. It is the official arm designated to monitor and collect safety data. Yet, it has not issued a single position paper on its behalf, or raised a single red flag to raise awareness of SAE cases, and has never gathered in full assembly. Additionally, it has come to our attention that one of the public representatives on this committee, who is a pediatrician (allergist, immunologist), never knew that he was appointed and did not attend any of the meetings, even when they did take place.

In accordance with the accepted perception established after World War II, the findings of experiments obtained in illegal and immoral ways should not be relied upon. We believe that the same rules should apply to the findings of the current experiment in Israel, since these findings were obtained through significant legal and ethical infringements. Our conclusion is further reinforced by the significant doubts about the reliability of the data reported by Israel, as detailed above, and the consequent major concern that their use might be misleading and thus disrupt the decision-making processes pertaining to the Pfizer-BioNtech COVID-19 vaccines.

In the Book of Leviticus, it is said “Do not stand idly by while your neighbor’s blood is shed”. In the spirit of those words, we implore the committee to take into consideration our urgent warnings and adopt utmost precaution when referring to the Israeli data about the safety and efficacy of the Pfizer-BioNtech COVID-19 vaccines.

Sincerely,

The Israeli Professional Ethics Front

https://www.facebook.com/Professional-Ethics-Front-%D7%94%D7%97%D7%96%D7%99%D7%AA-%D7%94%D7%9E%D7%A7%D7%A6%D7%95%D7%A2%D7%99%D7%AA-%D7%9C%D7%90%D7%AA%D7%99%D7%A7%D7%94-100659398970482

professionalethicsfront@protonmail.com

Mevorach, D. et al. (2021). Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel. New England Journal of Medicine. DOI: 10.1056/NEJMoa2109730. ↑
Vogel, G., & Couzin-Frankel, J. (2021). Israel reports a link between rare cases of heart inflammation and COVID-19 vaccination in young men. Science. ↑
Koren, O., Altuvia, S. & Levi, R. (2021). Green Pass and COVID-19 Vaccine Booster Shots in Israel– A More ‘Realistic’ Empirical Assessment Analyzing the Airport Data. ↑
Bar-On, Y.M. (2021). Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel. New England Journal of Medicine 385:1393-1400. ↑

 

Green Pass and COVID-19 Vaccine Booster Shots in Israel

Green Pass and COVID-19 Vaccine Booster Shots in Israel

Oz Koren, Shoshy Altuvia, Retsef Levi 6.10.2021

Green Pass and COVID-19 Vaccine Booster Shots in Israel

– A More ‘Realistic’ Empirical Assessment Analyzing the Airport Data

By Oz Koren1, MM, Shoshy Altuvia2, Retsef Levi3 Oct 3, 2021
Background
Since the 3rd week of June 2021 Israel has been experiencing another wave of COVID-19 infections, as seen in Graph A4.

This wave has continued in spite the implementation of a strict “Green Pass” policy that required any unvaccinated individuals above the age of 3 to show a recent (last 24 hours) negative COVID- 19 test in order to be able to enter restaurants, shows, sport events and other public settings and events. In fact, similar policy is now implemented by many work places.

Due to the rapidly increasing number of confirmed cases and resulting hospitalizations and deaths, the Ministry of Health (MOH) has concluded5 that the Pfizer-BioNTech vaccine’s efficacy is waning over time to the extent that it is necessary to administer a booster shot (3rd dose of the Pfizer- BioNTech vaccine). On July 30, 2021, Israel launched an aggressive booster vaccination campaign starting with the over 60 population and rapidly expanding to all ages above 12. As of September 20, 2021, the booster shot was administered to nearly 3.1 million people as can be seen in the Graph B6.

5F

 

As can be seen from Graph C7, as of September 20, 74% of the over 60 population received the booster. Similarly, 58% of the 50-59 population, 47% of the 40-49, 35% of the 30-39 population,

28% of the 20-29 population and 19% of the 16-19 population.

The New Green Pass Eligibility in Israel
Following the aggressive booster vaccination campaign, as of October 3, 2021 the Israel MOH has changed the eligibility criteria8 for Green Pass holders, requiring anyone that received the second dose of the Pfizer vaccine more than 6 months ago to get vaccinated with a booster shot or otherwise lose their Green Pass. Additionally, individuals who recovered more than 6 months ago will also be required to vaccinate. To summarize this change, the new definition of Vaccinated and Unvaccinated is as follows:
Vaccinated:

Anyone who has received the 3rd dose (booster) more than 7 days ago.
Anyone who has received 2 doses more than 7 days ago, but less than 6 months ago.
Anyone who recovered after testing positive (PCR test), or shows recovery signals on a serological test, and has received 1 dose more than 7 days ago.

