There are four factors to consider when weighing action against the coronavirus: public health, preservation of the economy, civil rights, and the international and regional context. National decision-making must take all four of these elements into account, with emphases shifting over the course of time as circumstances change.
The coronavirus crisis is putting the decision-making system at the national level to a tough test. Not only is this a severe crisis due to the loss of life and the collapse of medical systems that will occur should the wrong decisions be made, but the problem itself is not well-defined, hence the difficulty in setting priorities. There is a lack of medical information and it is difficult to assess the actual situation in real time, as there is a gap of a week or two between the time of infection and the point at which the disease can be detected.
Taking a broader view, there are no clear rules regarding the correct response to the crisis, as there is no previous experience applicable to the situation, and it is extremely difficult to learn from the experiences of other countries as the circumstances between them differ significantly. Even so, an effort must be made to learn from countries that are facing the crisis, some of them a step or two ahead of Israel, in order draw conclusions more quickly.
In principle, there are four factors to consider when weighing possible courses of action and priorities. The complexity of the solution is significant in part because some of these elements contradict each other, and yet they must all be considered: public health, preservation of the economy, civil rights, and the international and regional context.
Obviously, the most important mission is to protect the public’s health. This is a task that has two dimensions: preventing contagion of the masses and treating the few who are seriously ill in an optimal way.
The second mission is to maintain the functioning of the Israeli economy, which ultimately must finance all health (and other) needs, both in the short and long terms. A healthy economy will be vital to the preservation of Israel’s social fabric once the economic system resumes functioning in the difficult post-corona period.
All these endeavors must be made in accordance with the law, while safeguarding individual rights in a democracy. Some of the measures that have been taken around the world, especially in China, contradict the essential foundations of a liberal and open society that is sensitive to the rights of the individual and to the various cultural groups that live within it, so it is not practical for Israel to adopt them. It is precisely in this context of adherence to the law that it is worthwhile to exercise common sense rather than make do with the literal provisos of the law, which do not always apply to such an extreme and grave situation.
Finally, it should be kept in mind that Israel is part of the global struggle against COVID-19 and a member of the family of nations, and it does not want to jeopardize its status as such. At the same time, Israel’s security and other challenges are not going to dissipate, and its relations with its neighbors and with other countries will remain just as important after the crisis is over.
National decision-making must consider all four elements, giving greater weight to one factor over the other according to changing circumstances and continuous reassessments. Thus, a decision that clearly prioritizes one element may change over time in favor of a decision that attributes greater import to another concern that was previously perceived and valued as less essential.
For example, at the beginning of the process, Israel seemed to take its relations with countries around the world into consideration when making decisions, refraining from banning the entry of foreign citizens of countries with whom it wished to maintain good relations. Israel did so, even though, medically speaking, a total ban on the entry of foreign nationals from the moment the crisis broke out would have been the right thing to do.
Israel quickly retreated from this type of decision-making. Iran, however, avoided stopping flights from China and Chinese citizens from entering Iran for a long time, because relations with China are critical to Iran, perhaps more so than its relations with any other country in the world. China praised Iran’s actions, but the price Iran paid in terms of the infection of its citizens was very high.
The debate in Israel over the use of technological means to monitor the movements of those infected with the virus and of people who came into contact with them is also a good illustration of the complexity of decision-making and the tension between priorities.
This debate stems from a dispute over the extent to which civil rights can be compromised in order to improve the state’s ability to attain the goal of “public health,” preventing numerous people from becoming infected. Indirectly, it is quite clear that success in this mission will also contribute to a reduction in economic damage.
What does the technology offer? It helps to accurately detect where those people identified (in hindsight) as having contracted the virus have been, and to locate anyone who was in their immediate vicinity during the time when they were potentially contagious. Isolating everyone who was around the infectious person would mean that even if they themselves contracted the disease, they would infect less people. This is what is referred to as “flattening the curve” – meaning that one sick person will infect less people than he or she would without any measures in place.
In terms of maintaining public health, this is a supremely important mission, because the less contagious and sick people there are, the better the health system can care for those who are ill. “Flattening the curve” (which means in practical terms that each sick person infects fewer people over time) leads almost directly to fewer severely ill patients who require ventilators, and therefore also to fewer deaths. (Elderly people and those with underlying health problems fall severely ill at higher rates, and the tracking mechanisms do not differentiate between the young and the old).
It is therefore clear why Israel’s national health officials view the ability to monitor people’s movements as critical and essential. It will save many lives.
But at the same time, there is no doubt that this involves an infringement on the privacy of Israeli citizens. The General Security Services’ surveillance system can extract information about the (past) movements of those who have been diagnosed as having the virus, as well as of the unknowing citizens who were in their vicinity.
From the moment the surveillance begins, the “tracker” (the General Security Services and perhaps the Ministry of Health) knows where every Israeli citizen has been, and, specifically regarding those with the virus and the people who were around them. It can say with great precision and accuracy where they were and when, even though these people have done nothing wrong nor broken any law. For some, this may be a serious violation of privacy, especially if for whatever they prefer that no-one to know their whereabouts, and their only “sin” is having been in the same vicinity as a person with the coronavirus.
