surveillance of covid-19 in israel - health.gov.il · ministry of health gertner institute, chaim...

Israel Center for Disease

Control

Surveillance of COVID-19 in Israel

Report for week 23 ending June 06, 2020

1

Israel Center for Disease Control ministry of Health Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer 52621 [email protected] Tel: 03-7371500 Fax: 03-5349881

ICDC-Israel Center for Disease Control Ministry of Health Gertner Institute, Chaim Sheba Medical Center [email protected] Tel: 03-7371500 Fax: 03-5349881

Summary: On Week 23, the increase in repiratory morbidit continnues, mainly reflected

in babies, children and adolescents aged 0-18 years.

Clinical: Community clinics: The increase in raw rates of visits to the clinics due to

upper respiratory tract infections is continued and is reflected mainly in 0-18 year-olds; a

slight increase in raw rates of visits to clinics due to pneumonia in this age group was

also observed;

Hospitals (“Clalit Health Services”) The increase in the percentage of visits to the

pediatric emergency department due to pneumonia is continued.

Laboratory: 2 (1.2%) out of 173 samples collected from the sentinel clinics during the

past week tested positive for SARS-coV-2.

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1. Visits to Community Clinics due to Upper Respiratory Infections

(URI)

On Week 3 (ending 6/6/2020) a sharp increase was observed in the raw rate of visits

to "Maccabi Health Services" community clinics due to upper respiratory infections.

The sharp increase is expressed mainly in children 0-18 years old (an increase at a

rate of 48 patients per 10,000 in the 0-18 age group). In the other age groups, a

moderate increase was observed (Figures 1 and 2). A similar picture was observed at

“Clalit Health Services".

0

20

40

60

80

100

120

case

s/1

0,0

00

week

Figure 1: Weelky rate of visits due to the upper respiratory tract infections,2017-2020, compared to multi-annual

average

- - -

0

20

40

60

80

100

120

140

160

case

s/1

0,0

00

year & week

Figure 2: Weekly rate of visits due to the upper respiratory tract infections by age and year, 2017-2020

- -

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2. Visits to community clinics due to pneumonia

As of Week 23 (ending June 06, 2020) a slight increase was observed in the rate of

visits to “Maccabi Health Services clinics due to pneumonia in the ages of 3 & 4).

0

2

4

6

8

10

12

14

16

case

s/1

0,0

00

week

Figure 3: Weekly rate of visits due to pneumonia, 2017-2020, compared to multi-annual average

- - -

0

5

10

15

20

25

30

case

s/1

0,0

00

year & week

Figure 4: Weekly rate of visits due to pneumonia, by age and year, 2019-2020

- -

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3. Calls to the nurses call center, Maccabi Health Services

On Week 23, there was continued increase in the number of calls to the nurses call

center of Maccabi Health Services due to fever and repiratory symptoms. The

sharpest increase was observed in visits due to fever in children and adults, sore

throat and cough. Only a moderate increase was observed in complaints of shortness

of breath (Figure 5).

0

200

400

600

800

1000

1200

Nu

mb

er

year and week

Fig. 5: Calls to the Nursing Call center due to sore throat and cough, Maccabi Health Services

Fever in adults sore throat cough shortness of breath fever in children

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4. Visits to hospital Emergency Medicine Departments (ED) due to

pneumonia (Based on the Ministry of Health's database managed by the Health

Information Division).

On week 23, - the increase in the percentage of visits to pediatric emergency

departments at "Clalit Health Services" hospitals due to pneumonia is continued

(Figures). Im contrast, no significant change was observed in the percentage of visits

to internal medicine emergency department due to pneumonia.

Furthermore, during the past week, a decline was observed in the number of visis to

both pedeiatric emergency department and the internal medicine emergency

department due to some diagnosis (Figure 8).