Unvaccinated:

Anyone who did not receive 2 doses at least 7 days ago. (note that this includes completely unvaccinated individuals).
Anyone who has received their 2nd dose more than 6 months ago.

The Israel MOH justifies the epidemiologic rationale of the new Green Pass policy based on several studies that show that the protection of the initial 2 doses of the Pfizer vaccine against infection wanes over time9 and that the booster presumably regains this protection level back.

 

Thus, it is effectively ‘safe’ to let Vaccinated individuals (based on the new definition) to enter public settings with no tests and require Unvaccinated individuals (again see above) to be tested.

In particular, on Sep. 15, 2021 a group of researchers, including Dr. Sharon Alroy-Preis, Head of Public Health Services in Israel Ministry of Health (MOH) published a study of the booster efficacy10 based on data collected by the MOH during the campaign. The study asserts that the booster achieves a 11.3 (95% confidence interval [CI], 10.4 to 12.3) relative reduction in the risk of COVID-19 infection11 among the over 60 population, compared to the original 2 vaccine doses.

Overall, the paper follows 1,137,804 individuals ages 60 or older, who were eligible for a booster dose (who received their second dose before March 1, 2021) between July 30 (when the booster campaign was launched) and August 31, 2021. The study compares the rates of infection and severe COVID-19 outcomes per person-days at risk between two cohorts to estimate the booster efficacy, using Poisson regression, adjusting for possible confounding factors.

Unfortunately, there are multiple methodological problems with this study, the most significant of which is the fact that there is no appropriate control for the number of respective tests conducted among the members of each cohort. Moreover, the resulting respective positivity rates are not reported. This is a major potential source of an upward bias of the booster efficacy against infection, since there are all reasons to assume that the booster cohort was tested in significantly lower intensity, and in fact there are data in the MOH paper itself to support this assumption. The different intensity is the result of both individual behavior (i.e., individuals who are vaccinated with the booster will be less concerned about infections and will test less frequently) as well as the MOH testing policy.
Estimating of the Green Pass Efficacy Based on Data from Israel Airport
Recently, the MOH introduced a new “widget” to the public online Control Dashboard12 that presents detailed data on individuals entering into Israel. The data includes information on the vaccination status as well as the number of positive cases as a function of the vaccination status.

Graphs D & E present the aforementioned ‘widgets’ in the MOH Dashboard related to the individuals that indeed provide, for each day, the exact number in each group, as well as the number of positive cases, whereas positive cases constitute of individuals who tested positive within the first 10 days of their return date. Note that in spite of the difference in testing between the two groups of Vaccinated and Unvaccinated mentioned above, at least in this setting all individuals must take a test upon entering Israel.

 

Table 113 below shows the respective data of the above-mentioned airport widget for 45 days throughout September 25. There were 3016 confirmed cases among 314,369 Vaccinated, which is 0.96% positivity rate. Additionally, there were 4776 confirmed cases among 308,494 Unvaccinated which is 1.55% positivity rate. This implies that the relative risk of infection among the Vaccinated is reduced by a factor of 1.61, which is significantly lower than the 11.3-fold reduction estimate presented in the MOH’s paper.

Furthermore, it is important to note September 9-10, 2021 as unique days that capture an event where thousands of Orthodox Jews returned from Uman (Ukraine) and many falsified hundreds of PCR results prior to coming back to Israel. These two days represent an outlier and omitting them and the following 10 days (accounting for the 10 day period after arrival over which they consider positive cases) from the analysis further reduces the estimated efficacy of the booster vaccine to 1.35.

Based on high booster vaccination rates, it is reasonable to assume that at least 40 percent of the newly defined Vaccinated cohort (see above) are vaccinated with a booster and most of the rest are more recently vaccinated individuals with 2 doses. If one takes a conservative assumption that the relative protection of the individuals who are vaccinated with 2 doses (less than 6 months ago) is at least 20 percent (1.25-fold), it follows that the relative protection of the booster is at most 2.75- fold). In fact, assuming that the booster shot indeed provides protection of 11-fold implies that those vaccinated with 2 doses have no additional relative protection (less than 1-2 percent).