Since the security and health authorities now have data from thousands of unwitting citizens, anyone with access to this information will be able to misuse it for anything from commercial use to extortion. The concern that has been expressed regarding the use of this data by political actors seems to me (based on my long experience) far-fetched. Politicians have no way of accessing this information, and no security official would cooperate with them in any such dark scenario. Over the forty years that I have been involved with the security institutions possessing these tracking capabilities, only rarely have there been any leaks.
However, in order to keep any damage to a minimum, it is necessary to ensure that all of this data is erased after a period of time, say two to three weeks, after the time required to ascertain who is infected and who is not. It is also clear that any data that has been collected from the tracking mechanisms will be used only to locate these individuals in order to quarantine them, with none of the information gathered being transmitted to any government or private body, or even to family members. All communication based on the data collected will be carried out only with the owner of the telephone, and not with any other person.
If this is how the information is handled, and if it is destroyed immediately afterwards, any damage to people’s privacy will be minimal, and the benefit of preventing infection may be significant. The benefit in this case, it seems to me, is worth the harm caused. In any case, this is an illustration of a complex problem in which every decision made is difficult and imperfect.
This is also the crux of the ongoing debate over “the nature of the lockdown.”
On one side are those who are concerned about how to reduce the number of people infected with the virus and who therefore advocate a total lockdown and strict curfews (alongside exceptions for the purchase of food and medicine), with only essential healthcare workers in being allowed to leave home. The anticipated result would be that the risk of people contracting the virus via physical contact would be greatly reduced.
On the other side are those who argue that the economic price of such long-term curfew would be unbearable. The result of a total lockdown would be the almost complete halt of the Israeli economy.
What should the relationship between these two needs be? How does one calculate the severity of the economic problems arising from a lockdown versus the implications for public health? These are the questions that should be asked in assessment of the situation, although it well understood that there are no clear and quantifiable answers.
Regarding management of the crisis, the National Security Council seems to be proving its worth. It has grown from an organization mostly engaged in defense and foreign affairs to the cabinet’s main coordination tool.
It is interesting to note that when the first National Security Council was established by the British in the wake of the Boer War at the beginning of the last century, the main reasoning behind it was the British understanding that in the modern world, national efforts required the coordination and integration of the various government departments.
The British appointed a distinguished “imperial” committee that confronted the need to take the unique perspectives of the government ministries specializing in specific issues and put them into action in a concerted effort, with one defined goal for all. That is why the NSC did not become part of the Ministry of Defense, even though, in wartime, the MoD is the most important ministry. It is for the same reason that it is a mistake to let the Ministry of Health take the lead in the current crisis, as its professional health perspective is only one of many perspectives to consider.
Similarly, placing central responsibility on the shoulders of the Ministry of Defense for handling the not advisable. The MoD does not have a special understanding of either health or economic issues, the two main areas to consider in this crisis, nor does it have expertise in civil rights or the foreign relations of the State of Israel.
Indeed, the NSC is the right body for the synchronization of government decisions and actions in this context. It must evaluate the four needs outlined above and the courses of action proposed by relevant ministries, then recommend appropriate measures to be taken to the Prime Minister and the cabinet.
Regarding the carrying out of these measures, it is certainly correct to take advantage of the relative benefits each government ministry and agency has to offer. The military holds a clear edge in logistics, especially where manpower is required in large numbers, or when a hierarchical system needs to be deployed on the ground. The Ministry of Defense has an advantage in procurement and construction in Israel and abroad. The Mossad and the Foreign Ministry hold the relationships with foreign countries when needed, whether for atypical procurement, or to extract Israelis from countries that are virus-stricken or that have closed their borders to fight the spread of the disease.
The NSC is not a body that executes policy, and this is its advantage. It is the planning branch of the Prime Minister’s Office and the cabinet, and it is the appropriate body to deal with matters of national importance in which a “supra-ministerial” view is necessary. There is no room for ego battles or political skirmishes over status in this context. The NSC cannot do anything on its own; it must activate those who do have capabilities. The military and the security establishment are very important tools in this regard.
When the crisis abates, the weight of decision-making will shift to the socio-economic sphere.
Thousands of small businesses are being crushed, and tens of thousands of employees have lost their jobs. Many employees and many self-employed people will not return to their jobs. It will be very difficult to boost the economy after it has come to such a grinding halt, and intense and costly government involvement will be required in order to get the economy’s wheels moving again.
There is no doubt that the government will have to increase the deficit far beyond what is considered “correct” in order to finance loans and provide guarantees to the many businesses that will find it difficult to recover.
There will be no escaping cuts to higher salaries and pensions to subsidize the incomes of those who will become unemployed or whose employers will find it hard to pay them. Despite the difficulties involved in a decision to raise taxes, it may also to come to this (with a great deal of caution!) so that there are funds for what needs to be subsidized.