0

1

2

3

4

5

percen

tag

e

year & week

Fig. 6: Percentage of visits to internal medicine ERs due to pneumonia, Clalit hospitals, 2018-2020, compared to multi-annual average

0

1

2

3

4

5

6

percen

tag

e

year & week

Fig. 7: Percentage of visits to pediatric medicine ERs due to pneumonia, Clalit hospitals, 2018-2020, compared to multi-annual average

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0

50

100

150

200

250

300

Nu

mb

er

Year & week

Fig. 8: Number of visits to Clalit ERs due to pneumonia, 2019-2020

pediatric ERs Internal ERs

0

1000

2000

3000

4000

5000

6000

7000

Nu

mb

er

Year & week

Fig. 9: Number of visits to Clalit ERs due to any diagnosis, 2019-2020

pediatric ERs internal ERs

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5. Clusters of respiratory morbidity

Identification of clusters is based on data obtained daily from Maccabi and Clalit

Health Services. The clusters are identified by focusing on two diagnostic categories:

upper respiratory tract infections and pneumonia. Data analysis is performed based

on statistical geographic areas. Furthermore, with respect to clusters that last for over

a week, we are checking whether active COVID19 patients were identifies in the area

at that time, based on data provided by the Ministry of Health.

During week 23 and as of 4/6/2020, areas where there was a consistency in the

presence of the clusters longer than 7 days, of the two diagnostic categories and on

the basis of data from the two health funds, were:

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Locations where distinct clusters have been

identified that persist for over 7 days

BEGINNING OF

THE CLUSTER

DURATION OF

THE CLUST

ER (Days)

Number of patient with a positive SARS-CoV-2 sample in the location

and during the cluster period

Total number

(Prevalence)

New in the cluster’s period

(Incidence)

Rahat 6-5-2020 28 45 33

Atlit 6-5-2020 28 0 0

Gamzo, Kefar Daniel, Achi-Semech, Ben Shemen

19-5-2020

1 0 0

Bat Hefer, Yad Hana, Bahan, Gan Yoshia, Olesh, Nitzanei Oz

20-5-2020

15

1 0

Harish, Katzir 24-5-2020 10 0 0

Sdei Avraham, Yated, Yevul, Avshalom, Dekel, Talmei Yosef

26-5-2020 8 0 0

Noam, Ahuzam, Shalva, Even Shemuel, Eitan, Uza

26-5-2020 8 0 0

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6. Sentinel clinics in the community

Sentinel clinic activity for surveillance of morbidity caused by SARS-CoV-2 began on

week 12. As of Week 23, the network includes 42 clinics nationwide.

Nasopharyngeal samples are taken from patients attending clinics with fever and/or

respiratory symptoms with or without a diagnosis of pneumonia and with no known

exposure to a confirmed COVID-19 patient or returning from a foreign country in the

14 days prior to onset. In addition, for patients who do not physically come to the

clinic but rather consult their physician using digital technology methods, exhibiting

respiratory symptoms and/or fever and without an epidemic story, the sample is

collected by Magen David Adom (MDA) Emergency Services.

6.1. Samples from sentinel clinics’ subjects (Table 1)

Table 1. Patients that tested positive for SARS-CoV-2 out of the total number of

subjects that were tested in the sentinel clinics

Week 23 31/05-06/06/2020

Accumulated Data from Week 12

15/03-06/06/2020

Positive 2(1.2%) 27 (2.0%)

Negative 171 (98.9%) 1,335 (98.1%)

Total 173 1,362

* There may be a retroactive update of the number of samples and their

results.

* In the course of Week 23, there were no samples taken by MDA.

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6.2. Patients that tested positive for SARS-CoV-2 in sentinel clinics (Tables 2, 3 and Figure 10).