All of these conclusions follow from the fact that the overall relative efficacy of the Vaccinated cohort seems to be around 1.61-fold and the insight that the relative protection of the Vaccinated cohort is closely approximated by the weighted average (based on the relative proportion within the Vaccinated cohort) of the respective relative protection of each of the sub-cohort (boosters and 2 doses). Considering the recovered individuals who are known to have extremely high protection against infection will make this analysis even less favorable with respect to the booster efficacy.

More generally, the analysis above makes it very clear that the Green Pass policy epidemiological rationale is highly questionable. Considering all individuals over 12 who are vaccine-eligible, the

 

current Vaccinated cohort is 1.6 times larger than the Unvaccinated cohort. Thus, the absolute number of infected individuals from the Vaccinated cohort is likely to be at least as large as the number within the Unvaccinated cohort. Moreover, since these individuals will not be tested and be less likely to have symptoms or attribute their symptoms to being infected with the COVID-19 virus, it is quite likely that they will interact with many more contacts and run a significant risk to infect others. This risk is underscored by consistent findings that vaccinated individuals, once infected, can have high viral load14.

In conclusion, the analysis above suggests that the relative protection against infection between the individuals in the newly defined Vaccinated and Unvaccinated cohorts based on the new Green Pass policy is only 1.61 or even less. This suggests that unless the protection of the 2 doses have completely waned within less than 6 months, the relative protection of the booster shot is significantly lower than the MOH estimates of 11-fold, probably at most 2.75-fold.

Equally the analysis raises fundamental questions regarding the rationale of imposing the new Green Pass policy as it seems that it is not going to be effective in truly eliminating infections, especially considering the expected decline in the booster efficacy over time. In fact, the Green Pass policy could support the wrong perception within high risk patients that they are protected around vaccinated individuals, whereas those can be infected and infect them.

Table 1 was created on Sep 25, 2021 to reflect the most current data.

Group A: “Vaccinated”

Pos A: the number of confirmed cases (absolute number) among Group A

Group B: “Unvaccinated”

Pos B: the number of confirmed cases (absolute number) among Group B

1 Mr. Oz Koren, MM, BGSU, Bowling Green, OH

2 Professor Shoshy Altuvia, PhD, Department of Microbiology and Molecular Genetics, The Hebrew University, Jerusalem, Israel

3 Professor Retsef Levi, PhD, MIT Sloan School of Management, Cambridge, MA (retsef@mit.edu)

4 Taken from https://www.worldometers.info/coronavirus/country/israel/

5 Waning immunity of the BNT162b2 vaccine: A nationwide study from Israel https://www.medrxiv.org/content/10.1101/2021.08.24.21262423v1.full-text

6 Taken from the Israel MOH dashboard: https://datadashboard.health.gov.il/COVID-19/

7 Taken from the Israel MOH dashboard: https://datadashboard.health.gov.il/COVID-19/

8 https://www.gov.il/he/departments/news/29082021-01

9 Waning of BNT162b2 vaccine protection against SARS-CoV-2 infection in Qatar (https://www.medrxiv.org/content/10.1101/2021.08.25.21262584v1)

10 Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel https://www.nejm.org/doi/full/10.1056/NEJMoa2114255

11 The study also reports the rate of severe illness was lower by a factor of 19.5 (95% CI, 12.9 to 29.5).

12 https://datadashboard.health.gov.il/COVID-19/general

13 Table 1 was created on Sep 25, 2021 to reflect the most current data. Group A: “Vaccinated”

Pos A: the number of confirmed cases (absolute number) among Group A Group B: “Unvaccinated”

Pos B: the number of confirmed cases (absolute number) among Group B

14 Shedding of Infectious SARS-CoV-2 Despite Vaccination (https://www.medrxiv.org/content/10.1101/2021.07.31.21261387v4)

This is how Pfizer managed to obtain the FDA's emergency authorization for children

This is how Pfizer managed to obtain the FDA's emergency authorization for children

Yaffa Shir-Raz 3.06.2021

Analysis and comparison of the review document submitted by Pfizer to the US Food and Drug Administration… reveal concerning findings, including violations of the protocol established by Pfizer itself,

Thoughts of a psychologist in the time of Corona

Thoughts of a psychologist in the time of Corona

Clinical psychologist, Dr Simon Kuttner 28.02.2021

…One of the central roles of the psychologist is to help the client create a more balanced life of soul. Balance and perspective are the foundation of mental health
We need perspective, not in order to convince but in order to foster our mental health