More than one year ago, Health Minister Yaakov Litzman proposed raising health insurance payments by only a few percentage points and transferring the proceeds to the healthcare system in addition to its current budget. This was not approved; it was considered a verboten “tax hike.” Even the finance ministry opposed Litzman’s proposal because it would not control this addition to the budget.
Ultimately, the fundamental fact is that the state does not manufacture money. It can only use money from taxes and loans it takes. Any decision to fund something comes at the expense of being able to pay for something else, and the budget is limited.
According to those looking at the problem from an economic perspective, logical thinking should soon lead to the decision to quarantine only those who are considered high-risk, mainly the elderly and the sick, and at the same time allow the economy centered around people up to the age of 60 to return to full operation. This is because the cost of younger and healthy people becoming infected is not high and the risk to their lives is low.
The result would be the logical separation between those for whom the coronavirus is dangerous and those who – even if they catch it – probably will not become seriously ill, but who are crucial to the economy.
In their opinion, the deterioration of the economy will result in a social crisis, a great deal of pressure on most Israeli citizens, and the state not being able to meet future needs in the areas of security, education, welfare, transportation, and even health. Thus, the loss in Israel will exceed the profit, as more citizens would die as a result of the decline in the level of services the state would be able to provide (from road accidents, blood pressure, illnesses due to personal stress, etc.).
It is important to understand in depth of the disputes between the different approaches, which arise neither from narrow interests nor from a lack of understanding on the part of one of the parties. These are just two legitimate perspectives – two different worldviews that stem from differing responsibilities – which must be considered.
Understanding the complexity of the situation, as well as the fact that there are no simple solutions to the problem, will allow for:
- An appreciation that there are no perfect answers to these kinds of problems, and that every solution leaves unanswered questions and problems that are difficult to deal with in its wake. Sometimes, a solution exacerbates a problem that was secondary until that point.
- Recognition of the fact that there are several approaches and several solutions to every situation, and it is probably always best to come up with an optimal solution that takes all needs into account and sees all sides of the problem, even if it is not ideal from any point of view. There will always be less important issues versus more important matters, and the order of importance can change depending on the period of time and even in the same time period for different people. In many cases, a change in the course of action is not the result of confusion, but rather of a change in circumstances or the arrival of new information that affects the entire picture.
- The realization that one should not be swayed by the opinions of those who are prominent experts in their field, because they see their side alone, even if their professional expertise and credentials are exceedingly high. Contrary to what intuition would generally indicate, someone who does not bring their strong expert opinion to the table, who does not have a professional, yet narrow, perspective, can actually integrate the different viewpoints and provide a solution that causes the least impairment to the overall picture. All experts should be listened to carefully, but it is possible that none of them will offer the right solution. One must distinguish between the professional world, where expert opinions are the ones that determine what must be done, and the policy world, which must consider several perspectives that are fundamentally different from one another.
- The awareness that not everything that appears to be a mistake is a “failure.” This virus is the type of crisis that happens once every half-century, and one cannot prepare for it beyond the protocols that are in place. It is neither simple nor straightforward to plan for such things, as “there is no such thing as a free lunch.” Whatever is invested in planning for such a crisis (for example, buying and storing thousands of ventilators) will result in a lack of preparedness for another, more frequently occurring event, or the establishment of another general hospital that is needed in everyday life.
Something I once heard from a person involved in the building of the Ayalon highway (which runs through Tel Aviv, along a creek bed) highlights this point; and perhaps it is good to conclude a piece about a plague with a smile, as laughter is the best medicine.
The year following the opening of the Ayalon highway was a rainy one that flooded the project, and there was no choice but to close the highway for several days. The project’s CEO was called upon to explain the incident on television. He was asked about the “fiasco” that had resulted in the fact that such a new and expensive venture could not withstand the amount of water flowing into it.
The CEO quietly explained that they had studied the rainfall and flow patterns in the creek along which the highway was built, and learned that such flooding could happen every 50 years or so. On that basis, they decided to take the risk that once every half a century the highway would have to close for a few days. It was decided not to invest the money necessary to prevent flooding of the highway once every 50 years, he explained, because the amount of money needed for that was exactly the same amount needed to extend the project by a few kilometers. It was decided that extending the length of the highway was more important.
The CEO was then put to a tougher test. A year later, the Ayalon highway became flooded again. It was the third winter since opening of the highway. The CEO was called in once again to explain the flooding, in light of what he had explained the previous year. Of course, the television station played an excerpt from his interview the year before and questioned his rationalization. The CEO did not falter, saying quietly: “We will probably only see the next flooding in 100 years’ time.” The interviewer did not like that answer. Nevertheless, I believe that since then the Ayalon has not been flooded.
In other words, the “worst-case scenario” assumption can collapse any project, and one must be very wary of basing policy on worst-case scenarios.
Notwithstanding, there will of course be things to examine once the crisis is over in order to learn what needs to be prepared in advance should a similar predicament occur in the future, and what the right courses of action are even if such an event occurs in another several decades. After such a difficult crisis, it is important to learn lessons for improvement in the future.
JISS Policy Papers are published through the generosity of the Greg Rosshandler Family.