Table 2. positive patients for SARS-CoV-2 by location during the surveillance

period, by week

Week Positive Negative

Total

12 15/03-21/03/2020

0 (0%) 33 (100%) 33

13 22/03-28/03/2020

6 (2.3%) 253 (97.7%) 261

14 29/03-04/04/2020

13 (5.8%) 212 (94.2%) 225

15 05/04-11/04/2020

4 (3.8%) 101 (96.1%) 105

16 12/04-18/04/2020

1 (1.5%) 67 (98.5%) 68

17 19/04-25/04/2020

0 (0%) 97 (100%) 97

18 26/04-02/05/2020

0 (0%) 47 (100%) 47

19 03/05-09/05/2020

0 (0%) 70 (100%) 73

20 10/05-16/05/2020

0 (0%) 76 (100%) 76

21 17/05-23/05/2020

1 (1.3%) 79 (98.7%) 80

22 24/05-30/05/2020

0 (0%) 74 (100%) 74

23 31/05-06/06/2020

2 (1.2%) 171 (98.8%) 173

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Table 3. positive patients for SARS-CoV-2 by location during the surveillance

period

(Only the localities in which there was at least one positive sample during the surveillance period

are specified)

Municipality Number of positive samples

(Total no. of samples) Week 23

31/05-06/06/2020

Accumulated number of positive samples

(Total no. of samples) since Week 12

15/03-06/06/2020

Elad 0 (0) 3 (20)

Beit Shemesh 0 (0) 1 (68)

Bnei Brak 0 (0) 1 (5)

Jerusalem 0 (23) 13 (191)

Acre 0 (0) 1 (36)

Rosh HaAyin 0 (7) 1 (30)

Ramat HaSharon 0 (3) 1 (39)

Sderot 0 (0) 2 (11)

Tel Aviv 0 (5) 2 (68)

Ramla 1 (17) 1 (38)

Petach Tikva 1 (55) 1 (162)

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0

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300

Nu

mb

er

Week

Fig.10: Specimens positive for SARS-coV-2 out of total specimens collected by sentinel network, 2020

Positive Negative

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7. Cumulative national SARS-CoV-2 morbidity (the data are updated

for the end of Week 23 ending June 06, 2020) (Figure 11)

(This figure id based on the official data provided by the Public Health Services)

* Slight changes may occur due to retroactive changes.

0 18 23 42 1941029

3916

8166

10958

13544

153111606716357165241664516988

17736

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8000

10000

12000

14000

16000

18000

20000

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mb

er

Week

Fig.11: Number of national cumulate morbidity cases of COVID-19,2020

cases

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8. Mortality in Israel

8.1. Mortality of all causes (updated for week 18 ending on May 02, 2020)

As of week 18, the death rate is under the multi-annual average range (Figure 12).

8.2. Pneumonia mortality (updated for week 21 ending on May 23, 2020)

As of Week 21, the percentage of mortality due to pneumonia is within the seasonally

expected range (Figure 13).

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7

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9

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13

14

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-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

Cas

es/1

0,0

00

Year and week

Fig.12: Overall national mortality rate, 2017-2020, compared to multi-annual average

multy weekly mortality rate annual average 2010-2017

0

4

8

12

16

20

24

Per

cen

tag

e

Year and week

Fig.13: Deaths from pneumonia as a percentage of all deaths, 2017-2020' compared to multi-annual seasonal prediction

percentage of deaths from pneumonia seasonal prediction epidemic thershold

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9. Global COVID-19 snapshot

The upward trend in the number of people contracting SARS-CoV-2 is continued. As of

08/06/20, the total number of confirmed COVID-19 cases was 6,931,000 of which

1400,857 were new cases. The regions with the highest deaths are Europe (184,120), USA

(181,804), Middle East (14,602), Southeast Asia (9,970), and Africa (3,236) (data taken

from a World Health Organization report - Status Report no. 40).

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200608-covid-19-sitrep-

140.pdf?sfvrsn=2f310900_2

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200608-covid-19-sitrep-140.pdf?sfvrsn=2f310900_2

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200608-covid-19-sitrep-140.pdf?sfvrsn=2f310900_2

surveillance of covid-19 in israel - health.gov.il · ministry of health gertner institute, chaim...

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