Something Isn't Right

Something Isn't Right

Site Staff 24.01.2021

Here is a fact-based topic-by-topic assessment of the mainstream Covid perspective

Founding Document-Emergency Covid19 Council

Founding Document-Emergency Covid19 Council

Dr. Yoav Yehezkeli 29.12.2020

Founding Document-Emergency Covid19 Experts Council

A third Lockdown is not an option, and should be taken off the table Immediately

A third Lockdown is not an option, and should be taken off the table Immediately

Dr. Yoav Yehezkelli 15.12.2020

Focusing on the Pareto of illness and mortality, on protecting the vulnerable population, on a differential approach for areas with higher infection rates and on the careful reopening of all activities where Infection rate is low are essential for correct handling of the crisis .

It’s heartbreaking to see the small business owners whose businesses have collapsed, the unemployed and the children still withering at home, the destruction and suffering brought on by the second lockdown and the continuing Coronavirus measures in Israel. The collateral damage to our health, our emotional well-being, our society and our economy is immense. As is the way of crises, at first resources are mobilized to combat the danger, but these run out as the crisis continues, and so the worst of the damage is still before us, in the form of depression, anxiety, despair, loneliness, loss of livelihood, neglected treatment of chronic diseases, domestic violence and a general breakdown of trust.

Does the damage caused by the response to the pandemic, a result of government policy, equal or even exceed that of the natural damage of the pandemic itself? Is the decision to adopt a strategy of suppression of the virus at all cost justified and realistic? Has the government been trapped in a misconception in its dealing with the crisis?

The outbreak of a contagious disease has certain natural dynamics which depend on the characteristics of the disease and of the population. The severity of the disease, the immunity of the population and the availability of treatment and vaccines determine the number of cases and of deaths, as well as the shape of the
morbidity curve along the time axis. An epidemic continues until it has consumed its natural fuel, infections in the susceptible population, and until immunity is reached.

According to present knowledge, the mortality rate from COVID-19 (the infection fatality rate – or ratio of deaths to the number of people infected in the population) in the age bracket of 20-49 is 0.0002, while mortality above the age 70 is 0.054: Far from being a deadly disease like the great epidemics of plague and smallpox.

In the absence of a vaccine or treatment, the strategy is to limit the extent of illness by decreasing contact between people. However, a lockdown does not lower the number of deaths from an epidemic, it only delays it. Lockdowns, physical distancing and limitations on gatherings can flatten the infection curve over time, but will not change the ultimate number of infections and deaths, because the area under the curve remains the same. The attempt to suppress the virus at all cost is therefore foolish, destined to fail and damaging.

There are currently several vaccines undergoing emergency approval processes, which may be available to some of the population in the near future. However, mass production will take time, and the vaccine will not have any real effect on the spread of the epidemic in the coming months, and this will still be determined
by the natural immunity caused by infection. In addition, the vaccine studies will have to continue for a long period of time to ensure that their use is safe and there are no long-term side effects

The question is, how do we deal with this reality. There are two main strategies for combating an epidemic: The suppression strategy, which aims to eliminate the virus at all cost and bring the infection rate down to zero, and the containment strategy, which acknowledges the limitations of our power and strives to reduce

illness and mortality to bearable rates, which means a reproduction number (R) of between zero and one.

The asserted aim of “flattening the curve” was preventing a collapse of the health system due to an overload of patients. We can now say that at no stage, including at the height of the second wave, was the health system even close to its full capacity, since even non-urgent activities continued as usual. The “red line” of 800 severe patients was to begin with an unbased figure, and when this was exceeded, the bar was raised overnight to 1,500 severe patients. We can therefore say that even if the aim of protecting the health system was a valid one, the criterion that was set in order to attain it was mistaken.

Every step taken to eliminate the pandemic should be evaluated according to its cost in relation to its value. For this reason, “breaking the chain of transmission”, which involves enormous investment in a humongous system, is unavoidably limited in efficiency when there is transmission by asymptomatic patients.

Likewise, the acquisition of thousands of respirators, adding more hospital beds or building new departments in underground hospital parking areas are all useless if there is no additional professional personnel to staff them. The necessary and correct investment in the health system at this time is not in useless machines, but in the bolstering of exhausted and overburdened health care workers and in the modification of treatment strategies, such as planned referral of moderately ill patients to home hospitalization.

