What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion) who has consulted on COVID-19 for the government. “One of the big stories from Israel [is]: ‘Vaccines work, but not well enough.’”
“The most frightening thing to the government and the Ministry of Health is the burden on hospitals,” says Dror Mevorach, who cares for COVID-19 patients at Hadassah Hospital Ein Kerem and advises the government. At his hospital, he is lining up anesthesiologists and surgeons to spell his medical staff in case they become overwhelmed by a wave like January’s, when COVID-19 patients filled 200 beds. “The staff is exhausted,” he says, and he has restarted a weekly support group for them “to avoid some kind of PTSD [post-traumatic stress disorder] effect.”
To try to tame the surge, Israel has turned to booster shots, starting on 30 July with people 60 and older and, last Friday, expanding to people 50 and older. As of Monday, nearly 1 million Israelis had received a third dose, according to the Ministry of Health. Global health leaders including Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, have pleaded with developed countries not to administer boosters given that most of the world’s population hasn’t received even a single dose. The wealthy nations pondering or already administering booster vaccines so far mostly reserve them for special populations such as the immune compromised and health care workers.