From what we’ve learned, there is dramatic variability in the risk the virus poses for the population: from a light to an asymptomatic illness in the young and healthy, to a severe and dangerous illness in those over 70 or with underlying disease or obesity. In addition, there are differences in the transmission of the disease for different social groups and depending on situations such as living conditions, family size and lifestyle characteristics. One can either ignore this variability and treat the population as homogenous, as has been done in Israel so far, but at the same time, this can provide an opportunity for informed risk management, containment of the disease and the continuation of reasonably normal life alongside it.

Focusing on the Pareto of illness and mortality, on protecting the vulnerable population, on a differential approach for areas with higher infection rates and on the careful reopening of all activities where Infection rate is low are essential for correct handling of the crisis. By all these measures, the Israeli government has so far received a failing grade, first, because the professional appointees have fallen into a cognitive trap of tunnel vision, focusing on eliminating the Coronavirus while ignoring other aspects of public health, and second, because expert opinions have been pushed aside for political and sectorial reasons.

After months of combating the Coronavirus, it’s time to define a goal for this battle, an attainable goal, instead of the futile attempt to eradicate the disease.

The purpose of the effort should be minimizing mortality from the disease while maintaining normal life as best we can. From this aim, we can draw the measures of our success in the battlefield: Not the number of confirmed cases on a day to day basis, but the mortality rate, which we should strive to minimize; and at the same time, the levels of activity in education, society and the economy, which should be encouraged and enhanced whenever possible. Once the main goal is defined correctly and realistically, the mindset which has overtaken the government will be freed, new ways of coping will be found, trust can be re-established and the public can be encouraged to rejoin the effort.

The main challenge in dealing with an epidemic crisis of this scale is mental. Denial of reality, fear and avoidance are natural human responses, but when they infiltrate decision making, the outcome for the public can be devastating. Policy should be guided by a broad vision of public health, not a narrow one, in line with
the definition of health by the World Health Organization as “a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity”. Livelihood means health, social relations mean health, and education means health.

Just as we wouldn’t consider closing all roads to traffic in order to avoid traffic accidents, or closing all hospitals in order to prevent acquired infections, or for that matter staying home so as not to get caught in the rain, so it is unreasonable to lock everyone at home in order to avoid disease that is for the most part unpreventable. A third lockdown is not an option, and should be taken off the table Immediately. The illness we have at present, which is mostly mild, brings the public closer to immunity, providing we protect the vulnerable population, for whom the disease is more dangerous.

The continual attempt to avoid the unavoidable and suppress the virus at all and any cost to the population is foolish, futile and harmful. The acceptance of unpreventable disease is not a fatalistic approach that sees the epidemic as destiny, but a realistic attitude based on factual risk assessment, which aims to implement universal and proportional measures – such as social distancing, or masks in closed spaces and not out in the open air – alongside strengthening the real capacities needed to deal with the illness.

It’s time the policy makers freed themselves of the limiting mindsets that have been hampering them, in order to find the flexibility that is crucial to navigating the crisis along a different course. A redefinition of the goals of the battle against the Coronavirus will enable us to reach a new and sustainable equilibrium which acknowledges the values of life and health in their full sense.

 

The world and the coronavirus – the conviction stands

The world and the coronavirus – the conviction stands

Prof. (emeritus) Eyal Shahar 8.12.2020

In the spring of 2020, an experiment in public health was carried out which would not have passed an ethics committee even in an out-of-the-way small town in the U.S. 

Routine Days in the Department of Emergency Medicine –  An Island of Tranquility in a Stormy Sea of Pandemic Panic

Routine Days in the Department of Emergency Medicine – An Island of Tranquility in a Stormy Sea of Pandemic Panic

Dr. Amir Shahar 7.12.2020

The scientific truth:
 Most of those tested “positive” are not sick. A respiratory virus has passed through their throat, like many other viruses, and did not cause any illness.

Not for general closure, yes for behavioral change and personal responsibility

Not for general closure, yes for behavioral change and personal responsibility

Dr. Yoav Yechezkeli 31.08.2020

Half a year after the onset of the COVID-19 epidemic, morbidity in Israel is on the rise (the important figure is the number of serious patients) and a decision was made by the government to impose a general re-closure, as if it were the most effective and effective measure available to us. A general closure, after which the innovative system for “amputation of the infection chains” will be activated, followed by the vaccine, whose development in Israel is expensive and unnecessary, and will come to the rescue. But like the “exit strategy” from quarantine in the first wave, these are actions whose effectiveness is unclear and whose implementation in the field is unlikely to succeed.

The increase in morbidity and the imposition of a second closure are the result of the failure of the Israeli government to treat the epidemic. The delays in decision-making, their politicization and the loss of public trust, for which the government is responsible, are events that thwart the eradication of the epidemic. Would it have been conceivable during a war that the government would delay for weeks a decision on an action plan offered to it by the military professional echelon? This is exactly what happened with the projector’s traffic light plan appointed by the government itself, which did not receive its backing.

A general closure has not been shown to prevent mortality from an epidemic. It just “flattens the curve” and repels the disease and eventually the area under the curve does not change. A full closure has devastating health, social and economic side effects. The loneliness, anxiety, depression, neglect in balancing chronic diseases, the delay in treating urgent situations, the educational deprivation among children and the violence in closed homes are an unbearable health price to pay for a full closure. This is a price that has not yet been researched and quantified enough, but anyone who works in the field in the first line and treats people, and does not sit in front of the plasmas with the graphs, until he daily and feels it in his flesh. On the heavy economic and social price I think there is no exaggeration. A night curfew is generally a step devoid of any professional logic, as the reduction in contacts he achieves is minimal.

The new corona virus has a special feature that makes dealing with it particularly challenging. Patients with the virus are also contagious when they have no disease markers or in the two days before the first signs of the disease appear. This is why the effectiveness of epidemiological investigations in identifying and isolating contacts is limited in stopping the spread of the disease. The concept of “cutting off the chains of infection” may therefore turn out to be a failed brand, and the huge investment in the huge investigation system that has been established, important as it is, therefore deserves further examination.

What can be done? When in trouble return to base. The basis for stopping disease transmitted from person to person through the air are the physical distance measures, 2 meters and masks indoors, the same behavioral change that the public has not yet understood and internalized its importance, due to lack of trust in the establishment. When we set up the epidemic treatment team in the late 1980s, its members included a psychologist who specializes in population behavior, so that the treatment of behavioral aspects and the public’s involvement in the right actions will be reflected in crisis management. At this time there is no proper treatment of this critical component, the central condition for achieving which is the existence of credible leadership. In the absence of confidence in decision-making and financial compensation for the harm to livelihoods, the public’s willingness to cooperate with a draconian move as a full closure is questionable. Imposing a decree that the public will not abide by and mass disobedience can have heavy implications.

Professional logic must underpin the plan and be clear, understandable and assimilated in each and every one of us, in day-to-day behavior, personal responsibility and mutual guarantee. The responsibility of the younger generation, who are immune to a serious illness, for the older generation is much more vulnerable to the complications of the disease and mortality from it. The distinction between closed spaces and the open air should also be emphasized in the guidelines. The safest in the open air: As long as there is no crowded crowd, there is no professional need to wear a mask outside. On the other hand, wearing a mask indoors is very important.

After the first wave the health system did not receive the resources needed to reinforce it. Precious time went down the drain. Reinforcement, as much as is done at all, today focuses on “irons” instead of the human aspect, on the addition of beds instead of focusing on the addition of manpower and concern for the well-being of worn-out crews and their safety. The limiting factor in the health system’s failure is not the respirators and beds, but the shortening of the breathing of the doctors and nurses. There is something to be done: Recruiting physicians and retired nurses for bureaucratic tasks that do not involve direct contact with patients due to the risk of releasing medical staff to care for patients. Reducing elective surgical activity will make it possible to strengthen the staffs in the internal medicine departments. Hospital administrators still bear the trauma of the Ministry of Health’s decision, then wrong, to shut down elective activity in the first wave of revenue loss that involved, but if they knew they would be fully compensated for such a move economic considerations would not prevent them from making the right decision now.

There has been a lot of talk in recent days about a red flag that the health system has waved to the government in the face of the difficulty. The health care system is busy, the staffs are worn out, but it is far from collapsing. The message that needs to be conveyed is a message of resilience. The real red flag that medical teams wave is to the Israeli government, for the neglect of the health care system, for the politicization of decision-making in the professional field and for the abandonment of medical staff.

The World Health Organization defines health as follows: “Health is a state of perfect physical, mental and social well-being, and not just the absence of disease.” Decision-makers need to see the big picture, so that we do not pay in public health to prevent disease. There is no need for a full closure at this time. Leadership is needed that knows how to make brave decisions, based on professional rather than political considerations, and withstand pressure. Physical distance measures, in which deep professional and logical thought is invested, with uniform criteria for all, and which true leadership will know how to harness the public to follow, may restore public confidence and achieve a better overall result.